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Nursing Fundamentals

ANA American Nurses Association
ICN International Council of Nurses
NLN National League for Nursing
NSNA National Student Nurses Association
Sigma Theta Tau Honor Society of Nursing
CAM Complimentary Alternative Medicine
Moral Distress Inability to carry out moral decisions
Moral Outrage Belief that others are acting immorally
Morals "Private, personal, or group standars of right or wrong"
Ethics Systematic study of right and wrong conduct
Nursing Ethics Ethical questions that arise out of the practice of nursing
Autonomy Right of the patient to make informed healthcare decisions
Nonmaleficence Avoid causing harm
Beneficence "Benefiting the patient, benefits vs. risk"
Fidelity Keep promises
Veracity Tell the truth
Justice The obligation to be fair
Values Belief about the worth of something
Attitudes "Feelings toward a person, object, or idea"
Beliefs Something that someone accepts as true
Consequentialism Rightness or wrongness of an action depends on the consequeces of the action rather than the action itself
Teleology "The study of the ""end"". Teleology & Consequentialism deal in the ""ends"" justifying the ""means"""
Utilitarianism The value of an action is determined by its usefulness
Deontology "AKA Formalism - right and wrong are determined by moral rules and principles, not the value of the specific action itself"
Feminist Ethics "Considers principles and consequences, but also looks at social issures surronding the action."
Ethics of Care A nursing philosophy that directs attention to the specific situation of individual patients within the context of their life situation.
Nursing Code of Ethics Formal statement of a group's expecations and standars for professinal behavior
ANA Standards of Care "Standars of practice that, if followed, ensure ethical practice. Outlines nurses responsiblities to patients and directs management of ethical dilemmas."
Patient Bill of Rights "Assures healtcare system is fair and works to meet patient needs, gives patients ways to address problems, encourages patient to take an active role in getting and staying healthy."
MORAL Model "Massage Dilemma - identify & define issues, Outline Options - determine all avenues of action, even if not realistic, Resolve Dilemma - Review issues & options for all parties concerned. Act - apply chosen option, Look back - evaluate the process and co
Legal Principals of Nursing "Protect client & society, define the scope of nursing practice, and identify minimum level of care to be provided"
Patient Self Determination Act "Patients have the right to make decisions about their care, including the right to refuse treatment or make advanced directives."
HIPAA Health Insurance Portability and Accountability Act - protects privacy by controlling individually identifiying information about a patient.
Newborns' and Mothers' Health Protection Act Mandates a minimum 48 hour stay for insured delivieries (96 hours for C-section deliveries)
National Labor Relations Act "Enacted to protect the rights of workers and employers, to encourage collective bargaining, and curtail harmful business practices."
Emergency Medical Treatment and Active Labor Act Patient Anti Dumping Law - requires healthcare facilities to provide emergency care regardless of ability to pay. Only requires stabilization.
Health Care Quality Improvement Act Enacted to reduce medical errors and protect the consumer
ADA Americans with Disabilities Act - Provides non discrimination and access for disabled individuals
Manditory Reporting Laws "Laws that require reporting suspected cases of abuse, communicable infection, immunizations - must have proof, not just a ""hunch"""
Good Samaritan Laws Protect individuals that aid persons in need of first aid from being sued.
Patient Care Partnership Encourages healthcare providers to be more aware of the need to tret patients in an ethical manner and protect patient rights.
ANA Bill of Rights for Nurses Protect the dignity and autonomy of nurses in the workplace
Misdemeanor A minor crime punishable by fine and or imprisonment for less than a year
Felony Crime punishable by death or more than one year's imprisonement
Contract Law Controlls leagally enforceable agreements
Tort Deals with duties and rights among individuals not covered under contract law
Defamation Occurs when a false communicatino is made to at third person and communication is harmful
Slander Defamatory statements made orally
Libel Defamatory statements made in writing
Assault and Battery "Assault - placing a person in a position of fear that he/she will suffer harm, Battery - intentional, offensive physical contact e.g. performing surgery without consent"
False Imprisonent Intentional or wilful detention without consent
Fraud Willful or intentional misleading another person with intent to cause legal injury or deprive rights
Invasion of Privacy Violation of a person's right to be free from unwanted interference in private affairs
Negligence The failure to use reasonable and ordinary care
Malpractice Occurs when a medical professional is negilgent anf fails to exercise ordinary care.
Legal Safeguards for the Nurse "Seek informed consent, competent practice, documentation, liability insurance, sentinel reports"
Student Liability "Seek direction before acting, be familiar with agency policy, DO NOT work outside the license of instructor"
Common Malpractice Claims "Failure to assess & diagnose, Failure to plan, failure ti implement a plan of care, failure to evaluate"
Asepsis Absence of contamination by disease causing microorganisms
Infection Successful invasion of the body by a pathogen
Pathogen "Organisms capable of causing disease, consist of bacteria, viruses, fungi, protozoa, amoebae, helminths (worms), and prions"
Chain of Infection "The process by which infections spreads, consists of 6 links that interconnect. The chain can be broken at any link."
Infections Agent Pathogens that cause infection
Reservoir "A source of infection, a place where pathoghes survive and multiply. There are both living and non-living reservoirs tha support microbial growth."
