Nursing test 2

is a patient comes in to the hospital seeking medical emergency, and denies surgery what should the health care providers do next? these deeply held values reside underneath the iceberg, the visible sign (patient coming to the hospital) is a sign of the world view but the beliefs and attitudes are not visible to others; they lie beneath the surface

conduct a comprehensive cultural assessment to understand the patients world view, including how the religious values affect the willingness to receive care.

protected by HIPPA; ___ protection of patients personal health information

confidentiality

TJC and CMS developed a set of evidence based, scientifically researched standards of care called ___; Key quality indicators that help health care institutions improve performance, increase accountability, and reduce costs Consistent with national health priorities Intended to reduce health disparities ex: screening for depression and controlling high blood pressure

core measures

an ongoing process, As a nurse, you are responsible for incorporating ___ skills when using the nursing process, assessing each patient and their environment for hazards that threaten safety, and planning and intervening appropriately to maintain a safe environment. The nurse integrates knowledge from nursing and other scientific disciplines, previous experiences in caring for patients who had an injury or were at risk, __ attitudes such as responsibility and discipline, and any standards of practice that are applicable. By doing this, you will be a provider of safe acute, restorative, and continuing care, but also an active participant in health promotion. standards have been developed by both ANA and TJC

critical thinking of both

the goal of a __ is to obtain accurate information from a patient that allows you to formulate a mutually acceptable and culturally relevant plan of care for each health problem of a patient

cultural assessment

1. Respecting a patient's health beliefs and understanding the effect of the patient's beliefs on health care delivery 2. Shifting a model of understanding a patient's experience from a disease happening in the patient's organ systems to that of an illness occurring in the context of culture 3. Ability to elicit a patient's explanation of an illness and its causes 4. Ability to explain to a patient the health care provider's perspective on the illness and its perceived causes 5. Being able to negotiate a mutually agreeable, safe, and effective treatment plan

cultural competency

___Defined as the enabling of health care providers to deliver services that are respectful of and responsive to the health beliefs, practices, and cultural and linguistic needs of diverse patients. goal is to ultimately eliminate health disparities

cultural competency Culturally competent organizations: Value diversity Conduct a cultural self-assessment Manage the dynamics of difference Institutionalize cultural knowledge Adapt to diversity

___The motivation of a health care professional to "want to"—not "have to"—engage in the process of becoming culturally competent Health care organizations are increasingly integrating cultural competence principles into everyday organizational processes and practices

cultural desire

Are interventions that involve a nurse directly interacting with patients from culturally diverse backgrounds Have the potential for conflict Enable new forms of community and collective identity Provide the opportunity to show compassion cultural conflcits that do approach should be a "win-lose/wine-lose" for both nurse and patient; a mutual agreement

cultural encounters

goal of transcultural nursing is delivering Care that fits a person's life patterns, values, and system of meaning, referred as? ex: not every patient wants to take their medications at 8am

culturally congruent care

__: associated with norms, values, and traditions passed down through generations. it has also been labeled with Ethnicity, race, nationality, and language a more contemporary view acknowledges Gender, sexual orientation, location, class, and immigration status

culture

___ defines actions as right or wrong; focuses less on consequences and more on evidence to support why it is wrong or right; depends on the mutual understanding of justice, autonomy, and goodness ___proposes that the value of something is determined by its usefulness, also known as consequentialism ___ focuses on the inequality between people; looks at everyones impact when considering interventions, e.g the patients relationships w other ___ similar to feminist ethics; emphasizes the importance of understanding relationships, especially as they are revealed in personal narratives ___ case-based reasoning; intimate understanding of particular situations; depends on finding consensus more than an appeal to philosophical principle

deontology utilitarianism feminist ethics ethics of care casuistry

ability to learn ___: cognitive development, prior knowledge. learning in children: developmental stage

developmental capability

safety risk by ___ Children younger than 5 years of age- lead poisoning School-aged child-protective equipment, car seats Adolescent- smoking, alcohol, drug risk Adult- lifestyle habits biggest threat Older patient- physiological changes increases risk, wandering, multiple medications

developmental stage- mobility, sensory, cognitive status; lifestyle choices, and knowledge of common safety precaution

