Fundamentals of Nursing Prelim Reviewer PDF

FUNDAMENTALS OF NURSING PRELIM REVIEWER I. INTRO TO FUNDAMENTALS Characteristics of Nursing What is Nursing?  Nursing is Caring: Central to nursing is the  is not simply a collection of specific skills concept of care, whether p...

FUNDAMENTALS OF NURSING PRELIM REVIEWER I. INTRO TO FUNDAMENTALS Characteristics of Nursing What is Nursing?  Nursing is Caring: Central to nursing is the  is not simply a collection of specific skills concept of care, whether physical, nor just a person trained to perform psychological, or emotional. specific tasks.  Personal Contact: Nursing involves close, Definitions of Nursing: direct personal interaction with those Florence Nightingale's Definition (1860): receiving care.  Nursing is "the act of utilizing the  Holistic Approach: Nursing addresses environment of the patient to assist in individuals as physiological, psychological, recovery." and sociological beings. Virginia Henderson's Definition (1966):  Commitment to Health: Nurses promote  Nursing's unique function is to assist health goals for individuals, families, individuals (sick or well) in performing communities, and nations. activities that contribute to health or  Personalized Services: Nursing is dedicated recovery, aiming for independence. to providing personalized care regardless Theoretical Definitions: of race, creed, or economic status.  Nursing is described as:  Ethical Involvement: Nurses are engaged  Caring, an art, and a science. in ethical, legal, and political matters that  Client-centered, holistic, adaptive, and impact healthcare delivery. focused on health promotion, Focus of Nursing maintenance, and restoration.  Focus on human responses to both actual  A helping profession. and potential health problems. Nursing as an Art and Science  Health-restoring responses: Reactions to Nursing as an Art: existing health problems or illness.  Delivering care artfully with compassion,  Health-supporting responses: Concerns respect, and dignity for each client. about potential health problems. Nursing as a Science:  Nurses work with both sick and well  Nursing is grounded in a continually individuals, as human responses to health evolving body of knowledge, driven by new change dynamically. discoveries. Professional Qualities of a Nurse Art + Science = Provision of high-quality care.  Bachelor’s degree in nursing Profession  Physically and mentally fit  A profession is an occupation that requires  Licensed to practice nursing special knowledge, skill, and preparation. Personal Qualities of a Nurse: Difference between a job and a profession:  Compassionate: Deep awareness and  Job: A role primarily focused on earning a sympathy for others' suffering. living, often with less emphasis on personal  Respectful: Helps maintain patient dignity, growth or ethical responsibility. especially in vulnerable times.  Profession: A career requiring specialized  Calm Under Pressure: Able to make education and training, with a rational decisions in high-stress situations. commitment to ethical standards,  Detail-Oriented: Attentive to the smallest accountability, and continual development. details of care.  Professional Practice: Nurses deliver care  Good Communicator: Effective at listening with knowledge, competence, and and communicating clearly with patients. responsibility, being accountable not only  Knowledgeable: Skilled in critical thinking, to themselves but also to their patients, patient assessment, disease management, colleagues, and society. and care plans. BSN1 - SNR 1  FUNDAMENTALS OF NURSING PRELIM REVIEWER Roles and Functions of a Nurse Nurse Administrator  Caregiver: Assists clients physically and  Manages client care, staffing, budgeting, psychologically, preserving dignity. and program planning.  Communicator: Integral to nursing, helping Nurse Educator to identify problems and relay information  Teaches in educational institutions or to the healthcare team. clinical settings.  Client Advocate: Protects client rights and Nurse Entrepreneur communicates their needs.  Manages a healthcare-related business or  Counselor: Provides emotional, service. psychological support and helps clients Scope of Nursing Practice manage stress or social challenges. Republic Act 9173 (Philippine Nursing Act of  Change Agent: Helps clients change 2002). Approved on October 21, 2002. behaviors and advocates for changes in  Purpose: To provide a strong foundation clinical care systems. for nursing through quality education and  Teacher: Educates clients on health and practice. self-care.  