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NSG 252 Final Exam
Fdtns Of Professional Nursing (NSG 252)
Miami University
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NSG 252 - Final Exam
Nursing Process, Care Planning and Nursing Diagnosis - 12 (Modules 4 and 5)
Critical Thinking Model: to make clinical decisions - Competence - developing - Specific Knowledge Base - Experience - Environment - Attitude
The Nursing Process: Assessment, Diagnosis, Planning (goals and outcomes), Implementation, and Evaluation (examining results) - Thought and Actions combined - Reflect afterward: this when the nurse reviews how she did, and improves your ability to problem solve - this is about the nurse Diagnosis: - Characteristics: the symptoms of the health problem - headache - Etiology: the cause/reasons of the health problem - disruption of tissue - Diagnosis: the overall health problem
Maslow’s Hierarchy of needs - to help you decide which problem you have to work on first, what are the top things I need to do. 1. Physiological needs 2. Safety needs 3. Love and Belonging 4. Self-Esteem 5. Self-Actualization
Smart Goals for Planning: - Specific, measurable, achievable, realistic, and timely - *Goals are achieved by the patient Example: Patient will report pain in the head as less than 3/10 using a 0-10 pain scale, 60 minutes after receiving 1,000 mg of Acetaminophen (Tylenol) per oral route.
Interventions done by the Nurse during Implementation:
- Based on clinical judgment
- Used to enhance patient outcomes Direct care intervention implementation = treatment performed through patient interactions - in room with patient - IV, counseling, medical administration Indirect care intervention implementation = treatments performed away from the patient but on behalf of them - Safety, infection control, documentation
Difference between Medical diagnoses and Nursing diagnoses: Medical Diagnosis: Identification of a disease based on specific evaluation Nursing Diagnosis: Clinical judgment concerning a human response to health conditions This doesn’t mean you identify a specific disease or ailment. Rather, your diagnosis will identify a general cause of symptoms (e., constipation, hypothermia, anxiety) Nursing diagnosis = - Symptoms: Abdominal pain, trouble voiding, headache - Etiology: Lack of fiber, dehydration - Diagnosis: Urinary retention, Constipation Medical diagnosis = - Irritable Bowel Syndrome
After assessing a patient, a nurse develops a standard formal nursing diagnosis. What is the rationale for the nurse’s actions? To distinguish the nurse’s role from the physician’s role
Ms. Gilford is placed on Isolation Precautions due to colonization of MRSA in nasal cavities.
Isolation precautions as a treatment intervention are an example of which type of care?
Indirect care intervention
A nurse performs an assessment on a patient. Which assessment data will the nurse use as an etiology for Acute pain? Disruption of tissue integrity
A nurse assesses that a patient has not voided in 6 hours. Which question should the nurse ask to assist in establishing a nursing diagnosis of Urinary retention? Do you feel the need to go to the bathroom?
Which of the following is a diagnostic error involving identification of a goal of care rather than a patient need? The patient receives social support care related to caregiver stress.
6 QSEN competencies: prepare future nurses with the knowledge, skills, and attitudes necessary to continuously improve their future practice: validate skills
- Teamwork and collaboration
- Client centered care
- Safety
- Quality Improvement
- Evidence-based Practice EBP
- Informatics
IOM improvement aims: STEEP - Safe - Timely - Effective - Equitable - Patient-centered
Patient Education and Teach Back - 2 (Module 6)
Speak Up Program: Allows patients to know their rights in receiving medical care - S: speak up with questions - P: pay attention to the care you receive - E: educate yourself on your illness - A: ask for someone to advocate for you if need be - K: know which medicines you are taking and the dose - U: use the hospital/program that you have researched - P: participate in the decision making process about your treatment
3 purposes of patient education: 1. Promotion of health and illness prevention 2. Restoration of health 3. Coping with the diagnosed health impaired
Role of the nurse in patient education: - Patient-centered - Prevents readmission - Making sure patient understands the health and the medical care they are
receiving
Teach-back method: - A way of checking understanding by asking patients to state in their own words what they need to know or do about their health. - It is a way to confirm that you have explained things in a manner your patients understand
Evidence Based Practice and Research - 3 (Module 7)
Evidence Based Practice = how to make a clinical decisions
Steps to EBP: PICOT format Ask a clinical question the PICOT format: P = Patient population - age/gender I = Intervention of interest - treatment C = Comparison of interest - standard of care being used O = Outcome - what you wish to achieve T = Time - how much time you need for intervention
Example: In adult patients with total hip replacements (Population), how effective is pain medication (Intervention) compared to aerobic stretching (Comparison) in controlling postoperative pain (Outcome) during the perioperative and recovery time (Time)?