__:the cognitive and social skills that determine the motivation and ability of individuals to gain access to, understand, and use information in ways that promote and maintain good health this includes patients' reading and mathematics skills, comprehension, and decision-making and functioning skills with regard to health care. __ the inability to read above a fifth-grade level, a major problem in america. 1/2 medicare/medicaid pts a pats health literacy has one of the biggest impact on their overall health outcomes. always evaluate a pats health literacy, this determines how i deliver teaching strategies

health literacy functional illiteracy

health disparities are the differences among populations in the incidence, prevalence, and outcomes of health conditions, disease and related complications. on the other hand, ___ are differences among populations in the availability, accessibility, and quality of health care services(screening, diagnostic, treatment, rehabilitation) aimed at prevention, treatment, and management of diseases and their complications

health care disparities

__defined as a particular type of health difference that is closely linked with social, economic, and/or environmental disadvantage. status of a disadvantage group such as people with low incomes and wealth and and an advantage group such as people with high incomes and wealth.

health disparity

basic learning principles ___ Addresses the client's desire or willingness to learn; motivation is a force that acts on or within a person to cause the person to behave in a particular way ___ Depends on physical and cognitive abilities, developmental level, physical wellness, thought processes __ Allows a person to attend to instruction; appropriate furniture and comfortable temperature, well lit, good ventilation, quiet, private

motivation to learn ability to learn learning environment

____ in the hospital reducing physical hazards Lighting Obstacles Bathroom hazards Security Minimize Falls Minimize client-inherent accidents Minimize procedure-inherent accidents Minimize equipment-related accidents Maintaining skin care Meeting Basic Needs: Oxygenation Nutrition Sleep Elimination

nuring roles and responsibilities

how come patients may feel more comfortable revealing information to the nurses?

nurses generally engage with patients over longer periods of time than other disciplines

__ for patients with safety risk Risk for falls- associated with altered mobility or sensory alteration(visual) Impaired home maintenance Risk for injury Deficient knowledge Risk for poisoning Risk for suffocation Risk for trauma

nursing diagnoses

a relationship exist between the nursing and teaching process however they are not the same __: process requires assessment of all data _: process focuses on the client's learning needs and ability to learn

nursing process teaching process

A formal and informal system of advantages and disadvantages tied to our membership in social groups, such as those at work, school, and in families. this system impacts an individuals access to resources such as health care, housing, education, weather in a good way or a negative way

oppression

key concepts of intersectionality; the notion that intersecting categorys such as race, ethnicity, gender, socioeconomic status, sexual orientation, ect.. contribute to systemic injustice. social inequality ___: groups overlooked in research and the design interventions __: groups left out Social location __: understanding them within the context of the larger system of power and privilege that permeates society

overinclusion and underinclusion marginalization metrix of domination

___ Based on Communication Health Care Team Collaboration Involved both the patient and family in all care decisions Empowers the patient to participate- does this lend itself then to patient education?

patient centered care

Each emphasizes different aspects of quality ___ provides individualized care and restores an emphasis on personal relationships __ aims to increase health equity and reduce disparities by concentrating on people of color and other disadvantaged populations it is important for nurses to see themselves as __?

patient-centered care cultural competence becoming culturally competent

psychomotor learning includes: (simple to complex)

perception set guided response mechanism complex overt response adaptation origination

environmental hazards ___: include lighting, obstacles, bathroom hazards motor vehicle accidents poison fires falls transmission of pathogens- wash hands!! pollution- increases risk of pulmonary disease disasters; include natural and man-made

physical hazards

safety and the nursing process: ___ Goals and outcomes Prevent and minimize safety threats Are measurable and realistic May include active patient participation Setting priorities Teamwork and collaboration: SBAR for effective communication technique and dry-erase board with pt info

planning

__: Determine goals and expected outcomes that guide the choice of teaching strategies and approached with a client; this is ___ health approach Set priorities- specifically depends on what the ___ perceives is the most important Select timing to teach/when is there a right time to teach? - plan when the patient is most alert, receptive and attentive Organize the teaching material. Start from simple and progress to complex- textbook page 376

planning patient centered patient

___ providing information about procedures and outcome to the patient __: learning occurs when an educator translates complex language or ideas into words or concepts that a patient understands. this supplement verbal instruction with familiar images that make complex information more real and understandable. for example when explaining a patient arterial blood pressure, us an analogy of the flow of water thru a hose __: during individual or group discussion you pose a potential problem or situation for patients to solve

preparatory instruction analogies simulation

Different teaching methods are appropriate for each domain of learning. ___: discussion (one-on-one or group), lecture, question-and-answer session, role play, discovery, independent project, field experience ___: role play, discussion (one-on-one or group) ___: demonstration, practice, return demonstration, independent projects, games

cognitive affective psychomotor pg 331 box 25-2

domains of learning: ___: includes all intellectual behaviors and requires thinking __: deals with expression of feelings and acceptance of attitudes, opinions, or values/beliefs __: involves acquiring skills that require integration of mental and muscular activity

cognitive(understanding) affective(attitudes) psychomotor(motor skills)