Coverage: Includes nursing care across all  Leader: Influences others to achieve life stages and health conditions, both healthcare goals. independently and as part of a healthcare  Manager: Manages care, delegates tasks, team. and supervises performance. Sec. 28 - Scope of Nursing Practice:  Case Manager: Oversees care plans with a  Nursing care spans all life stages: from multidisciplinary team and monitors conception to old age. outcomes.  Independent Practice: Nurses are  Research Consumer: Engages in research responsible for promoting health and to improve patient care and identifies preventing illness. researchable problems.  Collaborative Practice: Nurses work with  elivery. other healthcare providers for: Expanded Roles of Nurses  Curative, preventive, and rehabilitative Nurse Practitioner care  Advanced education, certified in various  Alleviating suffering specialties (e.g., Family Nurse Practitioner,  Health restoration Pediatric Nurse Practitioner).  Ensuring a peaceful death when Clinical Nurse Specialist recovery is not possible.  Advanced education, expert in a Code of Ethics for Nurses: specialized area, involved in direct care,  Defines the principles guiding nurses in education, consultation, and research. their practice.  Ex: Gerontology, Oncology Basic Principles: Nurse Anesthetist  Advocacy: Advocating for the health,  Advanced education in anesthesiology, safety, and rights of clients. provides anesthesia services under  Responsibility: Upholding obligations and physician supervision. following through on promises. Nurse Midwife  Accountability: Being answerable for one’s  Advanced education in midwifery, provides actions. prenatal, postnatal, and delivery care.  Confidentiality: Protecting client’s Nurse Researcher personal health information.  Investigates nursing issues to enhance care, typically requires advanced education. BSN1 - SNR 2  FUNDAMENTALS OF NURSING PRELIM REVIEWER II. EVOLUTION OF NURSING  Lady with a Lamp/ Mother of Modern Intuitive Era Nursing  Practiced during the prehistoric, nursing  Correlate theory and practice, updates, was untaught, rendered by the mothers continuing education, research, self- (by intuition, it is the woman who is more supporting nursing school (separate from caring). hospital)  Out of love, sickness caused by black spirits,  Changed image of nursing, revolutionized based on instinct practice Rennaisance Period (1500AD-1850AD) Contemporary Era  The Dark Period of nursing  Known as the Modern nursing practice  nurses of this period are considered as  Nursing evolved toward a scientific, “wayward” women of low status who research-based defined body of nursing become “nurse” instead of going of going knowledge and practice to jail. PIONEERS IN NURSING The Knights of Saint Lazarus (circa 1200) Florence Nightingale (1820–1910)  dedicated themselves to the care of people  Founder of modern nursing, known for with leprosy, syphilis, and chronic skin improving wartime care, public health conditions. reform, and the establishment of the Apprentice Era Nightingale Training School.  Known as the “on the job training” period, Clara Barton (1821–1912) under the supervision of a more  Founded the American Red Cross and experienced person, but yet there is no helped ratify the Geneva Convention for formal education. humanitarian aid.  Experienced (through trial and error) nurse Linda Richards (1841–1930) teaches new volunteer nurses who usually  America’s first trained nurse, pioneer in came from religious orders. psychiatric and industrial nursing, and  Nursing the sick and wounded from the introduced nurse’s notes and uniforms. wars Mary Mahoney (1845–1926) Pastor Theodore Fliedner and Frederika (wife)  First African American professional nurse,  established the Kaiserswerth Institute for advocate for racial equality in nursing. the training for Deaconesses in Germany Lillian Wald (1867–1940)  The first formal training school for nurses  Founder of public health nursing, co- Florence Nightingale (1820-1910) founder of the Henry Street Settlement,  most famous student of Kaiserswerth and pioneer in school nursing. Institute Lavinia Dock (1858–1956)  Nursing was viewed as a very low paying  Feminist, political activist, and suffragette job in the social hierarchy who helped establish the American Society Sojourner Truth (1797–1883) of Superintendents of Training Schools for Harriet Tubman(1820–1913) Nurses.  