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NUR 111 Test 3
NUR 111 Test 3 Review
| The Communication Process | Source (encoder). Message. Channel. Receiver (decoder). |
| Levels of Communication | Intrapersonal - self-talk. Interpersonal - 2 or more. Small group - nurse + 2 or more. Organizational - interdisciplanary |
| Factors Influencing Communication Process: Space | Intimate: 0-1.5; Personal 1.5-4; Social 4-12; Public 12-14. |
| Intercultural Communication: Eye contact | Western cultures - positive, indicates attention/interest. Arabic cultures - reciprocity. Japan, Africa, Latin American, Carribean - avoid eye contact. |
| Aggressive Communication | Loud, heated arguing. Physically violent. Blaming, name calling, insults. Walking out before resolved. Being demanding. |
| Passive Communication | Concealing feelings. Denying anger. Feeling that one has no right to express anger. avoiding arguments. Being noncommittal. |
| Assertive Communication | Expressing feelings w/o being overbearing. Acknowledging emotions but staying open to discussion. Expressing self & giving others the chance to express themselves. Using I statements to defuse arguments. Asking & giving reasons. |
| Phases of Therapeutic Relationship | Orientation Phase. Working Phase. Termination Phase. |
| Orientation Phase | Introductions. Discuss nurse's role. Give client information about the purpose, possible goals, & time frame of relationship. |
| Working Phase | Implement plan of care. Re-plan if necessary. Think alternative solutions. Refer patient if necessary. Nurse assumes role of teacher & counselor. |
| Termination Phase | Begins during 1st interaction w/ pt. Occurs when goal have been reached or referral is advisable. Nurse & pt examine meaning & value of relationship. Feelings are discussed. Plans for follow-ups. Anticipatory guidance/teaching done. Evaluation. Summarize |
| Do Not Use Abbreviations | >, <, Abbreviations for drug names, Apothecary units, @, CC, U, IU, Q.D., QID, q.d., Q.O.D., QOD, q.o.d., qud, Trailing zero, lack of leading zero, MS, MSO4, & MgSO4. |
| SOAP/SOAPIE/SOAPIER | Subjective, Objective, Assessment, Plan, Intervention, Evaluation, Revision. |
| PIE | Problem, Intervention, Evaluation. |
| DAR | Data, Action, Response. |
| SBAR | Situation, Background, Assessment, Recommendation. |
| MAR | Medication Administration Record. |
| Define: Law | A standard or rule of conduct established & enforced by the government (at federal, state, or local level) that is intended to protect the rights of the public. |
| Public Law | People & government |
| Private (civil) Law | Between people. NPA is civil law. |
| Sources of Law | Constitution, Legislation (Statutes), Administrative, Common Law. |
| Nursing Regulation. Nurse Practice Acts - law | Defines: Legal scope of practice. Nursing education requirements. Licensure for disciplinary actions. Enforced by BON. |
| Credentialing | Ensure professional competence. Accreditation - ACEN. Voluntary. Licensure - mandatory. Allows nurses legal privilege to prac nursing as defined by NPA. Ea BON oversees admin of a licensure exam. Nat council of State Boards: NCLEX-RN, NCLEX-PN |
| Certification | Non-gov't. Association offer recognition in a specific practice area. Voluntary (could be mandatory) |
| Define: Crime | Act prohibited by statute or common law. May be punishable by fines or imprisonment. |
| Define: Tort | Civil(private) wrong committed against a person or persons property. Enforced by awards for damages or compensation. Intentional vs. unintentional. [ex: defamation, assault (verbal threat) Battery (physical threat).] |
| Elements of Professional Liability | Duty, breach of duty, causation, injury or harm. (Financial, emotional, physical) Must hit all four to be guilty. |
| Informed consent or informed refusal | Client's legal & ethical right to be informed of & give permission for procedure/treatment. Competency & capacity for consent. Emergency situations. Exceptions for minor child. |
| Controlled Substance Act | Federal law |
