Exam 1 - All Flashcards

  1. advanced practice nursing
    Nurse who has advanced degrees and certification (e.g., nurse practitioner)
  2. American Nurses Association
    Professional nursing organization concerned with all aspects of professional nursing provides standards and leadership for the profession comprised of individual state nursing associations and also has nursing specialty bodies representing all nursing practice areas
  3. clinical nurse specialist
    Registered nurse who holds a master’s degree in a nursing specialty and has advanced clinical experience
  4. change theory - 6 components
    • According to Lewin
    • 1. Recognition of the area where change is needed
    • 2. Analysis of a situation to determine what forces exist to maintain the situation and what forces are working to change it
    • 3. Identification of methods by which change can occur
    • 4. Recognition of the influence of group mores or customs on change
    • 5. Identification of the methods that the reference group uses to bring about change
    • 6. The actual process of change
  5. three states of change
    • unfreezing, movement, and refreezing
    • Unfreezing is the recognition of the need for change and the dissolution of previously held patterns of behavior. Movement is the shift of behavior toward a new and more healthful pattern. Movement marks the initiation of change. Refreezing is the long-term solidification of the new pattern of behavior.
  6. conceptual framework
    Formal explanation that links concepts and emphasizes relationships among them
  7. environment
    Context in which a person lives; includes social and inanimate characteristics
  8. functional health patterns
    A framework for collecting and organizing nursing assessment data to ascertain the patient’s strengths and any actual or potential dysfunctional patterns
  9. general systems theory
    A systems framework that assumes all systems must be goal directed; a system is more than the sum of its parts; a system is ever-changing and any change in one part affects the whole; boundaries are implicit and in human systems are open and dynamic
  10. health
    • (1) State of well-being and optimal functioning;
    • (2) Interactive process between the person and the internal and external environment
  11. human needs
    Any physiologic or psychological factors necessary for a healthy existence
  12. licensed practical nurse
    Person licensed by a state after completing a state-approved nursing program to provide technical nursing care under the direct supervision of a registered nurse
  13. Maslow’s hierarchy of human needs
    Theory that states that all humans are born with instinctive needs, grouped into five categories, and arranged in order of importance from those essential to physical survival to those necessary to develop a person’s fullest potential
  14. Physiologic Needs
    Part of Maslow's hierarchy of human needs - bottom of pyramid. Need for air, nutrition, water, elimination, rest, and sleep, and thermoregulation. Sex is unnecessary for individual survival, but it is necessary for the survival of humankind.
  15. Safety Needs
    Part of Maslow's hierarchy of human needs - second from bottom of pyramid. Need for shelter and freedom from harm and danger.
  16. Love Needs
    Part of Maslow's hierarchy of human needs - third from bottom of pyramid. Need for affection, feelings of belongingness, and meaningful relations with others.
  17. Esteem Needs
    Part of Maslow's hierarchy of human needs - fourth from bottom of pyramid (second from top). Need to be well thought of by oneself as well as by others.
  18. Self-Actualization Needs
    Part of Maslow's hierarchy of human needs - top of pyramind (fifth from bottom). Need to be self-fulfilled, learn, create, understand, and experience one's potential.
  19. nurse administrator
    Nurse who supervises the organization of nursing care to ensure overall safety and quality
  20. nurse anesthetist
    Nurse who specializes and is certified in the administration of anesthesia
  21. nurse educator
    Nurse responsible for nursing and healthcare education in various settings
  22. nurse midwife
    Nurse with advanced education and certification in the care of women during pregnancy and childbirth
  23. nurse practice act
    State guideline that governs the practice of professional nursing
  24. nurse practitioner
    Nurse with advanced education and certification who may practice independently in various settings
  25. nurse researcher
    Nurse responsible for continued development of nursing knowledge and improvement of practice through research
  26. nursing
    Profession that involves diagnosis and treatment of human responses to actual or potential health problems
  27. nursing theory
    Explanation or description of nursing issues that defines and predicts nursing practice
  28. person
    Human being; recipient of nursing care
  29. professional nurse
    Nurse possessing the baccalaureate degree in nursing
  30. self-actualization
    Process of developing one’s maximum potential and managing one’s life confidently
  31. socialization
    Process in which a person is familiarized with the ways of a specific culture or group
  32. Novice
    A beginning nursing student or any nurse entering a situation in which he or she has had no previous experience. Behavior is governed by established rules and is limited and inflexible. The novice nurse moves from relying on abstract principles to using concrete experiences.
  33. Advanced beginner
    The advanced beginner can demonstrate marginally acceptable performance. He or she has had enough experience in actual situations to identify meaningful aspects or global characteristics that can be identified only through prior experience. Advanced beginner is identified as being the first 5 years after graduation from nursing school and is described as seeing situations in parts to seeing them more conceptually, or as a whole.