provided care and safety to slaves fleeing Margaret Sanger (1879–1966) to the North on the Underground Railroad  Advocate for women’s reproductive rights Mother Biekerdyke and Clara Barton and founder of Planned Parenthood.  searched the battlefields and gave care to Mary Breckinridge (1881–1965) injured and dying soldiers  Established the Frontier Nursing Service, Educative Era providing healthcare in rural America and Florence Nightingale School of Nursing creating the first midwifery training school.  First theory author, first nurse-researcher BSN1 - SNR 3  FUNDAMENTALS OF NURSING PRELIM REVIEWER PHILIPPINE NURSING LEADERS theories (e.g., consequentialism, Cesaria Tan deontology)  1st Filipino Nurse to have Masters Degree 3. Nursing Aesthetics/Aesthetic Knowing in Nursing  The art of nursing. Magdalena Valenzuela  Expressed through actions, conduct,  1st Filipino Industrial Nurse (company) attitudes, and interactions. Col. Elvegla Mendoza  Involves a deep appreciation of the  1st Female Military Nurse meaning of a situation, often shared Dr. Julita Sotejo without words.  Florence Nightingale of the Philippines  Involves intuition, empathy, and skillful  Author of the Code of Ethics action to create meaningful nursing  Founder of the UP-CN situations. Anastacia Giron-Tupas  The “aha” moment.  Founder of the PNA (first week of MAY) 4. Personal Knowledge/Personal Knowing Rosario Montemayor Delgado  Grounded in self-awareness, confidence,  1st President of the FNA and reflection. III. NURSING AS AN ART  Involves engaging in therapeutic use of self Nursing as a Science during interactions with patients. Nursing as an Art:  Needs to be integrated with professional  Delivering care artfully with compassion, responsibilities through observation, respect, and dignity for each client. reflection, and self-actualization. Art + Science = Provision of high-quality care. Caring Behaviors and Encounters in Nursing Caring Knowing the Patient  Caring is a universal phenomenon  Nurse’s understanding of a specific patient influencing human interactions. to select appropriate interventions. Is Caring Teachable?  Facilitated by continuity of care and clinical  Caring is shaped by culture, values, expertise. experiences, and relationships. Nursing Presence  People who do not experience care may  A person-to-person encounter conveying find it hard to act in caring ways. closeness and a sense of caring. Carper’s Four Patterns of Knowing in Nursing  Involves “being there” and “being with.” Empowering the Client 1. Nursing Science/Empirical Knowing  Supporting patient autonomy and  Assumption: Knowledge is accessible responsibility for decision-making during through physical senses (seeing, touching, treatment. hearing).  Giving the patient freedom to choose their  Expressed in practice as scientific treatment options. competence. Compassion  Sources of Knowledge: Research, Theory,  Intelligent kindness based on empathy, Evidence-Based Practice (EBP). respect, and dignity. 2. Nursing Ethics/Ethical Nursing  Central to how people perceive their care  Guides and directs nursing practice and relationships with healthcare providers. through moral knowledge. Competence  Focus: Matters of obligation, what ought  Ability to understand individual health and to be done, right/wrong, and responsibility. social needs.  Source: Nursing Code of Ethics,  Involves clinical and technical knowledge Professional Standards, and various ethical to deliver effective care and treatments. BSN1 - SNR 4  FUNDAMENTALS OF NURSING PRELIM REVIEWER Touch  Grand theories are broad and rarely guide  A comforting approach to communicate research directly. concern and support.  Mid-range theories focus on specific  Includes both contact and non-contact concepts (e.g., pain, self-esteem). touch.  Critical theory explores social structures Listening (race, gender, economic class) affecting  Essential for meaningful interactions with health outcomes. patients. In Clinical Practice  Involves being present and engaging in a  Helps nurses reflect, question, and nonjudgmental, accepting manner. improve practice. IV. NURSING AS SCIENCE  Example: Orem’s Self-Care Deficit Theory  Based on a body of knowledge. applied to school nursing for children with  A blend of current knowledge and practice special needs. standards.  