ETHICS, LEGALITY, CARE/CASE MANAGEMENT WK5&6 NRS 221

After undergoing an abortion, a teenager asks the nurse, "Can you provide me with some information regarding birth control pills?" Which response from the nurse indicates ethical egoism?

"I am sorry. Providing information about birth control pills to teenagers will pose a risk for my job." If the nurse refuses to provide information about birth control pills to avoid risk of losing his or her job, it indicates ethical egoism. The decision made by the nurse is beneficial only to him or her, but not to the teenager.

ANA Code of Ethics for Nurses

-In all professional relationships, practices with compassion & respect -Primary commitment is to patient, family, group, community -Promotes, advocates, protects health, safety, & rights of patients -Responsible & accountable for his/her own patient care practice -Owes same duty to self...integrity, competence, growth -Participates in improving health care environments -Participates in advancement of profession -Collaborates with other health professionals & public to meet health care needs -Profession of nursing, as represented by associations/members...responsible for values & integrity & shaping social policy

What are patient expectations that are covered by the American Hospital Association Patient Care Partnership?

-right to high quality care (ID of caregivers) -clean, safe environment (safety, freedom from abuse & neglect, & discussions of care) -respect for healthcare values and goals -to be involved in decision making -info about right to refuse or make decisions of care -protection of privacy and confidentiality -help reviewing bills -prep and info when leaving hospital

Question 13. The nursing instructor is teaching a group of student nurses about performing body searches in clients with mental illness. Which statement made by a student nurse requires further teaching? 1. "A body search should be performed routinely on a day-to-day basis." 2. "A reason for performing a body search should be clearly defined." 3. "A body search is performed to avoid the risk of suicide attempts in mentally ill clients." 4. "A body search should be performed only after receiving an order from the primary health-care provider."

1 Option 1: A body search should not be performed routinely on a day-to-day basis because it is a violation of a client's right to privacy. Therefore, the student nurse's statement requires further teaching. Option 2: A proper reason for performing a body search should be clearly defined by the regulations. This statement from the student nurse is valid and does not require further teaching. Option 3: The presence of harmful weapons or substances used by the client to commit suicide can be caught by performing a body search. Therefore, this statement from the student nurse is valid and does not require further teaching. Option 4: A body search is a violation of a client's right to privacy and should be performed only if the primary health-care provider suspects suicidal behavior in the client. Therefore, this is a valid statement from the student nurse and does not require further teaching.

Which interventions of the nurse indicate his or her moral behavior? Select all that apply. 1. Being truthful to clients 2. Upholding the rights of a client 3. Caring for all clients alike without discrimination 4. Understanding the effect of values on nursing outcomes 5. Identifying and ranking his or her own personal values

1 2 3

Question 3. A client has been diagnosed with a life-threatening condition. The nurse discloses the client's health information to the client's family members. Which information does the nurse document in the client's record following disclosure? Select all that apply. 1. Date of disclosure 2. Reason for disclosure 3. Specific information disclosed 4. Contact number of professional who disclosed the information 5. Address of person to whom information was disclosed

1, 2, & 3 Option 1: After disclosing the client's health information, the nurse should enter the date of disclosure in the client's records as per hospital policies. Option 2: The reason for disclosure should be documented in the client's records because it is required by law. Option 3: The disclosed information should be entered in the client's reports in order to follow the law. Option 4: The nurse does not enter the contact number of the professional who disclosed the information in the client's reports. Option 5: The nurse will not enter the address of the person to whom information was disclosed in the client's reports.

Question 6. The registered nurse is teaching about the ethical principle of advocacy that has to be followed while caring for a client on the psychiatric unit. Which actions of the student nurse indicates effective learning? Select all that apply. 1. Educating the client's family about legal rights 2. Encouraging the client to fulfill his or her needs without assistance 3. Telling the truth to the client's family about the client's condition 4. Avoiding harming the client intentionally 5. Speaking about the client's condition on his or her behalf

1, 2, & 5 Option 1: Explaining about legal rights to client's family indicates effective implementation of the ethical principle of advocacy. Option 2: The nurse implements the advocacy principle by encouraging the client to fulfill his or her needs without any assistance. Option 3: Telling the truth to the client's family about the client's condition may indicate violation of HIPPA law. However, telling truth indicates veracity and not advocacy. Option 4: The nurse does not harm any client intentionally or unintentionally if he or she implements nonmaleficence in the practice effectively. Option 5: The nurse acts as advocate by speaking on behalf of clients with mental illness to secure essential mental health services.

Question 10. What characteristics will the nurse observe in a client who is suit prone? Select all that apply. 1. Critical behavior 2. Complaining nature 3. Uncooperative during treatment 4. Defensive and withdrawn nature 5. Poor interpersonal communications

1, 2, 3

Which are examples of protected health information? Select all that apply. 1. Client's diagnosis 2. Treatment for depression 3. Account turned over to collections 4. Appointments 5. Employer records of treatment

1, 2, 3, & 4 Option 1: Individual information regarding treatment and demographic information are considered protected. Option 2: Past as well as current medical treatment is considered protected information. Option 3: Payment history and transactions, including accounts placed in collections, are considered protected information. Option 4: Appointments are considered protected information, as are any other dates such as discharge and admission dates. Option 5: Employer documents are not protected under HIPPA when used for the purpose of employment.

When using the MORAL model for ethical decision making, what principles will help the nurse to function effectively as an advocate? Select All That Apply. 1. Know and document facts. 2. Know the argument. 3. Avoid getting into a power struggle. 4. Be aware of client vulnerability. 5. Assess the group's willingness.

