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206 Cards in this Set
- Front
- Back
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What are Florence Nightengale's contributions to nursing? |
1. Established hospital management standards 2. Nursing education 3. Nutrition important to health 4. Records maintenance |
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What was nursing like in the 19th - 21st Centuries? |
1. Schools w/hospitals ("apprenticeships") 2. WWII - more nurses in field; emphasis on education |
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What is ANA and what does it do? |
American Nurses' Association; Standards of Practice, lobbying, education |
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What is NLN and what does it do? |
primary source of research data re: nursing education |
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What is AACN and what does it do? |
American Association of Colleges of Nursing; Voice for higher nursing ed, quality education standards |
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NCLEX |
National Council Licensure Examination |
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APRN |
Advanced Practice RN |
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ICN |
International Council of Nurses |
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NSNA |
National Student Nurses Association |
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QSEN |
Quality & Safety Education for Nursing |
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What are the Nurse Practice Acts? |
State regulations on nursing |
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What are the six steps of the Nursing Process? |
1. Assess 2. Diagnose 3. Outcome Identification 4. Planning 5. Implementation 6. Evaluation |
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What are the eight nursing roles? |
1. Caregiver (primary role) 2. Communicator 3. Teacher/educator 4. Counselor 5. Leader 6. Researcher 7. Advocate 8. Collaborator |
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General Systems Theory |
Breaks whole into parts to learn how the parts work together |
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Adaptation Theory |
Adjustment of living things to other living things and environmental conditions |
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Developmental Theory |
Process of growth and development; definite stages, but progress and behaviors unique to each individual |
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What is Erik Erikson's Psychosocial Developmental Theory based on? |
How individuals learn to interact with the world (based on age) |
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What is Maslow's Theory of Human Needs based on? |
Physical and psychosocial needs (not age) |
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What are the types of quantitative research? |
1. Descriptive (explore, describe, no prior research) 2. Correlational (type & degree of relationship) 3. Quasi-experimental (cause & effect; clinical setting) 4. Experimental (highly controlled, lab setting) |
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What are the types of qualitative research? |
1. Phenomenology (experiences lived by the subject) 2. Grounded Theory (how people describe own reality and how beliefs related to their actions) 3. Ethnography (issues of a certain culture) 4. Historical (review past to increase understanding today) |
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What is PICO? |
Format in which to ask clinical questions: P = Patient, population, problem I = Intervention C = Comparison O = Outcome |
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What is Morbidity? |
How frequently a disease occurs |
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What is Mortality |
Number of deaths resulting from a certain disease |
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What is illness? |
Response of a person to a disease |
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What are the six human dimensions? |
1. Physical 2. Emotional 3. Intellectual 4. Spiritual 5. Environmental 6. Sociocultural |
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Primary Health Promotion |
Focus on people/groups; *teaching* |
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Secondary Health Promotion |
Screening for early detection; *screening* |
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Tertiary Health Promotion |
Begins after diagnosis & treatment; goal is to decrease disability and increase rehabilitation |
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What are the three components of the Health Belief Model? |
1. Perceived susceptibility to disease 2. Perceived seriousness of disease 3. Perceived benefit of action |
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Health Promotion Model |
Incorporates individual experiences & characteristics, behavior-specific knowledge & beliefs |
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Health-Illness continuum |
Health is constantly changing; person adapts |
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Agent-Host Environment |
Interaction between external agent & susceptible host; environment is cause of disease (useful with infectious disease) |
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What are levels in Maslow's Hierarchy of Needs? |
(From the bottom): 1. Physiological 2. Safety & Security 3. Love & Belonging 4. Self-Esteem 5. Self-Actualization |
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Community Health Nursing |
Focuses on whole population within a community |
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Community Based Nursing |
Focuses on healthcare needs of individuals and families |
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Cultural Assimilation |
Minority takes on values of dominant group (also called acculturation) |
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Ethnicity |
Sense of identification with a collective cultural group; based largely on common heritage |
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Race |
Based on physical characteristics |