  34. Competent
    Competence is reflected by the nurse who has been on the same job for 2 or 3 years and who consciously and deliberately plans nursing care in terms of long-range goals. Competency occurs 5 to 10 years after graduation, and the nurse is no longer outside the situation observing but is directly involved.
  35. Proficient
    The proficient nurse perceives situations as a whole rather than in terms of aspects and manages nursing care rather than performing tasks.
  36. Expert
    The expert nurse no longer relies on rules or guidelines to connect understanding of a situation to an appropriate action. The expert nurse, with an enormous background of experience, has an intuitive grasp of the situation and zeroes in on the problem. The expert nurse has an enormous background of experience, intuitive grasp of each situation, and accurately targets the problem without unnecessary consideration of a large range of alternative diagnoses and solutions.
  37. ASSESSMENT - Standards of Practice
    The RN collects comprehensive data pertinent to the patient’s health or situation.
  38. DIAGNOSIS - Standards of Practice
    The RN analyzes the assessment data to determine the diagnoses or issues.
  39. OUTCOMES IDENTIFICATION - Standards of Practice
    The RN identifies expected outcomes for a plan individualized to the patient or the situation.
  40. PLANNING - Standards of Practice
    The RN develops a plan that prescribes strategies and alternatives to attain expected outcomes.
  41. IMPLEMENTATION - Standards of Practice
    The RN implements the identified plan. This includes coordination of care, health teaching and health promotion, consultation, and prescriptive authority and treatment.
  42. EVALUATION - Standards of Practice
    The RN evaluates progress toward attainment of outcomes.
  43. ETHICS - Revised Standards of Professional Performance
    The RN practices using ethical principles.
  44. CULTURALLY CONGRUENT PRACTICE - Revised Standards of Professional Performance
    The RN practices in a manner that is congruent with cultural diversity and inclusion principles.
  45. COMMUNICATION - Revised Standards of Professional Performance
    The RN communicates effectively in all areas of practice.
  46. COLLABORATION - Revised Standards of Professional Performance
    The RN collaborates with the patient and key stakeholders.
  47. LEADERSHIP - Revised Standards of Professional Performance
    The RN demonstrates leadership in the practice setting and the profession.
  48. EDUCATION - Revised Standards of Professional Performance
    The RN attains knowledge and competency that reflects current nursing practice and promotes futuristic thinking.
  49. EVIDENCE-BASED PRACTICE AND RESEARCH - Revised Standards of Professional Performance
    The RN integrates evidence and research findings into practice.
  50. QUALITY OF PRACTICE - Revised Standards of Professional Performance
    The RN contributes to quality nursing practice.
  51. PROFESSIONAL PRACTICE EVALUATION - Revised Standards of Professional Performance
    The RN evaluates one’s own and others’ nursing practice.
  52. RESOURCE UTILIZATION - Revised Standards of Professional Performance
    The RN utilizes appropriate resources to plan, provide, and sustain evidence-based nursing services that are safe, effective, and fiscally responsible.
  53. ENVIRONMENTAL HEALTH - Revised Standards of Professional Performance
    The RN practices in an environmentally safe and health manner.
  54. bundle
    A combination of patient care elements that can be consistently implemented to reduce harm
  55. Centers for Medicare and Medicaid Services
    CMS - A federal organization that pays for healthcare for low-income and elderly people and tracks healthcare outcomes
  56. incident report
    A report filed that documents an accident or injury occurring in the hospital
  57. Institute for Healthcare Improvement
    An organization that focuses on safety of patients and that has developed a number of bundles of care to achieve that goal
  58. Institute of Medicine
    A professional organization that has identified six aims of 21st century healthcare: that all healthcare should be safe, effective, patient-centered, timely, efficient, and equitable
  59. Patient-centered care
    Recognize the patient or designee as the source of control and full partner in providing compassionate and coordinated care based on respect for patient’s preferences, values, and needs.
  60. Teamwork and collaboration
    Function effectively within nursing and interprofessional teams, fostering open communication, mutual respect, and shared decision making to achieve quality patient care.
  61. EBP
    Evidence-based practice - Integrate best current evidence with clinical expertise and patient/family preferences and values for delivery of optimal healthcare.
  62. QI
    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 healthcare systems.
  63. Safety
    Minimize risk of harm to patients and providers through both system effectiveness and individual performance.
  64. Informatics
    Use information and technology to communicate, manage knowledge, mitigate error, and support decision making.
  65. healthcare
    that all healthcare should be safe, effective, patient-centered, timely, efficient, and equitable
  66. just culture
    An approach to error evaluation that examines the nature of the error to assist in determining the appropriate response to the individual who made the error
  67. quality
    The excellence or superiority of something; often viewed on a continuum, from poor quality to high quality
  68. Quality and Safety Education for Nurses
    A project designed to provide a framework for the knowledge, skills, and attitudes necessary for future nurses
  69. root cause analysis
    RCA - A process used to determine the underlying cause of an event. Asking why 5 times.