___ occurs when multiple health workers from different professional background work together with patients, families, careers, and communities to deliver the highest quality of care

collaboration

Teaching closely parallels the ___process. Depends in part on effective interpersonal communication. The ___ objective describes what the learner will be able to accomplish after instruction is given

communication learning

__ should never occur. the centers of medicare and medicaid services (CMS) now denies hospitals higher payments resulting from or complicated by these. many hospital-acquired conditions are __ indicators the "speak up" campaign reduces accidents in hospitals; ex pt are supposed to ask providers if they have washed their hands

"Never events" nurse sensitive the NQF national quality forum helps judge the quality of a health care organization by tracking number of medical incidents that could of been prevented reporting incidence reports after a mistake or potential adverse event occurs, allows an organization to identify trends/patterns throughout the facility and areas to IMPROVE. focusing on the root cause

how does safety in health care settings affect the patient?

1. reduces the incidence of illness and injury 2. prevents extended length of treatment/stay 3. improves or maintains functional status 4. increases patients sense of well-being

who has the highest mortality rate of any race or culture for all cancers combined, contributing in part to a lower life expectancy for both ___ men and women.

African america

who has a highest incidence rate of liver cancer?

Asian Americans

Cultural awareness: __:a predisposition to see people or things in a certain light, either positive or negative. Becoming more self-aware of your biases and attitudes about human behavior is the first step in providing patient-centered care.

Bias

what are some risk in health care agencies?

Chemical use (Material Safety Data Sheets [MSDSs] use if something spills) Medical errors Medication errors Infection Bed sores Failure to diagnose and treat in time Falls

___ Includes meeting patients' physical and psychosocial needs Applies to all places where patients receive care Includes patients' and health care providers' well-being Reduces risk of injury and transmission of pathogens Maintains sanitation and reduces pollution

a safe environment

Campinha-Bacote model: __: in-depth self-examinations of ones background, recognizing biases, prejudices, and assumptions about other people __: sufficient comparative knowledge of diverse groups, and found within each group __: ability to assess social, cultural, and biophysical factors that influence patient treatment and care __: cross-cultural interactions that provide opportunities to learn about and develop effective intercultural communication __: the motivation and commitment to caring that moves an individual to learn from others, accept the role as a learner, be open to and accession of cultural differences ___ Building a relationship with the other Working outside the usual practice framework Reinventing practice in action

Cultural awareness Cultural knowledge Cultural skills Cultural encounters Cultural desire Blanchet and Pepin model

the enhanced national __ are intended to advance health equity, improve quality, and help eliminate health care disparities by establishing a blueprint to help individuals and health care organizations.

Culturally and Linguistically Appropriate Standards (CLAS)

what are factors influencing safety?

Developmental stages Individual risk factors: Mobility sensory, and cognitive status- associated with delirium, dementia, and depression contribute to lack of attention span, impaired memory Impaired mobility Lifestyle choices Lack of safety awareness- a nursing assessment that includes a home inspection to assure safety Risks in the health care agency

name implementation in acute care safety?? prevention is a priority in acute care setting

Fall risk prevention Restraints as a last resort Restraint alternatives- these are commonly preferred except in emergency, nursing homes cannot use restraints without a residents consent informed consent from family member in long-term care settings

three basic human needs? all of which affect environmental safety!!!

Oxygen Low concentration- cause nausea, fatigue, headache High concentration- cause death after 1-3 min Carbon monoxide- affects a persons oxygenation by binding with hemoglobin, preventing the formation of oxyhemoglobin, thus reducing supply of oxygen to tissues Nutrition Proper storage Proper refrigeration Preparation area Temperature Normal- 65 to 75 F Hyperthermia Hypothermia

Future nurses need knowledge, skills, and attitudes to promote safety. Continuous improvement is essential. ___ minimizes risk of harm to patients and providers by: System effectiveness Individual performance

Quality and safety education for nurses (QSEN)

what is the process of ethical dilemma?

