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WCU Professional Nursing Midterm Questions
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Nursing theory Describes, explains, predicts, and/or prescribes nursing care. Explains why nurses do what they do. Nursing theories guide the design of Nursing interventions Florence Nightingale discovered Environmental theory: manipulating the patient's environment to promote healing. Founded modern healing. 1st to document, 1st nursing theorist Florence Nightingale Main focal point of nursing Patients SMART goal Specific Measurable Attainable Relevant Timely
Health A state of complete physical, mental, and social well-being Wellness Active state of being healthy (lifestyle promoting good physical, mental and emotional health) ADPIE Assessment Diagnosis Planning Implementation Evaluation Gather information about pt. condition Assessment Identify the pt. problem Diagnose Set goals of care and desired outcomes and identify appropriate nursing actions Plan Perform the nursing actions identified in planning Implement Determine if goals and expected outcomes are achieved
Collection and analysis of data Five Rights of Delegation Right Task, Circumstance, Person, Direction, Supervision When the RN delegates interventions the person is performing them On your behalf The RN is ______________ for all pt outcomes Accountable RN can delegate all nursing interventions except Evaluating, Assessing and Teaching Standard Nursing Interventions Reduce/eliminate contributing diagnostic factors, promote higher-level wellness and monitor and evaluate status Direct Care Treatments performed through interactions with patients Indirect Care Treatments performed away from the patient but on behalf of the patient or group of patients Examples of direct care ADLs, physical care, lifesaving measures
Examples of indirect care Documenting, delegating, environmental safety, change-of-shift report, infection control Independent Interventions Nurse initiates, does not require an order, based on scientific rationale Dependent Interventions Requires an order, based on physician's response to treat/manage a diagnosis Collaborative Interventions Require combined knowledge, skills and expertise of multiple health care professionals (including pt, and their family) Team Nursing Model RN as the team leader, delegating tasks to LPN/CNA, team members provide direct pt care under supervision of RN (Hierarchical) Total Pt Care Model RN is responsible for all aspects of pt care for 1+ pts, can delegate to LVN/CNA, RN works directly with pt and family Primary Nursing Model
Preventative Care Focus is to promote good health and to prevent illness, health fairs, BP screenings, immunizations, program based Restorative Care Intermediate follow-up care for restoring health, getting better, rehab, SNFs, home health Continuing Care Long-term care or chronic health care needs, end-of-life care, hospice, not getting better Maslow's Hierarchy of Needs Physiological, Safety & Security, Love & Belonging, Self- Esteem, Self-Actualization (5 levels of basic human needs) Subjective Data Information a pt states, feels Objective Data Information that is seen, heard, felt, smelled Nursing Diagnosis Provides a precise definition of a patient's problem Nurse Practice Act is updated or amended when Changes in scope of practice occur
Guidelines of the Nurse Practice Act To provide safe parameters within which to work, and protect patients from unprofessional and unsafe nursing practice (differ in each state) Living Will Specific to end of life/hospice, statement detailing person's desires for medical treatment if they are no longer able to express informed consent Durable Power of Attorney A written document delegating authority to another to act on the patient's behalf, if unable to make healthcare decisions. Advance Directives Right now/today, allows person to state in advance what their choices are for healthcare should circumstances develop Living Wills, Durable Power of Attorney & Advance Directives require A witness to sign RNs cannot Assist suicide, pronounce death or inform pt family of death. Assault
Not doing what you know to do, nonintentional, when their is a failure to follow policies or standards of care in the same manner that another reasonable nurse would do Malpractice Doing what you do not know, nonintentional, malpractice including breach of duty, reasonable foreseeability that a nurse's act has a connection when pt injury/harm occurred, link to pt harm, they have a right for financial compensation Torts Civil laws addressing legal rights of pts and the responsibilities of the nurse in the nurse-pt relationship Negligence is a ______________ to act Failure Minor Anyone under the age of 18 Exceptions to minor consent 14 with emancipation, married, pregnant minor, minor with venereal disease or substance abuse Minors need ___________ to consent for abortion One-parent, court, or self consent granted by court order Physical Abuse
Intentionally causing physical harm to another person Sexual Abuse Any sexual act without consent Psychosocial/Emotional abuse Verbal and nonverbal acts that inflict mental pain, anguish, and distress Financial Exploitation Taking advantage of an older person for monetary or personal benefit Caregiver Neglect Intentional or unintentional failure to meet needs necessary for pt physical and mental well-being Abandonment Leaving a patient after care has been initiated and before the patient has been transferred to someone with equal or greater medical training. Nurses are _____________ Mandated Reporters (for suspected abuse) What do you do 1st when you suspect abuse Report to your chain of command (then document later)
ADPIE
Critical thinking is used in the Nursing process to Solve problems of pts and make decisions using a process that creates safe, efficient and skillful nursing interventions The American Nurses Association (ANA) develops Scope of standards applying to all nurses Nursing Organizations align with the ANA to create their own Specific scope and standards of practice Therapeutic Communication Verbal and nonverbal communication techniques that encourage patients to express their feelings and to achieve a positive relationship, it advances physical and emotional well-being of a pt Describe how evaluation leads to discontinuation, revision, or modification Each time you evaluate a pt you determine if the plan of care continues or if revisions are necessary. If your pt meets a goal successfully, discontinue that portion of the care plan. When goals are not met, identify the factors that interfere with their achievement. Usually a change in the patients condition, needs or abilities makes alteration of the care plan necessary.
Nurse is performing shift assessment on a pt, which objective data should the nurse document in the nurse's notes? A. Pt has 1 cm bruise on right forearm B. Pt complaining of 8/10 pain C. Pt's daughter reports pt is nauseated D. Pt requested laxative fue to constipation A. Pt has 1 cm bruise on right forearm Nurse is receiving change-of-shift report for group of clients. Nurse anticipates which activities 1st in delivering client care using the nursing process? A. Analyze client data collected to determine priorities B. Set client-centered, measurable and realistic goals C. Collect and organize client data D. Determine effectiveness of interventions C. Collect and organize client data A nurse gathers the following assessment data. Which of the following cues form(s) a pattern suggesting a problem? (Select all that apply) [16] A. The skin around the wound is tender to touch B. Fluid intake for 8 hours is 800 mL C. Patient has a heart rate of 78 and regular D. Patient has drainage from surgical wound E. Body temperature is 101F (38.3 C) F. Patient states, "I'm worried that I won't return to work when I planned."
Nurse is applying for a position with a Rehabilitation Org. that specializes in spinal cord injury & physical therapy. The nurse is applying to work in which level of care? A. Secondary B. Tertiary C. Continuing D. Restorative D. Restorative Nurse is providing BP screening at the local senior center. This is an example of which level of health care? A. Secondary B. Preventative C. Tertiary D. Restorative B. Preventative Pt admitted to acute care with severe diarrhea and vomiting for the past week, he is weak with labored breathing. He is an active business man worried about getting back to work. Using Maslow's hierarchy of needs, identify the pt's immediate priority. A. Self-actualization B. Air, water and nutrition C. Safety D. Esteem and self-esteem needs B. Air, water and nutrition