  70. safety
    The avoidance or prevention of adverse outcomes for patients
  71. safety science
    The study of safety knowledge and technology to prevent harm to patients
  72. sentinel event
    Safety error in which hospitals are required to report serious safety events to regulatory agencies and state health agencies
  73. Tall Man Letters
    Medications with similar names may lead to administration errors. The Institute for Safe Medication Practices (ISMP) has advocated a system of using capitalized letters within a drug name to differentiate drugs with similar names.
  74. CLABSI
    • Care bundle: central line–associated bloodstream infection. 5 elements:
    • -Hand hygiene
    • -Maximal barrier precautions during insertion of the line (sterile gown and gloves, cap, face shield, sterile drape)
    • -Preparation of skin at insertion site with chlorhexidine
    • -Optimal catheter site selection, avoiding the femoral vein site in adults
    • -Daily review of line necessity with prompt removal when no longer needed
  75. Value-Based Purchasing
    VBP - CMS adjusts hospital reimbursement based on adherence to guidelines for processes and outcomes of care and patient satisfaction.
  76. Latent errors
    Latent errors are those due to systems issues. The effects of latent errors may be apparent immediately and may certainly cause significant harm to patients.
  77. active euthanasia
    Physician- or nurse-caused death that deliberately hastens a person’s death and may be considered murder in many states
  78. advance directives
    Written document (e.g., living will) that states in advance a patient’s desires about the types of healthcare he or she wishes to receive should the patient become unable to decide
  79. assault
    Threat of touching a person without his or her consent
  80. assisted suicide
    Providing the patient with a means to end life, but not the direct action that results in death
  81. attitude
    A person’s dispositions toward an object or situation; can be a mental or emotional mind-set and positive or negative
  82. autonomy
    Degree of discretion and independence a practitioner has
  83. battery
    Unlawful touching of a person’s body without his or her consent
  84. behaviors
    Observable actions
  85. beliefs
    Ideas that a person accepts as true
  86. beneficence
    Doing or promoting good, the basis for all healthcare
  87. brain death
    Irreversible cessation of heart and lung functions or an irreversible loss of all functions of the entire brain
  88. capacity
    Mental or physical ability to make healthcare decisions
  89. civil law
    The body of law that deals with relationships between private individuals
  90. community-based no code order
    Document that requires the signatures of the primary physician or nurse practitioner and the patient or legal surrogate and allows emergency medical personnel, if called, to provide care and support to patient and family without resuscitation
  91. confidentiality
    Practice of keeping patient information private
  92. crime
    Violation of the law punishable by the state. Results in prison term, fine, or short jail sentence to punish offender.
  93. criminal law
    A type of public law that deals with the public’s safety and welfare
  94. do not resuscitate (DNR) orders
    Orders not to provide resuscitation in the event of cardiopulmonary arrest
  95. durable power of attorney for healthcare
    Advance directive that allows a person to designate another to make decisions if the patient becomes incapacitated and cannot make independent decisions
  96. ethics
    Professional standards of behavior related to right and wrong
  97. felony
    Premeditated killing (first-degree murder) - impulsive or unintentional killing (second-degree murder; manslaughter, rape, arson, treason, kidnapping, burglary, bribery, child abuse, drug trafficking, fraud, and terrorism.
  98. fidelity
    Being faithful to one’s commitments and promises
  99. intentional
    • Assault and battery
    • Defamation of character
    • Fraud
    • Invasion of privacy
    • False imprisonment
  100. unintentional
    • Negligence
    • Malpractice
  101. justice
    Principle of fairness basis of the obligation to treat all patients equally and fairly
  102. laws
    Standards of human conduct established and enforced by the authority of an organized society through its government
  103. liability
    Responsibility for one’s actions an obligation one is bound to perform
  104. libel
    False communication by means of print that results in injury to a person’s reputation
  105. living will
    Written evidence of a patient’s preferences regarding treatment options
  106. malpractice
    Professional misconduct, causing harm or injury to a person from lack of experience, skill, knowledge, or judgment
  107. To prove malpractice, 4 elements are necessary
    • -A duty to the plaintiff
    • -A failure to meet the standard of care, or a breach of duty, which may be an act of omission
    • -Causation (i.e., that the breach of duty produced the injury in a natural and continuous sequence)
    • -Damages, which require a physical, emotional, financial, or other injury to the patient
  108. morality
    The set of beliefs about the standards of right and wrong that help a person determine the correct or permissible action in a given situation
  109. moral courage
    The ability to surmount fear and act to protect patient’s rights and values
  110. misdemeanor
    An offense punishable by imprisonment of less than 1 year or a fine of less than $1,000. Does not amount to a felony.
