Nursing Concepts 3 Test 1 practice

Leadership Styles

• Democratic: characterized by a sense of equality among the leader and other participants, with decisions and activities shared
• Laissez-faire: the leader relinquishes power to the group, making it difficult to identify the leader
• Servant: begins with the natural feeling that one wants to serve
• Quantum: views an organization and its members as interconnected and collaborative, helpful in unpredictable events and changing environments
• Transactional: based on a task-and-reward orientation
• Transformational: charismatic, inspiring, and motivating leaders who are unique in their ability to inspire and motivate others

Leadership Qualities

• Charismatic
• Dynamic
• Enthusiastic
• Poised
• Confident
• Self-directed
• Flexible
• Knowledgeable
• Politically aware

Leadership Skills

• Commitment to excellence
• Problem-solving skills
• Commitment to and passion for one's work
• Trustworthiness and integrity
• Respectfulness
• Accessibility
• Empathy and caring
• Responsibility to enhance personal growth of all staff

Conflict Resolution Strategies

• Lewin's Theory of Change:
  • Unfreezing: recognizing the need for change
  • Moving: initiating change after careful planning
  • Refreezing: making change operational

Achieving Self-Knowledge

• Identify strengths
• Evaluate how you accomplish work
• Clarify values
• Determine where you belong and what you can contribute
• Assume responsibility for relationships

ANA Principles for Delegating Care

• RN is responsible for:
  • Initial patient assessment
  • Discharge planning
  • Health education
  • Care planning
  • Triage
  • Interpreting patient data
  • Care of invasive lines
  • Administering parenteral medications
• RN can delegate tasks such as:
  • Assistance with basic care activities
  • Collecting patient data (e.g., vital signs)
  • Simple dressing changes
  • Transfers
  • Postmortem care
• RN is responsible and accountable for nursing practice and supervises AP providing direct patient care
• Purpose of AP is to work in a supportive role to the RN

Considerations When Delegating Nursing Care

• Stability of the patient's condition
• Complexity of the activity
• Potential for harm
• Predictability of the outcome
• Overall context of other patient needs

Developing Leadership Responsibilities

• Knowledge of administrative structure
• Mentorship
• Preceptorship
• Participation in nursing and other professional organizations
• Continuing education

Overcoming Resistance to Change

• Explain proposed change to all affected
• List advantages of the change
• Relate change to person's existing beliefs and values
• Provide opportunities for open communication and feedback
• Indicate how change will be evaluated
• Introduce change gradually
• Provide incentives for commitment to change

Physical Assessment

• Types of Health Assessments:
  • Comprehensive
  • Ongoing partial
  • Focused
  • Emergency
• Preparing the Patient:
  • Consider physiologic and psychological needs
  • Explain process to patient
  • Explain that physical assessments should not be painful
  • Explain each procedure in detail
  • Answer patient questions directly and honestly
• Preparing the Environment:
  • Ensure patient is as free of pain as possible
  • Prepare examination table
  • Provide gown and drape
  • Gather supplies and instruments
  • Provide a comfortable room temperature
• Positions Used During a Physical Assessment:
  • Standing
  • Sitting
  • Supine
  • Dorsal recumbent
  • Sim's
  • Prone
  • Lithotomy
  • Knee-chest

Integumentary Assessment

• Identify risk factors:
  • History of rashes, lesions, bruising, allergies
  • Exposures to sun, chemicals
  • Piercings or tattoos
  • Degree of mobility
  • Nutritional status
• Inspection and palpation
• Terminology:
  • Erythema (redness)
  • Ecchymosis (collection of blood in subcutaneous tissue)
  • Petechiae (hemorrhagic spots/capillary bleeding)
  • Cyanosis (bluish or grayish color)
  • Jaundice (yellow color)
  • Pallor (paleness)
  • Diaphoresis (excessive perspiration)
  • Turgor (elasticity)
  • Edema (excess fluid)

Other Systems Assessments

• Head and Neck:
  • Identify risk factors
  • Inspection and palpation
  • Visual acuity, extraocular movements, peripheral vision
  • Hearing and sound conduction
  • Thyroid gland and lymph nodes
• Thorax and Lungs:
  • Identify risk factors
  • Inspection, palpation, auscultation, and percussion
  • Posterior thorax excursion/chest expansion
  • Lung sounds:
    • Bronchial or tubular
    • Bronchovesicular
    • Vesicular
    • Adventitious
    • Wheeze
    • Rhonchi
    • Crackles
    • Stridor
    • Friction rub
• Cardiovascular and Peripheral Vascular Systems:
  • Identify risk factors
  • Inspection, palpation, and auscultation
  • Carotid arteries, heart sounds, peripheral pulses
  • Neurovascular status
• Abdomen:
  • Identify risk factors
  • Inspection, auscultation, percussion, and palpation
  • Characteristics of masses:
    • Shape
    • Size
    • Consistency
    • Surface
    • Mobility
    • Tenderness
• Musculoskeletal System:
  • Identify risk factors
  • Inspection, palpation
  • Neurovascular status
• Neurological System:
  • Identify risk factors
  • History of numbness, tingling, seizures, trembling
  • Headaches or dizziness
  • Trauma to head or spine
  • History of HTN or stroke
  • Changes in vision, hearing, taste, or smell
  • History of diabetes or cardiovascular disease
  • Alcohol and medications
  • Health history interview
  • Mental status:
    • Level of consciousness
    • Level of awareness
    • Memory
    • Emotional status
    • Cognitive abilities and behavior
    • Cerebellar function
    • Cranial nerve function
    • Motor and sensory function
    • Reflexes

