Nursing Chapter 01: The Evolution of Nursing

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Questions and Answers

When a nurse becomes involved in a legal action, the first step to occur is that a document is filed in an appropriate court. What is this document called?

  • Appeal
  • Summons
  • Deposition
  • Complaint (correct)

The nurse caring for a patient in the acute care setting assumes responsibility for a patient’s care. What is this legally binding situation?

  • Accountability
  • Standard of care
  • Advocacy
  • Nurse-patient relationship (correct)

What are the universal guidelines that define appropriate measures for all nursing interventions?

  • Standard of care (correct)
  • Advocacy
  • Prudent practice
  • Scope of practice

An LPN/LVN is asked by the RN to administer an IV chemotherapeutic agent to a patient in the acute care setting. What law should this nurse refer to before initiating this intervention?

<p>Nurse practice act (C)</p> Signup and view all the answers

A nurse fails to irrigate a feeding tube as ordered, resulting in harm to the patient. This nurse could be found guilty of:

<p>malpractice (B)</p> Signup and view all the answers

Patients have expectations regarding the health care services they receive. To protect these expectations, which of the following has become law?

<p>American Hospital Association’s Patient’s Bill of Rights (D)</p> Signup and view all the answers

The nurse is preparing the patient for a thoracentesis. What must be completed before the procedure may be performed?

<p>Informed consent (B)</p> Signup and view all the answers

When a nurse protects the information in a patient’s record, what ethical responsibility is the nurse fulfilling?

<p>Confidentiality (B)</p> Signup and view all the answers

An older adult is admitted to the hospital with numerous bodily bruises, and the nurse suspects elder abuse. What is the best nursing action?

<p>Report the bruises to the charge nurse (A)</p> Signup and view all the answers

What is the best way for a nurse to avoid a lawsuit?

<p>Provide compassionate, competent care (D)</p> Signup and view all the answers

The nurse is caring for a patient with a do-not-resuscitate (DNR) order. Although the nurse may disagree with this order, what is his or her legal obligation?

<p>To follow the order (C)</p> Signup and view all the answers

The nurse has strong moral convictions that abortions are wrong. When assigned to assist with an abortion, what is the most appropriate action for the nurse to take?

<p>Ask for another assignment (C)</p> Signup and view all the answers

The new LPN/LVN is concerned regarding what should or should not be done for patients. What resource will best provide this information?

<p>Standards of care (A)</p> Signup and view all the answers

What role is the nurse who diligently works for the protection of patients’ interests playing?

<p>Advocate (A)</p> Signup and view all the answers

When asked to perform a procedure that the nurse has never done before, what should the nurse do to legally protect himself or herself?

<p>Discuss it with the charge nurse, asking for direction (A)</p> Signup and view all the answers

The nurse is assisting a patient to clarify values by encouraging the expression of feelings and thoughts related to the situation. What is the most appropriate action for the nurse?

<p>Withhold an opinion (A)</p> Signup and view all the answers

What fundamental principle must the nurse first observe when confronted with an ethical decision?

<p>Respect for people (B)</p> Signup and view all the answers

A nurse working on an acute care medical-surgical unit is aware that his or her first duty is to the patient’s health, safety, and well-being. Given this knowledge, which of the following is most necessary for the nurse to report?

<p>Unethical behavior of other staff members (A)</p> Signup and view all the answers

A nurse is considering purchasing malpractice insurance. What should the nurse be aware of regarding malpractice insurance provided by the hospital?

<p>Only offers protection while on duty (B)</p> Signup and view all the answers

Which is a nursing care error that violates the Health Insurance Portability and Accountability Act (HIPAA)?

<p>Leaving a copy of the patient’s history and physical in the photocopier (B)</p> Signup and view all the answers

Which of the following could cause a nurse to be cited for malpractice?

<p>Giving prochlorperazine (Compazine) to a patient allergic to phenothiazines (A)</p> Signup and view all the answers

A lumbar puncture was performed on a patient without a signed informed consent form. This patient might sue for:

<p>civil battery (A)</p> Signup and view all the answers

A health care provider instructs the nurse to bladder train a patient. The nurse clamps the patient’s indwelling urinary catheter but forgets to unclamp it. The patient develops a urinary tract infection. What do the nurse’s actions exemplify?

<p>Malpractice (A)</p> Signup and view all the answers

What is true about nurse practice acts?