1, 3, & 4

Which questions are examples of bioethics considerations? Select all that apply. 1. Should a client be allowed to die? 2. Should a nurse practice outside of scope? 3. Should a nurse question an order? 4. Should a nurse sign with "RN" behind her name? 5. Should a client be told about a medical error?

1, 3, & 5

Which expectations are covered by the American Hospital Association Patient Care Partnership? Select all that apply. 1. High-quality care 2. No unexpected costs 3. Explanation of a diagnosis 4. Involvement in care 5. A clean and safe environment

1, 4, & 5

According to the Health Information Portability and Accountability Act Privacy Rule, protected health information can only be shared for which purposes? Select all that apply. 1. Treatment 2. To ensure everyone on a nursing unit is aware of the client 3. Reassurance to family 4. Payment 5. Operations 6. Understanding past treatments

1, 4, & 5 Option 1: Treatment is a valid reason for disclosure of protected health information to other members of the treatment team. Option 2: Only those involved in the care of the client should have access to client information. Option 3: Protected health information cannot be shared with the family unless the client provides specific permission. Option 4: Protected health information can be shared with third-party payers to facilitate payment. Option 5: Information can be shared to support operations such as education or data collection. Option 6: Understanding of past treatments is not a reason to disclose protected health information.

Question 20. While making an ethical decision, the nurse thinks, "It is my moral duty to convey the truth to the client even if it is not beneficial." Which phase of ethical decision-making is indicated by the nurse's thought process? 1. Planning 2. Evaluation 3. Assessment 4. Problem identification

1. Planning Option 1: When the nurse considers the ethical theories involved in decision-making, it indicates the planning phase of decision-making. The ethical theories and their implication on the decision are considered in this phase. Option 2: The nurse's thought process does not involve the evaluation of the outcome resulting from a decision. Option 3: The assessment phase of decision-making involves gathering the subjective and objective data about the situation. The assessment phase is not evident from the nurse's thought process. Option 4: The thought process of the nurse does not infer that the nurse is trying to identify the problem between two or more alternative decisions.

Question 4. Which actions in the nursing practice can result in the nurse being accused of false imprisonment? Select all that apply. 1. Keeping an aggressive client alone in a room 2. Taking the clothes of a depressed client against his or her wishes 3. Restraining the extremities of a voluntary competent client demanding release 4. Locking the client in a room for the nurse's convenience 5. Administering tranquilizers to the client who attempts to harm others

2, 3, & 4 Test Taking Tip: Recollect the illegal nursing interventions which would result in false imprisonment. This will help you to reach at correct answers. Option 1: An aggressive client can cause harm to others. Therefore, placing an aggressive client alone in a room is not false imprisonment. Option 2: Taking the clothes of any client against his or her wishes may be considered false imprisonment. Option 3: Restraining the extremities of a voluntary competent client who demands to be released can result in false imprisonment. Option 4: The nurse should not lock the client alone in a room for the nurse's convenience. This intervention can lead to false imprisonment accusations. Option 5: Tranquilizers are administered to control symptoms associated with mental disturbances. Therefore, this intervention is not false imprisonment.

Question 5. Which psychiatric client requires the nurse to obtain informed consent from the closest relative before treatment? 1. A client who is aggressive and attempting to harm others 2. A client who is mentally incapable of making decisions and attempts suicide 3. A client who is scheduled for electroconvulsive therapy 4. A client with a life-threatening condition

3 The nurse should obtain informed consent from the closest relative to start the electroconvulsive therapy in the client.

Which are examples of negligence? Select all that apply. 1. A nurse inadvertently giving a wrong dose of a medication 2. A nurse documenting vital signs in a medical record when they have not been taken 3. A nurse not turning and repositioning a bedridden client, resulting in the development of bedsores 4. A nurse not administering pain medications as needed for a hospice client 5. A client falling after the client has called for assistance in getting up, for which nobody responded after 25 minutes

3, 4, & 5 *Test Taking Tip: Negligence is failure to use ordinary and reasonable care or to act in a responsible manner.* Option 1: A medication error is not an example of negligence. Option 2: This is an example of falsification of records. Option 3: A nurse failing to provide basic care that a reasonable person with similar credentials should provide is negligent. Option 4: Not administering pain medications to a client who is in severe pain is negligent. Option 5: If a client has a need and the nurse does not respond, this is negligence.

The nurse is teaching a newly recruited nurse about unlawful acts. Which action described by the nurse would be categorized as intentional tort? 1. Failing to fulfill an obligation to others 2. Stealing hospital supplies and drugs 3. Showing negligence during a medical treatment 4. Touching a client without his or her consent

4 Option 1: Failing to fulfill an obligation to others is categorized as breach of contract. Option 2: Stealing hospital supplies and drugs is a violation of criminal law. Option 3: Showing negligence during a medical treatment is categorized as malpractice, which is unintentional tort. Option 4: Touching a client without his or her consent may result in charge of battery, which is categorized as intentional tort.

Question 16. A student nurse is charged with assault and battery. What could be the reason for this lawsuit? 1. The student nurse touched the client without his or her consent. 2. The student nurse disrespected the decision of a mentally ill client. 3. The student nurse disclosed the client's information during an emergency situation. 4. The student nurse performed a life-sustaining treatment even though the client was refusing it.

4 Option 1: If the student nurse touched the client without his or her consent, then the student nurse may be charged with battery but not assault. Option 2: Disrespecting the decision of a client is a violation of the ethical principle of autonomy. This will not result in a lawsuit charged with assault and battery. Option 3: The student nurse can disclose the client's information to others during emergency. This will not result in a lawsuit charge of battery and assault. Option 4: If the student nurse performed a life-sustaining treatment to a client who has not agreed to it, it could result in an accusation of assault and battery. Touching a client without his or her permission is battery and performing a procedure forcefully is called assault.