Step 1: Ask if this is an ethical dilemma. Step 2: Gather all relevant information. Step 3: Clarify values. Step 4: Verbalize the problem. Step 5: Identify possible courses of action. Step 6: Negotiate the outcome. Step 7: Evaluate the action.

___ speak up tips for patients Speak up if you have questions or concerns. Pay attention to the care you get. Educate yourself about your illness. Ask a trusted family member or friend to be your advocate. Know which medicines you take and why. Use a health care organization that has been carefully evaluated. Participate in all decisions about your treatment.

TJC's

what is the purpose of patient education?

To help individuals, families, or communities achieve optimal levels of health Patient education includes: Maintenance and promotion of health and illness prevention- this allows patient to assume more responsibility of their own health and are more likely to seek early diagnosis of health problems Restoration of health- help them regain or maintain their levels of health. as a nurse i need to learn to identify patients willingness to learn and motivate interest in learning; do not assume that a family should be involved in eduction; assess the patient-family relationship before providing education for family caregivers Coping with impaired functioning

___: A set of guiding principles that all members of a profession accept Helps professional groups settle questions about practice or behavior Includes advocacy, responsibility, accountability, and confidentiality ANA is in charge of this what presents ethical challenges for nurses?

code of nursing ethics social networking

__refers to the ability to answer for ones actions. you ensure that your professional actions are explainable to your patients and your employer

accountability

New standards Focus on cultural competency, health literacy, and patient- and family-centered care Recognize that valuing each patient's unique needs improves the overall safety and quality of care and helps to eliminate health disparities.

addressing health care disparities

ability to learn ___: self-directed(often able to identify their own learning needs), patient-centered education by developing educational topics and goals for them. __: ability to learn depends on level of personal development, physical health, fatigue

adult-learning physical capability

__refers to the support of a particular cause. as a nurse i support the health, safety, and rights of a patients (right to refuse treatment)

advocacy

name isolation precautions

airborne precautions contact precautions droplet precautions protective isolation neutropenic precautions postexposure management

___ to restraints: Orient client and families to surroundings Encourage constant companions for pt Assign pts to rooms near nursing station Provide meaningful audio/visual stimuli Eliminate bothersome therapies Use relaxation techniques Institute exercise & ambulation schedules Maintain toileting routines Consult with PT and OT for ADLs Evaluate all client medications Conduct ongoing assessment & evaluation

alternatives

what two racial groups has a infant mortality rate 60% higher than non-hispanic whites?

american indian and Alaska native populations

SAFETY AND THE NURSING PROCESS ___ Through the patient's eyes Patient's home environment Assessment questions -Activity and exercise -Medication history -History of falls -Home maintenance and safety Nursing history- DATA ABOUT A PATIENTS LEVEL OF WELLNESS TO DETERMINE IF ANY UNDERLYING CONDITIONS EXIST THAT POSE THREATS TO SAFETY Health care environment -Risks in immediate environment -Risk for falls -Risk for medication errors- NAME AND DOB OR NAME AND MEDICAL RECORD NUMBER -Disaster preparedness-BIOTERRORIST ATTACK- first include nonspecific symptoms (nausea, vomiting, diarrhea, skin rash, fever) that may persist for several days before the onset of more severe disease.

assessment

Select the nursing diagnosis that reflects the client's learning needs after the ___is completed. Clarifying the diagnosis by __ helps the nurse focus on the subject matter and teaching methods.

assessment domain

___ mental state that allows the learner to focus on and comprehend a learning activity. a mild level of anxiety motivates learning but too much interferes with learning

attentional set

__refers to freedom from external control. in health care the concept allies to provider respect for the freedom of providers; refers to the commitment to include patients in decisions about all aspects of care. acknowledge and protects a patients independence. ex: explains procedure/risk to procedure and receiving a signed signature on the consent from patient

autonomy

___taking positive actions to help others. implies that the best interest of the patient remain more important that self-interest. nurses are the service of others

beneficence

issues in health care ethics: ___: Interventions unlikely to produce benefit for the patient; ex end-stage liver cancer and physician orders for a liver transplant even when the chances of survival is unknown __Facilitated access to care for millions of uninsured Americans