<p>The nurse must know the nurse practice act within his or her state (D)</p> Signup and view all the answers

Documentation of type of care, time of care, and signature of the person prove?

<p>Interventions were implemented to meet the patient’s needs. (A)</p> Signup and view all the answers

Why is documentation especially significant in managed care?

<p>Institutions are reimbursed only for patient care that is documented. (B)</p> Signup and view all the answers

The nurse charts only additional treatments done, changes in patient condition, and new concerns. What is this system of documentation?

<p>CBE (D)</p> Signup and view all the answers

What does documentation of type of care, time of care, and signature of the person prove?

<p>Interventions were implemented to meet the patient’s needs. (D)</p> Signup and view all the answers

Personal beliefs about the worth of an object, idea, custom, or attitude that influence a person’s behavior in a given situation are referred to as ______.

<p>values</p> Signup and view all the answers

Acts whose performance is required, permitted, or prohibited are defined by ______ of care.

<p>standards</p> Signup and view all the answers

The Patient’s Bill of Rights is not legally binding.

<p>False (B)</p> Signup and view all the answers

A nurse’s personal values should always dictate the care they provide, regardless of the patient’s needs and wishes.

<p>False (B)</p> Signup and view all the answers

It is always acceptable for a nurse to share a patient’s confidential information with their family members, even if the patient has not consented.

<p>False (B)</p> Signup and view all the answers

In a managed care setting, documentation is less important compared to other settings because patients are less likely to file lawsuits.

<p>False (B)</p> Signup and view all the answers

What is the purpose of nursing documentation?

<p>All of the above (D)</p> Signup and view all the answers

Which of the following is an example of objective documentation?

<p>The patient's blood pressure is 140/90 mmHg. (B)</p> Signup and view all the answers

What is the role of the LPN/LVN in documentation?

<p>LPN/LVNs document according to the scope of their practice and the nurse practice act of their state. (C)</p> Signup and view all the answers

Which of the following documentation systems is commonly used in hospitals?

<p>All of the above (D)</p> Signup and view all the answers

What does SOAP stand for in the context of documentation?

<p>Subjective, Objective, Assessment, Plan</p> Signup and view all the answers

Flashcards

Complaint

A document filed in an appropriate court as the first step in litigation.

Nurse-patient relationship

A legally binding 'contract' formed when a nurse assumes responsibility for a patient's care.

Standards of care

Accepted legal guidelines for appropriate nursing interventions.

Nurse practice acts

Laws that formally define and limit the scope of nursing practice.

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Malpractice

Failure to meet a legal duty, resulting in harm to another.

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Patient's Bill of Rights

The document that outlines a patient's expectations regarding health care services.

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Informed consent

Full disclosure of facts needed for informed decision-making before invasive procedures.

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Confidentiality

Ethical and legal duty to protect patient information and keep details private.

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Mandatory reporting

The nursing profession's obligation to report certain information to authorities.

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Do-not-resuscitate (DNR) order

A written order from a doctor stating that resuscitation efforts should not be performed.

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Values

Personal beliefs about the worth of something that influence behavior.

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Nonmaleficence

The ethical principle of 'do no harm'.

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Autonomy

The principle of respecting a person's right to make their own choices.

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Charting by exception (CBE)

A system of documenting patient care that focuses on deviations from expected care.

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Diagnosis-related groups (DRGs)

A system of reimbursement for hospital care based on patient diagnoses.

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Documentation

The nurse's notes document time of care, type of care, and signature of the person providing the care.

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Holistic Health Care

They reflect the patient's overall health and wellbeing, encompass physical, mental, social, and spiritual aspects.

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Nurse Practice Act

It formally defines and limits the scope of nursing practice, ensuring public safety from unqualified individuals.

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Standards of Care

This document guides the nurse's judgement on what is expected, permitted, or prohibited for care interventions.

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Nonmaleficence

This principle emphasizes the nurse's responsibility to avoid causing harm to patients.

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Advocacy

It reflects a commitment to patient care, not just following orders but protecting the patient's best interest.

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Patient Medical Record

This document provides a clear legal record of care delivered, offering proof of actions and outcomes.

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Confidentiality

This ethical principle emphasizes the nurse's responsibility to keep patient information confidential.

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Autonomy

This principle involves respecting the patient's right to make choices about their own healthcare.

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Beneficence

The nurses' ethical obligation to act in the patient's best interest.