Practice theories (e.g., theory of  Data obtained from current research and postpartum depression) support evidence- nursing theories based practice. The Metaparadigm of Nursing Selected Nursing Theories  Meta = “with” Nightingale’s Environmental Theory  Paradigm = “pattern”  Nursing involves creating an environment Four Major Concepts: for recovery. a) Person Five Key Environmental Factors  The recipient of nursing care (individuals, 1) Pure/Fresh Air families, groups, or communities). 2) Pure Water b) Environment 3) Efficient Drainage  Internal and external surroundings that 4) Cleanliness affect the client (includes physical, social, 5) Light (especially direct sunlight) and emotional factors).  Deficiencies in these factors lead to illness c) Health or poor health.  The level of wellness or well-being the  Additional Environmental Considerations client experiences.  Importance of maintaining warmth, a d) Nursing quiet environment, and proper diet for  The attributes, characteristics, and actions patients. of the nurse providing care in collaboration  Special focus on assessing the intake, with the client. timeliness, and effect of food on Role of Nursing Theory recovery. In Education Peplau’s Interpersonal Relations Model  Initially used to establish nursing as a  Therapeutic relationship between nurse profession in universities. and client.  To clarify the essential meanings and  Nurses assume various roles to support the values of the nursing profession while also client: stranger, teacher, resource person, enhancing its recognition and credibility as surrogate, leader, and counselor a professional field. Four Phases of the Nurse-Client Relationship In Research 1) Orientation: The client seeks help, and the  Provides philosophical foundations for nurse assists in understanding the problem research. and need for help.  Helps identify gaps and generate new ideas 2) Identification: The client’s relationship to for study areas the nurse varies (dependence, BSN1 - SNR 5  FUNDAMENTALS OF NURSING PRELIM REVIEWER interdependence, independence), and the Types of Nursing Systems nurse helps the client understand the Wholly Compensatory Systems interpersonal meaning of their situation.  individuals who cannot control or monitor 3) Exploitation: The client fully benefits from their environment. the relationship, using available services Partly Compensatory Systems based on self-interest. Power shifts from  individuals who need help with some self- nurse to client. care activities. 4) Resolution: Older needs and goals are Supportive-Educative Systems resolved, and new, more mature needs  individuals who need assistance learning and goals emerge. self-care measures. Orem’s General Theory of Nursing Leininger’s Cultural Care Diversity and  Focuses on three related concepts: self- Universality Theory care, self-care deficit, and nursing systems.  Human caring is universal but varies across  Addresses when nursing is needed and cultures in its expressions, processes, and how people can be assisted. patterns.  Nursing is required when individuals  Emphasizes cultural competence in nursing cannot meet self-care needs. care.  Self-Care: Activities individuals perform to Intervention Modes for Culturally Competent maintain personal well-being. Care  Self-Care Agency: The ability to perform 1) Culture Care Preservation and self-care activities, involving both self-care Maintenance agents (individuals) and dependent care  Supporting and preserving cultural agents (others assisting). practices.  Self-Care Requisites: Measures taken to 2) Culture Care Accommodation and maintain self-care, including: Negotiation 1) Universal Requisites: Common needs  Adapting care while respecting cultural (e.g., air, food, rest, safety). values. 2) Developmental Requisites: Needs 3) Culture Care Restructuring and arising from maturation or life events Repatterning (e.g., adjusting to body image changes).  Modifying care practices for better 3) Health Deviation Requisites: Needs outcomes while considering cultural arising from illness or treatment (e.g., differences. seeking healthcare, following Roy’s Adaptation Model therapies).  Focuses on individuals as biopsychosocial  Therapeutic Self-Care Demand: All self- adaptive systems. care activities needed to meet requisites  Uses feedback cycles and adaptive and maintain health. responses. Self-Care Deficit Four Adaptive Modes  Occurs when self-care agency is insufficient 1) Physiological Mode to meet self-care demands, requiring  involves the body’s basic physiological nursing assistance through: needs and ways of adapting  Acting or doing for i. E.g. fluids and electrolytes, activity  Guiding and rest, the senses, and  Teaching neurologic and endocrine function.  