Nursing Foundation 1001 Midterm Note PDF

lOMoARcPSD|48372353 Nursing Foundation 1001 Midterm Note Nursing Foundations 1001 (NorQuest College) Scan to open on Studocu Studocu is not sponsored or endorsed by any college or university Downloaded by Phia ([email protected]) ...

lOMoARcPSD|48372353 Nursing Foundation 1001 Midterm Note Nursing Foundations 1001 (NorQuest College) Scan to open on Studocu Studocu is not sponsored or endorsed by any college or university Downloaded by Phia ([email protected])  lOMoARcPSD|48372353 Unit 1: Influential Figures in Nursing Nursing history has shaped how we are educated & practice our profession today. History promotes evolution to be more effective. Making the same mistakes is dangerous. Indigenous peoples were the first health care providers to early Canadian settlers in New France (aka Quebec) First hospital established in Canada Hôtel-Dieu de Québec opened in 1639. Health care in hospitals was provided by nurses to settlers & Indigenous people. Early nurses were Jesuit priests whose mission was to convert Indigenous people to Christianity. Augustine nuns were recruited to provide nursing care. In 1639, the first nursing mission (Hotel Dieu de Quebec) outside the citadel of Quebec was to deal with the smallpox epidemic. Marie Rollet Hebert*** Arrived at New France in 1617 Assisted her physician husband to care for early settlers Assess & respect indigenous people’s culture for their home remedies Jeanne Mance Came to New France to establish a hospital Learned about nursing & health care from an Augustinian nun in Hotel Dieu de Quebec In 1642 helped establish “Hotel Dieu de Dille Marie” in Montreal, where served settlers and indigenous people Marguerite d’Youville Changed & moved nursing care into the community Provided quality nursing care to all regardless of race or social class Formed a unique Canadian order of nuns Sister of Charity of Montreal 1738 Were called “Les Soeurs grises” (grey nuns) Began moving west in 1844 & est the General Hospital in Edmonton in 1895 Downloaded by Phia ([email protected])  lOMoARcPSD|48372353 Florence Nightingale Founder of modern nursing (evidence-based) & advocate for women in nursing Crimean War in Scutari (1853-56) prompted her to lead the movement to improve nursing care standards & led to the emancipation of women Nightingale Fund est to promote nurses’ training in England 1860 published “Notes on Nursing” focusing on cleanliness, reduced mortality & good food & conditions to promote health Based on her conclusions on statistical research she collected Colonization & settlement & War had a major impact on the demand for nursing WWI – increased demand for trained nurses Worked mainly on the front lines WWII – nursing viewed as a respected career Increased demand for practical nurses Set of thoughts, beliefs, or ideas to promote the evidence-informed nursing practice. A conceptual framework that allows nurses to understand a patient's situation & determine which strategy will work the best to restore or promote health. Promotes clinical reasoning & critical thinking by identifying basic values, guiding principles, elements & phases of nursing. Metaparadigm Nursing metaparadigm incorporates concepts of: Person - patient/client, groups of people, families, communities Environment - home life, mental state, addictions, physical pain, changes of relapse, rewarding work, sociocultural, religious beliefs……. Health - Subjective (physical, psychosocial, relational & spiritual aspects of an individual, family/community) Nursing - characteristics & actions of the nurse in relationship Social Justice - ensuring allocation of life resources that benefit privileged Downloaded by Phia ([email protected])  lOMoARcPSD|48372353 Nursing Process 5 stages of the nursing process Assessment - (Identify problem) gather info to understand the health status Nursing Diagnosis - (Collect data) perspective on what is important to focus Planning - (Form hypothesis) prioritize concerns/issues related to diagnosis Intervention - (Test hypothesis) plan of care that performed/carried out Evaluation - (Result) assess patient’s health status after intervention & compare - Logical process to organize & apply nursing knowledge to clinical practice - Use scientific method & nursing process to problem solve & make clinical decisions - A framework to identify diagnosis, treat actual & potential health issues & challenges of clients from a holistic perspective. To practice, an LPN must complete o Educational prep & registration exam o Provide evidence of current practice & continuing education o Evidence of good character and fitness to practice Regulated profession guided by legal acts to ensure public/patient safety Regulatory bodies govern members to maintain professional standards CLPNA – College of Licensed Practical Nurses of Alberta Alberta LPN regulatory body o Set entry to practice requirements