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Nurse-patient relationship

This legal document establishes a nurse-patient relationship, where the nurse takes on the responsibility for care

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Accountability

This term refers to the nurse's individual actions and the responsibility they hold for the outcomes of those actions.

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Malpractice

These actions are seen as negligence toward a patient which leads to harm, impacting the patient's healthcare negatively.

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Mandatory Reporting

This term refers to the nurse's obligation to report any abuse or neglect toward a patient, ensuring their safety.

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Do-Not-Resuscitate (DNR) order

This legal document outlines a patient's right to refuse treatment and have end-of-life decisions respected.

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Ethics in nursing

The nurse's personal beliefs and values about what's right and wrong.

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State nurse practice acts

Laws that formally define and limit the scope of nursing practice, ensuring public safety from unqualified individuals.

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Study Notes

Chapter 01: The Evolution of Nursing

  • Nursing programs are considered "approved" when certified by a state agency, meeting minimum standards. "Accredited" means certified by the NLN, with more rigorous standards.
  • The main goal of the healthcare delivery system is to achieve optimal levels of health care.
  • An individualized care plan, developed by the entire healthcare team, outlines the care needed by an individual patient.
  • Increased education about the causes of illness, such as health conditions or habits, has led to an emphasis on wellness over illness.
  • Evaluation of care plans involves communication between healthcare team members, to identify and modify as needed.
  • An interdisciplinary approach to patient care prevents the fragmentation of care from multiple parties.
  • A newly licensed LPN/LVN practices under the supervision of a healthcare provider or RN.
  • Florence Nightingale's 19th-century influence focused on improving patient environments for health promotion through sanitary conditions and fresh air.
  • The Nurse Practice Act outlines the roles and responsibilities of LPN/LVNs.
  • Case management, a cost-effective approach to patient care, allows LPN/LVNs to work with RNs to meet patients' needs.
  • The Patient's Bill of Rights, created by the American Hospital Association in 1972, outlines patient expectations for dignified and compassionate treatment.
  • Nursing models are theories based on the relationships among nursing, patients, health, and environment.
  • The healthcare delivery system, impacting patient health, prioritizes optimum health care.
  • Cost reimbursements for care are dependent on documented interventions.
  • There are various methods of documentation, including SOAP and charting by exception (CBE).
  • Health conditions, behaviors, and social factors are all aspects of the wellness / illness continuum.
  • State licensing boards regularly assess and update the scope of practice for LPN/LVNs.
  • The Cadet Nurse Corps provided nursing training during World War II.
  • In legal actions involving nurses, the first document filed in court is the complaint.
  • The nurse-patient relationship is legally binding where a nurse takes responsibility for a patient's care.
  • Standards of care are universal guidelines defining appropriate nursing interventions.
  • The Nurse Practice Act is the law nurses should refer to when asked to administer a particular procedure involving a patient.
  • Malpractice is when a nurse fails to meet legal duties, causing patient harm.
  • The American Hospital Association's Patient's Bill of Rights protects patients' expectations in healthcare.
  • Informed consent is required before performing invasive procedures.
  • Confidentiality is an ethical and legal responsibility of nurses, protecting patient information, and is subject to legal disclosures.
  • Reporting suspected elder abuse is a legal requirement for healthcare professionals.
  • Providing competent and compassionate care is the best way to avoid legal issues.
  • Nurses have a legal obligation to follow DNR orders, even if they disagree with them.
  • The most appropriate course of action when assigned a procedure a nurse is unfamiliar with is to discuss it with the charge nurse and ask for direction.
  • Values clarification involves assisting patients in expressing feelings and thoughts related to situations without giving an opinion.
  • Respect for people is the first principle to consider when faced with ethical decisions.
  • Reporting unethical behavior of staff members is a necessary action for nurses for the safety and well-being of patients.
  • Some hospitals offer malpractice insurance; however, hospital insurance typically only covers nurses when they are actively on duty.
  • HIPAA violations could result from disclosing patient medical information to an inappropriate party.
  • Performing a procedure without a patient's informed consent can create legal issues.
  • The purpose of licensing laws for LPN/LVNs is to protect the public from unqualified health care providers.
  • The early nursing education of Florence Nightingale focused on practical skills, records keeping, and sanitary practices.
  • The nurse's responsibilities in documenting care, as well as the role documentation plays in managed care, are vital.
  • Nurses must be legally and ethically aware of the care they provide.
  • Protecting patients' rights by adhering to standards of care and informed consent is crucial.

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