Intro to Nursing Final Exam Review UTA
What is the delegatee responsible for
caring out the action that was delegated
Delegation and RN
professional nurses may delegate independent nursing practice activities (as well as medical functions that have been delegated to them) to other nurses
Requirements of licensure by endorsement
proof of license in another state licensure fee
What is the purpose of licensing?
protect the public health, safety, and welfare of the people - not the nurses
What is a second way to make sure that there are no malpractice suits
provide a caring and therapeutic relationship - make sure the patient likes you
What is the third phase of the nursing process
Planning
What is the most common reasons nurses are diciplined
Practicing under the influence of alcohol and drugs (RN & Morphine)
Term: Places life threatening problems first
Prioritization
What does the R stand for in a smart goal?
Realistic - is it a goal that your patient will be capable of achieving? Can your patient really complete this goal?
EX: The patient will walk in the halls three times a day for 15 minutes each time for three days
Smart Goal
What does the S stand for in a smart goal?
Specific - Provide specific details to describe what you want your patient to accomplish
What are the two types of data
Subjective and Objective
What can the nurse diagnose
response to bio/social/psycho stressors and health problems
The nursing evaluation may
reveal data, diagnose, goals, and nursing interventions indicate a need for change in the nursing care plan
The State board of nursing has the power to
sanction a nurse for preforming professional functions that are dangerous to the patient or general public
How do you write a smart goal
1) "The patient will" "The patient will be able to" 2) add a verb 3) outcome of the criteria 4) short/long term goal
What are the three major conditions of informed consent
1) Consent must be given voluntarily 2) Consent must be given by an individual with the capacity and competence to understand 3)The the patient must be given enough information
What can the Nurse Practice Act (NPA)
1) Define the practice of professional nursing -> what you can and can't do 2) set the minimal qualifications for education and other requirements for licenses 3) Determine the legal titles and abbreviations buses may use (RN/LPN/LVN) 4) Provide disciplinary actions for license for certain causes -In many states, the NPA is a stationary law affecting nursing practice within the bounds of the state
What are the four elements of a cause of action for negligence
1) The professional has assumed the duty of care (responsibility for the patients care) 2) The professional has breached the duty of care by failing to meet the standard of care 3) The failure of the professional to meet the standard of care was the proximate cause of the injury 4) The injury is proved
1 liter is equal to
1.057 qt
1 gram is equal to
15.43 gr
1 lbs is equal to
16 oz
1 pt is equal to
16 oz
1 ml is equal to
16.23 minimus
1 oz is equal to
2 tablespoons or 8 drams
1 kg is equal to
2.2 lbs
1 inch is equal to
2.54 cm
1 fl oz is equal to
29.57 ml
1 tablespoons is equal to
3 teaspoon
1 gal is equal to
4 qt
1 teaspoon is equal to
4.93 ml
What is equal to 1 teaspoon
5 mL
1 teacup is equal to
6 oz
1 dram (dr) is equal to
60 grains (gr)
1 dram (fl dr) is equal to
60 minims
1 grain is equal to
64.8 mg
1 cup (C) is equal to
8 oz
1 glass is equal to
8 oz
What is the second phase of the nursing process
Analysis/Diagnosis
Phase 1 of the nursing process
Assessment
This ethical principle states that individuals have the right to determine their own actions and the freedom to make their own decisions
Autonomy
To do only good EX: Choosing the treatment that does more good than harm, maintaining confidently of personal health information, acting in the best interest of the patient
Beneficence
Nurses have to qualify for these by working a certain number of hours in a specialty role but is not required to practice
Certifications
Who was the nurse who funded the American Red Cross
Clara Bartin
What are the part of the cultural checklist
Communication Method: What is preferred/do you need a translator? Language Barriers: Non-Verbal cues? identify the culture Any spiritual religious beliefs that affect care Check trust of care-givers: any biases? family dynamic: how they affect care view on recovery and treatment preference double check comprehension DIET
This includes examining your view points
Critical thinking
This is needed to establish boundaries of the nursing practice
Definitions of Nursing
An act was moral if its morals or intentions were good, regardless of the outcome EX: "always keep a promise" "never tell a lie" "Right/wrongness of an action depends on doing ones duty regardless of the consequences"
Deontology
This phase of the nursing process includes identifying actual or potential problems.
