Fundamentals Exam 1.pdf

Fundamentals Exam 1 1. Identify concepts from nursing history significant to practice today a. Florence Nightingale i. Evidence based practice 1. Data collection and reporting her findings 2. Note taking...

Fundamentals Exam 1 1. Identify concepts from nursing history significant to practice today a. Florence Nightingale i. Evidence based practice 1. Data collection and reporting her findings 2. Note taking 3. Hand drawn graphs to illustrate correlation of cleanliness and health 4. connection of calming fears and instilling hope and healing 5. hand hygiene ii. Started nursing schools b. Clara Barton i. Formalized nursing education ii. Started the American Red Cross to locate missing soldiers 1. brought food, supplies and comfort to wounded soldiers c. Dorothea Dix i. Advocated for mental health reform and indigenous rights 1. Mental Health Awareness ii. Superintendent of army nurses of the union army 1. set up temporary hospitals on the battlefield, training nursing recruits iii. Indigenous rights d. Ildaura Murillo-Rohde i. founded national association of Hispanic nurses (NAHA) e. Eddie Johnson i. First RN as a congressional representative ii. introduced STEM Education Act that provides grant awards to minorities f. Nursing focus i. reduce harm and negative impact of crises on nurses and their clients ii. promote health and healing resulting in maximum client success 2. Identify concepts of professional nursing a. Holistic nursing care i. providing care for the whole person 1. physical 2. mental 3. emotional 4. spiritual b. Advocacy i. The act of defending interests, rights and safety of those who cannot do it for themselves ii. speaking up for clients needs when clients are unable to  1. supporting their choices, defending rights, interests and safety of a vulnerable client 2. Ex: speaking to providers about patient care, reporting HIPAA violations (Whistleblowing), being a member of a organization that focuses on the impact of client health a. suicide prevention c. Change Management i. improvements in client care and staff workflow d. Communication i. Personal way a nurse can convey trust, empathy, understanding, cultural consideration and interest ii. intentional listening, showing compassion and demonstrating respect iii. Effective communication is the understanding of the client’s needs and the nurse’s response to those needs through communication with client and health care team. iv. learning a client’s personal and cultural preferences is important for effective communication and building trust v. Interprofessional communication 1. communication with colleagues is effective client care a. verbal b. written c. electronic documentation vi. Collaboration 1. respectful communication and sharing of ideas, policy, practices and research with team members to provide quality care 2. ex: nurses, respiratory therapist, physical therapists, physicians, lactation consultants, etc e. Honesty f. Integrity i. the quality of being honest and having strong moral principles or moral uprightness g. Social justice i. distributive justice h. Tort Law i. if an individual carries out an act or fails to that results in injury or harm to a client ii. civil wrong, intentional or unintentional, against an individual i. Licensed nurses are mandatory reporters 3. Demonstrate professionalism in nursing in the classroom, lab and clinical setting a. In the Classroom: Maintaining a respectful learning environment, being prepared, and engaging actively in discussions. b. In the Lab: Demonstrating attention to detail, practicing clinical skills ethically, and adhering to safety protocols.  c. In Clinical Settings: Showing respect for patients, adhering to ethical and legal guidelines, collaborating with healthcare teams, and maintaining confidentiality. 4. Discuss the relationship of ethical and legal practice to the role of nurses. a. Ethical Practice: Involves making decisions based on moral principles, such as beneficence, non-maleficence, autonomy, and justice. i. autonomy 1. freedom or independence to make own decisions ii. beneficence 1. actions guided by compassion/kindness iii. veracity 1. telling the truth iv. fidelity 1. keeping promises and commitments v. justice 1. actions are fair and equal b. Legal Practice: Nurses must follow laws such as patient confidentiality under HIPAA, informed consent, and mandatory reporting of abuse. Nurses are also accountable for adhering to their scope of practice. 5. Discuss values and their role in ethical decision-making. a. Values: These include compassion, integrity, and respect for autonomy. Nurses' personal values may influence their decisions, but they must align with ethical standards of care. b. Ethical Decision-Making: Nurses often face ethical dilemmas, such as end-of-life care, where values like respect for patient autonomy and beneficence come into play. Ethical decision-making models help guide the process. 