care at the end of life health care reform

seizures are associated with involuntary muscle contractions, episodic, loss of conciousness, falling, tonicity(rigidity of muscles), clonicity(jerking of muscles) and incontinence this can cause musculoskeletal injuries a aura is often reported in patients right before a seizure occurs which is a bright light, taste or smell during a seizure the patient experiences shallow breathing, cyanosis, and loss of bladder and bowel control a postical phase follows the seizure, during which the pt has amnesia or confusion and falls into a deep sleep prolonged or repeated seizures indicate __, a medical emergency that requires intensive monitoring ___ encompass all nursing interventions to protect a patient room traumatic injury, position for adequate ventilation and drainage of oral secretions, and provide privacy and support following the seizure

disorderly discharge of neurons in the brain status epilepticus seizure precautions

cultural knowledge- world view World view(determines how people perceive others, how the interact and relate to reality, and how they process information) __: inside perspective, (you know it/aware) __: outside perspective, (no clue, left out) Avoid stereotyping Treat the individual See every patient encounter as cross-cultural __:Most aspects of a person's world view are hidden; tool that helps visualize the visible and invisible aspects of your world view, and see that its the same way for my patient. Conduct a cultural assessment- Cultural assessment model Open-ended, focused, and contrasted questions, Explanatory model(person views about health and illness and its treatment), Trust

emic world view etic world view iceberg analogy

the study of conduct and character. it is concerned with determine what is goo or valuable for individuals, groups, and society at large.

ethics

___:are usually multidisciplinary and serve several purposes: education, policy recommendation, and case consultation. Any person involved in an ethical dilemma, including nurses, physicians, health care providers, patients, and family members, can request access to them

ethics committees

___ Necessary to determine whether the client has learned the material Helps to reinforce correct behavior and change an incorrect behavior Success depends on the client's performance of expected outcomes

evaluation

safety and the nursing process: ____ Through the patient's eyes Are the patient's expectations met? Are the family's expectations met? Patient outcomes Monitor care by the health care team. Measure outcomes for each diagnosis. Continually assess needs for additional support.

evaluation

___ A safe physical environment A patient whose expectations have been met A patient who is knowledgeable about safety factors and precautions A patient free of injury

expected outcomes

___ his or her views about health and illness and its treatment. there are five questions in most explanatory models. __: time and mode of onset of symptoms pathophysiology course of illness treatment for an illness episode

explanatory model etiology

what are the four classifications of health care agency accidents to patient?

falls Patient-inherent accidents- accidents other than falls that a patient is the primary reason for the accident; ex a seizure Procedure-related accidents- caused by health care providers and include medication and fluid administration errors, improper application of external devices, ect.. Equipment-related accidents- equipment malfunction, disrepair, or misuse of equipment or electrical hazard; must report medical device-related deaths to both the FDA and the manufacturer of the product if known, and tagging the machine so no one else uses it

__agreement to keep promises. following through on my actions and interventions. monitor patients response to the intervention. Also promise to not abandon patient even if views are different to theirs ex: assess pain, come up with plan to manage pain, fidelity now encourages me to monitor patients response to plan, to keep the promise to reduce pain

fidelity

what group of individuals are more likely to be depressed, have anxiety, and substance use disorders, and are FOUR times more likely to make suicide attempts that require medical attention.

gays, lesbian, and bisexual young people

___ the ability to obtain, process, and understand health information need to make informed health decisions. studies found that this has a direct affect on health outcomes. lower __ has been associated with older adults, increasing risk for mortality. linguistic competence helps increase this and for individuals with limited english proficiency (LEP) other people targeted: seniors 65+older immigrants people with low income people who dont have high school diploma or GED people with chronic mental and/or health conditions

health literacy health literacy

what racial youth group (2-19) has the highest rate of obesity? resulting in chronic diseases such as diabetes, high blood pressure, asthma

hispanic youth

restraints are __,__,or __ to restrict freedom. can cause serious complication: Pressure ulcers Constipation Pneumonia Urinary and fecal incontinence Urinary retention Contractures Nerve damage Circulatory impairment Loss of self-esteem, humiliation, fear, anger ___is required based on face-to-face assessment of client: must be part of the pts prescribed medical treatment and plan of care Order must state type and location of restraint Must have limited time factor Orders need to be renewed in specific time frame according to facility's policy- 8hrs adults, 2hrs 9-17 yrs old, 1 hr >9 No PRN orders Ongoing assessments are necessary Must be periodically removed and need reassessed proper documentation- behaviors that led to restraint, procedure used in restraining, the condition of the body restrained (circulation of hand), evaluation of pt response is essential types of restraints: Side rails on beds Bed restraint Jacket: vest or chest Belt or waist Extremity: mitt, hand, wrist, ankle, elbow alternatives: thanks to technology has created sensor mats to alert nurses when getting up theraputeic/visistation/hobbies all four side rails up is a restraint less-restricitive restraint is the Posey bed