  111. negligence
    Failure to do something that a reasonably prudent person would do, or doing something that a reasonably prudent person would not do
  112. no code order
    Order not to provide resuscitation in the event of a cardiopulmonary arrest
  113. nonmaleficence
    Principle of avoidance of doing harm
  114. personal values
    Beliefs a person considers highly important and are learned through interactions with social systems
  115. privacy
    Patient confidentiality
  116. professional ethics
    Values held by a disciplinary group deemed as having generalizable standards of conduct to be upheld in all situations
  117. proxy directive
    Advance directive that allows a person to designate another to make decisions if the patient becomes incapacitated and cannot make decisions independently
  118. res ipsa loquitur
    “The thing speaks for itself ” invoked when it is impossible to prove who was at fault when a patient’s injury results from negligence
  119. respondeat superior
    “Let the master answer”; doctrine in which a facility is held liable for an employee’s negligence
  120. resuscitation
    Act of reviving after apparent death or unconsciousness
  121. slander
    False communication by spoken word that results in injury to a person’s reputation
  122. standards of care
    Comprise the expected level of performance or practice as established by guidelines, authority, or custom
  123. surrogate decision maker
    Person identified to act on a patient’s behalf when the patient is an infant, young child, mentally handicapped or incapacitated, or in a
  124. persistent vegetative state or coma and does not have the capacity to participate in decision making about healthcare
  125. terminal sedation
    Infrequently used method of pain management, not considered euthanasia, provided in response to a dying person’s persistent and unremitting pain and suffering; it provides analgesia that produces light sedation even though this is likely to hasten death somewhat secondary to resulting immobility
  126. tort
    Wrong committed against a person or property; subject to action in a civil court to assess compensation for plaintiff
  127. values
    Personal standards for decision making
  128. value system
    Enduring set of personal principles and rules
  129. veracity
    Principle of telling the truth, essential to the integrity of the patient-provider relationship
  130. worldview
    Unquestioned framework or predominant set of assumptions through which people view life
  131. Developmental Stage: Infant - What is the Erikson's Values, What is the Hall's Phase of Consciousness and Associated Values
    Hope, Phase I - Security
  132. Developmental Stage: Toddler - What is the Erikson's Values, What is the Hall's Phase of Consciousness and Associated Values
    Will, Phase I - Survival, Wonder
  133. Developmental Stage: Preschool - What is the Erikson's Values, What is the Hall's Phase of Consciousness and Associated Values
    Purpose, Phase I - Awe
  134. Developmental Stage: School age - What is the Erikson's Values, What is the Hall's Phase of Consciousness and Associated Values
    Competence, Phase II - Belonging, Work
  135. Developmental Stage: Adolescence - What is the Erikson's Values, What is the Hall's Phase of Consciousness and Associated Values
    Loyalty, Phase II - Self-competence, Self-worth
  136. Developmental Stage: Young adulthood - What is the Erikson's Values, What is the Hall's Phase of Consciousness and Associated Values
    Love, Phase III - Independence, Service/vocation
  137. Developmental Stage: Middle adulthood - What is the Erikson's Values, What is the Hall's Phase of Consciousness and Associated Values
    Care, Phase III - Creation, Being self
  138. Developmental Stage: Older adulthood - What is the Erikson's Values, What is the Hall's Phase of Consciousness and Associated Values
    Wisdom, Phase IV - Harmony, Interdependence, Intimacy, Esthetics
  139. Autonomy
    self determination, independent choice
  140. Beneficence
    to do or promote good – the client’s best interest, promote good as defined by the client
  141. Confidentiality
    information shared in the course of treatment is not shared with others
  142. Fidelity
    fulfillment of one's duties and obligations and strict adherence to vows or promises
  143. Justice
    principle of fairness – treat all clients equally and fairly - equal share of available resources
  144. Nonmaleficence
    to do no harm, to remove from harm to prevent harm
  145. Veracity
    truthfulness, honesty
  146. The student nurse is aware that a safety goal of the Joint Commission is proper patient identification and that two identifiers have to be used. The student nurse is aware that acceptable identifiers are:
    • -having the client tell them their name while looking at their wrist band
    • -having the client tell them their birth date while looking at their wrist band
    • -scanning their medical record number on their wrist band
  147. Malpractice, an unintentional tort, is negligence on the professional’s part. To prove malpractice four elements are necessary.
