NUR 300 Quiz 1 ch 1

RN education

-Completion of either an associate or baccalaureate degree program. Graduates of each program are eligible to take the NCLEX to become RNs in the state in which they will also practice. -Associates degree is a 2-year program usually offered at universities or community colleges and focuses on basic sciences and theoretical and clinical courses related to the practice of nursing -Baccalaureate degree is usually 4 years of study in college or university. Focuses on the basic sciences, theoretical and clinical courses, and courses in social sciences, arts, and humanities in support of nursing theory.

Medically undeserved and nursing

Unemployment, underemployment, low-paying jobs, mental illness, homelessness, and rising health care costs contribute to increases in medically undeserved populations. Number of home-based palliative care services who are undeserved is increasing because high cost. Some opt out of care all together.

Interventions for compassion fatigue

agency-based programs that allow nurses to talk and cope with their difficulties.

Nursing novice

beginning nursing student or any nurse entering a situation in which there is no previous level of experience (ex. an experienced operating room nurse chooses to now practice in home health) The learner learns via a specific set of rules or procedures which are usually step-wise and linear.

Certification

beyond NCLEX nurses may choose to work toward specific certification in an area of nursing practice. After passing initial certification must maintain certification by ongoing continuing education and clinical or administrative practice.

Professional organization

deals with the issues of concern to those practicing in the profession. Educational organizations and specialty organizations. Organizations seek to improve standards of practice, expand nursing roles, and foster the welfare of nurses within the specialty areas. Present educational programs and publish journals.

Compassion fatigue

describes a state of burnout and secondary stress. It occurs without warning and often results from giving high levels of energy and compassion over a prolonged period to those who are suffering.

Clara Barton

founder of the American Red Cross, tended soldiers on the battlefields, cleansing their wounds, meeting their basic need and comforting them in death.

Harriet Tubman

helped in underground railroad and led over 300 slaves to freedom.

Secondary traumatic stress

the trauma that health care providers experience when witnessing and caring for other suffering trauma.

American Nursing Association's (ANA) definition of nursing

*illustrates the consistent commitment of nurses to provide care and promotes well-being of their patients and communities.* Nursing is the protection, promotion, and optimization of health and abilities; prevention of illness and injury, alleviation of suffering through the diagnosis and treatment of human response; and advocacy in the care of individuals, families, communities, and populations.

Contemporary nursing requires that the nurse has knowledge and skills for a variety of professional roles and responsibilities. Which of the following are examples? (select all that apply) 1. Caregiver 2. Autonomy and accountability 3. Patient advocate 4. Health Promotion 5. Lobbyist

1, 2, 3, 4

Health care reform bring changes in the emphasis of care. Which of the following models is expected from health care reform? 1. Moving from an acute illness to a health promotion, illness prevention model 2. Moving from an illness prevention to a health promotion model 3.Moving from an acute illness to a disease management model 4. Moving from a chronic care to an illness prevention model

1.

Standards of Nursing Practice (Nursing Process)

1. Assessment- The registered nurse collects comprehensive data pertinent to the patient's health and/or the situation 2. Diagnosis-The registered nurse analyzes the assessment data to determine the diagnoses or issues. 3. Outcome Identification- The registered nurse identifies expected outcomes for a plan individualized to the patient or the situation. 4. Planning- The registered nurse develops a plan that prescribes strategies and alternatives to attain expected outcomes. 5.Implementation- The registered nurse implements the identified plan. A. Coordination of Care: The registered nurse coordinates care deliveries B. Health Teaching and Health Promotion: The registered nurse uses strategies to promote health and a safe environment C. Consultation: The graduate level-prepared specialty nurse or advanced practice registered nurse provides consultation to influence the identified plan, enhance the abilities of others, and effect change. D. Prescription Authority and Treatment: The advanced practice nurse uses prescriptive authority, procedures, referrals, treatment, and therapies in accordance with state and federal laws and regulations. 6.Evaluation - The registered nurse evaluates progress toward attainment of outcomes