Question 14. Which client requires the renewal of restraint orders for every 2 hours unless state law is more restrictive? 1. A client who is 8 years old 2. A client who is 13 years old 3. A client who is 20 years old 4. A client who is 35 years old

A client who is 13 years old Option 1: The children younger than 9 years of age require the renewal of restraint orders for every 1 hour and not every 2 hours. Option 2: Clients between 9 to 17 years of age require the renewal of restraining orders every 2 hours. Therefore, a 13-year-old client requires this intervention. Option 3: The client who is 18 years of age or older requires the renewal of restraining orders every 4 hours, not every 2 hours. Option 4: The adult client who is 35 years old requires the renewal of restraining orders every 4 hours, not every 2 hours.

Which describes an ethical dilemma?

A pregnant woman may miscarry if she takes a strong chemotherapy agent, but if she doesn't, her cancer will progress quickly. Both choices are undesirable. The client must be allowed to make the decision based on ethical principles.

A) LAW B) liability c) malpractice d) sources of law (4) e) constitution f) statute g) administrative law

A) A binding practice rule or code of conduct that guides appropriate actions and defensible decisions of an individual group B) Means that the person is financially or legally responsible for something C) One source of legal liability that means a professional person has failed to act in a responsible a prudent manner D) The constitution, statutes, administrative bodies, and the courts E) A system of fundamental laws and principles that describes the nations function and limits of government F) A law passed by the federal Congress or by a state legislative body G) Laws that govern the activities of administrative agencies

a) common law b) federal laws nurses should be aware of (6) c) HIPAA (3) d) health information technology for economic and clinical health act (HITECH act) e) emergency medical treatment and labor act (EMTALA) f) patient self determination act g) living will

A) A compilation of laws made by judges or courts and is based on common customs and traditions B) Bill of rights, health insurance portability and accountability act, health informational technology for economic and clinical health act, emergency medical treatment and labor act, patient self determination act, Americans with disabilities act C) Protect health insurance benefits for workers who lose or change their jobs; protect coverage to persons with pre-existing medical conditions; establish standards to protect the privacy of personal health information. d) Healthcare agencies are required to notify clients of breaches without unreasonable delay and by no longer than 60 days and it enhances enforcement provisions e) Requires healthcare facilities to provide emergency medical treatment to patients who seek healthcare in the emergency department, regardless of their ability to pay, legal statutes, or citizenship status f) Recognizes the clients right to make decisions regarding his own healthcare, based on the information provided to him by the healthcare provider, regarding the medical or surgical treatment options available, the benefits, risks, and alternatives g) Prepared by an alert and oriented individual and gives direction to others about the persons wishes regarding life prolonging treatments if he becomes unavailable to make those decisions

a) social justice b) value neutrality c) modes of value transmission (5) d) ethical/moral frameworks e) consequentialist f) utilitarianism g) principle of utility

A) Upholding moral, legal, and humanistic principles. Treating others fairly regardless of race, age, citizenship, economic status, disability, or sexual orientation. This values reflected in professional practice when the nurse works to ensure equal treatment under the law and equal access to Quality healthcare. B) This means that we attempt to understand our own values regarding an issue and to know when to put them aside, if necessary, to become non-judge mental when providing care to clients C) Modeling, moralizing, LAISSEZ-fAIRE, Reward and punishment, and responsible choice d) Systems of thought/theories that are The basis for the differing perspectives people have an ethical situations. They will not provide the right answer for what to do in a specific situation. They merely offer a lens through which you can examine an ethical problem e) The rightness or wrongness of an action depends on the consequences of the action rather than on the act itself f) The most familiar consequentialist theory, asserts that the value of an action is determined by its usefulness g) states that an act must result in the greatest good for the greatest number of people

what constitutes unprofessional conduct

Acting outside your scope of practice; accepting duties or responsibilities for which you are not prepared or competent; inaccurate recording, falsifying, or altering patient or agency records; causing intentional or careless physical abuse or harm to a client including unreasonable use of restraint, isolation, or medication; threatening or frightening patients; verbal abuse; sexual abuse, misconduct, or exploitation; violating the patient confidentiality; failing to take appropriate action to safeguard a patient from incompetent practice of another nurse; diverting drugs, supplies, or property of an any patient or agency; and using a false or assumed name or in personating another person license by the board

Question 8. While caring for a client with psychiatric illness, the nurse explores the client's activities and interests. Which ethical principle does the nurse follow through this assessment?

Autonomy Autonomy refers to the nurse's duty to respect the client's decision about the treatment.

Question 15. The nurse has educated a client and family members about exercising their legal rights during an unfavorable situation in a health-care facility. Which ethical principle has the nurse demonstrated?