    • -A duty to the plaintiff
    • -A failure to meet the standard of care, or a breach of duty, which may be an act of omission
    • -Causation (i.e., that the breach of duty produced the injury in a natural and continuous sequence)
    • -Damages, which require a physical, emotional, financial, or other injury to the patient
  148. The registered nurse, prior to delegating to another RN, LPN/LVN or UAP must do all of the following:
    • -Assess the skills of the RN, LPN/LVN or UAP
    • -Assess the client
    • -Determine if a prudent nurse would delegate this intervention
  149. At the center of the Nurse of the Future Nursing Core Competencies diagram is:
    Nursing Knowledge
  150. Communication
    interact effectively with patients, families, and colleagues, fostering mutual respect and shared decision making, to enhance patient satisfaction and health outcomes
  151. Evidence-Based Practice
    identify, evaluate, and use the best current evidence coupled with clinical expertise and consideration of patients’ preferences, experience and values to make practice decisions

    • Informatics and Technology
    • use information and technology to communicate, manage knowledge, mitigate error, and support decision making
  152. Leadership
    will influence the behavior of individuals or groups of individuals within their environment in a way that will facilitate the establishment and acquisition/achievement of shared goals
  153. Patient-Centered Care
    provide holistic care that recognizes an individual’s preferences, values, and needs and respects the patient or designee as a full partner in providing compassionate, coordinated, age and culturally appropriate, safe and effective care
  154. Professionalism
    demonstrate accountability for the delivery of standard-based nursing care that is consistent with moral, altruistic, legal, ethical, regulatory, and humanistic principles
  155. Quality Improvement
    uses data to monitor the outcomes of care processes, and uses improvement methods to design and test changes to continuously improve the quality and safety of health care systems
  156. Safety
    minimize risk of harm to patients and providers through both system effectiveness and individual performance
  157. Systems-Based Practice
    demonstrate an awareness of and responsiveness to the larger context of the health care system, and will demonstrate the ability to effectively call on microsystem resources to provide care that is of optimal quality and value.
  158. Teamwork and Collaboration
    function effectively within nursing and interdisciplinary teams, fostering open communication, mutual respect, shared decision making, team learning, and development
  159. antiseptic
    Agent that stops or slows the growth of microorganisms on living tissue, commonly used for handwashing, skin preparation, and wound packing or irrigation
  160. asepsis
    Absence of disease-producing microorganisms
  161. bactericidal
    Able to kill bacteria
  162. bacteriostatic
    Able to inhibit the growth of bacteria
  163. carriers
    Person from whom a microorganism can be cultured but who shows no sign of a disease
  164. disinfectant
    Chemical used to kill microorganisms on lifeless objects
  165. extended-spectrum beta-lactamases
    (ESBLs) Enzymes that give bacteria immunity to both penicillin and cephalosporin antibiotics
  166. hand hygiene
    Handwashing with soap and water or cleansing the hands with a water-less alcohol-based cleanser to prevent the spread of infection
  167. healthcare-associated infection
    (HAI) A term that encompasses infections contracted in all healthcare settings and is now used in place of the older term, nosocomial infection, which refers only to hospital-acquired infection
  168. infectious disease
    • Process resulting from infection that produces manifestations such as fever, leukocytosis, inflammation, or tissue damage
    • Infectious disease refers to pathologic events that result from the invasion and multiplication of microorganisms in a host.
  169. isolation
    Techniques used to prevent or to limit the spread of infection
  170. medical asepsis
    Measures taken to control and to reduce the number of pathogens present; also known as “clean technique”; measures include handwashing, gloving, gowning, and disinfecting to help contain microbial growth
  171. multidrug-resistant organisms (MDROs)
    Organisms that have developed resistance to multiple antibiotics
  172. nosocomial infection
    • Infection acquired during receipt of healthcare
    • Nosocomial infections are those that occur in the setting of the hospital
  173. opportunistic infections
    Infections that do not result in disease in individuals with properly functioning immune systems
  174. pathogenicity
    An organism’s ability to harm and to cause disease
  175. pathogens
    Microorganisms that can harm humans
  176. personal protective equipment
    (PPE) Techniques or equipment that prevents the transfer of pathogens from one person to another; also referred to as “barriers”
  177. prions
    Organisms that cause a rapidly progressing neurodegenerative disease affecting both animals and humans that is untreatable and always fatal
  178. sepsis
    • Poisoning of body tissues; usually refers to bloodborne organisms or their toxic products
    • Sepsis is an infection that manifests with systemic or widespread microbial destruction of tissues, often accompanied by high fever or hypotension.