Professional Responsibilities and Roles

1. Autonomy and Accountability- Autonomy involves the initiation of independent nursing interventions without medical orders. Accountability: with increased autonomy comes increased accountability; a nurse is responsible professionally and legally for the type and quality of nursing care provided. A nurse must remain CURRENT and COMPETENT in nursing and scientific knowledge and technical skills. 2. Caregiver- A nurse helps a patient maintain and regain health, manage disease and symptoms, and attain maximal level of function and independence through the healing process. Must meet all health care needs (emotional, spiritual, social, physical, environmental, and intellectual. Set realistic goals and meet them. 3. Advocate- Nurse is patient advocate; protect's their legal and human rights and provides assistance in supporting these rights. (i.e. explain the treatment to patient, use an interpreter to make sure they understand, defend patient's rights by speaking against policies or actions that conflict patient's rights) 4. Educator- Explain concepts and facts about health, reasons for routine care activities, demonstrate procedure like self-care, evaluate patient's progress in learning. Teaching methods match patient's capabilities and needs and incorporate w/ resources (i.e. family) in teaching plans. 5. Communicator- central to nurse-patient relationship and meeting the needs of the patient, family, and community. Know your patient's strengths, weaknesses, and needs. Communicate with patients and families. other nurses and health care professionals, resource people, and community. 6. Manager- Need to manage collaborative-patient centered care to provide safe, quality care with positive patient outcomes. A manager coordinates the activities of members of the nursing staff in delivering nursing care and has personnel, policy, and budgetary responsibility for specific unit or agency.

The nurse spends time with the patient and family reviewing the dressing change procedure for the patient's wound. The patient's spouse demonstrates how to change the dressing. The nurse is acting in which professional role? 1. Educator 2. Advocate 3. Caregiver 4. Case manager

1. Educator

Nursing Scope and Standards of Professional Performance

1. Ethics- The registered nurse practices ethically 2. Education-The registered nurse attains knowledge and competency that reflects current nursing practice 3. Evidence-Based Practice and Research-The registered nurse integrates evidence and research findings into practice 4. Quality of Practice-The registered nurse contributes to quality nursing practice 5. Communication-The registered nurse communicates effectively in all areas of practice 6.Leadership-Demonstrates leadership in the professional practice setting and the profession 7. Collaboration-Collaborates with health care consumer, family, and others in the conduct of nursing practice. 8. Professional Practice Evaluation- The registered nurse evaluates her or his own nursing practice in relation to professional practice standards and guidelines, relevant statutes, rules and regulations. 9. Resources-Uses appropriate resources to plan and provide nursing services that are safe, effective and financially responsible. 10. Environmental Health- The registered nurse practices in an environmentally safe and healthy manner.

which of the following internet resources can help consumers compare quality care measures? (select all that apply) 1. WedMD 2. Hospital Compare 3. Magnet recognition program 4. hospital consumer assessment of healthcare 5. the american hospital assocation's web page

2, 4

A nurse is caring for a patient with end-stage lung disease. The patient wants to go home on oxygen and be comfortable. The family wants the patient to have a new surgical procedure. The nurse explains the risk and benefits of the surgery to the family and discusses the patient's wishes with them. The nurse is acting as the patient's 1. Educator 2.Advocate 3. Caregiver 4. Case manager

2. Advocate

An 18-year-old woman is in the emergency department with fever and cough. The nurse obtains her vital signs, listens to her lung and heart sounds, determines her level of comfort, and collects blood and sputum samples for analysis. Which standard of practice is performed? 1. Diagnosis 2.Evaluation 3. Assessment 4. Implementation

3. Assessment

A nurse meets with the registered dietitian and physical therapist to develop a plan of care that focuses on improving nutrition and mobility for the patient. This is an example of which Quality and Safety in the Education of Nurses (QSEN) competency? 1.Patient-centered care 2. Saftey 3. Teamwork and collabortation 4. Infromatics

3. Teamwork and collaboration

Nurses in an acute care hostpial are attending a unit-based education program to learn how to use a new pressure-relieving device for patients at risk for pressure ulcers. This is which type of education? a. Continuing education b. graduate education c. in-service education d. professional registered nurse education

3. in service education

You are preparing a presentation for your classmates regarding the clinical care coordination conference for a patient with terminal cancer. As part of the preparation you have your classmates read the Nursing Code of Ethics for Professional Registered Nurses. Your instructor asks the class why this document is important. 1. Improves self-health care 2. Protects the patient's confidentiality 3. Ensures identical care to all patients 4. Defines the principles of right and wrong to provide patient care