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Cultural Imposition |
Belief that all should conform to your own system |
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Culture Conflict |
Aware of cultural differences, feel threatened, respond by ridiculing other beliefs |
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Ethnocentrism |
Belief that own culture, beliefs, etc. are superior to others |
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Common health problems: Native Americans/Alaska Natives |
Heart disease; cirrhosis of the liver, FAS, DM |
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Common health problems: African Americans |
Hypertension, stroke, sickle cell anemia, lactose intolerance, keloids |
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Common health problems: Asians |
Hypertension, lactose intolerance, cancer of the liver, Thalassemia |
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Common health problems: Hispanics |
DM, lactose intolerance |
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Common health problems: Whites |
Heart disease, DM, obesity, breast cancer |
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What are the five Professional Values stated by AACN? |
1. Altruism (self-less) 2. Autonomy 3. Human dignity (respect) 4. Integrity 5. Social Justice |
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Utilitarian Theory of Ethics |
Rightness/wrongness depends on its consequences |
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Deontologic Theory of Ethics |
Rightness/wrongness is based on a rule, regardless of consequences |
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What are the five principles of Bioethics? |
1. Autonomy (self-determination) 2. Nonmaleficence (avoid causing harm) 3. Benficence (benefit the pt) 4. Justice 5. Fidelity (keep promises) |
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Ethical Distress |
Knowing the right thing to do, but unable to execute |
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Civil Law |
Regulates relationship among people |
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Criminal Law |
State & federal criminal statutes |
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Crime |
Punishable by the state |
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Tort |
Subject to civil court; damages settled with $ |
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Sentinel Event |
Unexpected occurrence involving death, serious injury, or the risk of |
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Never Event |
Serious reportable event |
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Pay-for-Performance |
Financial incentives for certain achievements |
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DRGs |
Diagnosis-Related-Groups: fixed reimbursement for certain things (adjustments for severity) |
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Capitation |
Fixed amount per enrollee of health plan |
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Primary Healthcare |
Family practice physicians Goal: prevention |
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Secondary Healthcare |
Specialty physicians Goal: specialized expertise |
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Tertiary Healthcare |
Subspecialty physicians Goal: care, complex disorders |
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Fee-for-service |
Fee paid for each thing provider does; rewards more care, not better care |
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Community Health Centers |
Regionalized services for vulnerable populations; emphasize primary care and education |
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What are the two types of Prepaid Group Practice? |
1. HMO (Health Maintenance Org): Group of affiliated providers; little or no choice of providers 2. PPO (Preferred Provider Org): Third-party payer contracts w/group of healthcare providers |
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Accountable Care Organizations |
Incentives to provide well-coordinated care to patients; one bill for all services |
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Medicare |
Government-financed, age 65+; DRGs; some things not paid for (hospital errors) |
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Medicaid |
Government-financed; low income, blind, disabled; DRGs |
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Respite Care |
Gives caregivers time away |
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Palliative Care |
Relief of distress; goal to prevent and relieve suffering |
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QSEN |
Quality & Safety Education for Nurses |
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What are the six QSEN competencies? |
1. Patient-Centered Care 2. Teamwork & Collaboration 3. EBP 4. Quality Improvement 5. Safety 6. Informatics |
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What is Concept Mapping? |
Identifying, Displaying, and linking key concepts |
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What are the five steps to Concept Mapping? |
1. Skeleton diagram 2. Analyze & categorize data 3. Analyze nursing diagnosis relationships 4. Identify goals, outcomes, interventions 5. Evaluate |
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What are the four space zones? |
1. Intimate (0-18 inches) 2. Personal (19 - 4 ft) 3. Social (4 ft - 12 ft) 4. Public (12 ft. +) |
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What does SBAR stand for? |
S = Situation B = Background A = Assessment R = Recommendation |
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What are the three phases of helping relationships? |
1. Orientation (development of trusting relationship important) 2. Working (interaction essential) 3. Termination (examine goals) |
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What are the six interviewing techniques? |
1. Open-ended 2. Closed 3. Validity (validate what nurse believes she heard/observed) 4. Clarifying (to gain understanding of pt's comment) 5. Reflective (repeating what patient said) 6. Directing |
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What factors affect patient learning? |
