Term
| Discuss the benefits of evidence-based practice (EBP). |
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Definition
a. Nurse’s practice in an age of accountability where quality and cost issues drive the direction of health care. Greater scrutiny is being given to why certain health care approaches are being used, which ones work, and which ones do not. As a result, EBP is a response to the broad societal forces that nurses and other health care professionals must contend with.
b. EBP is a problem-solving approach to clinical practice that integrates the conscientious use of best evidence in combination with a clinician’s expertise and client preferences and values in making decisions about client care.
c. EBP is a systematic approach to rational decision making that facilitates achievement of best practices. Using a step by step approach ensures that you will obtain the strongest available evidence to apply in client care. There are 5 steps of EBP. |
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Term
| What are the (5) steps of EBP. |
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Definition
a. Ask a clinical question.
b. Collect the most relevant and best evidence.
c. Critically appraise the evidence you gather.
d. Integrate all evidence with one’s clinical expertise and client preferences and values in making a practice decision or change.
e. Evaluate the practice decision or change. |
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Term
| Describe the process of asking a clinical question. |
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Definition
| Always think about your practice when caring for clients, question what does not make sense to you and question what needs clarification. Think about a problem or area of interest that is time consuming, costly or not logical. Use problem or knowledge focused triggers. Use the PICO format to state your question. |
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Term
| What are Problem focused triggers? |
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Definition
| are things you see when caring for a patient or possibly trends you may see on the nursing floor such as frequent falls or infections. Use this trigger to ask a question such as, “What is the best way to prevent falls or prevent infections?” |
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Term
| What are Knowledge focused triggers? |
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Definition
| are questions involving new information available on a topic. You might see these when reviewing research articles or possibly sources such as standards and practice guidelines from national agencies including the Agency for Healthcare Research and Quality (AHRQ), the American Pain Society (APN), or the American Association of Critical Care Nurses (AACN) |
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Term
| The 4 elements of a PICO question are: |
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Definition
1. Patient population of interest, identify patients by age, gender, ethnicity, and disease or health problem.
2. Intervention of interest, what is the intervention that is worthwhile to use in practice?
3. Comparison of interest, what is the usual standard of care or current intervention used in practice?
4. Outcome, what result do you wish to achieve or observe as a result of an intervention?
iv. The questions raised in the PICO format help to identify knowledge gaps within a clinical situation. |
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Term
Explain how nursing research improves nursing practice?
Research means to search again or to examine carefully. It is a systematic process that asks and answers questions that generate knowledge. The knowledge then provides a scientific basis for nursing practice and validates the effectiveness of nursing interventions. |
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Definition
| Research means to search again or to examine carefully. It is a systematic process that asks and answers questions that generate knowledge. The knowledge then provides a scientific basis for nursing practice and validates the effectiveness of nursing interventions. |
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Term
| Discuss ways to apply evidence in practice: |
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Definition
| Teaching tools, clinical practice guidelines, policies and procedures and new assessment or documentation tools. Application of evidence in some of these scenarios may require involving a number of staff from a given nursing unit. It is important to consider the setting where you want to apply the evidence, is there support from all staff, does the practice change fit with the scope of practice in the clinical setting, and are there resources available to make a change? |
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Term
| Identify the nurse’s responsibility to the client for research and informed consent. |
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Definition
a. Researchers must protect the confidentiality of the participants, provide informed consent, minimize risks to subjects, identify risks and benefits of participating, ensure that participation the study is voluntary, and allow subjects to withdraw at any time. Informed consent means that:
i. Research subjects are given full and complete information about the purpose of the study, procedures, data collection, potential harm and benefits, and alternative methods of treatment.
ii. Are capable of fully understanding the research and the implications of participation.
iii. Have the power of free choice to voluntarily consent or decline participation in the research.
iv. Understand how the researcher maintains confidentiality or anonymity. |
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Term
| Discuss the steps of the research process. |
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Definition
Phase 1. Conceive the study. Indentify the problem, review the literature, develop theoretical framework, and formulate variables.
Phase 2. Design the study. Select research design, identify sample and setting, select data collection methods, and evaluate instrument quality.
Phase 3. Conduct the study. Get approval to use human subjects, recruit subjects, and collect data.
Phase 4. Analyze the study. Describe the sample, answer the research questions, and interpret the results.
Phase 5. Use the study. Recommend further research, state implications for nursing, and disseminate results. |
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Term
| Explain the relationship between evidence-based practice and quality improvement. |
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Definition
Evidence-based practice is a problem-solving approach to clinical practice that integrates the conscientious use of best evidence in combination with a clinician’s expertise and client preferences and values in making decisions about care. Quality improvement is an approach to continuously study and improve the process of providing health care services to meet the needs of clients and others.