Beneficence The nurse has demonstrated the ethical principle of beneficence. Educating the client and his or her family members about their rights is beneficial to the client.

transition management

Care coordination and transition management (CCTM) partners the health care team with patients and families to get the right care, at the right time, by the right provider. With CCTM, patients get help deciding which specialist to use, choosing where to go for care, and setting up appointments. They also get guidance about tests, procedures, medications, and follow-up care. You can find care transition manager jobs at hospitals, long-term care facilities, and assisted living facilities.

tips for avoiding malpractice

Client relationships: Develop open, honest, respectful, and caring relationships; maintain patient privacy and confidentiality; recognize problem clients. Professional interactions: don't blame or criticize other healthcare providers; don't make statements that may appear to be admission admission of guilt Client assessments: perform timely assessments and recognize significant assessment cues; Recognize significant assessment cues I notify primary care provider of changes; use the proper chain of command; and perform fall risk assessments. Documentation: careful, through documentation; document the time and content of telephone conversations with other healthcare providers; and send copies only. Competition practice: no and follow applicable laws; no and follow agency policies and procedures; no in follow it standards of care; stay competent in your area practice; and don't except an assignment that you think you are not competent to perform Medication administration: follow the rights of medication administration; and follow medical prescriptions

Care Management

Coordination of a plan or process to bring health services together as a common whole in a cost-effective way. Patient Care Managers usually work in healthcare facilities, including hospitals, medical offices, nursing homes, and clinics.

Which is a description of nurses being able to apply standards of ethical conduct to professional practice and participate in ethical decision making?

Ethical agency Ethical agency is the application of ethical principles to professional practice.

A client is placed under involuntary confinement for suicidal ideation. During this time, the nurse applies restraints to insert a urinary catheter. Which situation has occurred?

False imprisonment False imprisonment is the application of restraints without proper legal authorization.

What is one major drawback of applying the Golden Rule way of thinking when addressing a client's wishes?

It is presumptuous in that nursing actions may not really be what the client wants. Presuming the client would want to be treated the same way the nurse does can have significant clinical and ethical implications, as it causes health-care professionals and families to make decisions for the client that are, in reality, not what the client would want.

guidelines of advocacy

Keep the ethical principle of patient autonomy always in your mind; know and document the facts of the case; know the audience of those involved; have a sound base of support for your actions; form a coalition of allies; intervene high enough in the hierarchy to get the job done; demonstrate to the system how it is defeating its own goals; avoid getting into a power struggle if possible; be aware of client vulnerability; and have alternative actions

The primary health-care provider prescribes antipsychotic medications to a client with bipolar disorder. The client refuses to take the medication. The nurse does not administer the medication, but monitors the client for the presence of psychotic symptoms. What is the most beneficial ethical principle the nurse implements in this situation?

Nonmaleficence Nonmaleficence is the principle of doing no harm to the client, intentionally or unintentionally. In this case, the nurse monitors the client closely for the presence of psychotic symptoms. The nurse attempts to ensure the client's safety by not administering medications but instead by monitoring psychotic symptoms, which indicates that the client is implementing nonmaleficence in practice.

Question 11. The nurse finds that an agitated, psychotic client is at risk of violence directed towards himself and others. What is the priority nursing intervention in this situation? 1. Applying mechanical restraints to the client 2. Encouraging verbal communication with the client 3. Reporting to the police about the client's behavior 4. Informing the family member about the client's behavior

Option 2: The nurse encourages verbal communication with the client because it reduces hyperexcitability of the central nervous system and decreases agitation.

What is an appropriate nursing intervention for moral distress?

Self-manage emotions; discuss with mentor if you are having difficulty An intervention of self-management and working with a mentor is appropriate for a client who is experiencing moral distress.

Question 16. The nurse teaches measures to be followed by a family to reduce progression of mental illness in a client. During follow-up visits, the nurse finds that the client's condition is not improved after the treatment course. Which action of the nurse indicates effective practicing of ethical principles?

Telling the truth about the client's condition to the family Maintaining secrecy about the client's health condition can result in lack of trust in the client's family members. Therefore, the nurse should always tell the truth by implementing veracity effectively in the practice.

The provider prescribed Demerol 50 mg at 1400 as an initial dose for a post-operative client to be monitored for reactions and titrate accordingly every 3 to 4 hours prn for pain. The nurse documented the following: 1500Demerol 150 mg given intramuscularly. 1530R: 10 breaths/min; BP 98/62; skin pale.1600 Called provider. Prescription for naloxone (Narcan) 1 mg IV STAT1605 Narcan given as prescribed. R: 14 breaths/min, BP 112/68What important step could be called into question when reporting this incident?

The 30-minute delay in contacting the provider The standard of care would require that the provider be notified immediately, and a 30-minute delay could be detrimental to this client.

Question 9. Which term is used to refer to the personal beliefs of the nurse about what is important and desirable in a given situation?

Values Values refer to the personal beliefs of the nurse about what is important and desirable in a given situation.

A nurse suspects a colleague is taking a client's narcotics. The colleague has been behaving erratically at work and his or her clients complain of uncontrolled pain. The nurse reports this concern to the colleague's supervisor. Which is this an example of?

Whistleblowing Whistleblowing is done in response to moral outrage and recognizing an unsafe situation.

why should nurses study ethics (8)

You will frequently encounter ethical problems in your work Ethics is central to nursing Multi-disciplinary input is important Ethical knowledge is necessary for professional competence Ethical reasoning is necessary for nursing credibility among other disciplines Ethical proficiency is essential for providing holistic care Nurses have a responsibility to be advocates for patients Studying ethics will help you to make better decisions

a) elements required for good Samaritan laws (5) b) to ensure protection (4) c) nurse practice acts d) designed to (3) e) medical malpractice f) institutional policies and procedures g) ANA code of ethics for nurses

a) Care was provided in an emergency situation; person providing the care did not caused the emergency or injury; care was provided in a reasonable competent manner; care provided must be voluntary; person receiving care did not object to receiving care b) Call 911; do not leave the person; place the person under the care of emergency personnel or other as soon as possible; and do not accept money or other compensation. c) Statutory laws passed by each states legislative body that defined the practice of nursing d) Regulate nursing practice to protect the health safety and welfare of the general public; define the scope of nursing practice and; approve programs provide pre-licensure nursing education to students e) A lawsuit brought against a healthcare provider for damages when there has been death of, injury to, or other loss to the person being treated f) Usually are more specific and detailed than standards set by professional organizations and describe care that is reasonable, appropriate, and expected in the context of that facility g) Describes the standards of professional responsibility for nurses and provide insight into ethical and acceptable behavior along with nurses obligation for safe, compassionate, non-discriminatory, and quality care, while to finding commitments to self, the client, the employer, and the profession. It is not a law.