human, chemical, or physical device physicians order

Culture affects how an individual defines the meaning of illness ___:The way that individuals and families react to disease ___:Malfunctioning biological or psychological processes

illness disease

all includes the __ category Maintain learning attention and participation- active participation is a key to learning; more than one of the senses are stimulated Build on existing knowledge. Select teaching approach. Incorporate teaching with nursing care. Select appropriate instructional methods. Illiteracy and other disabilities. Cultural diversity. Using different teaching tools. Special needs of children and older adults.

implementation

safety and the nursing process: __ ACUTE CARE safety seizures poisoning electrical hazards radiation disasters hospitals must have an ___?

implementation emergency management plan

safety and the nursing process: ___ Health promotion Individualization of ___ Developmental stage Lifestyle Environment Basic needs General preventive measures Lighting Changing the environment

implementation (for both)

a dynamic perspective recognizes that we all belong simultaneously to multiple social groups within changing social and political contexts; according to this framework our memberships in social groups are NOT neutral would use this dynamic to consider the multitude of different experiences of your patients so that i can provide effective, evidence-based, culturally competent care

intersectionality

__ refers to fairness; this is a debate for health care reform and access to care. __: term refers tot eh promotion of open discussion w./o fear of recrimination whenever mistakes occur or nearly occur.

justice just culture

instead of assuming that a patient of a ethinic wants to be treated as their religion be sure to instead combine your __ about a cultural group with an attitude of helpfulness and flexibility to provide quality, patient-centered, culturally congruent care

knowledge

__ to describe the behaviors the learner will exhibit as a result of successful instruction attitudes, values, emotions, cultural preparative, and knowledge influence the way information is __ __ with teaching is also helpful for choosing the best way to to present necessary content the receiver in the teaching-learning process is the __ attitudes, anxiety, and values influence the ability to understand the message effective communication involves ___

learning objectives delivered past experiences learner feedback

__ ability of an organization or staff to communicate effectively and convey information in a manner that is easily understood by diverse audience. health care organization MUST provide interpreters if necessary Do not use a family member to interpret for you or any other health care provider

linguistic competence

Expanding the original focus on interpersonal skills, many of the current approaches to cultural competency now also focus on: All ___ groups and not just immigrants Prejudice, stereotyping, and social determinants of health The health system, communities, and institutions.

marginalized

__: groups of people within a given culture, context and history at risk of being subjected to multiple discrimination due to the interplay of different personal characteristics or grounds, such as sex, gender, age, ethnicity, religion or belief, health status, disability, sexual orientation, gender identity, education more likely to have poor health outcomes and die at an earlier age

marginalized groups

issues in health care ethics: ___Central to discussions about end-of-life care, cancer therapy, physician-assisted suicide, and Do Not Resuscitate (DNR) ___ Antidiscrimination laws enhance the economic security of people with physical, mental, or emotional challenges

quality of life disabilities

six cognitive behaviors is hierarchical and increases in complexity

remembering understanding applying analyzing evaluating creating

many times patients undergo greif when they are informed of a practicular illness. grief has stages that nurses need to identify which stage the patient is in. this will guide us to knowing if that person is ready to learn or not. if so then we need to introduce a teaching plan. teaching continues as long s the pt remains in a stage of conductive to learn. which stages are appropriate to teach in future tense, while the other ones only shared info in present tense?

resolution and acceptance stages

__willingness to respect ones professional obligations and to follow through. an example is following an agency's policies and procedures.

responsibility

___ in teaching and learning include: Teach information that the patient and the family need to make informed decisions regarding their care. determine what patients need to know identify when patients are ready to learn

role of the nurse in teaching and learning

older adults have slower cognitive function and reduced short-term memory establish __ goals when teaching older pt

short-term

the following physical characteristics are necessary to learn psychomotor skills

size, strength, coordination. sensory acuity

Mnemonics LEARN: Listen, Explain, Acknowledge, Recommend, Negotiate RESPECT: Rapport, Empathy, Support, Partnership, Explanations, Cultural Competence, Trust ETHNIC: Explanation, Treatment, Healers, Negotiate, Intervention, Collaboration C-LARA: Calm, Listen, Affirm, Respond, Add Linguistic competence Heath literacy Teach back

