Foundations exam 4

What is the nursing process?

A critical thinking model Foundation for clinical judgement - Structured way of thinking and planning care - Foundation of nurses' decision-making - Encompasses all significant actions taken by an RN - Client/patient centered- Outcome directed

lifelong professional growth

preservation of integrity and safety maintenance of competence commitment to continue personal and professional growth

Morals

private, personal, or group standards of right and wrong, good/bad.

Evidenced based practice

problem solving approach that involves the use of current best evidence, along with clinical expertise and client preferences and values in making decision about client care -best practice -clinician expertise -patient preference & values

values clarification

process by which people come to understand their own values and value system -distinguish between values/facts/opinions -What to you value and why

standard 3

promotes, advocates for and strives to protect by maintaining patient privacy and confidentiality, report illegal, incompetent or impaired practices, accountable for practice and delegation, lifelong professional growth, participate, collaboration and articulate values

confidentiality

protection of clients personal health information (HIPAA)

What is nursing process?

provides the framework in which nurses use their knowledge and skills to express human caring -critical thinking model -foundation for critical judgement -foundation for decisions making -client/patient centered process -outcome directed

Responsibility

respect obligations and follow through on promises

Which definition is correct to explain the nursing process?

sequence of steps used to meet the clients needs

illegal, incompetent or impaired practice examples

smell of alcohol on breath missing narcotics errors in drug counts sleeping on the job inaccurate/falsified documentation patient abandonment poor practice

Advocacy

support health, safety, rights of client

Duty of Care

the obligation people owe each other not to cause any unreasonable harm or risk of harm

veracity

truth telling

Feminist Ethics

type of ethical approach that aims to critique existing patterns of oppression and domination in society, especially as these affect women and the poor

Nursing Diagnosis

used to evaluate the response of the whole person to actual or potential health problems. May change day to day as patients response changes.

which describes Evidence informed nursing practice? EIP

using results from research to improve the outcome of nursing care

Utalitarianism

Greatest good for greatest amount of people, cost and benefit analysis

Intellectual standards of quality

-

Characteristics of critical thinkers

-raise vital questions -gather relevant information -come to well reasoned conclusions -think open mindedly -effectively communicate with other to problem colve complex issues

Expected characteristics of entry level RN's

-application of knowledge to practice -critical thinking -ethical and moral standards -competent in clinical skills -effective communication skills

6 steps of ANA

-assessment -problems identification (diagnosis) -outcome identification -planning -implementation -evaluation

Benefits for using critical thinking

-detect problems early -prevent adverse occurrences -decrease mortality rate -decrease failure to rescue rate -improve patient outcomes

Cachetic nursing interventions/goals and outcome

-encourage proper nutrition -educate on importance of being active goals -return to a healthy weight -Improve in ADL's

value formation

-experiences in the family -religious beliefs -cultural traditions -schooling -governmental ideals -history -individual experience

Development of critical thinking

-knowing right from wrong -What are the alternatives? -Able to deal with complex issues and think outside of the box

Assessing stage of nursing process

-preparing for data collection -collecting data -identifying cues and making inferences -clustering related data and identifying patterns -reporting and recording data

Ethical frameworks

-utilitarianism -Deontology -feminist ethics -ethic of care/duty to care

Processing an Ethical Dilemma

1-presumption of good will on all parts 2- strict confidence 3- Client-centered decision making 4- Welcome family

Nursing process @ NNU

1. Assessment 2. Problem Identification/Diagnosis 3. Planning & Outcome Identification 4. Implementation 5. Evaluation

Elements of Reasoning

1. Has a purpose 2. An attempt to figure something out question, problem, issue at hand 3. Based on information, data, and evidence 4. Interpretation & Inference give meaning to the data 5. Expressed through and shaped by concepts, definitions, principles, models

development of critical thinking

1. Right from wrong - Patient Safety - Ergonomics - Policies, Best Practice Standards 2. What are the alternatives? - Developmental level - Gender, Culture, Religion - Diagnosis, Medications, Treatments, etc 3. Able to deal with complex issues/think outside the box (layered learning)

philosophy

A system of beliefs and values and assumptions

Types of Nursing diagnoses (NANDA)

Actual Risk (potential) Possible Syndrome Wellness

ANA professional standards

Advocacy responsibility accountability confidentiality

Order for nursing process

Assessing Diagnosis Outcome/planning Implementating Evaluating

The nurse is explaining the nursing process to a student. Which step of the nursing process would include interpretation of the data?