6. Identify concepts of civility and incivility in nursing education and clinical practice a. Civility: Respectful behavior, constructive feedback, and professional communication, creating a positive learning and clinical environment. b. Incivility: Disrespect, bullying, and unprofessional behavior can negatively affect learning, job satisfaction, and patient care outcomes. 7. Discuss the importance of academic integrity in nursing education a. Academic Integrity: Upholding honesty in coursework, tests, and clinical evaluations is essential. This ensures that future nurses are competent and trustworthy. b. Impact on Professional Practice: Nurses with strong academic integrity are more likely to act ethically in their professional roles, providing safe and effective patient care. 8. Identify your role as a student in maintaining a culture of academic integrity a. Honesty: Ensuring that all academic work is your own, citing sources appropriately, and avoiding plagiarism or cheating. b. Accountability: Acknowledging mistakes and understanding their impact on learning and patient care. c. Encouraging Integrity: Promoting honesty among your peers and reporting any misconduct when observed. d. Professional Behavior: Demonstrating the same ethical principles expected in the nursing profession in all academic activities. 9. Describe the importance of nursing organizations to the profession and how they affect current trends and issues. a. Nursing Organizations: These groups, such as the American Nurses Association (ANA) or National Student Nurses' Association (NSNA), offer: i. Advocacy: Lobbying for policy changes that affect nursing practice and healthcare. ii. Education: Providing continuing education, certifications, and resources to enhance professional skills. iii. Networking: Offering opportunities to connect with other professionals and stay updated on new developments. iv. Impact on Trends: Nursing organizations influence trends like patient safety, quality improvement, and professional standards by setting guidelines and advocating for evidence-based practices. 10. Discuss clinical decision making a. Assessment: Assess the objective and subjective data that pertains to the client. i. Two types of data 1. Objective- what we can see a. inspection (seeing), auscultation (hearing), and palpation (smelling and touching) b. Measurable c. Ex: vital signs, expressions, physical assessment findings, intake and output 2. Subjective- client’s self report a. Ex: clients report of pain, client’s reason for seeking care b. Be sure to include past medical history, medications, support system, substance abuse, economic factors, cultural preferences, and sexual history c. Often documented using quotation marks. EX: client states “my pain is an 8/10” b. Analysis: Determine the client problems.  c. Planning: Create a plan to address client problems. i. short term goals ii. long term goals iii. goals must 1. have a time frame 2. be measurable 3. realistic 4. attainable 5. include patient d. Implementation: Take action to provide care as outlined in planning. i. interventions must be specific to client problem addressed ii. document when completing interventions e. Evaluation: Evaluate the effectiveness of the interventions provided and document the client’s response. 11. Describe factors that affect vital signs and the accurate measurement of them a. Nurses assess vital signs i. on admission ii. change in patient health status iii. patient reports symptoms iv. pre and post surgery v. pre and post nursing interventions that could affect vitals b. BP i. Affected by age, stress, activity level, medications, and underlying medical conditions 1. Intrinsic factors a. age b. ethnicity c. genetics d. natural hormonal variations 2. Extrinsic Factors a. external factors a client can control to an extent i. weight ii. stimulants 1. caffeine 2. nicotine 3. Medications 4. sodium 5. stress 6. activity level 7. anxiety/fear 3. Health status a. Increase in bp  i. pain ii. fever b. Decrease in bp i. hypoglycemia ii. heart failure ii. Accurate measurement 1. Systolic a. max amount of pressure exerted when heart contracts and forced blood into the aorta 2. diastolic a. minimum amount of pressure exerted when the heart is relaxed 3. Measured by a. Sphygmomanometer i. BP cuff b. Stethoscope 4. appropriate sized cuff 5. legs never crossed 6. feet flat on the floor 7. support clients arm 8. palm upward 9. Korotkoff sounds a. Series of sounds created by movement of blood through a particularly compressed vessel during a bp assessment 10. ex of avoiding checking arm bp a. edema b. breast surgery with lymph removal c. arm with surgery or fracture d. IV catheter iii. Hypertension 1. bp above expected range a. stage 1 i. systolic 130-139 ii. diastolic 80-89 b. stage 2 i. systolic 140< ii. diastolic 90< c. Hypertensive crisis i. systolic 180< ii. diastolic 120< 2. encourage client to adopt lifestyle interventions iv. Hypotension 1. below expected range 2. absence of baseline data  a. systolic