| Good Samaritan Law | Encourage health care providers to help victims in an emergency. Protects health care workers from potential liability. Nurse responsible for following through w/ emergency care. |
| Advance Directives | Legal document. Expresses an individual's desires regarding medical treatment. Pt Self-Determination Act. [Ex: Living will, durable power of attorney for health care (must be written), Advance instruction for mental health treatment.] |
| HIPAA | Health Insurance Portability & Accountability Act. Purpose: Minimizes exclusion of pre-existing conditions. Designates special rights for those who lose other health coverage. Eliminates medical underwriting in group plans. Includes privacy rule. |
| Privacy | Right of individuals to keep their personal information from being disclosed. |
| Confidentiality | Assurance that private information will not be disclosed w/o client's consent. |
| Mandatory Reporting | Legal requirement to report act, event, or situation that is designated as reportable by law. |
| Risk Management. High risk areas: | Medical administration, falls, skin breakdown, restraints, allergies, valuables. |
| Whistleblower | A person who exposes misconduct, alleged dishonest or illegal activity occurring in an organization. |
| Define: Ethics | Standards of right & wrong that influence human behavior. Considers rights, obligations, benefits to society, fairness, and/or specific virtues. |
| Morality | Refers to private, personal standards of what is right & wrong in conduct, character & attitude. |
| Ethical Principles | Beneficence- promote good. Nonmaleficence- do no harm. Justice- uphold what is just & fair. Fidelity- be accountable. Veracity- tell the truth. |
| Essential Nursing Values | Altruism- concern for the welfare of others. Autonomy- right to self-determination. Human Dignity- inherent worth & uniqueness. Integrity- acting consistent w/ code of ethics & standards of practice. Social Justice- fairness on a social scale. |
| Define: Enculturation | Cultural transmission from adults to children. |
| Define: Assimilation | Process of adapting or integrating characteristics of the dominant culture as one's own. |
| Define: Morbidity | Sickness |
| Define: Mortality | Death |
| Define: Ageism | Prejudice against older adults. |
| Autosomal chromosomes | Intellect, personality, often can be changed. |
| Define: Teratogenesis | Process by which congenital malformations are produced in an embryo or fetus. |
| Five major components of G & D | Psychosocial. Cognitive. Moral. Spiritual. Biophysical. |
| Freud's 5 stages of Development | a. Oral (Birth-1.5yo) mouth center of pleasure. b. Anal (1.5-3yo) Anus center of pleasure. c. Phalic (4-6yo) Genital source of pleasure. i. Oedipus Comp ii. Electra Complex. d. Latency (6yo-pub) phys & intell activities. e. Gen (Pub-after) sexual maturity |
| Erikson - Psychosocial Theorist | a. Life - sequence of developmental stages of achievement. b. Health of personality depends on level of success @ ea stage or crisis. c. Stages reflect pos & neg aspects of critical life periods. d. Stress can cause regression to unresolved stages |
| Erikson's Stages of Development | a. Infancy to birth - 18 months. b. Early childhood - 18mo-3y. c. Late childhood - 3-5y. d. School age - 6-12y. e. Adolescence - 12-18. f. Young adult - 18-25y. g. Adult - 25-65y. h. Maturity - 65y-death. |
| Erikson's Central Task | a. Infncy- trust v mistrust. Erl chld- autonomy v shame/doubt. Lt chld- initiative v guilt. Sch age- industry v inferiority. Adlscn- identity v role confusion. Yng adlt- intimacy v isolation. Adlthd- generativity v stagnatn. h. Matur- integrity v despair |
| APGAR Scoring Chart | Test & score given to newborn baby immediately after birth to determine health status. |
| Define: Infant colic | Extended crying, usually in first 3 months. |
| Define: Failure to thrive | Inadequate height & weight. |
| SIDS | Sudden infant death syndrome. |
| Infant: | 1mo-1yr. Birth weight triples. Brain & organs experience rapid growth. Eyes focus & fixate. Body temp stabilizes. Able to speak few words. Psychosocial development. Safety issues: Aspiration, suffocation, falls, SIDS, FTT, abuse. |
