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Nursing Proc./Health

WWCC Nursing Process and Health and Wellness.

Describe the art & science of nursing. Art:Intentional creative use of self based on skill and expertise. Science:Requires knowledge to deliever care
Describe the concepts/components of critical thinking & clinical decision making. *Confidence *Contextual persepective *Creativity *Flexiblity *Inquisitive *Intellectual integrity *Intuition *Open-mindedness *Perserverance *Reflection
Describe how journal writing helps develop critical thinking. Journaling inspires reflection. Thinking back and discover meaning or purpose. Allows to track what to continue or change.
Discuss Benner's model for skill acquisition. (Bottom to top) Novice-Relies on rules, Advanced beginner-recognize common patterns, Competent-recognize own thinking/analizing problems. Proficient-intuitive thinking begins. Expert-Intuition becomes prominent
Explain how professional standards influence a nurse's clinical decidsion making. Standards give structure where critical thinking takes place. They are a framework/blue print that guides.
Define the use of the nursing process in clinical practice. A structure/guideline to promote critical thinking.
Explain the relationship between data collection and critical thinking. Data collection is just the gathering of facts, and the critical thinking is the analyzing of the data you collected in order to make a plan.
List common techniques for data collection. Observation, Interviewing and Examining.
Differentiate between subjective and objective data. Subjective-What you are told. Objective- What you see or measureable data. Such as VS.
Describe data collection using client interview/nursing assessment. Includes: Nursing health hx, physical exam, observation of client behavior, diagnostic & lab data
Compare vital signs values in health with those observed during illness. Know what normal rages are and what illness will impact which vitals and how.
Discuss the purpose of obtaining a physical assessment. Assists in identifying problems that need nursing interventions. Establish baseline patterns. Comparing status between then and now.
Compare and contrast a comprehensive physical assessment, a basic physical assessment and the focused assessment. Comprehensive:Total body assessment, holistic Basic: Focused:Assessment focused on a specific area of concern.
Describe vital signs. PULSE Pulse: adult norm 60-100, absent 0 weak/thready +1 normal +2 strong +3 bounding +4
Describe vital signs. RESPIRATIONS Resp: adult norm 12-20, regular/irregular/deep/shallow
Describe vital signs: BLOOD PRESSURE BP: adult norm 120/80 Hypotensive 90/60, normotensive 120/80, prehypertension >120/80 Hypertension 140/90
Describe vital signs: TEMPERATURE Temp: adult norm 96.8-99.5 hypothermic <93.2, normothermic 96.8-99.5, hyperthermic/febrile >99.5, hyperpyerxia >105.8
Sites for thermometers Oral: mouth, Tympanic: ear, Temporal: across the forehead to ear, Axillary: Arm pit (1 degree below) Rectal: anus (1 degree above)
Pain Assessment Pain scale of 0-10
Identify normal asssessement finding in the adult Normal ranges...
Describe possible rationale for varitations in the baseline assessment. Changes in pt. status or body condition, error etc.
Develope a systematic framework for organizing assessment date.
Describe rationale for data clustering Organizing data into clusters to form meaningful patterns in order to reach diagnostic reasoning(critical analysis of the clustered data.)
Differentiate between a medical diagnosis and a nursing diagnosis Medical:Focus on disease process Nursing:Focus on human response to health problems.
Identify the components of a nursing diagnosis Types: Actual, Risk for, health promotion/wellness 3 part statement:diagnostic label(approved ND), Related factors("related to..." no med. diagnosis)Defining characteristics(conditions supporting diagnosis)
Identify sources of diagnostic error Error in data collection(missing/gaps/inconsistencies), Error in interpretation of data, Error in data clustering(don't make diagnosis fit s/s)
Discuss criteria used in priority setting High priority:Emergent(ABC) Intermdeidate:Non-life threatening Low:Not always directly related to illness but effects pt. future.
Differentiate between goals and expected outcomes.
List guidelines for writing a client centered outcome statement. Pt. centered, realistic, directly related to ND, specific measurable change in pt. status as result of intervention, outcomes drive intervention
Describe the skills neccessary for implementing nursing care.
Identify types of nursing interventions and when each type is used: Nursing initiated, collaborative, physician-initiated. Nurse:No MD orders needed, act independently on pt behalf, based on science MD:Orders needed, MD response to med diagnosis. Collaborative:Interdependent nursing interventions requiring mult. professionals.
Identitfy nursing interventions to meet established expected outcomes. Direct:Intervintions through pt(meds, dressing change, IV, Ambulation) Indirect:Performed away from pt on pt behalf
Discuss rationales for selected nursing interventions. 6 factors(ND charac, goals/expected outcomes, evidenced based interventions, feasiblity, acceptabilty to pt, personal competency) Not all interventions work the same on all pt. Individualize to pt.
Evaluate the client's progress toward meeting identified goals. Assessments, Compare w/ baseline, Did it meet outcome?, What is problem status?, Cont/Mod/Term care plan.
Define heath, wellness and illness using WWCC concepts. Heath is a process that varies w/ a person's PERCEPTION of well-being. Achieve mx potential.
Discuss the issues that impact an individual's view of health, wellness & illness. Internal: interllectual, age/developement, spiritual, family/culture, perception. External:Family practices, socio-economic, culture.
Describe the factors the influence health, wellness & illness. Genetic/physiological, behaviors/lifestyles, physical/social/enviromental, age.
Describe the difference between primary, secondardy & tertiary prevention. Primary:Before illness-education Secondary:Early detection/treatment Tertiary:Late illness/Irreversible-reach max function.
Differentiate between illness & disease. Disease:Physiological alteration of the body. Illness:Includes disease & impacts functioning/wellbeing of pt.
Differenctiate between acute & chronic. Acute:Sudden onset, temp. less than 6mo. Chronic:Long term,slow onset, greater than 6mo.
Describe the nurse's role in health promotion & disease prevention. Assessment:(Health Hx, Physical fitness assessment, Lifestyle assessment, Social support system-Gordon's)Diagnosis:ND Planning:resource person to improve health Implementation:"doing" Evaluation:ongoing
Discuss factore affection adult development & health in oler adults. Developmental tasks of older adults: Integrity vs despair, physical changes, reduced income, loss, self-esteem, living arrangements, role changes, sense of purpose.
Discuss factore affection adult development & health in oler adults. Physiological changes of aging: Loss, Loneliness, living arrangements.
Discuss factore affection adult development & health in oler adults. Psychosocial changes of aging: Prevalence of ageism, body image, elder abuse, lack of transporation, inadequate safe housing, decreased access to healthcare, retirement, isolation
Describe modifications of the health history & phsical examination for older adults. ENVIORMENT:quiet, low voice tone, good lighting, temp of room, no distractions. FUNCTIONAL ASSESS:ADLs, mobility, social interactions, problem solving.
Identify nursing interventions related to the physicological, psychosocial, cognitive changes of aging. Education(lifestyle changes, med management, stop smoking, immunization, dental care, health visits, screening) Individual attention, Reality orientation, Validation theraphy, Reminiscence, Body-image interventions.
Identify nursing interventions related to the changes of aging. *Education:lifestyle changes, med. management, stop smoking etc. *Individual Attention:therapeutic comm., *Reminiscence *Body-Image Interventions
Stages of Change: *Precontemplation:No thought/desire to change *Contemplation:Thinking about change *Preparation: *Action: *Maintenance: *Termination:
SPICES Sleep Disorders, Problems with eating, Incontinence, Confusion, Evidence of falls, Skin breakdown
Created by: 692020196