Diagnosis/Assessment
Who was the first superintendent of female nurses in the civil war
Dorothea Dix
Refers to faithfulness or honoring ones commitments EX: Taking care of a patient you are assigned and keeping nursing skills correct "Taking the patient to the play room on a promised day/time" "Keeping a promise"
Fidelity
What does "assessment", the first phase of the nursing process include?
Gather information or data about the patient, family, or community.
If there is a 25 yo Hispanic patient and she is sick, what should you do?
Give her the option to wait for details when her family arrives
Cultural Competence
Having the attitude, knowledge, and skills necessary for providing quality care to diverse populations - focus on patient specific needs shaped by culture
This phase of the nursing process includes pain management, education, and nursing orders.
Implementation
What is the highest priority of Mastlows Hierarchy of Needs
Ineffective Airway Clearance ABC's
If there are markings on a child, what should you do?
Inquire about the marking and do not judge
Confidentiality
Is a legal and ethical concern protection of privet information gathered about a patient during provision of care
This ethical principle means equals should be treated the same or impartially to provide equality of service
Justice
Who founded the frontier nursing service and provided midwifery services in rural Kentucky
Mary Breckenridge
Who was a Jamaican business woman and nurse who was a Cholera expert
Mary Seacole
What does the M stand for in a smart goal?
Measurable - How will you know you have achieve your goal? How much/often/many/far?
Do LPN/LVN have the ability to delegate tasks
NO - state nursing practice acts of not give them the authority to delegate
The ethical principle where the nurse does no harm EX: carefully examining a patients medications before administration, the outcome outweighs the harm, considering the degree of risk permissible
Nonmaleficence
This applies to adult learning situations as nurses transition from inexpert to expert practitioners.
Novice to Expert Novel
Example of empathy
"This must be very hard for you"
What is the conversion equation for medication
(Dr.'s Orders/-) x (form on top-on hand/dosage in back) x (conversion)
1 qt is equal to
0.946 liters or 2 pts
1 minum is equal to
1 drop
When providing a diagnosis as a nurse, what type of diagnosis should you use?
Nursing diagnosis only, not a medical diagnosis Only provide symptoms the patient is experiencing
The absence of this is why nursing is considered an emerging profession
Only one standardized education entry level
This code provides nurse with ethical guidelines regarding human dignity and respect of the patient
ANA Code of Ethics
What is the type of question that you should ask patients when gathering information
Open ended questions
What does the A stand for in a smart goal?
Action Oriented - What specific action or steps will you take in order for your patient to meet your goal
When a RN delegates a task to another, what does the nurse have to make sure of before he/she is able to delegate?
The RN is responsible for determining that the delegated person is competent to preform the delegated action
Endorsement
The RN may practice in another state without having to take another license exam
What does the assessment of delegation require according the the ANA Code of Ethics: Provision 4.4
The assessment involves evaluating knowledge, skills, and experience of the individual to whom the care is assigned the complexity of the assigned tasks and the health status of the patient
ANA Code of Ethics: Provision 4.4 - Delegation of Nursing Activities
The nurse must make responsible efforts to asses individual competence when assigning selected competence of nursing care to other health care providers.
If a task is delegated, who is legally responsible?
The professional RN remains legally liable. However, for the nursing acts delegated to others, unless the delegates is also a licensed professional who's scope includes the assigned act
The Principle of Double Effect
The proposed action, independent of its consequence must be good or at least morally neutral. The good effects must outweigh the bad effects
Examples include when a nurse conveys acceptance, doesn't judge a patient, and uses touch only in a way that is acceptable to the patient.
Therapeutic Communication
What does the T stand for in a smart goal?
Timely - clearly specify a completion time (end of shift/day/week)
This is important to establish with a patient
Trust
Moral rightness of an action is determined by its consequence. EX: greatest good for the greatest number of people prioritize what helps the most, rather than what helps the the few
Utilitarianism
Defined as telling the truth or not lying EX: Honestly answering questions without opinion or guessing, not making excuses for mistakes "Gently telling the truth to the patient about his/her prognosis" "Tell the truth"
Veracity
Emphasizes the character of the decision maker EX: tendencies to act, feel, and judge that develop through appropriate training but come from natural tendencies
Virtue Ethics
P&E Framework: Implications and Consequences
What are the implications and are there any consequences?
P&E Framework: Assumptions
What assumptions am i using in my reasoning?
P&E Framework: Information
What info do i need to answer this question
P&E Framework: Interpretation and Inference
What is my conclusion? Does my data support? What are some other conclusions?