Portal of Exit "A pathogen must exit a reservoir in order to spread infection. The path out of, or off of the reservoir is the portal of exit"
Mode of Transmission "Direct contact (person to person), indirect contact (fomite), dropplet transmission, airborne transmission, vector transmission (organism that carries a pathogen to a host e.g mosquitos"
Portal of Entry "Normal body openings, cuts, scrapes, surgical sites, IV sites are all examples of portals of entry"
Susceptible Host "A person with inadequate defenses (natural, chemical, phyiscal) to prevent infection by pathogen"
Stages of Infection "Incubation, Prodromal, Illness, Decline, Convalescene"
Local Infection Infection localized to a limited region of the body
Systemic Infection Occurs when infection occurs in blood or lymph systems and spreads throughout the body
Primary Infection First infection that occurs in a patient
Secondary Infection An infection that occurs after primary infection as a result of compromised immunity.
Bacteremia Clinical presence of bacteria in the blood
Septicemia Symptomatic systemic infection spread via blood
Acute Infection "Rapid onset, short duration"
Chronic Infection "Slow development, long duration"
Latent Infection Infection present with no discernable symptoms
Nosocomial Infection Infections acquire in a healthcare facility
Primary Defenses "First line of defense agains infections such as Skin, mucous membranes that trap pathogens, saliva & tears, GI & genitourinary acids & bile"
Secondary Defenses "Phagocytosis, Complement cascade, inflamation, fever"
Tertiary Defenses "B&T cells, humoal immunity, phagocytosis, neutralization, agglutination, activation of complement and inflammation, immunoglobins"
Factors that Increase Infection Risk "Age (young & elderly), breaks in 1st line defenses, illness or injury, smoking, substance abuse, multiple sex partners, environment, chronic disease, medications , procedures"
Factors that Support Host Defese "Nutrition, Hygeine, Rest & exercise, Stress reduction, Immunization"
Medical Asepsis State of cleanliness that decreses the potential for spread of infection
Hand Washing Most effective method of preventing spread of infection
Standard Precautions "AKA Universal precautions - used whenever contacting blood, body fluids, excretions and secretions, mucous membranes, braks in skin. Wash hands, use clean gloves."
Contact Precautions "Direct contact of microrganisms can lead to spread of pathogens. Standard + private room, gown & gloves"
Droplet Precautions When pathogen can be spread in droplets. Standard + Contact+ mask w/ eye protection
Airborne Precautions "Pathogens in air. Standard+Contact+private room w/ negative air pressure, gown, gloves, N95 mask. Measles, Chickenpox, TB"
Protective Isolation Isolation of the pathogen (not the patient - be kind!) to prevent infection of others
Surgical Asepsis Requires creation of a sterile (no life) field and use of sterile equipment
Voiding Urination or micturnition
Infant Urination "15-60mL of urine output per Kg per day, 8-10 wet diapers per day, No voluntary control"
Enuresis Occasional wetting
Nocturnal Enuresis Bed wetting
Older Adult Urination "Kidney function decreases, urgency and frequency increases, loss of bladder elasticity causes nocturia(need to urinate at night) & incomplete emptying"
Substances Affecting Urine "Caffeine, Alcohol, Sodium"
Medications Affecting Urine "Anticoagulants (Red urine), Diuretics (yellow urine), Pyridium (orange /red urine), Elavil (green/blue urine), Levodopa (brown urine)"
Factors Affecting Urination "Personal, cultural, environmental, nutrition, hydration, activity level, medication, surgery & anesthesia"
Physical Assessment of Urine "Volume, Color, Clarity, Sediment, Odor"
Promotion of Urination "maintain normal voiding habits, promote fluid intake, promote muscle tone (kegel), stimulate urination and resolve urinary retention"
Normal Voiding Habits "Schedule, privacy, position, hygeine"
Urinary Tract Infection "Normally E. coli, enter the urethra and bladder from the colon. Improper hygiene."
Urinary Retention Inability to completely empty the bladder
Urinary Incontinence lack of voluntary control over urination
Stress Incontinence "pregnancy, laughter, lifting, coughing, etc. cause stress incontinence"
Urge Incontinence "urination associated with strong urge to void, overactive bladder"
Mixed Incontinence Urge + Stress
Overflow Incontinence "distended bladder, ususally caused by fecal compaction, neurological disorders, enlarged prostate"
Total Incontinence person isn't able to control urination at all
Urinary Diversion/Ostomy surgically created opening for elimination of urine
Reasons fo Catheterization "Relieve urinary retention, obtain sterile sample, measure urine, empty bladder before/during/after surgery, monitor critically ill patients"
Urinary Studies "Freshly voided specimen, clean catch, sterile specimen, 24 hour urine"
Peristalsis movement of feces through the large intestine
Factors Affecting Defecation "pregnancy, pathological conditions, bowel diversion (Ileostomy/Clostomy)"
Medications Affecting Defecation "Aspirin - (pink/black stool), Iron salts - (black stool), Antacids - (white w/specks), Antibiotics - (green)"
Physical Assessment of Feces "Mnitor frequency, amount, coor and consistency of stool. Monitor for diarrhea, constipation, impaction. May still have an impaction w/diarrhea."
Promotion of Defecation "Privacy, positioning, Regular schedule, fluids & nutrition, exercise"
Diarrhea "Water and potassium loss a big concern. Dehydration risk. Ideally, replace lost fluids and potassium PO."
Constipation "Decreased activity, post surgery, medications , decreased fluid & fiber intake"
Fecal Impaction Hardened fecal material in the rectum.
Bowel Diversion "Ileostomy, colostomy"
CEU "Continuing Education Units. Post formal education training that ensures nurses keep up with latest developments. Not required by State of Indiana, but employer may require them."
Nursing Models "Case method, functional nursing, team nursing, differentiated practice, primary nursing"
Purpose of Nursing "Health promotion, illness prevention, health restoration"
Created by: jknowles