o Establish and enforce standards of practice and professional conduct o Set continuing competency requirements o Public safety transparency Professional bodies are self-regulated Members practicing within professional standards competently Self-regulate and accountable to maintain practice standards Autonomous and collaborative to deliver quality nursing Client-centred Address diverse client needs Expand competence to meet changes in delivery, treatments, and technologies Self-awareness, reflection, commitment to personal growth to better serve public Downloaded by Phia ([email protected])  lOMoARcPSD|48372353 (CLPNA)*** 1. Professional Accountability and Responsibility 2. Knowledge-based Practice 3. Serve to the Public & Self-regulation 4. Ethical Practice Responsible for nursing practice & conduct meets standards of profession Responsibility to possess knowledge to practice competently & safely Collaborate w/ clients & healthcare team to ensure health & public interests Conduct manner upholds, promotes to the values & beliefs of the profession UNIT 2: Critical Thinking and Holism Inductive Reasoning - leads to broad ideas Deductive Reasoning - leads to specific ideas A problem-solving process Requires application of intellectual standards to improve one’s thinking Use of logic and reasoning to make accurate clinical judgments and decisions Observe, interpret, analyze, evaluate, explain, & self-regulate Ask questions, be well informed Consider Knowledge gained from previous experiences and think differently Be honest in self-reflection (facing personal biases) Take action! Awareness, curiosity, creativity & Empathy What are the alternative options? Downloaded by Phia ([email protected])  lOMoARcPSD|48372353 Basic critical thinking o Trusting the experts o Step by step Complex critical thinking o Seeing complex alternatives or alternate solutions o Able to anticipate and weigh risks and benefits Commitment level critical thinking o Able to assume responsibility and accountability o Acting on knowledge and experience o Able to support action / choose no action 2 main approaches o Internal processes -Values, Assumptions, Thinking o External processes: -Engaging in critical questioning -Writing to Develop and Communicate Thought -Reflective practice Reflection: intentionally thinking back/recalling a situation to discover its meaning (Playing a situation back in your mind & taking time to honestly review everything) Part of the process of making clinical decisions How does critical thinking lead to clinical judgment? How do critical thinking skills & behaviours contribute to quality nursing care? Downloaded by Phia ([email protected])  lOMoARcPSD|48372353 Holism Holistic Care Focus on the physical, mental, and social well-being Psychosocial development focuses on mental & social Erickson’s stages: - Basic Trust vs Mistrust (Infancy 1-2 years) - Autonomy vs Shame & doubt (Early childhood 2-4 years) - Initiative vs guilt (4-5 years) - Industry vs Inferiority (5-12 years) - Identity vs Role confusion (13-19 years) - Intimacy vs Isolation (Early adulthood 20-40 years) - Generativity vs Stagnation (Adulthood 40 -65 years) - Ego Integrity vs Despair (Maturity 65 - Death) Each member of the interdisciplinary team is a part of holistic care Holistic nursing treats the client’s mind, body, and spirit How can one’s perception of health affect health outcomes? A person’s perception of their health: -Believe their condition is stable/functions effectively -Do they see strengths/weaknesses -See themselves as a whole person/just their disease process. -Positions the patient as the focus of care delivery & as a partner in the delivery of care -Build trust with patient/client/family/community, designing & implementing care/services -Including a patient’s perspective/assessing the patient’s goal are -Understanding where it comes from before you can plan what you gonna do Respect for preferences in food, music & religion Attentive listening Using appropriate physical assessment norms Personal health practices, family customs, lifestyle preferences, & spiritual Downloaded by Phia ([email protected])  lOMoARcPSD|48372353 Touch, Prayer, Massage, Deep breathing, Music therapy, Yoga, Hypnosis, Chiropractor, Physiotherapist, Metaparadigm In holistic nursing, nurses foster relationships with their patients to promote healing & wellness. (Biological, social, psychological & spiritual) Empowers patients, allowing them to determine their own needs, and encourages reflection, self-awareness & personal & professional growth Specific: What are you trying to achieve? Measurable: How will you determine success od=f each milestone & goal? Attainable: How will you accomplish the milestone & goal? List the steps. Realistic: Is the milestone/goal that you can realistically accomplish with the available resources & timeframe? Timely: What is the deadline for each milestone & goal? Downloaded by Phia ([email protected])  lOMoARcPSD|48372353 UNIT 3: Nursing Process Assessment Allows to identify, diagnose, & treat patient actual/potential health concerns holistically Problem-solving approach - identification & treatment of health problems Provides a framework to assist the patient to an optimal level of functioning Focus attention on the given health situation Holistic & actively involves the client Uses critical thinking throughout all steps Purpose 1) Establish an individualized client database 2) Respond to identified health challenges/problems Consist 1) Collection & verification of data (primary & secondary sources) 2) Analysis of all data Lead to 1) Development of nursing diagnoses 2) Identification of collaborative problems 3) Plan of an individualized plan of care Beginning of providing patient-centred care Entails gathering data and compiling a health history o Patient interview, physical exam, analysis of diagnostic and lab review o Healthcare record & research Collaborate with patient, family, and healthcare team Result in holistic perspective of patient’s health status Subjective - client’s description & perceptions (e.g.pain) Objective - measureable or factual (e.g. vital signs) Primary - Client Secondary - Family members, medical record, healthcare team, documentation Tertiary - Nurse’s experience, research literature Downloaded by Phia ([email protected])  lOMoARcPSD|48372353 - Interview - Physical examination - Observation of patient - Diagnostic & lab results - Interpretation & validation of data How history has impacted the nursing profession Patient assessment begins similarly Comprehensive history of the patient o Biographic data o Past & current history o All other health variables o Patient understanding, the perspective of health, needs & care priorities Focus on client strengths & supports, identify actual/potential health concerns Current health status Development & psychological variables Spiritual & sociocultural Physiological (past history, medications & allergies, health promotion practice ROS for S & S of abnormalities the patient is not aware indicate an issue/concern Piaget’s theory of cognitive development Assimilation & accommodation lead to adaptation How we adapt to new info/experiences Kohlberg's theory of moral development Moral & cognitive development are interrelated Gender & cultural bias in research Freud’s theory of personality development When basic pleasures are altered by illness, nurse empathy/support helps patient adapt & cope Downloaded by Phia ([email protected])  lOMoARcPSD|48372353 Erickson’s 8 stages of development** Expanded Freud’s theory to include 8 lifespan stages & influence of socialize Move thru each stage by accomplishing a task of that stage Tasks include opposing conflicts that require balancing, requires readiness to be successful, mastery is tested thru new situations/conflicts Theory implies that the quality of early development work is important (child grows up with environment violence - impact on future intimate relationships) Can’t redo previous stages, so if screw up “trust-mistrust” must live with fear and anger associated with mistrust Nursing can influence familial, community & societal supports to help vulnerable children achieve successful transitions with each stage Adaptive processes will have successive positive development outcomes Physiological needs (Food, Water, Shelter, Warmth) Safety needs, love (Security, stability, freedom from fear) Belonging needs (Friends, family, spouse, lover) Esteem needs (Achievement, mastery, recognition, respect) Self-actualization needs (Pursue, inner, talent, creativity, fulfillment) o Predict, prevent, and detect any changes from patients’ expected patterns o Development approaches & programs can further enhance develop well-being o Provides framework for planning nursing care The ability to access, comprehend, evaluate & communicate info as a way to promote, maintain & improve health in a variety of settings across the life-course. Strives to ensure allocation of health resources are accessible to everyone Strives to prevent marginalization of vulnerable population & constrains over-use of resources by privileged Nurses advocate for disadvantaged/vulnerable populations & policy changes to reduce health inequities Health inequity & health equity Downloaded by Phia ([email protected])  lOMoARcPSD|48372353 Metaparadigm Person - patient/client, groups of people, families, communities - Each has distinct physical, psychological, social, spiritual, cultural & development characteristics that impact health status. Nurse - interact with the person for the purpose of providing holistic care by considering all relevant aspects of the person (religion, education & income) Environment - “Internal & external” impact a “person” - External: Physical, emotional, mental, sociocultural aspects - Internal physical aspects