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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

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