a) misdemeanor b) civil law c) contract law d) tort law e) quasi intentional tort f) essential elements (4) g) intentional torts

a) Compared with a felony, is a minor charge, involves less than a year in jail, and includes crimes such as assault, battery, and petty theft and often involves a loss of license b) Involves a dispute between individuals or entities. A settlement in civil law I can result in a guilty party paying a monetary charge. Two types: contract and tort c) Involves a written or oral agreement between two parties in which one party accepts an offer made by the other party to perform certain acts in exchange for something of value d) Deals with wrongs done to a person by another person that do not involve contracts. Three types: quasi-intentional, intentional, and unintentional e) Involve actions that injure a persons reputation. Overall, the result is defamation of character f) The communication was false, made it to another person or persons, caused the defamed person to experience shame and ridicule and had a negative impact on the persons reputation, include libel w written and slander with spoken. g) an action taken by one person with the intent to harm another person. Harm does not have to be violent, hostile, or cause a significant amount of pain or distress. Common in nursing: assault, battery, false imprisonment, and invasion of privacy

a) ethics commitees role (3) b) autonomy model is useful when? c) patient benifit model: for? by? d) social justice model focus? e) why is advocacy important? (5) f) how to improve ethical decisions making? (6)

a) Develop guidelines and policies, provide education and counseling, and, in the case of ethical dilemmas, review the case and provide a forum for the expression of the diverse perspectives of those involved b) Useful when the patient is competent to decide and emphasizes client autonomy and choice c) Assist in decision making for the incompetent patient by using substituted judgment d) This model focuses more on broad social issues involving the entire institution rather than on a single client issued e) you have special knowledge that the client does not have, your professional role include defending client autonomous decisions, you have a special relationship with clients, your role as an advocate is to inform support and communicate, and you should inform clients about advanced directives f) Use theoretical knowledge, use self knowledge, use practical knowledge, consult reliable sources, share, and evaluate

a) ANA code of ethics b) patient care partnership rights (3) c) values clarification d) behaviors indicating need for value clarification (4) x) steps of value clarification (3) e) first f) second g) third

a) Establishes the ethical standard for the profession and serves as a guide for nurses to use in ethical analysis and decision making b) Make their own decisions, be active partners in the treatment process, be treated with dignity and respect c) Refers to the process of becoming conscious of and naming one's values. It does not tell you what your values are to be; it merely helps you discover what they are. d) Ignoring the advice of a health professional, clients words not consistent with his actions, numerous admissions for the same problem, and uncertainty or confusion about which action to take. x) choosing/cognitive, prizing/effective, acting/behavioral e) Beliefs are chosen: freely, from alternatives, after considering all consequences f) Beliefs and behaviors that are chosen are prized: with pride, and with public affirmation g) Beliefs are acted on: by incorporating the choice into one's own behavior, with consistency and repetition

a) risk benifit analysis b) deontology c) similar princibles of deontology theories d) ethics of care nursing philosophy e) autonomy f) informed consent g) nurses role (2)

a) Evaluate every alternative action for its potential outcomes and then selecting the action that results in the most benefits for the greatest number of people involved in the situation b) Uses rules, principles, and standards to determine whether in action is right or wrong c) Rights and duties, treat people as ends and never as means, ethical rules and principles, the categorical imperative, and additional considerations (conflict of universal principles and evaluating motives) d) Directs attention to the specific situation of individual clients viewed within the context of their life narrative e) Refers to a persons right to choose an ability to act on that choice. f) The right of competent patients to decide whether to agree to a proposed treatment g) Verify that a patient understands and obtain their signature. The nurse should notify the provider if the patient does not understand the treatment before obtaining her signature.

a) massage the problem b) outline the options c) resolve the dilemma d) look back and evaluate e) good compramise f) things that are inheritly good in compramising g) rn obligations in ethical situations

a) First identify and defined the issues in the dilemma, and consider the values and options of all the major players, and then identify the informational gaps b) You should outline all of the options to all parties, including those that are less realistic and conflicting c) Now carefully review the issues and options. Apply basic ethical principles. If you can, also look at the situation using alternative ethical frameworks. I have a key for the past client and family and make sure everyone's viewpoint has been respected and considered d) The last phase calls for evaluation of the entire process, not just the consequences of the decided action e) One that preserve the integrity of all parties. Meaning that: the discussions are carried out in a spirit of mutual respect and the compromise solution itself is ethically sound f) First, it is never good to settle things by force; keeping peace on a nursing unit is good for both the nurses and clients; there is intrinsic good in taking part in a process in which we must try to see things from others point of you; keep in mind that most issues do contain room for reasonable differences of opinion; and a compromise may achieve mutual respect g) Be aware of and sensitive to issues, assume responsibility for your own ethical actions, function as a team member, support client and family members, support clients who are not being allowed to decide, use and participate in institutional ethics committees, most importantly, advocate for your client, and continually strive to improve your ethical decision making

a) durable power of attorney for health care b) nurses role in advanced care plan for EOL (4) c) americans w disabilities act d) disability e) state laws nurses should be aware of (4) f) mandatory reporting laws g) good Samaritan laws