Communication

• Forms of Communication:
  • Verbal (e.g., telling a patient to wash their hands)
  • Non-Verbal (e.g., touch, eye contact, facial expressions)
• Factors Influencing Communication:
  • Developmental level
  • Sociocultural differences
  • Roles and responsibilities
• Providing Culturally Competent Patient Education:
  • Develop an understanding of the patient's culture
  • Work with a multicultural team
  • Be aware of personal assumptions, biases, and prejudices
  • Understand the core cultural values of the patient or group
  • Develop written material in the patient's preferred language

Teaching and Learning

• Assessment of the Learner:
  • Identify learning needs
  • Assess learning readiness
  • Assess learning style
  • Assess learning strengths
  • Consider the patient's motivation
• Promoting Patient and Family/Caregiver Adherence:
  • Adherence is preferred over compliance
  • Refers to the extent to which a person's behavior corresponds with agreed-upon recommendations
  • Uses a team approach to the treatment plan
  • Reflects the patient's right to choose
  • Supports inclusive and active patient role
• Suggested Teaching Strategies:
  • Cognitive domain: lecture, panel, discovery, written materials
  • Affective domain: role modeling, discussion, audiovisual materials
  • Psychomotor domain: demonstration, discovery, printed materials
• Factors Affecting Patient Learning:
  • Age and developmental level
  • Family/caregiver support networks
  • Financial resources
  • Cultural influences and language
  • Health literacy
• Teaching Plans for Older Adults:
  • Identify learning barriers
  • Allow extra time
  • Plan short teaching sessions
  • Accommodate for sensory deficits
  • Reduce environmental distractions
  • Relate new information to familiar activities or information
• Effective Communication Techniques:
  • Be sincere and honest
  • Show genuine interest
  • Avoid giving too much detail
  • Ask if the patient has questions
  • Be a cheerleader for the patient
  • Use simple words
  • Vary the tone of voice and keep content clear and concise
  • Ensure the environment is conducive to learning and free from interruptions
  • Be sensitive to the timing and length of the session
• Role of the Nurse as Coach:
  • Establishing relationships and identifying readiness for change
  • Identifying opportunities, issues, and concerns
  • Establishing patient-centered goals
  • Creating the structure of the coaching interaction
  • Empowering and motivating patients to reach goals
  • Assisting the patient to determine progress toward goals### Leadership Styles
• Democratic: equality among leader and participants, shared decisions and activities
• Laissez-faire: leader relinquishes power to the group, hard to identify the leader
• Servant: leader serves others, prioritizes others' needs
• Quantum: organization and members are interconnected and collaborative
• Transactional: task-and-reward orientation
• Transformational: charismatic, inspires and motivates others

Leadership Qualities

• Charismatic
• Dynamic
• Enthusiastic
• Poised
• Confident
• Self-directed
• Flexible
• Knowledgeable
• Politically aware

Leadership Skills

• Commitment to excellence
• Problem-solving skills
• Commitment to and passion for work
• Trustworthiness and integrity
• Respectfulness
• Accessibility
• Empathy and caring
• Responsibility to enhance personal growth

Conflict Resolution Strategies

• Lewin's Theory of Change
  • Unfreezing: recognize need for change
  • Moving: plan and implement change
  • Refreezing: change becomes operational

Achieving Self-Knowledge

• Identify strengths
• Evaluate work accomplishment
• Clarify values
• Determine where you belong and what you can contribute
• Assume responsibility for relationships

ANA Principles for Delegating Care

• RN responsible for initial patient assessment, discharge planning, health education, care planning, triage, interpreting patient data, care of invasive lines, and administering parenteral medications
• RN can delegate tasks such as assistance with basic care activities, collecting patient data, simple dressing changes, transfers, and postmortem care
• RN responsible and accountable for nursing practice and supervises AP providing direct patient care
• AP works in a supportive role to the RN

Considerations When Delegating Nursing Care

• Stability of the patient's condition
• Complexity of the activity
• Potential for harm
• Predictability of the outcome
• Overall context of other patient needs

Overcoming Resistance to Change

• Explain proposed change to all affected
• List advantages of the change
• Relate change to person's existing beliefs and values
• Provide opportunities for open communication and feedback
• Indicate how change will be evaluated
• Introduce change gradually
• Provide incentives for commitment to change