Evidence-based practice and quality improvement go hand in hand. When implementing an evidence based practice project, is important to review available QI data. |
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Term
| Differentiate between quality improvement and performance improvement. |
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Definition
| Performance improvements are typically clinical projects conceived in response to identified clinical problems and designed to use research finding to improve clinical practice. |
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Term
| Identify the purpose of the International Council of Nurses (ICN): |
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Definition
| The ICN supports the need for nursing research as a means for improving the health and welfare of people. |
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Term
Discuss the implications of nursing research in the ANA’s Standards of Nursing Practice.
The ANA supports nursing research and use their findings to update and revise the Standards of Nursing Practice. Standard 13 recommends that the professional nurse use research findings in practice: |
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Definition
| The ANA supports nursing research and use their findings to update and revise the Standards of Nursing Practice. Standard 13 recommends that the professional nurse use research findings in practice. |
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Term
| Identify moral principles involved in ethical situations: |
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Definition
• Autonomy-refers to the commitment to include clients in decisions about all aspects of care
• Beneficence- refers to taking positive actions to help others
• Nonmaleficence- avoidance of harm or hurt to others
• Justice- refers to fairness. Often used in discussion of healthcare resources. Trying to ensure a fair distribution of health care services to all
• Fidelity- refers to the agreement to keep promises. |
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Term
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Definition
| refers to the commitment to include clients in decisions about all aspects of care |
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Term
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Definition
| refers to taking positive actions to help others |
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Term
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Definition
avoidance of harm or hurt to others
Justice- refers to fairness. Often used in discussion of healthcare resources. Trying to ensure a fair distribution of health care services to all |
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Term
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Definition
| refers to the agreement to keep promises. |
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Term
| Discuss purpose and content of the nurse’s professional code of ethics: |
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Definition
• A set of guiding principles that all members of a profession accept
• Helps professional groups settle questions about practice or behavior
• Includes:
i. Responsibility-refers to a willingness to respect obligations and to follow through on promises. As a nurse, it is being held responsible for your own actions.
ii. Accountability- refers to the ability to answer for one’s own actions. As a nurse you will learn to ensure that your professional actions are explainable to your clients and your employer.
iii. Confidentiality- the rights and privileges of the client for protection of privacy without diminishing access to quality of care. HIPAA mandates the confidential protection of client’s personal health information. As a nurse you cannot share health information about a client with anyone that is not providing direct care without specific client consent.
iv. Advocacy-refers to the support of a cause. As a nurse you advocate for the health, safety, and rights of your client by following institutional policies and procedures and reporting any incompetent, illegal, and unethical behavior by any health care professional. |
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Term
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Definition
| refers to a willingness to respect obligations and to follow through on promises. As a nurse, it is being held responsible for your own actions. |
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Term
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Definition
| refers to the ability to answer for one’s own actions. As a nurse you will learn to ensure that your professional actions are explainable to your clients and your employer. |
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Term
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Definition
| the rights and privileges of the client for protection of privacy without diminishing access to quality of care. HIPAA mandates the confidential protection of client’s personal health information. As a nurse you cannot share health information about a client with anyone that is not providing direct care without specific client consent. |
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Term
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Definition
| refers to the support of a cause. As a nurse you advocate for the health, safety, and rights of your client by following institutional policies and procedures and reporting any incompetent, illegal, and unethical behavior by any health care professional. |
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Term
| Discuss and describe ethical dilemmas: |
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Definition
| Ethical dilemmas almost always occur in the presence of conflicting values. To resolve ethical dilemmas one needs to distinguish between value, fact and opinion. |
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Term
| What are the steps in processing an ethical dilemma: |
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Definition
• Step 1: Ask: Is an ethical dilemma?
• Step 2: Gather all relevant information.
• Step 3: Clarify values.
• Step 4: Verbalize (identify) the problem.
• Step 5: Identify possible courses of action.
• Step 6: Negotiate a plan.