| Toddler: | 1-3yr. Rapid brain growth, incr in long bone growth, growth of muscle. Picks up sm obj w/ fingers. Walk, run, kick, climb. Drink frm cup, use spoon. Bladder control dur day, sometimes @ nite. Shrt sent. Risk: Accidents, poison, burn, drown, choking/asp. |
| Preschooler: | 3-6yr. Improved motor abilities. Printing letters & numbers. Baby teeth begin to fall out. Clearly identify themselves as male or female. Fear of dark, nightmares; vivid imagination. Risk same as toddler w/ increase risk of communicable disease. |
| School-Aged Child: | 6-12yr. Physical growth slow, but cont. steady w/ refinement & subtle changes. Permanent teeth present. Think logically. Aware of others feelings & points of view. Increased obesity. ADHD, disabilities diagnosed. |
| Adolescent & Young Adult: | Begins w/ puberty-20yr. Young adult considered 20s & 30s. Rapid physical growth & development. Development of primary & secondary sexual charact & puberty. Sebaceous & ax sweat glands act. Risk: Injuries, MVA, substance abuse, suicide, preg, eat dis, STI. |
| Middle Adult: | 40-65yr. Still consider themselves young. Gradula, normal internal/external physiologic changes. Hormonal changes- menopause, andropause. Employment/career changes, retirement, economic security. Relationships. Risk: Malignant neoplasm, CVD, Diabetes. |
| Older Adult: | >65 Subj to agism. Fastest growing popul. Incr chronic problems: CAD, CVA, BPH, Htn. Family & role reversal. Dementia, Alzheimer's, sundowning syndrome, delerium, reality orientation, cascade iatrogenesis |
| Cascade iatrogenesis | a series of adverse events triggered by an initial medical or nursing intervention initiating a cascade of decline. |
| Older adult: Fulmer SPICES tool | S - sleep disorders. P - problems with eating/feeding. I - incontinence. C - confusion. E - evidence of falls. S - skin breakdown. |
| Sources of data | Client, family, Sig O, client record, other health care professionals, nursing and other literature, health history/interview, (subjective), observation (objective). Datatbase, PE. May use simultaneous sources. Normal/abnormal findings revealed. |
| Types of assessments | Initial (general). Problem focused (focuses on specific problem). Emergency (focus on most emergent problem). Time lapse (over days/weeks/months). |
| Health history | Name, gender, age, DOB, occupation, family/social situation, source of referral, reason for seeking care, health beliefs/practices, PMH, FH, psychosocial history, ROS, meds/allergies, immunizations. |
| Assessment guidelins | Stand on right side of client. Perform in a head-toe sequence. Compare R/L for symmetry. Proceed from least to most invasive. Use systematic approach. |
| Head to toe assessment | General survey, VS, head, neck, upper ext, chest & back, abd, genitals, anus/rectum, lower ext. |
| Palpation - uses sense of touch to assess | Texture, temp, moisture, swelling, vibration, pulsation, crepitation, rigidity, spasticity, tenderness/pain, lumps and masses |
| Palpation procedure | Calm, gentle approach. Systematic, clean & warm hands, light before deep, palpate tender areas last. |
| Light vs deep palpation | Light - skin surfaces and superficial surfaces, technique: depth of 1cm, circular motions. Deep - assesses position or sizes of organs/masses, depth of 4-5cm, contraindicated if acute abdominal pain. (Deep bimanual: 1 hand on top of the other) |
| Characteristics of percussion sounds | Depth (shallow to deep): Tympany, hyper-resonance, resonance, dullness, flatness. |
| Examples of normal percussion sounds | Tympany - gastric air bubble. Hyper-resonance - children's lungs. Resonance - lungs. Dullness - liver. Flatness - bone or muscle. |
| Ascultation: AWFUL. Ascultation: BELLOW. | Ascultation With Fabric Upon Lungs. BELL = LOW pitched sounds. (Diaphram for high pitched sounds). |
| HEENT | Head, Eyes, Ears, Nose, Throat. |
Created by:
mojoshare
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