1. Age & developmental level 2. Family support networks & financial resources 3. Cultural influences 4. Health literacy |
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Piaget's Theory for children & adolescents |
1. Infants: teaching directed @parents 2. Toddlers/preschoolers: teaching directed @parents 3. School-aged: simple & logical statements 4. Adolescents: formal vs. concrete operations |
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What are Formal Operations? |
Using logical reasoning to solve hypothetical problems |
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What are Concrete Operations? |
Using logical reasoning to solve concrete problems |
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What barrier is there to adult learners? |
They must believe that they need to learn before they are ready to |
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What must be identified in aged adults before teaching? |
Learning barriers |
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What are the three learning domains? |
1. Cognitive 2. Physical (physical activity) 3. Affective (changes in attitude, value, feeling) |
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What is the Outcome/Identification phase of the Nursing Process for Teaching based on? |
Learning domain (cognitive, physical, affective) |
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What are the 11 teaching strategies? |
1. Role modeling 2. Lecture 3. Discussion 4. Panel Discussion 5. Demonstration 6. Discovery (patient guided to discover solution) 7. Role Playing 8. Audiovisual Materials 9. Printed Material 10. Programmed Instruction 11. Web-Based Introduction & technology |
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How does a nurse act as a counselor? |
Helping patients make decisions that promote their well-being |
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What are the three types of counseling? |
1. Short-term (situational crisis) 2. Long-term (developmental crisis) 3. Motivational Interviewing (discussing feelings & incentives with pt) |
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What are the four teaching tools? |
1. Teach-back (assesses literacy & confirms learner understanding) 2. Ask me 3 (promotes understanding) 3. Newest Vital Sign (assesses low health literacy) 4. TEACH acronym |
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What does TEACH stand for? |
T = Tune into pt E = Edit pt info A = Act on every teaching moment C = Clarify often H = Honor of pt as partner |
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What are the six styles of leadership? |
1. Autocratic 2. Democratic 3. Laissez-faire 4. Quantum 5. Transactional 6. Transformational |
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Autocratic leadership |
Leader has control; others have little say |
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Democratic leadership |
Equality |
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Laissez-faire leadership |
Leader relinquishes power; encourages independent activity |
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Quantum leadership |
Organization & members viewed as interconnected & collaborative |
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Transactional leadership |
Good behavior rewarded, bad is punished |
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Transformational leadership |
Leaders inspire change |
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What are the six conflict resolution strategies? |
1. Avoiding 2. Collaborating (win-win) 3. Competing (win-lose) 4. Compromising (both relinquish something) 5. Cooperating/Accommodating (one party lets other win) 6. Smoothing (compliment, focus on agreement, decrease emotions) |
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What are the three components of heritage? |
1. Culture 2. Ethnicity 3. Religion |
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Acculturation |
Process of adopting to and acquiring another culture |
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Assimilation |
Process by which a person develops a new cultural identity; becomes like dominant culture |
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Biculturalism |
Dual pattern of identification and often of divided loyalty |
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What are the traditional causes of illness? |
1. Biomedical (scientific) - germ theory 2. Naturalistic (holistic) - forces of nature; origins in Greek humoral theory; hot/cold theory 3. Magicoreligioius - domination of supernatural forces |
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What is normal adult BMI range? |
19 - 25 (lbs/inches)*703 |
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What is stroke volume? |
Amount of blood pumped into aorta each cycle (normal is 70 ml in adults) |
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What three factors are assessed with pulse? |
Rate, rhythm, force |
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What is pulse pressure? |
Difference between systolic and diastolic |
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What are the five determining factors of BP? |
1. Cardiac output 2. Peripheral vascular resistance 3. Volume of circulating blood 4. Viscosity 5. Elasticity of vessel walls |
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Ausculatory Gap |
Period when Korotkoff sounds disappear during auscultation |
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When are orthostatic vital signs taken? |
When decrease in volume suspected; hypertension; fainting/syncope |
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What are the steps for Orthostatic (Postural) VS? |
1. Baseline at supine; wait 2-3 minutes 2. Sitting; wait 2-3 minutes 3. Standing; wait 2-3 minutes |
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Hypopituitary Dwarfism |
Deficiency in GH in childhood |
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Gigantism |
Increased secretion of GH before puberty |
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Acromegaly |
Increased secretion of GH in adulthood |
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Marfan's Syndrome |