a) Identifies a person who will make decisions in the event the patient is unable to do so b) Listen to patients to identify the concerns, expectations, and hopes regarding end-of-life care; review patients documented preferences upon admission to healthcare facilities; recognize that advance care planning is a continual process and not a one time execution of documents; and encourage patient and family participation in healthcare decisions about advance directives and end-of-life decisions. c) Provides protection against discrimination of individuals with disabilities. Employers must provide reasonable accommodations within the work setting to allow employees with disabilities to perform their jobs d) A physical or mental impairment that substantially limits One or more major life activity, has a record of such impairment, or is regarded as having an impairment e) Mandatory reporting laws, good Samaritan laws, nurse practice act, and medical malpractice statutes f) The requirement that healthcare workers report communicable diseases, physical, sexual, or emotional abuse or neglect of vulnerable individuals such as children, older adults, or mentally ill; whether you suspect it or have actual evidence of it. Protection is also given for reporting abuse. g) Designed to protect from liability those who provide emergency care to someone who is in need of medical services

a) ACT b) THINK c) societal factors that lead to ethical problems (4) d) the nature of nursing work that lead to ethical problems (2) e) the nature of the nursing profession that leads to ethical problems (4) f) what factors affect ethical decisions (5) g) Kholbergs stage I

a) Immediately reporting situations that involve an immediate threat to the health, safety, and well-being of others b) Talk with an attorney or other legal representative; have concrete and credible evidence of the violation or wrongdoing; institute a survival plan if you're Job is put in jeopardy where you are fired; note the nature and consequences of the problem and weigh the risks and benefits; Know your reporting options and support systems that can correct the problems c) Increased consumer awareness, technological advances, multicultural population, and cost containment d) Nurses ethical problems, and nurses unique position in healthcare organizations (employees, professionals, lower status on power hierarchy) e) Caring versus time spent with clients, autonomy versus escaping hard choices, higher pay versus cost effectiveness, And professionalism versus caring f) Developmental stages, values, ethical frameworks, ethical principles, and professional guidelines G )Moral reasoning is based on personal interest and avoiding punishment

a) vicarious liability? ex? (3) b) litigation c) negotiation d) mediation e) arbitration f) potential boundary violations between nurse and client (6)

a) In certain circumstances, the law will assign liability to a person or entity that did not directly caused the injury, but with whom you have a specific kind of relationship. Examples: captain of the ship (surgical suite situations), Borrowed servant doctrine (Agency nurse), and respondent superior (The employer must answer for the negligent act or omission of its employees) b) The formal process where in the legal issues, rights, and duties between the parties are heard and decided c) Takes place informally between the lawyers for the plaintiff and the defendant in an attempt to settle the case prior to trial d) The attempt to resolve the dispute using a neutral third-party. The primary role of the mediator is to help the parties focus on issues and to facilitate communication to identify what is needed to reach a resolution e) Involves a third-party making a decision after formally hearing the evidence and information from both parties f) Excessive self disclosure; flirtation; secretive behavior; super nurse attitude; excessive attention to client; and unclear communication.

a) special cases of licensure (2) b) LPN scope (3) c) what is the process of disciplinary action d) credentialing e) accredited f) criminal law is? levels? g) felony

a) Mutual recognition model/multi state licensure contract and government/military personnel b) Limited in assessment privileges and interpretation of clinical data. They do not have authority to alter nursing care plans. c) A complaint from someone that the nurse has engaged and unprofessional conduct; which is then assigned to a investigator to determine its legitimacy or validity; if legitimate, the investigator gathers more info; the case then maybe Heard by the board of nursing to decide if a violation occurred and punishment; you can appeal your case if you are not satisfied; and you always have the right to have an attorney present. d) A form of self-regulation which includes accreditation and certification e) Ensure students receive education that meets the minimum standard for quality client care. f) Deals with wrongs or offenses against society that may result in prosecution. Two levels: misdemeanor and felony g) A crime punishable by more than one year in jail for example murder, assisted suicide, rape/sexual assault, stealing drugs, and equipment, felony abuse

a) assalt b) battery c) assalt and battery d) false imprisonment e) AMA f) invasion of privacy g) fraud

a) Occurs when a nurse intentionally places a client in immediate fear of personal violence or offensive contact. Must include: words expressing and intention to cause harm and some type of action. b) Committed when an offensive or harmful physical contact is made to the client without his consent, or there is unauthorized touching of a persons body by another person. c) Occurs when there is the intent to cause a person, combined with an offensive or harmful contact d) The restraining of a person without proper legal authorization. Includes any type of unjustified restriction of a persons freedom of movement. e) To leave AMA the client must be given information of the risks associated with leaving and given the choice to stay and receive treatment or to sign out AMA. f) involves a person's right to be left alone and this law recognizes that a persons personal life should not be opened up for public scrutiny and the person has the right to freedom from unwanted interference in a private affairs. g) The false representation of significant fact by words or by conduct

a) Kholbergs stage II b) Kholbergs stage III c) values d) characteristics of values (6) e) value set f) value system g) attitudes

a) Principles focus on pleasing others and following rules b) Moral principles are based on universal and impartial principles of justice. This is the final level; it occurs in adulthood c) the beliefs you have about the worth of some thing; it serves as a principal or a standard that influences your decision making d) Highly prized, expressed through behaviors and feelings, begin to emerge shortly after birth and continue throughout life, total number of values a person has is usually small, highly individualized, and can vary and change with new experiences and thoughtful consideration. e) Your list of values, giving you direction for your life and forms a basis for behavior f) Youre value set ranked from most important to least important g) Mental dispositions or feelings toward a person, object, or idea and our way of responding to situations or things