Maslow - 2 (Module 4, Module 7 part 1 and Module 8)
Maslow’s Hierarchy of needs - to help you decide which problem you have to work on first, what are the top things I need to do. 6. Physiological needs 7. Safety needs 8. Love and Belonging 9. Self-Esteem 10. Self-Actualization
Maslow's Hierarchy of basic human needs is useful when planning and implementing nursing care as it provides a structure for: Establishing priorities of care
Careful hand-washing and using sterile techniques are ways in which nurses meet
The patient has been overweight for most of her life. She has tried dieting in the past and has lost weight, only to regain it when she stopped dieting. She is visiting the weight loss clinic/health club because she has decided to do it. She states that she will join right after the holidays, in 3 months. The nurse recognizes that the patient is in which stage of the change process? Contemplation
The patient is describing moderate incisional pain that was not relieved by the last dose of hydromorphone (Dilaudid) given 90 minutes earlier. The patient is not due for another dose of medication for another 2 1/2 hours. The nurse repositions the patient, asks what type of music she likes, and puts on the music channel on the television, setting it to play that type of music. The nurse is attempting to utilize which health care model? Holistic Health Model
Ethical Principles and ethical dilemma - 7 (Module 9)
Ethical Principles: Autonomy: Freedom from external control - the right to make informed decisions - Respecting patient autonomy = including the patient in decisions and all aspects of care Beneficence: Positive actions to help others - doing the good - Oldest requirements for health care providers - This is the agreement to act on the best interest of the patient and family Nonmaleficence: Avoiding harm and hurt - Ethical practice involves the will to do good, but the equal commitment to not do any harm
- Example: Balancing risks and benefits conversations with patient and family Justice: Fairness and the distribution of resources
- Used a lot when talking about health care resources
- Just culture refers to the promotion of open discussion without fear
- As a nurse we have to keep promises to be just to our patients Fidelity: Professional agreements and responsibilities
- As a nurse we are responsible for following through with practice and not abandoning our patients
- Duty to be faithful regardless of the patients beliefs or criminal background Veracity: Being truthful
- To not intentionally deceive or mislead a patient
- Basic foundation of trust
- Example: admitting mistakes and asking for help when you need A Right to Know: Patients have the right to know the information about their condition and their test results
Ethical Dilemma: when two opposing courses can be justified by ethics
Moral Distress: when the nurse feels the need to take a specific actions while believing that action is wrong
Approaches to Ethics: Deontology: defines actions as right or wrong based on their adherence to rules and principles such as fidelity, truthfulness, and justice. Utilitarianism: the value of something is determined by its level of usefulness Casuistry: case-based reasoning Feminist ethics: unequal power, point of view is ignored or invisible Ethics of care: emphasizes the role of decision-maker. Decisions are made based on context of the situation
Cultural, Caring and LGBTQ - 10 (Module 11)
Joint Commission's 4 questions of culture:
Grief, Loss and Death -6 (Module 13)
Self-concept, self-esteem and sexuality - 6 (Module 12)
Stress and Coping - 2 (Module 12)
Professional Practice Standards - 4 (Module 9)
NSG 252 Final Exam
Course: Fdtns Of Professional Nursing (NSG 252)
University: Miami University
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