Describe briefly the history of nursing and what led to its emergence as a profession
-both florence nightingale and the care provided for the casualties during the civil war focused attention on the need for educated nurses-WWII led to changes in women and society that lead to an increased emphasis on education--------------------------------------------------Chapter 1 Taylor fundamentals:During early civilization, health care providers were medicine men, nurse was a mother who cared for her family during sickness.Greek Civilizations used temples as centers of medical careAncient Hebrews developed Mosaic Health Code for ethical human relationships, mental health, disease control (nurses cared for sick in home and community, practiced as midwives)Early Christian period led to Women called "deaconesses" who visit the sick, male and female nursing orders were founded during crusades 11-13th century, hospitals were built.Florence Nightingale brought about Nursing as a profession when she joined the nursing care for a military hospital in Turkey. Upon coming back, she established the first nursing school. Hospitals tried to mix nursing school in but there weren't clear guidelines separating nursing service and nursing education. Lack of educational standards and male dominance in healthcare slowed progress toward professionalism.World War II created more need for nurses and expanded knowledge in medicine and technology. Schools of nursing geared toward educational objectives and appeared more often in university/college settings allowing degrees for men, women, and minorities.
Describe Dorothea Orem's Self Care Deficit nursing theory.
-wholly compensatory: nurse gives total care to meet client needs (paralyzed)-partly compensatory: nurse and client perform care measures together-supportive educative: client can carry out self care activities but requires assistance through teaching-Main idea: Patients are better able to recover when they maintain some independence over their own self-care. ----------------------------------------------------------Person (client/patient) self-care deficits are the result of environmental situations. Nurses have always recognized the rights of clients of all ages to be both informed and active participants in care. Nursing models are client-centered. The goal of self-care is to empower our clients and families.
Dorothea Orem's Self-care Model
-Self-care - activities the person carries out on his own-Self-care agency - ability of person to perform self-care-Therapeutic self-care requisites - what is necessary for the person to maintain or improve present state of health-Self-care deficit - the person is unable to meet the therapeutic self-care demands
Discuss the modern definition of nursing according to the American Nurses Association.
-. ANA defined Nursing as "the diagnosis and treatment of human responses to actual and potential health problems"-. Nursing is the protection, promotion, and optimization of health and abilities, prevention of illness and injury, alleviation of suffering through the diagnosis and treatment of human response, and advocacy in the care of individual families, communities and populations.PPOAAT-The scope defines the range and boundaries of nursing practice-The standards are authoritative statements by which the nursing profession describes the responsibilities for which its practitioners are accountable
Describe techniques for assisting with Activities of Daily Living, maintaining comfort and safety.
-encourage attempts at behaviors that promote self care activities despite limitations-reinforce behaviors that promote healthy functioning-correct behaviors that compound the mobility deficit over time (teaching adaptive strategies)
Apply Erickson's developmental theory to varied client populations.
-infancy (0-1.5): trust vs. mistrust -early childhood (1.5-3): autonomy vs. shame -play age (3-6): initiative vs. guilt-school age (6-12): industry vs. inferiority-adolescence (12-18): identity vs. role confusion-young adult (19-40): intimacy vs. isolation-middle adulthood (40-65): generativity vs. stagnation -maturity (65+): integrity vs. despair--------------------------------------------------Preschool 3-5 years, Initiative vs guilt (exploration)Child is a dictator (just kidding), wants to control environment. Success = Competence, Exerting too much power = sense of guilt.-School age 6-11 years, Industry vs Inferiority (school)Welcome to the social academic life, hope you cope. Success = Competence, failure = Inferiority-Adolescence 12-18 years, Identity vs Role Confusion (Social Relationships)Teens are finding themselves/identity. Success = Staying true to self, Failure = Confusion/Weak Sense of Self-Young Adulthood 19-40, Intimacy vs Isolation (Relationships)Young Adults gotta feel the love in the air with other people. Success = Strong Relationships, Failure = Loneliness/Isolation-Middle Adulthood 40-65, Generativity vs Stagnation (Work and Parenthood)Adults either gotta kids or creating positive change for other people (creating things to outlast them). Success = Feeling Usefulness/Accomplishment, Failure = Shallow involvement in world-Maturity 65-Death, Ego Integrity vs Despair (Reflection on Life)Older adults need to reflect on life and feel sense of fulfillment. Success = Wisdom, Failure = Regret, Bitterness, and Despair (Grumpy grump
Define the role of client advocate as it relates to nursing.
-the protection and support of another's rights -make sure loyalty to job or colleagues doesn't compromise patient commitment -the good of the patient is more important than the good of society -evaluate patients autonomy and well being
Discuss the role that caring plays in building a nurse-patient relationship.
The role that caring plays in building the nurse patient relationship involves getting to know the patient, identifying there problems, and implementing a solution. By caring the nurse is able to better perform these steps and build a better nurse patient relationship.