4. Defines the principles of right and wrong to provide patient care

A patient in the emergency department has developed wheezing and shortness of breath. The nurse gives the ordered medicated nebulizer treatment now and in 4 hours. Which standard of practice is performed? 1.Planning 2. Evaluation 3. Assessment 4. Implementation

4. Implementation

A critical care nurse is using a computerized decision support system to correctly position her ventilated patients to reduce pneumonia caused by accumulated respiratory secretions. This is an example of which QSEN competency? 2. Saftey 3. Teamwork and collabortation 4. Infromatics

4. Infromatics

The examination for register nurses liscensure is exactly the same in every state. This examination 1. Guarantees safe nursing care for all patients 2. Ensures standard nursing care for all patients 3. Ensures that honest ethical care is provided 4. Provides a minimal standard of knowledge for an RN in practice

4. Provides a minimal standard of knowledge for an EN in practice

The nurses on an acute care medical floor notice an increase in pressure ulcer formation in their patients. A nurse consultant decides to compare two types of treatment. The first is the procedure currently used to assess for pressure ulcer risk. The second uses a new assessment instrument to identify at-risk patients. Given this information, the nurse consultant exemplifies which career? 1. Clinical nurse specialist 2. Nurse administor 3. Nurse educator 4. Nurse researcher

4. nurse researcher

competent

A nurse who has been in the same clinical position for 2-3 years. This nurse understands the organization and specific care required by this type of patients (ex. oncology, surgical, orthopedic). He/she is competent practitioner who is able to anticipate nursing care and establish long-range goals. In this phase the nurse has usually had experience with all types of psycho-motor skills required by this specific group of patients.

Nursing Advanced-Beginner

A nurse who has had some level of experience with the situation. This experience may only be observational in nature, but the nurse is able to identify meaningful aspects or principles of nursing care

Expert

A nurse with diverse experience who has an intuitive grasp of an existing or potential clinical problem. This nurse is able to zero in on the problem and focus on multiple dimensions of the situation. He/she is skilled at identifying both patient-centered problems and problems related to the health care system or perhaps the needs of the novice nurse.

proficent

A nurse with more than 2-3 years of experience in the same clinical position. The nurse perceives a patient's clinical situation as a whole, is able to assess an entire situation, and can readily transfer knowledge gained from multiple previous experiences to a situation. This nurse focuses on managing care as opposed to managing performing skills.

Nurse-midwife a. Provides independent care, including pregnancy and gynecological services. b. Expert clinician in a specialized practice such as adult diabetes care c. provides comprehensive care, usually in a primary care setting, directly managing the medical care of patients who are healthy or have chronic conditions d. provides care and services under the supervision of an anesthesiologist

A.

ACA and changes and nursing

Affordable Care Act- how care is paid for and delivered. Greater influence on health promotion, disease prevention, and illness management in the future. How and where nursing care is provided-more nursing in community-based settings.

ANA

American nursing association

Clinical nurse specialist a. Provides independent care, including pregnancy and gynecological services. b. Expert clinician in a specialized practice such as adult diabetes care c. provides comprehensive care, usually in a primary care setting, directly managing the medical care of patients who are healthy or have chronic conditions d. provides care and services under the supervision of an anesthesiologist

B.

Nurse practitioner a. Provides independent care, including pregnancy and gynecological services. b. Expert clinician in a specialized practice such as adult diabetes care c. provides comprehensive care, usually in a primary care setting, directly managing the medical care of patients who are healthy or have chronic conditions d. provides care and services under the supervision of an anesthesiologist

C.

Nursing in the 21st Century

Changing needs of society- aging population, bio-terrorism, emerging infections, and disaster management. Advances in technology and informatics, high knowledge of patients, and early discharge from health care institutions require nurses in all settings to have a strong current knowledge base from which to practice. Nursing organizations involved in programs to support nursing scholars, decrease nurse shortage, and improve the health of the nation's population. Nursing taking a leadership role in developing standards and policies to address the needs of the population now and in the future.

Demographic changes and nursing

Continuing rise in population with most of population over 65 years old. Requires expanded health care resources. Population shifting from rural to urban areas and more people living with chronic and long-term illness.

Nurse anesthetist a. Provides independent care, including pregnancy and gynecological services. b. Expert clinician in a specialized practice such as adult diabetes care c. provides comprehensive care, usually in a primary care setting, directly managing the medical care of patients who are healthy or have chronic conditions d. provides care and services under the supervision of an anesthesiologist

D.