• Step 7: Evaluate the plan. |
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Term
| Describe the connection between values and ethics: |
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Definition
| A value is a personal belief about the worth of a given idea, attitude, custom, or object that sets standards that influence behavior. The connection between ethics and values is that ethical issues require that you maintain respect for differing values. |
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Term
| Describe ways values influence behavior: |
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Definition
| Value formation begins in childhood and is shaped by our many family experiences. Additionally schools, government, and religious traditions reinforce or challenge our values. Individual experiences also influence how a person values certain things. For example a person who experiences loss at an early age may grow to value things quite differently that someone whose life has been free of suffering. |
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Term
| Discuss how values are acquired and utilized in nursing care: |
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Definition
| When caring for clients, we deal with them physiologically as well as emotionally, spiritually, and psychologically. At times, ideals surrounding values may differ. It is important for us to remember that values an individual holds reflect cultural and social influences and that these values vary among people and develop and change over time |
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Term
| Explain legal concepts that apply to nurses: |
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Definition
| Standards of care are the legal guidelines for nursing practice and provide the minimum acceptable nursing care. Standards reflect values and priorities of the profession. |
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Term
| Describe sources of law and types of law: |
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Definition
Sources of law are the legal guidelines that come from statutory, regulatory, and common law
• Statutory- laws created by state legislatures and the US Congress. Statutory laws are either civil or criminal (ex. Nurse Practice Acts- describe the legal boundaries for nursing in Each State)
i. Civil- protect the rights of individual person within our society and encourage fair and equitable treatment among people
ii. Criminal- prevent harm to society and provide punishment for crimes
• Regulatory- reflects decisions made by administrative bodies such as the State Boards of Nursing when they pass rules and regulations
• Common law- results from judicial decisions made in courts when individual legal cases are decided. |
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Term
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Definition
| laws created by state legislatures and the US Congress. Statutory laws are either civil or criminal (ex. Nurse Practice Acts- describe the legal boundaries for nursing in Each State) |
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Term
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Definition
| protect the rights of individual person within our society and encourage fair and equitable treatment among people |
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Term
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Definition
| prevent harm to society and provide punishment for crimes |
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Term
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Definition
| reflects decisions made by administrative bodies such as the State Boards of Nursing when they pass rules and regulations |
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Term
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Definition
| results from judicial decisions made in courts when individual legal cases are decided. |
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Term
| Give examples of legal issues that arise in nursing practice: |
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Definition
Tort: is a civil wrong made against a person or property. Classifications for torts include intentional, quasi-intentional, or unintentional.
Intentional Tort: will full acts that violate another’s rights. Such as assault battery and false imprisonment.
~assault: intentional threat to bring about harmful of offensive contact
~battery: any intentional touching without consent
~false imprisonment: unjustified restraining of a person without legal warrant
Quasi intentional tort: acts where intent is lacking but volitional action and direct causation occur, such as found with invasion of privacy and defamation of character
~invasion of privacy: protects clients right to be free from unwanted intrusion into his or her private affairs (i.e. don’t release clients medical record to unauthorized person)
~defamation of character: publication of false statements that result in damage to persons reputation. Malice means that the person publishing the info knows it is false and publishes it anyway or publishes it with reckless disregard as to the truth. Slander is when one verbalizes the false statement. Libel is the written defamation of character. (i.e. charting false entries is defamation of character)
Unintentional tort: includes negligence or mal practice
~negligence: conduct that falls below a standard of care. (i.e. hanging wrong iv solution or letting assistant administer medication)
~malpractice: type of negligence and often referred to as professional negligence. When nursing care falls below standard of care, nursing malpractice results |
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Term
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Definition
| is a civil wrong made against a person or property. Classifications for torts include intentional, quasi-intentional, or unintentional. |
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Term
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Definition
| willfull acts that violate another’s rights. Such as assault battery and false imprisonment. |
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Term
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Definition
| intentional threat to bring about harmful of offensive contact |
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Term
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Definition
| any intentional touching without consent |
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Term
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Definition
| unjustified restraining of a person without legal warrant |
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Term
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Definition
| acts where intent is lacking but volitional action and direct causation occur, such as found with invasion of privacy and defamation of character |
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Term
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Definition
| protects clients right to be free from unwanted intrusion into his or her private affairs (i.e. don’t release clients medical record to unauthorized person) |
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Term
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Definition
| publication of false statements that result in damage to persons reputation. Malice means that the person publishing the info knows it is false and publishes it anyway or publishes it with reckless disregard as to the truth. Slander is when one verbalizes the false statement. Libel is the written defamation of character. (i.e. charting false entries is defamation of character) |
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Term
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Definition
| includes negligence or malpractice |
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Term
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Definition
| conduct that falls below a standard of care. (i.e. hanging wrong iv solution or letting assistant administer medication) |
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Term
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Definition