Connective tissue disorder; arachnodactyly, hyperextensible joints, tall, thin |
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Achondroplastic Dwarfism |
Genetic; converting cartilage to bone |
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Endogenous Obesity (Cushing's) |
Uneven distribution of fat; increased production of ACTH, which stimulates cortisol secretion |
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What is a PHR? |
Personalized Health Record; updated by patient |
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What is a HIE? |
Health Information Exchange; done by hospital, accessible by patients |
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What are Source-Oriented Records? |
Paper records kept by each health care group |
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What are POMR's? |
Problem-Oriented Medical Records |
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What is SOAP? |
Format for documentation: S = Subjective Data O = Objective Data A = Assessment P = Plan |
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What is PIE? |
Format for documentation: P = Problem I = Intervention E = Evaluation Done at beginning of each shift |
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What is CBE? |
Charting by Exception; only significant findings charted |
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What are the benefits of CBE? |
1. Saves time 2. Increases emphasis on significant data 3. Easy retrieval |
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What are Collaborative (Critical) Pathways? |
Care maps |
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What is Occurrence Charting? |
Charts unexpected outcomes, outcomes not met, interventions not implemented |
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What is a Patient Care Summary |
Overview of valuable patient info (documentation, lab & test results, orders, meds) |
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What are flow sheets? |
Used to quickly record routine care |
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What are graphic records? |
Used to record specific patient variables (pulse, RR, BP, etc.) |
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What is charted on a medication record? |
Meds, administering nurse, reason |
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What is an acuity record? |
Ranks patient condition and need for nursing assistance from high to low |
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What is an RAI? |
Resident Assessment Instrument (RAI) - form of long term care documentation |
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What does an RAI contain? |
1. Minimum data set (core set of screening, clinical, functional status elements) 2. Triggers - resident responses indicating risks |
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What do nursing informatics integrate? |
Nursing science, computer science, information science |
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Infection |
Disease state resulting from presence of pathogens |
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Pathogens |
Disease-producing microorganism |
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Bacteria |
Most common cause of infection |
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Gram positive |
Thick cell wall, resist colorization |
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Gram negative |
Complex cell wall; decolorized by alcohol |
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What two types of antibiotics are there? |
1. Gram positive efficient 2. Broad spectrum |
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Virus |
Smallest microorganism; viewable by electron microscope; antibiotics don't affect; (some antiviral meds for prodromal stage) |
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Fungi |
Plant-like organism; treated with anti-fungals (many infections resistant) |
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Parasites |
Live on or in host |
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What factors affect infection? |
1. Number of organisms 2. Virulence 3. Immune system function 4. Length & contact with person |
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Endemic |
Occurring in one region/population |
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Reservoirs |
Natural habitat of organism People: carriers exhibit no signs/symptoms Animals (e.g. Rabies) Soil (e.g. Tetanus) Water (e.g. Giardia) Milk (e.g. Listeria) |
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Portal of Exit |
Point of escape from reservoir |
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Direct Transmission |
Touching, kissing, etc. |
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Indirect Transmission |
Contact with contaminated fomite (inanimate object) |
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Vector |
Non-human carriers that transmit through injection of saliva |
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Vehicle |
Transmission without injection |
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Droplet transmission |
Airborne; >5 mcm sized particles |
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Portal of Entry |
Entry to new host (most common: urinary, respiratory, skin, GI) |
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What are the stages of incubation? |
1. Incubation (between invasion and appearance of symptoms) 2. Prodromal (most infections, vague signs/symptoms) 3. Full Stage (specific signs & systems; localized vs. systemic) 4. Convalescent (recovery Some infections cycle through |
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What are the two types of defense against infection? |
1. Inflammatory response (eliminates pathogen; tissue repair) 2. Immune response (body responses to invader) |
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Antigen |
Foreign body/material |
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Antibody |
Body's response to antigen |
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Antigen-antibody reaction |
Humoral immunity |