  179. specificity
    Organism’s attraction to a specific host, which may include humans
  180. standard precautions
    The latest CDC isolation system that combines the major features of Universal Precautions (blood-borne transmissions) and Body Substance Isolation (moist body substances transmission), thus protecting against blood and body-fluid transmission of potentially infective agents
  181. sterilization
    (1) Destruction of all bacteria, spores, fungi, and viruses on an item, accomplished by heat, chemicals, or gas; (2) Rendered unable to reproduce biologically
  182. surgical asepsis
    Refers to “sterile technique” in which an object is free of all microorganisms to prevent the introduction or spread of pathogens from the environment into the patient; employed when a body cavity is entered with an object that may damage the mucous membranes, when surgical procedures are performed, and when the patient’s immune system is already compromised
  183. virulence
    Vigor with which an organism can grow and multiply
  184. Factors that have contributed to the evolution of resistant microbial organisms include the following:
    • Overprescription of antibiotics
    • Use of inappropriate antibiotics for the infecting organism
    • Incomplete use of antibiotic prescriptions as symptoms subside
    • Harboring and spreading of resistant organisms by carriers who remain symptom free, usually unaware that they have been infected
    • Increased use of antibiotics in farming, thus contaminating milk and meat
  185. infectious agents
    • bacteria
    • fungi
    • virus
    • parasites
    • prions
  186. Sources of infection
    • human beings
    • animals
    • inanimate objects
  187. Portal of exit for infection
    • sputum
    • emesis
    • stool
    • blood
  188. Susceptible hosts for infection
    • Immunosuppressed elderly
    • chronically ill
    • trauma
    • surgery
  189. Portal of entry for infection
    • mucous membranes
    • nonintact skin
    • GI tract
    • GU tract
    • respiratory tract
  190. Mode of transmission for infection
    • contact
    • vehicle
    • droplet transmission
    • airborne
    • vectorborne
  191. Contact transmission
    • Direct or indirect contact
    • Direct - body surface to body surface
    • Indirect - susceptible host comes in contact with contaiminated object
  192. Vehicle transmission
    • contaiminated items that transmit pathogens
    • e.g. food can carry Salmonella, water can carry Legionella, blood can carry hepatitis and HIV
  193. Droplet transmission
    Mucous membranes of nose, mouth, or conjuntiva are exposed to secretions of an infected person who is coughing, sneezing, or talking. Droplets do not remain suspended in the air for very long and seldom travel more than 3 feet. This is not the same as airborne transmission.
  194. Airborne transmission
    Fine particles are suspended in the air for a long time or when dust particles contain pathogens. Air currents widely disperse organisms, can be inhaled or deposited on the skin of a susceptible host. Patient must be in rooms with special air handling and ventilation systems.
  195. Vector-borne transmission
    • biologic or mechanical
    • Biologic are living creatures carrying pathogens, e.g. rats, insects, birds. Most concerning in tropical areas; mosquitoes carrying malaria
    • Mechanical vectors are inanimate objects contaiminated with infected body fluids, e.g. central line catheters, ventilators, contaiminated needles, syringes. MRSA, hepatitis B, HIV are commonly spread in this manner.
  196. Environment - reservoir for infectious organisms
    • hospitals, outpatient clinics, extended care facilities, the home, and schools - threat to those with decreased resistance.
    • Sources include: air; other patients; families and visitors; and contaminated equipment, food, and personnel.
    • Pneumonia and influenza is commonly spread in these facilities.
  197. Therapeutic regimen and risk of infection
    Drugs such as steroids, immunosuppressive agents, and cancer therapy, as well as prolonged use of antibiotics, predispose patients to infection. Equipment such as IV catheters, urinary catheters, feeding tubes, and ventilators provide routes for bacterial and fungal invasion. Inadequate dressing techniques for wounds can provide media for bacterial growth.
  198. Patient resistance and infection
    • Changes in the physical or psychological status of a patient can affect his or her resistance to infection. Any break in the integrity of the skin or mucous membranes increases the chance of infection.
    • Stress, fatigue, poor nutrition, poor hygiene, and chronic illness also can decrease the patient’s ability to ward off infection by impairing normal defenses.
    • The elderly are extremely susceptible to infection because of age-related changes to major body systems.
    • Immunocompromised patients are the most susceptible to infection because they are unable to invoke the immune response necessary to fight off infection-causing pathogens.
  199. PICO Question
    Problem/Patient/Population, Intervention/Indicator, Comparison, Outcome
  200. Categories of institutional waste and types
    • Infectious waste:
    • Blood and blood products
    • Pathology laboratory specimens
    • Laboratory cultures
    • Body parts from surgery
    • Contaminated equipment (e.g., dialysis materials, suction receptacles)
    • Injurious Waste:
    • Needles
    • Scalpel blades
    • Lancets
    • Broken glass
    • Pipettes
    • Aerosol cans
    • Hazardous Waste:
    • Radioactive materials
    • Chemotherapy solutions
    • Caustic chemicals
  201. Alcohol based hand sanitizers are NOT effective against?
    • C. difficile
    • Norovirus
    • wash hands after any contact with a patient with diarrhea
  202. Transmission based precautions and indications for Airborne organisms
    • Precautions:
    • Private AIIR with adequate filtration; mask; mask worn by the patient during transport out of room
    • Indications:
    • Transmission via airborne route (small-particle droplets); tuberculosis, measles, varicella
  203. Transmission based precautions and indications for Droplet organisms
    • Precautions:
    • Private room or cohabitation with the patient infected with same organism; mask required when working within 3 feet of the patient; mask worn by the patient during transport
    • Indications:
    • Transmission of large droplets through sneezing, coughing, or talking; Haemophilus influenzae, multidrug-resistant strains, Neisseria meningitidis, diphtheria, rubella, Mycoplasma pneumoniae
  204. Transmission based precautions and indications for Contact organisms
    • Precautions:
    • Private room or cohabitation with the patient infected with same organism; gloves at all times (don before entering room and remove before leaving) with change after exposure to organism; handwashing immediately after removal of gloves; gown and protective barriers when direct contact with organism occurs; daily cleaning of bedside equipment and patient care items; exclusive use of items such as stethoscope and sphygmomanometer for infected patient with terminal disinfection when precautions are no longer necessary
    • Indications:
    • Serious infections easily transmitted through direct contact; any multidrug-resistant strains, C. difficile, Shigella, impetigo, and others
  205. clinical experience
    Use of knowledge, critical thinking, and past performance to solve problems
  206. clinical reasoning
    Use of critical thinking to question why the patient has an abnormal finding
  207. competence
    Ability to understand rights and responsibilities
  208. critical thinking
    Purposeful process that is disciplined, active, multidimensional, reasonable, rational, and reflective to arrive at insight and draw conclusions
  209. diagnostic reasoning
    The process of gathering and clustering data to draw inferences and propose diagnoses
  210. diagnostic reasoning process
    Skills used to make nursing diagnoses
  211. human patient simulator
    A life-sized mannequin with a sophisticated computer interface, which presents clinical scenarios that evolve based on decisions a user makes
  212. learning styles
    How students learn best
  213. nursing judgment
    Knowledge, experience, critical thinking, and clinical reasoning
  214. nursing process
    Systematic approach to providing nursing care using assessment, diagnosis, outcome identification, planning, implementation, and evaluation
  215. primary source
    The patient
  216. reflection
    Identifying the main emotional themes contained in a communication and directing them back to the patient for the purpose of verifying and checking feelings that are being heard
  217. secondary sources
    Family, significant others, other healthcare professionals, health records, and literature review
  218. nursing process ADPIE
    assessment, (nursing) diagnosis, planning, implementation, and evaluation
  219. assessment
    First phase of the nursing process in which data are gathered to identify actual or potential health problems
  220. auscultation
    Technique of listening to body sounds with a stethoscope
  221. confidentiality
    Practice of keeping patient information private
  222. cues
    Pieces of data, subjective or objective, about a patient
  223. inspection
    Systematic visual examination of the patient
  224. interviewing
    • Communication technique in which the nurse questions the patient in a goal-directed conversation
    • Interaction and communication process for gathering data by questioning and information exchange
  225. objective data
    Observable, measurable information that can be validated or verified
  226. observation
    Art of noticing patient cues
  227. palpation
    Use of the sense of touch to ascertain the size, shape, and configuration of underlying body structures
  228. percussion
    Examination by tapping the body surface with the fingertips and evaluating the sounds obtained
  229. physical examination
    Use of the techniques of inspection, palpation, percussion, and auscultation to obtain information about the structure and function of body parts
  230. subjective data
    Symptoms or covert cues that include the patient’s feelings and statements about his or her health problems
  231. validation
    Reexamining information to check its accuracy
  232. Admission assessment
    • Initial identification of normal function, functional status, and collection of data concerning actual or potential dysfunction
    • Baseline for reference and future comparison
    • Within the specified time frame after admission to a hospital, skilled nursing facility, ambulatory healthcare center, or home healthcare setting
  233. Focus assessment
    • Status determination of a specific problem identified during previous assessment
    • Ongoing process; integrated with nursing care; a few minutes to a few hours between assessments
  234. Time-lapse reassessment
    • Comparison of patient’s current status to baseline obtained previously; detection of changes in all functional areas after an extended period of time has passed
    • Several months (3, 6, or 9 mo or more) between assessments
  235. Emergency assessment
    • Identification of life-threatening situation
    • Any time a physiologic, psychological, or emotional crisis occurs
  236. Primary Source
    The patient is the primary source of data, and the information collected from the patient is considered to be the most reliable, unless circumstances such as altered level of consciousness, severe pain, impending surgery, acute illness, or age make data collection impossible. The patient is deemed unreliable if he or she is confused or suffering from physical or mental conditions that alter thinking, judgment, or memory. In these situations, secondary sources help provide the necessary assessment information.
  237. Secondary Sources
    • Secondary sources provide data that supplement, clarify, and validate information obtained from the patient.
    • Family members or significant others supplement and verify information obtained from the patient, often providing information that the patient forgets to mention or is unwilling to reveal. They may be the only source of data for children or for confused, unresponsive, or severely ill patients. Data provided by family members and significant others include a description of how the patient reacts to illness, the patient’s perceptions of changes in health status, the patient’s ability to cope with life stressors, and information about the patient’s home situation.