skills and interventions

__helps explain the complexity of the interactions with marginalized groups. according to WHO these interactions are "the conditions in which people are born, grow, live, work and age..shaped by the distribution of money, power, and resources at global, national, and local levels." ex: neighborhood conditions, discrimination, income and wealth

social determinants of health

__: theory that states a persons state of mind and intrinsic motivational factors (sense of accomplishment, pride, or confidence) reinforce behaviors and influence learning. this theory considers the personal characteristics of the learner, behavior patterns, and the environment and guides the educator in developing effective teaching interventions; thiss type of internal reward system allows a person to attain desired outcomes and avoid undesirable ones, resulting in improved motivation __: concept included in the above theory, refers to person perceived ability to successfully complete a task. when someone believes they have the ability to complete a task correctly they are more likely to perform the behavior consistently and correctly

social learning theory self-efficacy

__intervention that helps you to confirm that you have explained what a patient needs to know in a manner that the patient understands

teach-back method

___An interactive process that promotes learning ; concept of imparting knowledge through a series of directed activities; a conscious, deliberate set of actions that help people gain new knowledge, change attitudes, adopt new behaviors, or perform new skills. ___The purposeful acquisition of knowledge, skills, behaviors, and attitudes through experience or external stimulus. process of both understanding or applying newly acquired concepts. a mother demonstrates learning when she applies the knowledge of bathing her child

teaching learning

___: Deficient knowledge (affective, cognitive, psychomotor) Ineffective health maintenance Impaired home maintenance Ineffective family therapeutic regimen management Ineffective self-health management Noncompliance (with medications) decisional conflict self-neglect when nursing diagnosis is deficient knowledge, the diagnosis statement must describe the specific type of learning need and its cause e.g. DEFICIENT KNOWLEGE regarding a surgical procedure related to lack of recall and exposure to information when you can manage or eliminate health care problems through education, the related factor is Deficient knowledge. e.g. ineffective health maintenance related to deficient knowledge regarding scheduling of medications if nursing diagnosis would affect ability to learn, acute pain or activity intolerance, then wait to teach material until that is under control

teaching process diagnoses for patient education

____: See through the patient's eyes. Teaching is patient-centered. Assess the patient's learning needs. Ask questions to identify motivation to learn. Determine the patient's physical and cognitive ability to learn. Provide an appropriate teaching environment. Assess the readiness and ability of a family caregiver or other learning resource. Assess health literacy/learning disabilities

teaching process: assessment

types to teaching approaches __: use this method when giving limited information. the nurse outlines a task that a patient will perform and gives explicit info. no opportunity for feedback __: nruse and pt set objectives and beacon involved in the learning process together __: provides pt with the opportunity to manage self-care. pt accepts responsibility and performs tasks correctly and consistently. nurse is available for help and available to assist __: requires use of a stimulus to increase the probability of a desired response. a learner who receives this before and after a desired learning behavior is more likely to repeat that behavior. smiling or verbal praise are ex.

telling participating entrusting reinforcing

__sets standards for patient and family education. Successful accomplishment of standards requires collaboration among health care professionals. All state Nurse Practice Acts recognize that patient teaching falls within the scope of nursing practice.

the joint commission

a comparative study of cultures to understand their similarities(cultural that is universal) and differences(cultural specific to that group)

transcultural nursing

most health care providers in the US are primarily educated to __, whereas most individuals seek health care because of their experience with ILLNESS. in addition, their is a lack of cultural diversity among health care providers

treat disease

___: personal belief about the worth of a given idea, attitude, custom, or object that sets standards that influence behavior. Ethical dilemmas almost always occur in the presence of conflicting ___ To resolve ethical dilemmas, one needs to distinguish among values, facts, and opinion.

value values

__ is an example of affective learning, which is just stepping back and evaluating ones own values, patients, and co workers to decreases ethical dilemmas affective learning includes:

values clarification receiving responding valuing organizing characterizing

self-efficacy beliefs come from four sources: __: nurse expresses to child her belief that he can use the inhaler __: nurse demonstrates the use of the inhaler __: child uses the inhaler __: child wheezing and asthma improves

verbal persuasion vicarious experience enactive mastery experience physiological and affective state

refers to the way people tend to look out upon the world or their universe to form a picture or value stance about life or the world around them develops from 1. culture and 2. socialization

world view