Lillian Wald and Mary Brewster

Expansion of nursing in the community. opened the Henry Street Settlement, which focused on the health needs of the poor people who lived in tenements in NYC

Florence Nightingale Historical Influence

First practicing epidemiologist. Poor sanitation connected to diseases. Established first nursing philosophy based on health maintenance and restoration. Saw the role of nursing as having "charge of somebody's heath" based on the knowledge of "how to put the body in such a state to be free of disease or to recover from disease". Developed the first organized program for training nurses.

Mary Mahoney

First professionally trained African American nurse. Brought forth an awareness of cultural diversity and respect for the individual, regardless of background, race, color, or religion.

Continuing and in-service education

Formal organized education programs offered by universities, hospitals, and nursing organizations. Maintain current nursing skills, gain new knowledge and theory, and obtain skills reflecting changes in the health care delivery system. Can specialize in a particular area of practice. In some states continuing education is required for some RNs to keep their licences. In service training: are training programs employed by their institution

Nursing in the 20th Century

Movement towards scientific, research-based practice and defined body of knowledge. Nurses assumed expanded and advanced practice roles.

Lisencsure

Must pass NCLEX in all states. Standardized throughout states.

NSNA

National Student Nursing Association

Impact of emerging technologies

Need to use technology to facilitate mobility, communication, and relationships. Need to develop an expertise to acquire and distribute knowledge. Understand and use genomics (the study of all the genes in a person and interactions of these genes with on another and with that person's environment).

NPAs

Nursing Practice Acts. Varies from state to state but most are similar. Establish specific legal regulations for practice overseen by the State Boards of Nursing. Include education, licensure and training requirements

International Council of Nurses (ICN) definition of nursing

Nursing encompasses autonomous and collaborative care of individuals of all ages, families, groups, and communities, sick or well, and in all settings. Nursing includes the promotion of health; prevention of illness; and the care of ill, disabled, and dying people. Advocacy, promotion of a safe environment, research, participation in shaping health policy and in patient and health systems management, and education are also key nursing roles.

Mother Bickerdyke

Organized ambulance services and walked abandoned battlefields at night looking for wounded soldiers

Evidence-based practice

Practice needs to be based on current evidence, not just according to your education and experiences and the policies and procedures of health care facilities. A component of excellence in practice is quality of care, which is achieved by implementing evidence-based practice.

Quality and Safety Education for Nurses

QSEN Competencies of patient-centered care, teamwork and collaboration, evidence-based practice, quality improvement, safety, and infromatics. For each competency there are targeted knowledge, skills, and attitudes (KSAs). -Patient-centered care: patient or designee as source of control and full partner in providing compassionate and coordinated care based on respect of patient's preferences, values, and needs. -Teamwork and Collaboration- function effectively within nursing and inter-professional team to achieve quality patient care. -Evidence-Based Practice- integrate best current evidence with clinical expertise and patient/family preferences and values for delivery of optimal health. -Quality improvement- use data to monitor the outcomes of care processes and use improvement methods to design and test changes to continuously improve the quality and safety of health care systems. -Safety- Minimize risk of harm to patients and providers through both system effectiveness and individual performance. -Infromatics- use info and technology to communicate, manage knowledge, mitigate knowledge and support decision making.

Nursing as art

Quality care you provide to your patient

Importance of Self Care

You cannot give quality care if you feel depleted yourself. Risk for Compassion fatigue, Secondary traumatic stress, burnout.

Nursing as a science

nursing practice is based on a body of knowledge that is continually changing with new discoveries and innovations

Burnout

perceived demands outweigh perceived resources. A state of physical and mental exhaustion. Emotional exhaustion (irritable, restless, and unable to focus and engage with patients). Often occurs with little social support, organizational pressures influencing staffing, and inability of nurse to practice self-care. Compassion fatigue.

Master's degree in nursing

required to have bachelors before. Provides strong skills in nursing science and theory. Emphasizes advance knowledge in basic sciences and research-based clinical practice. Required of an APRN, nurse educator, and nurse administer.

lateral violence

sometimes in nurse-nurse interactions: includes withholding information, making snide remarks, and demonstrating nonverbal expression of disapproval. New grads and nurses new to unit most likely to experience this.

Genomics

study of all the genes of the person and how they interact with that person's environment