Physical Assessment

Types of Health Assessments

• Comprehensive: conducted upon admission to healthcare facility
• Ongoing partial: conducted at regular intervals
• Focused: conducted to assess a specific problem
• Emergency: conducted to determine life-threatening or unstable conditions

Preparing the Patient for Physical Assessment

• Consider physiologic and psychological needs of the patient
• Explain the process to the patient
• Ensure privacy and comfort

Preparing the Environment for Physical Assessment

• Ensure patient is as pain-free as possible
• Prepare the examination table
• Gather necessary supplies and instruments
• Provide a comfortable room temperature

Positions Used During a Physical Assessment

• Standing: assess posture, balance, and gait
• Sitting: assess upper body
• Supine: assess abdominal muscles
• Dorsal recumbent: assess rectum and vagina
• Sim's: assess rectum and vagina
• Prone: assess hip joint and posterior thorax
• Lithotomy: assess female genitalia and rectum
• Knee-chest: assess anus and rectum

Integumentary Assessment

• Identify risk factors: rashes, lesions, bruising, allergies
• Inspection and palpation: assess skin, hair, and nails

Head and Neck Assessment

• Identify risk factors: vision changes, hearing loss, allergies
• Inspection and palpation: assess eyes, ears, nose, and throat

Thorax and Lungs Assessment

• Identify risk factors: chest pain, lung disease, smoking
• Inspection, palpation, auscultation, and percussion: assess lungs and chest

Cardiovascular and Peripheral Vascular Assessment

• Identify risk factors: chest pain, palpitations, dizziness
• Inspection, palpation, and auscultation: assess heart, blood pressure, and peripheral pulses

Abdominal Assessment

• Identify risk factors: abdominal pain, nausea, vomiting
• Inspection, auscultation, percussion, and palpation: assess abdomen and organs

Musculoskeletal System Assessment

• Identify risk factors: trauma, arthritis, neurologic disorders
• Inspection, palpation, and range of motion exercises: assess muscles, bones, and joints

Neurological System Assessment

• Identify risk factors: numbness, tingling, seizures, trembling
• Inspection, palpation, and tests of cognitive function: assess brain function and nervous system

Communication

Forms of Communication

• Verbal communication: spoken words
• Non-verbal communication: touch, facial expressions, body language, tone of voice

Factors Influencing Communication

• Developmental level
• Sociocultural differences
• Roles and responsibilities
• Space and territoriality
• Physical, mental, and emotional state
• Values and beliefs
• Environment

The Therapeutic Relationship

• Sets the climate for participants to work towards common goals
• Characterized by unequal sharing of information
• Patient should be the one oversharing### Leadership Styles
• Democratic: characterized by a sense of equality among the leader and other participants, with shared decisions and activities
• Laissez-faire: the leader relinquishes power to the group, making it difficult to identify the leader
• Servant: begins with a natural feeling of wanting to serve
• Quantum: views an organization and its members as interconnected and collaborative, helpful in unpredictable events and changing environments
• Transactional: based on a task-and-reward orientation
• Transformational: charismatic leaders inspire and motivate others

Leadership Qualities

• Charismatic
• Dynamic
• Enthusiastic
• Poised
• Confident
• Self-directed
• Flexible
• Knowledgeable
• Politically aware

Leadership Skills

• Commitment to excellence
• Problem-solving skills
• Commitment to and passion for one’s work
• Trustworthiness and integrity
• Respectfulness
• Accessibility
• Empathy and caring
• Responsibility to enhance personal growth of all staff

Conflict Resolution Strategies

• Lewin’s Theory of Change:
  • Unfreezing: recognizing the need for change
  • Moving: change is initiated after careful planning
  • Refreezing: change becomes operational

Achieving Self-Knowledge

• Identify your strengths
• Evaluate how you accomplish work
• Clarify your values
• Determine where you belong and what you can contribute
• Assume responsibility for relationships

ANA Principles for Delegating Care

• RN is responsible for initial patient assessment, discharge planning, health education, care planning, triage, interpretation of patient data, care of invasive lines, and administering parenteral medications
• RN can delegate tasks such as assistance with basic care activities, collecting patient data, simple dressing changes, transfers, and postmortem care
• RN is responsible and accountable for nursing practice and supervises any AP providing direct patient care
• Purpose of AP is to work in a supportive role to the RN

Considerations When Delegating Nursing Care

• Stability of the patient’s condition
• Complexity of the activity
• Potential for harm
• Predictability of the outcome
• Overall context of other patient needs

Developing Leadership Responsibilities

• Knowledge of the administrative structure
• Mentorship
• Preceptorship
• Participation in nursing and other professional organizations
• Continuing education

Overcoming Resistance to Change

• Explain proposed change to all affected
• List the advantages of the change
• Relate the change to the person’s existing beliefs and values
• Provide opportunities for open communication and feedback
• Indicate how change will be evaluated
• Introduce change gradually
• Provide incentives for commitment to change