Supporting 2) Self-concept mode  Providing a conducive environment  Physical self - sensation and body image BSN1 - SNR 6  FUNDAMENTALS OF NURSING PRELIM REVIEWER  Personal self - self-ideal, self- Evidence-Based Practice (EBP) consistency, and the moral ethical self. 3) Role Function mode  the need for social integrity and refers to the performance of duties based on given positions within society. 4) Interdependence mode  one’s relations with significant others and support systems that provide help, affection, and attention. Watson’s Human Caring Theory  Central focus: Caring is the essence of nursing.  Nursing is a caring relationship that What is EBP? promotes healing. Evidence-based practice (EBP), or evidence-  Focuses on holistic care—mind, body, and based nursing, occurs when the nurse can soul “integrate best current evidence with clinical 10 Carative Factors expertise and patient/family preferences and 1) Altruistic Values and Loving Kindness values for delivery of optimal health care”  Embrace values and practice kindness Uses the following steps: with self and others.  Cultivate a spirit of inquiry. 2) Faith and Hope Nurses need to be curious and willing  Instill faith, hope, and honor others. to investigate how various practices 3) Sensitivity to Self and Others compare and which might be best for  Nurture individual beliefs and practices. a specific client. 4) Helping-Trusting Relationships  Ask clinical questions.  Develop caring, trusting relationships. For consistency and efficiency, nurses 5) Acceptance of Feelings should state the question in a standard  Listen authentically to positive and format such as PICOT negative emotions.  Search for the best evidence. 6) Creative Problem-Solving In the previous step, key terms are  Use scientific methods in decision- identified that facilitate identifying making. relevant evidence in the literature. 7) Teaching and Learning  Critically appraise the evidence.  Address individual needs and Several toolkits or schema are comprehension styles. available to assist the nurse in 8) Healing Environment determining the most valid, reliable,  Create a respectful, dignified physical and applicable evidence. In some cases, and spiritual space. relevant studies may already have 9) Assistance with Human Needs been synthesized (see Box 2–1).  Help with basic physical, emotional, and  Integrate the evidence with clinical spiritual needs. expertise and client/family preferences 10) Openness to Mystery and values.  Allow room for miracles and mystery. Evidence must not be automatically applied to the care of individual clients. Each nurse must determine how the evidence fits with the clinical condition BSN1 - SNR 7  FUNDAMENTALS OF NURSING PRELIM REVIEWER of the client, available resources, Approaches to Nursing Research institutional policies, and the client’s Quantitative Research wishes. Only then can an appropriate  Systematic collection, statistical analysis, intervention be established. and interpretation of numerical data.  Implement and evaluate the outcomes of  The quantitative approach to research the intervention. is linked to the philosophical The nurse gathers all relevant data perspective of logical positivism, that may indicate whether or not which maintains that “truth” is Sources of Synthesized Knowledge absolute and can be discovered by  Cochrane Collaborative, DARE, Evidence- careful measurement. Based Nursing Journal, and more. Qualitative Research  Systematic collection and thematic analysis of narrative data.  Concerns with Solely Relying on Research  The qualitative approach to research is for EBP: rooted in the philosophical perspective  Research may be done in controlled of naturalism (constructivism), which environments, not applicable to the maintains that reality is relative or real world. contextual and constructed by  May stifle creativity by suggesting a individuals who are experiencing a single solution for all patients. phenomenon.  Research may ignore personal life events or the cost-effectiveness of care. Nursing Research Using research findings to guide decisions about client care. Historical Context: 3 Distinctive Qualitative traditions:  Crimea 1854: Nightingale’s sanitary  Phenomenology: reforms and their effect on reducing  Focuses on lived experiences. mortality.  