Test 2
There are 4 goal directed phases
Preinteraction
Orientation
Working
Termination
This legislation is the governing framework for all healthcare professionals in ON
- Governs the CNO
- Sets rules for complaints, discipline, registration, and regulation
Regulated Health Professionals Act 1991
Scope of Practice is:
What a profession does and its methods
The RHPA is intended to:
- Protect and serve public interest
- Improve care
- Provide framework for modern care
This legislation regulates all nurses in ON
- Includes Scope of Practice, Entry-to-Practice Competencies, Quality Assurance, Professional Misconduct, Controlled Acts
The Nursing Act 1991
CNO Responsibilities:
Entry to practice requirements, practice standards, quality assurance program, enforcing practice and conduct
Outlines expectations, nurses accountabilities, public protection
Standards
Practice-related issues, ethics, responsiblities
Guidelines
Entry to practice competencies Roles:
1. Clinican
2. Professional
3. Communicator
4. Collaborator
5. Coordinator
6. Leader
7. Advocate
8. Educator
9. Scholar
The 5 Components of the Theraputic Nurse-Client Relationship:
Trust, respect, professional intimacy, empathy and power
The 4 standards of the Theraputic Nurse-Client Relationship:
Theraputic communicaiton, client-centered care, maintaining boundaries, protecting client from abuse
The 5 components of the nursing process:
1. Assessment
2. Diagnosis
3. Planning
4. Implementation
5. Evaluation
Data that includes patient's decriptions of their health concerns (feelings, symptoms, perceptions)
- Only can come from a patient
Subjective data
Data that comes from measurements, observations, inspection of wound/observed behavior/measurement based off accepted standard
Objective data
A primary source:
Patient
Secondary source:
Family, healthcare team, medical records
Tertiary source:
Textbooks, literature, nurses own experience
The process of recognizing patterns or trends in clustered data, comparing them with standards, then drawing conclusions
Data Analysis
Actual Nursing Diagnosis:
Documented from assessment
Risk Nursing Diagnosis:
Clinical judgement that client is more vunerable to develop this problem than others in the same situation
Health Promotion:
Clinical judgement of a client's motivation and desire to increase well-being and actualize human health potential
Wellness:
Potential for human enhancement of current well state
Planning types:
Initial (first 24 hrs)
Ongoing (when patient status changes)
Discharge (decreases length of stay)
Implementation types:
Indepenent intervention
Dependent intervention
Collaborative intervention
When choosing interventions, there are 6 factors the nurse considers:
Nursing diagnosis
Goals/expected outcome
Evidence base
Feasibility
Acceptability to patient
Nurse's competence
Documents guiding decisions and interventions for specific health care problems based on current scientific evidence
Clinical Practice Guidelines and Protocols
A statemen(s) of routine therapies, monitoring guidelines, and diagnostic procedures for specific patients
Medical directives/standing orders
The Implementation Process: 6 Steps
1. Reasses patient
2. Review/revise existing
3. Organize recources
4. Anticipate/prevent complications
5. Identify areas of assistance
6. Implementing skills (cognitive, interpersonal, pyschomotor)
The Evaluation Process:
1. Identify criteria and standards (goals)
2. Collecting/evaluating data
3. Interpreting/summarizing findings
4. Document findings
5. Care plan revision
6. Modifying care plan
Recognizing cues is also:
Getting the information/assessing
Analyzing cues is also:
Making meaning of the information/diagnosis
Prioritizing hypotheses is also:
Determining action to take/planning
Generating solutions is also:
Determining actions to take/planning
Taking action is also:
Implementing
Evaluating outcomes is also:
Evaluating outcomes and your thinking/evaluating
Cue vs Inference
Cue: Info gathered through the senses
Inferences: Nurse's interpretation of cues
Interview phases:
Orientation, working, termination
A priority setting is a:
Rank assigned to a nursing diagnosis by urgency and importance
What organization catergorizes diagnoses into actual, risk, health promotion, wellness
NANDA International
Nursing diagnoses are presented in a ___ part format:
2; Diagnostic label followed by related factor
Errors in diagnostic process occurs during:
Data collection, interpretation, clustering, statement creation
Implementation involves:
Direct and indirect interventions
Direct care involves:
Physical techniques and effective communication
Indirect care includes:
Coordinating information to support direct interventions
Key factors in implementation:
Diagnosis, outcomes, evidence, feasibility
Which organization standardizes care?