P&E Framework: Point of View
What is my point of view with respect to the issue? What is the patients point of view? Are there any other point of views to consider?
P&E Framework: Purpose
What is my purpose of asking this question
P&E Framework: Question at issue
What is the key question i am trying to answer
P&E Framework: Concepts
What is the most basic concept in this question? Am i clear about the concept i am using?
The applicant for licenser must graduate from
a state approved nursing education program
What does ABC stand for?
airway, breathing, circulation - most important to treat
how do you get subjective data
ask the patient open ended questions and then organize the data
What can nurses not delegate
assessments and evaluations
Why does the nursing diagnosis not have universal support from the various continents of the discipline and profession?
critics believe that the nursing diagnosis obscures rather than clarifies patient problems
The Nursing Practice Act
defines and controls nursing
The RN is responsible for _____________
determining if the elements for valid consent are in place providing feedback if the patient wished to change the consent communicating the patients need for further info to the primary provider
Malpractice commission
do something that should not have been done
What is the fifth phase of the nursing process
evaluation
Store Knowledge in a highly evolved manner
expert
aware of resources and how to use them
expert
collect relevant and in depth data
expert
known when to bend the rules
expert
more self confident
expert
rethink procedures
expert
think about actions before you do them
expert
understand policies
expert
Malpractice omission
failing to do something that should have been done
What is the significance of the data to the patient
formulate a diagnosis and identify the problem
What is the first thing you should do as a nurse before providing a nursing diagnosis?
gather data - gather VS, history, and use a cluster map
The State Board of Nursing can
give licenser review everyones licenses make sure licenses are up to date can put restrictions on licenses revoke license
What does planning, the third phase of the nursing process include
goals that are agreed upon by both the patient and the nurse
What is the main focus of a nursing diagnosis
help the patient achieve maximum level of wellness and highest level of independence
What does analysis/diagnosis, the second phase of the nursing process include
identify the problems the patient is having as a result of the disease process, human response to illness, injury, or threat.
What is the fourth phase of the nursing process
implementation
What are some methods of collecting data
interview physical examination consultation
Diversity helps the workplace how
making a more diverse workforce
What can the primary care provider diagnose?
medical diagnosis disease process treatments to death, disease, and curing
Describe the licensure exam
min question: 75 max question: 265 6 hours Critical thinking questions
focus on actions: what do i need to do
nocive
follow standards and policies by flow
nocive
lack of self confidence
nocive
need clear cut rules
nocive
organize knowledge into separate facts
nocive
pampered by unawareness of resources
nocive
rely on step by step procedures
nocive
superficial data collection
nocive
uncomfortable with patient needs during procedures
nocive
What does implementation, the fourth phase of the nursing process, include
nursing orders are carried out, continually asses the patients, notes responses to care plan, documents findings
Malpractice
occurs when a professional fails to act as a reasonably prudent professional would have acted under the same circumstances
What kind of professionals can practice nursing?
only licensed nurses, RN, LVN, and LPN can practice nursing
If you are a RN and you have a patient that does not speak the same language as you, what should you do?
only use touch that is agreed upon by the patient
Research shows that this is increased when hospitals have more BSN than APN prepared nurses
patient safety/quality of care
The RN is not responsible for evaluating if the ________
physician has truly explained the significant risks, benefits, and alternative treatments
A nurse demonstrated this when respecting team members, identifying others strengths
player/collaboration
A way to systematically use patient data
prioritization
The State boards of nursing has the authority to
set and enforce minimum criteria for nursing education criteria and has the authority to put schools on probation
What is objective data
signs - something you can physically see example: HR BP
How do you use mastlows
stare form the bottom and go up - the bottom is the highest priority
What is subjective data
symptoms - opinion form a patient and what they say to you
What can nurses delegate
tasks
What kind of questions does the licensure exam have
tests critical thinking and nursing competence in all phases of the nursing process
In order for there to be a malpractice suit
the injury has to be proven -> there has to be harm done to the patient "laying the bed down and the patient inhaled the tube feeding"
what does evaluation, the fifth and final phase of the nursing process include
the nurse evaluates the patients progress in relation to the goals and outcome criteria to determine weather the problem is relieved, in the process, or unresolved
All states have a mandatory licensure law for
the practice of nursing to safeguard the public every state has their own laws
Culture
traditions, values, norms
What does BID mean
twice a day
How often is the licensure exam updated
updated regularly
A nurse may _________ but is not responsible for __________
whiteness a patients signing & explaining the proposed treatment