Assessment

intellectual standards of quality thinking

Clarity Accuracy Precision Relevance Depth Breadth Logic Fairness

outcomes for using critical thinking

Detect patient problems early Prevent adverse occurrences Decrease mortality rate Decrease failure to rescue rate Improve patient outcomes

Beneficence

Do good for others best interests of the patient

Ethics of Care

Emphasizes the importance of understanding relationships, especially as they are revealed in personal narratives

Cachetic nursing diagnosis

Failure to thrive

HELP pneumonic

Help observe the first signs patient may need help. Look for signs of distress Environmental equipment- look for safety hazards. Ensure all equipment is working Look and examine patient thoroughly People. Who are the people in the room? What are they doing?

Which step in the nursing process is similar to the assessment step of The nursing process?

Identifying the problem

The nurse is performing care therapies and including the client as an active participant in the care. Which step in the nursing process is involved in this situation?

Implementation

standard one nursing ethics

In all professional relationships, practices with compassions and respect for the inherent dignity, worth, and uniqueness of every individual. unrestricted by considerations of social or economic status, personal attributes, or the nature of the health problems.

medical diagnoses

Medical • Describes a disease, illness, or injury • Identifies a pathology so that appropriate treatment can be given. • More narrowly focused than a nursing diagnosis .• Can have any number of nursing diagnoses associated with it.

Nursing diagnoses process

Organizing & validating data (Cluster) - What info is pertinent at this time for this patient? - Is this "normal" for this patient? Analyze the data - What is the patients present status? - What is contributing to it? - Nursing focused Identify actual and potential problems - Hypothesize about their health status - Validate with patient Prioritize the problems

Sources of ethical standards in nursing

Patient self-determination act (Danforth amendment) Patient bill of rights ANA code of ethics

Values

Personal belief about the worth of a given idea, attitude, custom or object that sets standards that influence behavior

Can I Delegate Assessments?

The ANA's Code of Ethics for Nurses, Provision 4 (2001), states: "The nurse . . . determines the appropriate delegation of tasks consistent with the nurse's obligation to provide optimum patient care."

standard 2

Primary commitments is to the patient, whether an individual, family, group or community.

Autonomy

Respect for the patients ideas and beliefs Include them in all care decisions self-determination

SMART goals

Specific, Measurable, Attainable, Realistic, Timely

Outcome, identifying and planning

The nurse works in partner with patient and family to establish priorities, identify and write expected patient out comes

accountability

answer for your own actions follow agency and community standards of best practice

Ethics

The study of conduct and character (what should I do in this situation)

bioethics

The study of ethics related to issues that arise in health care.

Which features distinguish a nursing diagnosis from a medical diagnoses?

They involve the patient when possible They involve the sorting of problems within the nursing domain They involve clinical judgement about the patients response to health problems

collaboration

collaborate with other health professionals and the public in promoting community, national and international efforts to meet health needs -world hunger -environmental pollution -health disparities -equitable access to care -social reform -local and regional threats to health

Five Rights of Delegation

a) Right Task b) Right Circumstance c) Right Person d) Right Direction/Communication e) Right Supervision

ethical values/principles

autonomy beneficence nonmaleficence justice fidelity veracity

justice

be fair

ethics committee

committee made up of individuals who are involved in a patient's care, including health care practitioners, family members, clergy, and others, with the purpose of reviewing ethical issues in difficult cases -focus to educate, change policy and to provide direction for specific cases -focus on strengthening relationships

Deontology

defines actions as right or wrong

nonmaleficence

do no harm

fidelity

keep your promises be trustworthy

Nursing diagnoses

• A statement of client health status that nurses can identify, prevent, or treat independently •You cannot predict a patient's nursing diagnoses just by knowing his or her medical diagnosis or pathology. •Clients with the same medical diagnosis may have different nursing diagnoses.

NANDA-I

• Diagnostic label • Definition • Defining characteristics • Related factors • Risk factors

collaborative problems

• Physiological complications of diseases, medical treatments, or diagnostic studies • Clients with certain diseases or treatments are at risk for developing the same complications. • Always a potential problem

Nursing diagnoses- outcomes and diagnoses

• The problem (Label & Definition) suggest the goal .• The etiology (Characteristics, related factors, risk factors) suggest interventions.

standardized plans

• Unit standards of care are general guides; describe the care that nurses are expected to provide for all clients in defined situations • Standardized Plans provide detailed nursing care for a particular nursing diagnosis; for all nursing diagnoses that commonly occur with a certain medical condition • Critical pathways are outcome-based, interdisciplinary plans that sequence client care based on case type • Concept Maps are care plans developed using colors, shapes, that show relationship between the sections