Nursing Interventions Classification (NIC)
Nursing requires what skills?
Cognitive, interpersonal, technical skills
Learning occurs in 3 domains:
Cognitive, affective, pyschomotor
_____ and _______ are interdependent processes influenced by endocrine, genetic, environmental and nutritional factors
Growth and development
3 main factors influencing growth:
Genetics, environment and their interaction
__________ theories explain physical change throughout life
Biophysical theories
______ suggested that environmental factors can modify growth patterns
Gesell
_______ noted that children learn by interacting with their environment
Piaget
Piaget theory:
Moral development occurs in a series of stages (cognitive development)
_______ believed that levels of moral development vary by individual and are not age-specific, lacking cultural measurement
Kohlberg
_______ highlighted that moral development differences between genders relate to relationships and dependency issues
Gilligan
What is a nursing health history?
Detailed database on patient strengths/support/health challenges
The physiological vavriables in the nursing health history include:
Past illnesses/injuries, current medications and review of body systems
Which patients would the nurse rely on family members to collect health information?
Unconcious patients, infants, critically ill adults
What is included in a physical exam?
Height, weight, vital signs, head to toe assessment of all body systems
When using the diagnostic process, which task is performed by the nurse during the screening assessment?
Clustering of information
A medical diagnosis is described as:
The idenitification of a disease condition based on a specific evaluation of physical signs, symptoms, health history, and tests
What is a wellness diagnosis?
Levels of health in an individual, family, or community that can be enhanced and is a clinical judgement about the transition from a level of health to a higher level
The purpose of NANDA International, NIC and NOC?
Facilitates matching nursing diagnoses with appropriate interventions and outcomes
What is a diagnostic label?
Describes the patient's response to health conditions in as few words as possible
Factors used to prioritize nursing interventions:
Urgency of problems
Safety
Nature of treatment
Relationship among diagnoses
Which length of time is appropriate for short-term goals?
Less than 1 week
A critical pathway is:
An interprofessional treatment plan that outlines treatment/intervention.
Which step in the nursing process does consulation with other health care professionals occur the most?
Planning
A change in a patient's blood pressure from 180/100mmHg to 130/82mmHg 6 hours after antihypertensive medication is an example of what?
Evaluative measure
What is the highest level of the Nursing Interventions Classification (NIC)
Domains
The set of nursing interventions that nurses perform, providing a level of standardization that enchances communication of nursing care across all health care settings and enables comparing of health outcomes
Nursing Interventions Classification (NIC)
Which term describes orders for specific patients with identified clinical problems?
Medical directives
What does LEARNS stand for:
Listen, establish, adopt, reinforce, name, strengthen
Which behavior is the most complex in the psychomotor learning domain?
Origination (creating new movement patterns)
Which factor increased the need for high-quality patient education?
Time-constraints
What statement about developmental theories describes their importance to nursing?
Knowledge of human developmental processes helps nurses to assess and treat a patient’s response to an illness and plan appropriate individualized care
What term describes the process of adapting existing ways of thinking to a new experience?
Accomodation
According to Piaget's theory, how do people come to know their world?
Piaget theorized that people in all cultures would move through four periods, each of which subsumes several stages, at different rates but in the same sequence
Which concept(s) may be symbolized by the Medicine Wheel in many Indigenous cultures?
Aspects of Human Life
Stages of Life
Four Seasons
Autonomous means:
Individuals consider the consequences of moral decisions, base judgements on mutual respect for rules, and think about the subjective intent.
The scenario where "A teenager skips going to a party because there will be alcohol present" is an example of the ______ stage of Kohlberg's theory
The society-maintaining orientation stage
What statements can be said about Kohlberg's theory?
- It is nonreplicable in other settings (outside of teens boys in the west)
- Kohlberg's study is gender biased
- The study is age biased