Identify culturally sensitive nursing assessment and interventions
?-knowing that certain cultures will require different things -ask permission at all times no matter what -provide care to patients with diverse values, beliefs, and behaviors-tailor care delivery to meet patients social, cultural, and linguistic needs
Describe basic elements of therapeutic communication techniques
-purposeful and goal directed-well defined boundaries-client focused-non judgemental -active listening-caring, honest, empathy-encourage verbalization of feelings1. oreintation2. working phase3. termination
Describe teaching implications related to adult learning principles
-prioritize when educating: what would my client need to know to prevent life threatening systems?-most important information first
Identify physical, psychological, socio-cultural characteristics that affect client care and teaching.
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Describe strategies that facilitate elderly adult's learning abilities
?-Focus on current health problems-bring in all medication-allow time for answers-assess functional status: ADL's, roles and relationships-Assess health behaviors, safety precautions, and self-concept. -support system?
Describe the purpose of National Patient Safety Goals,ACEN,BRN and Health Care Reform
-promote specific improvements in patient safety-highlight problematic areas in healthcare-what are the goals that apply to the hospital? (remember IIIUUP)-identify patients correctly-improve staff communication-identify patient safety risks: suicide -use medicines safely-use alarms safely -prevent infection
Apply concepts of QSEN to nursing.Quality and Safety Education for Nurses (QSEN)
??PIEQST6 CORE-Patient centered care-Informatics and technology-Evidence based practice-Quality improvement -Safety-Teamwork and collaboration
Apply concepts of evidenced based practice to nursing.
think of this example:-abnormal amount of patients started getting blood clots-realized those patients were not being moved-set up a protocol to fix that-risk factor of blood clot decreased*EBP=Best research evidence+clinical expertise+patient values and preferences.
Describe strategies for successfully communicating with a person who speaks a foreign language that the nurse does not understand.
-interpreters -audio/visual materials -pamphlets -language phone lines
Identify aspects of culture and ethnicity that may affect a person's health
-chronic illness rates are higher among minority people-some cultures believe pain should be tolerated so they do not seek medical help-some people may attribute illness to religious reasons-some cultures have traditional healers -language barrier may be present -economic factors-ex: woman who is Jehovah witness who refuses blood transfusion.
CA Nurse Practice Act
-Help people cope with difficulties in daily living that are associated with their ACTUAL or POTENTIAL health or illness problems or the treatment requires scientific knowledge or technical skill including:*1. Services that enswurethe safety, comfort, personal hygiene, and protection of patients; and the performance of disease prevention and restorative measures.*2. Administration of medications, implement a treatment, disease prevention, or rehabilitative regimen ordered by a physical, dentist, podiatrist or clinical psychologist.
Nursing intervention: Orem Model
-Wholly compensatory - nurse gives total care to meet client needs. Ex: patients hands are paralyzed and need to be fed. -Partly compensatory - nurse and client perform care measures together Ex: they just need help getting up but can walk -Supportive-educative - client can carry out self-care activities but requires assistance through teaching
SBAR (situation-background-assessment-recommendation)
Offers a way to talk about a patient's condition among members of the healthcare team
When doing a physical assessment what is the best approach?
-inspection, auscultation, palpation, percussion-"I Am Peter Pan
What are some examples of cultural competency?
What are some examples of cultural competency?
When trying to educate the patient what should you do?
-prioritize-most important first-S.M.A.R.T: specific, measurable, attainable, realistic, time orientated
When trying to learn more about the patient's condition what should you do?
-ask open ended questions such as "tell me more
Describe how nursing care and patient outcomes can be improved using the Quality and Safety Education for Nurses (QSEN) competencies and The Joint Commission standards.
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Apply professional standards to nursing students.
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Discuss RN nursing licensure process in California and reasons for license revocation.
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Identify nursing student liability and ethical responsibilities inside and outside the clinical setting.
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Apply the principles of veracity, autonomy, fidelity, justice, beneficence, and non- maleficence.
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Define negligence, malpractice, and informed consent.
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Apply concepts of confidentiality, including HIPAA.
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Identify nursing legal responsibilities as defined in practice acts and standards of care.
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Cite the nurse's role & responsibilities in the signing of informed consents & advanced directives.
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Define ethical conduct for nurses as defined by the American Nurses Association.
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Identify the nurse's role in the nursing process when helping clients with hygiene, activities of daily living, impaired mobility, illness, loss, grief, or death.
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Explain the purpose, components, and techniques related to a patient history and physical examination.
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. Describe the steps of the nursing process and give examples of behavior performed by the nurse in each step.
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Describe the key parts of a Nursing Diagnosis using NANDA's approved format and lists.
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Nursing Process
ADPIEproblem-solving approach to the identification and treatment of patient problems that is the foundation of nursing practice. The nursing process consists of five phases: assessment, diagnosis, planning, implementation, and evaluation.
Develop nursing diagnoses and write measurable goals.
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Goal of Pt teaching?
SMARTSpecific, Measurable, attainable, realistic, time oriented"by the en dot instruction, client will demonstrate correct use of the asthma inhaler