of “person” - Homelife, mental state, addictions, physical pain, changes of relapse, rewarding work, sociocultural, religious beliefs, finances, laws, education, resources, attitude toward death & suffering Health - Subjective - Physical, psychosocial, relational & spiritual aspects of an individual, family/community - Changes thru the lifespan - What health relationship (metaparadigm concept) have with holism? Combine body, mind & spirit to nursing theory, expertise, intuition & creativity Nursing - Entering into a partnership with the client - Ensure ethical & culturally safe relationship with the client - Guide by Code of Ethics & Standards of Practice Social Justice - Identify & achieve personal aspirations, satisfy needs, cope with environment - Economic & social conditions shape the health of the individual, communities & jurisdictions as a whole… Metaparadigm involves person, health, nursing, environment and social justice, where nursing process included assessment, nursing diagnosis, planning, implementation & evaluation. The relationship between the two is how to apply the nursing skills to holistically focus on solving the patient’s problem by using critical thinking. Downloaded by Phia ([email protected])  lOMoARcPSD|48372353 UNIT 4: NURSING DIAGNOSIS Open-ended questions: Data related to client’s perspective of health, identification of client goals for care needed. (e.g. How are you feeling today?) Closed-ended questions Additional data related to an identified issue/concern (e.g. follow up questions) Analyzing the data - looking for patterns & clusters in the data. Uses cues (5 senses) Use critical thinking skills to determine with is prioritize & give the best care Data collection & analysis to get a diagnosis Data analysis: critical thinking & clinical reasoning to consider implication Form diagnostic conclusions that determine client care needs Critically evaluate and interpret data to make informed decisions about patient’s health needs and care requirements. Medical Diagnosis 1. Define a disease process/injury 2. Based on physical S&S, medical history, & diagnostic tests (Diabetes & cancer) Nursing Diagnosis 1. Clinical judgment of client to actual/potential health problems/life processes 2. Non-linear so that you can go back & assess if you need to 3. Focus is on client response to health problems NOT physiological event, disease, or complication Develop, refine & promote terminology that accurately reflects clinical judgement Purpose: develop, refine, and promote standardized diagnostic nursing language Supports evidence-based care, clinical judgment & accurate documentation Downloaded by Phia ([email protected])  lOMoARcPSD|48372353 Defines nursing diagnosis as a clinical judgment about a “client” in response to actual or potential health problems or life processes Provides the basis for selecting nursing interventions Focuses on client-centred problems instead of “tasks” of nursing practice Provides common language & organizes diagnoses by category Health promotion Nutrition Elimination & exchange Activity & rest Perception & cognition Self-perception Role relationships Sexuality Coping & stress tolerance Life principles Safety & protection Comfort Growth & development Actual Diagnosis/Problem Focused 1. Responses to health conditions/life processes that exist at the PRESENT time 2. Written as the issue or concern defined by NANDA e.g. Impaired gas exchange Potential/Risk Diagnosis 1. Issue or concern that could be prevented with nursing intervention 2. Is not an issue yet - BUT factors exist that increase vulnerability 3. Written as “risk for…” (falls/infection) 4. CAN NOT take an actual diagnosis & modify to make a risk diagnosis Wellness/Health Promotion Nursing Diagnosis 1. Health promotions focus 2. Level of wellness in a client, family or community that can be enhanced 3. Written as “readiness for…” (enhanced sleep/nutrition/health literacy/family coping) Downloaded by Phia ([email protected])  lOMoARcPSD|48372353 1. Problem – diagnostic label 2. Etiology – related factors (cause or contributors) 3. Symptoms – defining characteristics Label (What) - NANDA approved name of nursing diagnosis e.g. impaired physical mobility (impaired as described of client’s mobility) Related factors (Why) - identified assessment data that respond to nursing intervention e.g. inadequate gas exchange related factor (hypoxia) Definition - NANDA describes characteristics of the identified response e.g. impaired tissue integrity defined as “damage to mucous membranes, cornea, integumentary system, muscle fascia, muscle, tendon, bone, cartilage, joint capsule, & ligament” Risk factors (how) - environmental, physical, psychological, genetic, or chemical element that increases vulnerability e.g. risk of infection can be caused by surgery !"#$%&'()%*$&%+(,(-./#%#01()"&%*.&2(3*4.#"5+(,(65(&7/2&84&2($1()9/085(:(51';.#'5+( 9."&55(#7&"%#*2(,(