    • Usually, the patient’s permission is obtained before information is sought from family members or significant others. All people involved must understand the confidential nature of the information they provide. The patient’s permission must also be obtained to divulge any information (e.g., diagnosis of cancer, positive HIV status, pregnancy) to family members or significant others.
  238. actual nursing diagnosis
    An existing human response to a health problem the nurse identifies that is amenable to nursing intervention
  239. cluster
    Patient data combined into meaningful patterns
  240. collaborative health problems
    Problems based on medical diagnoses, medically ordered treatments, or other related problems that require interdependent standards and activities to be addressed
  241. medical diagnosis
    Identified disease or pathologic process; treatment focuses on correcting or preventing specific pathology of specific organs or body systems
  242. nursing diagnosis
    Actual, potential, or possible health problem identified by the nurse that is amenable to nursing intervention
  243. possible nursing diagnosis
    Health problem amenable to nursing intervention that requires additional data collection and validation before it can be confirmed or deleted as a nursing diagnosis
  244. premature closure
    Selecting a diagnosis before analyzing pertinent information
  245. risk nursing diagnosis
    State of being at risk for the development of a health problem amenable to nursing intervention
  246. taxonomy
    Classification system to organize information
  247. validation
    Reexamining information to check its accuracy
  248. concept map
    A graphical tool for organizing and representing knowledge
  249. evaluation
    Judgment of the effectiveness of nursing care in achieving patient goals
  250. goal
    Aim or expected end to which the nurse and patient work together
  251. nursing interventions
    Any treatment the nurse performs to enhance patient outcomes based on clinical judgment and knowledge
  252. Nursing Interventions Classification (NIC)
    Any treatment the nurse performs to enhance patient outcomes based on clinical judgment and knowledge
  253. Nursing Outcome Classification (NOC)
    System of organizing desired patient outcomes according to categories, classes, labels, outcome indicators, and measurement activities for outcomes
  254. outcome
    A measurable statement of expectations
  255. outcome criteria
    Specific, measurable, realistic statement of goal attainment
  256. outcome identification
    Formulation of goals and measurable outcomes that provides the basis for evaluation
  257. planning
    Management function of deciding what to do, when, where, how, by whom, and with what resources
  258. priority
    Nursing problem that takes on a position of prominence
  259. qualifier
    Description of the parameter for achieving a goal
  260. scientific rationale
    Reason for a nursing intervention that is supported by clinical research
  261. variances
    Deviation that alters an expected outcome or date of discharge
  262. delegation
    • Transferring to a competent person the authority to perform a selected nursing task in a selected situation
    • The transfer of responsibility for the performance of a task to another staff while retaining accountability for the outcome. A licensed RN will delegate tasks to unlicensed assistive personnel (UAP).
  263. evaluation
    Judgment of the effectiveness of nursing care in achieving patient goals
  264. implementation
    Action phase of the nursing process in which nursing care is provided
  265. Nursing Interventions Classification (NIC)
    System of organizing nursing interventions in a three-level taxonomy consisting of domains, classes, and interventions and developed by a research team at the University of Iowa College of Nursing
  266. nursing audit
    Any review completed by a nurse of a patient’s care or records to evaluate whether established standards were met
  267. peer review
    Evaluation and judgment of performance by other nurses
  268. quality improvement programs
    Mechanisms for healthcare organizations to assess and improve care
  269. standards of care
    Comprise the expected level of performance or practice as established by guidelines, authority, or custom
  270. Types of Cognitive Nursing Interventions
    • Teach/educate.
    • Relate knowledge to activities of daily living (ADLs).
    • Provide feedback.
    • Create strategies for patients with dysfunctional communication.
    • Delegate to UAP.
    • Supervise nursing team.
    • Supervise patient in performance.
    • Supervise family in performance.
    • Alter the environment as needed.
  271. Types of Interpersonal Nursing Interventions
    • Coordinate activities.
    • Provide caregiving.
    • Use therapeutic communication.
    • Provide a personal presence.
    • Set limits.
    • Provide opportunity to examine values and attitudes.
    • Explore and legitimize feelings.
    • Provide spiritual support.
    • Use humor.
    • Provide individual therapy.
    • Provide group therapy.
    • Become patient’s advocate.
    • Support patient and family plans.
    • Make referrals for follow-up.
    • Serve as a role model.
  272. Types of Technical Nursing Interventions
    • Provide basic hygiene, skin care.
    • Perform routine nursing activities.
    • Detect change from baseline data.
    • Reorganize abnormal responses.
    • Provide independent and dependent treatment.
    • Assist with ADLs.
    • Provide appropriate sensory stimulation.
    • Mobilize equipment.
    • Maintain equipment.
    • Use special abilities or talents.
Card Set
Exam 1 - All Flashcards
Craven Ch 1, 4, 7, 19, 11, 12, Management of Care Post-Test