a) morals b) ethics c) moral behavior d) what is not ethics e) bioethics f) nursing ethics g) advocacy

a) Refers to private personal or group standards of right and wrong b) Answers the question, what should I do in a given situation and is the study of a system of moral principles and standards, or the process of using them to decide your conduct and actions c) Behavior that is consistent with customs or traditions based on external influence, such as religious beliefs, d) Ethics is not the same as law, religion, institutional practices, or customs. An action that is legal or customary may not be morally right or ethically justifiable e) Refers to the application of ethical principles to every aspect of healthcare and is concerned with every area of healthcare f) A subset of bio ethics referring to ethical questions that arise out of nursing practice g) The communication and defense of the rights and interests of another and includes protecting patients legal or moral rights

a) partient care partnership (replaced? provides? which are? (6) ) b) nurses bill of rights c) ANA standards of practice proffesional... d) standards of care e) performance standards f) guidelines g) what does a state nurse practice act usually include? (5)

a) Replaced the aha bill of rights; And it provides information that patient should expect: high-quality care, a clean and safe environment, involvement in care, protection of privacy, help when leaving the hospital, and help with billing claims b) A policy statement adopted by the ANA to identify seven conditions the nurses should expect from their workplace that are necessary for sound professional practice c) Professional standards of care, professional performance standards, good practice guidelines d) Incorporates the nursing process in the diagnostic, interventional, and evaluation aspects of client care e) Identifies the various role functions of the nurse in direct client care, quality of practice, ethics, education, communication, research, leader ship, collaboration, resource management, and environmental health f) For the various specialty areas that are developed by professional organizations g) The authority of the board of nursing, it's composition, and powers; the definition of nursing and the boundaries of nursing practice; standards for the approval of nursing education programs; requirements for licensure of nurses; and grounds for disciplinary action against a nurses license

a) clients that UAP/LPN should not care for (4) b) sexual harrassment c) safe harbor laws d) signs of potential chemical dependence in the workplace (9) e) occurrence type insurance f) claims made insurance

a) Require complex care, are unpredictable, require nursing judgment, and involve a high level of interaction b) Involves the use of power over people lower in the power structure of the organization. Defined as unwelcome sexual advances, requests for sexual favors, and other verbal or physical conduct of a sexual nature c) Found in the nurse practice act or other state laws, and provide for exceptions to certain laws. They protect you from being suspended, terminated, disciplined, or discriminated against for refusing to do or not do something you believe would be harmful to a client d) Absenteeism, absent on the job, difficulty concentrating, inconsistent work patterns, physical or emotional problems, decreased efficiency, poor relationships on the job, medication centered problems, and personal life interferes with job e) Most often recommended for nurses, because this policy covers malpractice claims for any injury or damage that occurred during the time the policy was in force, regardless of when the claim was reported and the lawsuit occurred f) Covers only those claims in which the neglected action or omission occurred and the claim was filed or reported during the policy Period.

a) beliefs b) how are values made and how they are r/t ethics c) personal value system d) altruism e) autonomy f) human dignity g) integrity

a) Something that one accepts as true: sometimes based on faith or facts, true or false, alterable by acquiring knowledge and experiences, and may or may not involve values b) Values and morals are learned in conscious and unconscious ways and become a part of your make up; your values shape the manner in which you make ethical decisions in your nursing practice. c) A set of values that you have reflected on and chosen that will help you to lead a good life D) Concern for the welfare and well-being of others. Altruism is reflected by the nurses concern for the welfare of patients, other nurses, and other healthcare providers. Includes patient advocacy. E) The right to self determination to choose and act on that choice. Every competent person has a right to decide his own course of action. F) Respect for the inherent worth and uniqueness of individuals and populations G) Acting in accordance with an appropriate code of ethics and acceptance standards of practice. Includes honesty.

a) privacy and confidentiality b) nonmaleficence c) respect for dignity d) benificence e) paternalism f) fidelity g) veracity

a) Support the principle of autonomy. An autonomous person has control over the collection of, use of, and access to her personal information b) The twofold duty to do no harm and to prevent harm c) Refers to the nurses respect for the intrinsic worth of a person, regardless of age, race, religion, medical condition, or any other factor d) The duty to do good or promote good. Do no harm, prevent harm, remove harm, and bring about positive good e) Can be viewed by some as beneficence but can have negative outcomes due to treating others like children f) The duty to keep promises regardless of the level of importance g) The duty to tell the truth

a) moral or ethical agency for nurses b) an ethical agent must be able to do what? (5) c) moral distress d) moral outrage e) impaired nurisng practice f) what are some sources of ethical problems for nurses (3) g) wistleblower

a) The ability to base their practice on professional standards of ethical conduct and to participate in ethical decision making b) Perceive the difference between right and wrong; understand abstract ethical principles; reason and apply ethical principles to make decisions, weigh alternatives, and plan sound ways to achieve goals; decide and choose freely; and act according to choice c) When situational constraints prevent nurses from acting on their moral decisions and occurs when nurses are unable to act as moral agents d) This is experienced when nurses perceive that others are behaving immoraly. It is similar to moral distress, except that nurses do not participate in the act, They are not responsible for doing wrong, but they are powerless to prevent others from doing so e) Occurs when the nurses ability to perform the essential nursing functions is diminished by chemical dependence on drugs or alcohol or by mental illness f) Societal factors, the nature of nursing work, and the nature of the nursing profession itself g) A person who reveals information about practices of others that are perceived as wrong, fraudulent, corrupt, illegal, or a detriment to the health, safety, and welfare of the clients they serve