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Cellular immunity |
Increase in WBC to destroy harmful cells |
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What is susceptibility affected by? |
1. Skin integrity 2. pH of GI & GU 3. # of WBC 4. Age, sex, race, heredity 5. Immunizations 6. Fatigue, health/nutrition, preexisting illness, previous/current treatments, certain meds 7. Stress |
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Asepsis |
All activities to prevent or break chain of infection |
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Medical Asepsis |
"Clean technique"; decrease in number and transfer of pathogens |
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Surgical Asepsis |
"Sterile technique"; render and keep objects and areas free from microorganisms |
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When do you use hand hygiene? |
1. Before & after touching patient 2. Before a clean or aseptic procedure 3. After body fluid exposure 4. After touching patient surrondings |
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HAI |
Healthcare Associated Infections; nosocomial infections |
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Exogenous HAI |
Causative organism acquired from other people |
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Endogenous HAI |
Causative organism acquired from microbial life in the person |
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Iatrogenic |
Results from treatment or diagnostic procedure |
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Bundles |
Evidence-based practices with proven positive outcomes |
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Disinfection |
Destroys pathogens (except spores) |
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Sterilization |
Destroys pathogens (including spores) |
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PPE |
Personal Protective Equipment |
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Standard Precautions |
Used in All hospital care |
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Transmission-based precautions |
Used when pathogens suspected |
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Airborne Precautions |
When infections spread through air (TB, Varicella, Rubeola, SARS) Private room w/negative air pressure; door closed |
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Droplet Precautions |
When infections spread by large droplet (Rubella, Mumps, Diptheria) Private room, door open, visitors 3 ft away from patient |
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Contact Precautions |
When infections are multi-drug resistant (MDRO) |
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When should you use soap and water to wash hands? |
When hands visibly soiled |
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When should you use alcohol-based handrubs? |
Hands not visibly soiled; before/after patient contact; after body fluid contact; after removing gloves; before donning gloves; before inserting catheters; if moving from contaminated site to clean after contact with objects |
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What factors affect safety? |
1. Developmental 2. Lifestyle (occupation, social behavior) 3. Environment 4. Mobility 5. Sensory Perception 6. Knowledge 7. Ability to communicate 8. Physical health state 9. Psychosocial health state |
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What increases likelihood of falls? |
1. History of falls 2. Age 65+ |
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Types of restraints |
Side rails; geriatric chairs with attached trays; tie appliances; chemical restraints |
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What does RACE mean? |
R = Rescue A = Activate alarm C = Confine fire E = Evacuate |
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What does PASS mean? |
P = Pull pin A = Aim S = Squeeze S = Sweep |
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Disaster |
Tragic event of great magnitude; requires response of people outside involved community |
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Bioterrorism |
Deliberate spread of pathogens in a community |
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Chemical terrorism |
Deliberate release of chemical compound that has potential for harming health |
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Nuclear terrorism |
Intentional introduction of radioactive materials to cause harm |
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Cyber terror |
Use of high technology to disable/delete critical infrastructure data |
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Erythema |
Dilation of superficial blood vessels; inflammation |
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Cyanosis |
Inadequate oxygenation |
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Janudice |
Elevated bilirubin |
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Pallor |
Decreased amount of circulating blood causing inadequate oxygenation |
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Ecchymosis |
Collection of blood in subcutaneous tissues; purple |
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Petechiae |
Hemorrhagic spots caused by capillary bleeding |
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Primary lesions |
Arise from previously normal skin |
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Secondary lesions |
Arise from changes in primary lesion |
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Turgor |
Elasticity of skin; measured at sternum or clavicle |
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Edema |
Excess fluid in tissues; skin folds sometimes difficult to lift; taut/shiny; indentations remain |
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What could Edema be caused by? |
Heart failure, overhydration, kidney failure; trauma; peripheral vascular disease |
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Senile keratosis |
Raised, dark areas |
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Senile lentigines |
Flat, brown age spots |
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Cherry angiomas |
small, round red spots |