Ethnography:  Journal Nursing Research - published in  Focuses on cultural patterns. 1952 to serve as a vehicle for  Grounded Theory: communicating nurses’ research findings.  Focuses on social processes.  Current priority areas for research funding by NINR are health promotion and disease prevention, symptom management, innovation, developing nurse scientists, and palliative/end-of-life care BSN1 - SNR 8  FUNDAMENTALS OF NURSING PRELIM REVIEWER Overview of the Research Process:  A method in which decisions are made that result in a detailed plan or proposal for a study & actual implementation of the plan  Nurses need a basic understanding of the research process in order to judge the credibility of a study’s findings and their usefulness for EBP. General steps are involved:  Formulating the research problem and purpose  Determining study methods  Collecting research data  Analyzing research data  Communicating research findings  Using research findings in practice Research Related Rolesfor Nurses  Research Consumer: Regularly reading research to stay current on insights.  Research Team Member: Participate in research and EBP activities. FORMULATING THE RESEARCH PROBLEM AND PURPOSE One strategy for stating the problem you wish to explore is to use the PICO format:  P – Patient, population, or problem of interest  I – Intervention or therapy to consider for the subject of interest  C – Comparison of interventions, such as no treatment  O – Outcome of the intervention. Protecting the Rights of Study Participants  Right not to be harmed.  Right to full disclosure.  Right to self-determination.  Right to privacy. V. NURSING AS A PROFESSION Profession  An occupation requiring extensive education, specialized knowledge, skill, and preparation. Professionalism BSN1 - SNR 9  FUNDAMENTALS OF NURSING PRELIM REVIEWER  refers to professional character, spirit, or Stage III: Competent methods. It is a set of attributes, a way of  (2–3 years of experience) life that implies responsibility and  Develops organizational and planning skills. commitment.  Differentiates important vs. less important Professionalization factors.  is the process of becoming professional,  Manages multiple complex care demands. that is, of acquiring characteristics Stage IV: Proficient considered to be professional.  (3–5 years of experience) Key Characteristics  Sees situations holistically rather than in a) Specialized Education isolated parts.  Requires prolonged and specialized  Uses experience-based maxims for education. decision-making. b) Body of Knowledge  Focuses on long-term goals and patient  Nursing has a well-defined knowledge base. outcomes. Conceptual frameworks guide practice, Stage V: Expert education, and research.  Performance is fluid, flexible, and intuitive. c) Service Orientation  No longer relies on strict rules or guidelines.  Commitment to serving a community or  Uses advanced analytical and intuitive skills organization. to act decisively. d) Ongoing Research  Continuous development and application Fields of Nursing of new knowledge. Institutional Nursing d) Code of Ethics  Includes hospital staff nursing with roles in  Adherence to ethical standards guiding medical-surgical, critical care, pediatrics, professional conduct. emergency care, and more. e) Autonomy Community Health Nursing (PHN)  Ability to make independent decisions  Works to understand and address within the profession. population health needs.  Nurses have independence, responsibility, School Nursing and accountability in practice.  Provides care within a school environment, f) Professional Organization including injury treatment and managing  Membership in a recognized body that health conditions affecting students. upholds standards and supports members Independent Nursing Practice  Governance allows nurses to control  Requires advanced education and allows practice, discipline, and working conditions. nurses to work in primary, acute, or restorative care settings. Benner’s Levels of Proficiency in Nursing Private Duty Nursing Stage I: Novice  Provides care in private settings, requires  No experience (e.g., nursing student). extensive critical care experience.  Performance is rigid, rule-based, and lacks Nursing in Education flexibility.  Requires a master’s degree, along with at Stage II: Advanced Beginner least two years of clinical experience.  Demonstrates marginally acceptable performance.  Begins recognizing meaningful aspects of situations.  Gains experience to make basic judgments. BSN1 - SNR 10