a) care coordination b) purpose of case management c) transition management

a) The deliberate organization of and communication about patient care activities between two or more members of the healthcare team to facilitate appropriate and continuous healthcare to meet the patient's needs b) Case management process is to provide quality and cost effective services and resources to achieve positive patient outcomes. The case manager coordinate inpatient and community-based care before discharge from the hospital or other facility c) Involves safe and seamless movement of patients among healthcare settings, healthcare providers, and the community for ongoing care to meet patient needs

a) unintentional torts b) negligence c) malpractice d) four elements e) duty f) breach of duty g) causation

a) The most common types are negligence or malpractice b) The failure to use ordinary or reasonable care or the failure to act in a responsible and prudent manner c) Similar to negligence, but applies only to professionals, such as nurses and physicians. Defined as the failure of a professional person to act in a responsible and prudent manner. d) Duty, breach of duty, causation, and damages to prove preponderance of evidence e) Formed when the client is assigned to the nurse or seek treatment from the nurse, or when the nurse observes another person doing something that could cause harm to the client f) Occurs when the nurse fails to meet standards of care g) Established based on testimony of experts who can clearly show the connection between the nurses action or omission and the resulting client injury

case management

optimizes self-care capabilities of individuals and families and the capacity of systems and communities to coordinate and provide services. Case managers today work in a broad range of specialties including healthcare, addictions, aging, disabilities, child welfare, mental health, long-term care, HIV/AIDS, occupational services, and refugee and immigrant services.

a) justice b) distributive justice c) compensatory justice d) procedural justice e) proffesional code of ethics f) purpose of a nursing code of ethics (6) g) ICN code of ethics

a) The obligation to be fair. It implies equal treatment of all clients b) Requires fair distribution of both benefits and burdens c) Focuses on making amends for wrongs that have been done to individuals or groups d) This is important in processes that require ranking or ordering e) Formal statements of a groups expectations and standards for professional behavior generally excepted by members of the profession f) Inform the public about the professions minimum standards; demonstrate nurses commitment to the public; outline major ethical considerations of nursing; provide general guidelines for professional behavior; guided professions self regulating functions; reminds us of the special responsibility we assume in caring for the sick g) A guide for action based on social values and needs and serves as the standard for nurses worldwide. It stresses respect for human rights, including cultural rights, the right to life and choice, the right to dignity and the right to be treated with respect

A) how to minimize malpractice risk (12) *POP MONO-DRAMA* b) FACTUAL (documenting) c) incident report d) elements of informed consent (4) e) nurses role (4)

a) Use the nursing process and follow professional standards of care, avoid medication and treatment errors, report and document, obtain informed consent, maintain patient safety, maintain patient confidentiality and privacy, provide education and counseling, delegate according to guidelines, accept assignments for which you are qualified, Participate in continuing education, observe professional boundaries, observe mandatory reporting regulations b) Your information must be factual and objective: Don't document your opinions; you must be accurate: for example, record the vital signs accurately; your information must be complete: Don't omit any important information; you must be timely: document care as soon as possible after doing it; don't wait until the end of your shift and then try to remember everything that happened; you must always document unusual occurrences; you must document you're assessment data and the plan of care; remember the clients chart is a legal record and is subpoenaed in a malpractice case c) If a standard of care is breached or an unusual incident occurs, this needs to be completed. The goal is to prevent the incidence from occurring again. Do not write anything about incidence reports in the patient record. d) Completeness, clarity and comprehension, voluntariness, and competence e) You may *witness a client signature on a consent form*, but you are not legally responsible for explaining the treatments and options, or for evaluating whether the provider has adequately explain to them. You must, however *determine that the elements of a valid informed consent are in place*, *communicate the client needs for more information to a care provider*, and *provide feedback if the client wishes to change her consent*

a) how can i recognize ethical issues? (6) b) ethical dilemma c) true dilemma d) model for ethical problem solving e) how to work through an ethical problem (3) f) the first step in ethical decision making: using problem solving g) MORAL

a) there is usually conflict about the right action to take, between the duties and obligation of healthcare professionals, between the needs and interests of a individual and a group of clients, between the family wants and what the client wants or needs, between the family and health professionals, between ethical principles or values b) A situation in which a choice must be made between two equally undesirable actions. There is no right or wrong option c) Only problem is that pose a question between competing and equally valuable interests are true dilemmas d) MORAL model e) First, use problem-solving; next, use the MORAL model; and Look for a good compromise f) Assessment: what are the relevant facts? Analysis/diagnosis: identify the problem; state the conflict g) Massage the dilemma, outline the options, resolve the dilemma, act by applying the chosen option, and look back and evaluate

care coordination

coordination of services provided to patients before they enter a health care setting, during the time they are in the setting, and after they leave the setting The role is most commonly associated with hospital settings, but many large medical practices now have care coordinators to help patients navigate their follow-up and post-treatment options.

guidelines for documentation

uDocument immediately, or ASAP uNever chart ahead uChart Chronologically uDesignate late entries uInterventions - Make sure you document symptom AND what you did about it uTeaching uAttempts to contact MD uDischarge or AMA uDocument Refusal of treatment or medications uUse of restraints uComplete medication documentation - 6 rights uAccurate, objective, non-judgmental uAvoid vague, subjective terms uApproved Abbreviations only uIf information is critical and it is what someone else said, "USE quotes"

Rights of patient given by PSD act (5) *AFIRE*

uRight to appropriate treatment u uRight to individualized treatment plan u uRight to exercise decisions without reprisal u uRight to file grievances u uRight to referral after discharge