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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