| type of negligence and often referred to as professional negligence. When nursing care falls below standard of care, nursing malpractice results |
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Term
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Definition
| is when one verbalizes the false statement. |
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Term
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Definition
| the written defamation of character. (i.e. charting false entries is defamation of character) |
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Term
| Describe ways the Nurse Practice Act, Standards of Care, and Policies affect the practice of nursing: |
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Definition
Nurse practice act: describes and defines the legal boundaries of nursing practice within each state
Standards of care: legal guidelines for nursing practice and provide the minimum acceptable nursing care
All of these things are established to provide safety for our clients and for ourselves. |
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Term
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Definition
| describes and defines the legal boundaries of nursing practice within each state |
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Term
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Definition
legal guidelines for nursing practice and provide the minimum acceptable nursing care
All of these things are established to provide safety for our clients and for ourselves. |
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Term
| Describe the legal responsibilities and obligations of nurses: |
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Definition
| Nurses need to understand the law to protect themselves from liability and to protect their clients' rights. The legal guidelines that nurses follow come from the statutory law, regulatory law, and common law. The Nurse Practice Acts describes and defines the legal boundaries of nursing practice within each state. Standards of care are legal guidelines for nursing practice and provide minimum acceptable nursing care. The law defines the standards of care for nurses to follow. All nurses are responsible for knowing the provisions of the Nurse Practice Act for the state they work, as well as the rules and regulations enacted by the State Board of Nursing and other regulatory administrative bodies. The Joint Commission requires that accredited hospitals have written nursing policies and procedures. These standards should be posted on every unit and you need to know them. |
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Term
| Describe the elements of informed consent: |
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Definition
| Informed consent is a person's agreement to allow something to happen, such as surgery or an invasive diagnostic procedure, based on full disclosure of risks, benefits, alternatives, and consequences of refusal. Informed consent creates a legal duty for the health care provider to disclose material facts in terms the client is able to understand and make an informed choice. The explanation also describes treatment alternatives, as well as the risks involved in all treatment options. Because nurses do not perform surgery or any direct medical procedures, in most cases, obtaining the clients' informed consent does not fall within the nursing duty. The nurse's signature witnessing the consent means that the client voluntarily gave consent, that the client's signature is authentic, and that the client appears to be competent to give consent. When nurses provide consent forms they must ask the clients if they understand the procedures they are giving consent for. |
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Term
| Discuss the legal status of the nursing student when giving care: |
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Definition
| Nursing students are liable if their actions cause harm to clients. If a student harms a client as a direct result of his or her actions or lack of action, the student, instructor, hospital or health care facility, and university share the liability for the incorrect action. Nursing students should never be assigned to perform tasks for which they are unprepared, and instructors should carefully supervise them as they learn new skills. When students work as nursing assistants when not attending class, they should not perform tasks that do not appear in the job description. |
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Term
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Definition
| Any intentional threat to bring about harmful or offensive contact. No actual contact is necessary. It is an assault for a nurse to threaten to give a client an injection or to threaten to restrain a client for an x-ray procedure when the client has refused consent. The key issue is the client’s consent. In an assault lawsuit, if the client gives consent, the nurse is not responsible for assault. |
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Term
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Definition
| Any intentional touching without consent. The contact can be harmful to the client and cause an injury, or it can be merely offensive to the client’s personal dignity. A battery always includes an assault, which is why the terms assault and battery are commonly combined. In the example of a nurse threatening to give a client an injection without the client’s consent, if the nurse actually gives the injection, it is battery. |
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Term
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Definition
| The written defamation of character. Charting false entries is another example of defamation. |
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Term
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Definition
| Occurs when one verbalizes the false statement. For example, if a nurse tells people erroneously that a client has venereal disease and the disclosure affects the client’s business, the nurse is liable for slander. |
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Term
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Definition
| Occurs with unjustified restraining of a person without legal warrant. For example, this occurs when nurses restrain a client in a bounded area to keep the person from freedom. |
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Term
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Definition
| The tort of invasion of privacy protects the client’s rights to be free from unwanted intrusion into his or her private affairs. HIPAA sets forth standards indicating that clients are entitled to confidential health care. A client’s medical record is confidential. Do not disclose the client’s confidential medical information without the client’s consent. |
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Term
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Definition
| Conduct that falls below a standard of care. The law established the standard of care for the protection of others against an unreasonably great risk of harm. For example, if a driver of a car acts unreasonably in failing to stop at a stop sign, it is negligence. Negligent acts such as hanging the wrong intravenous solution for a client or allowing a nursing assistant to administer a medication often will lead to disciplinary action by a state. |
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Term
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Definition
| One type of negligence and often is referred to as professional negligence. When nursing care falls below a standard of care, nursing malpractice results. To establish nursing malpractice, there are certain criteria: 1. The nurse owed a duty to the client 2. The nurse did not carry out the duty 3. The client was injured, and 4. The nurse’s failure to carry out the duty caused the injury. Example: failing to check a client’s armband and then administering medication to the wrong client or administering a medication to a client even though the medical record contains documentation that the client has an allergy to the medication. The best way for nurses to avoid negligence is to follow standards of care, give competent health care, and communicate with other health care providers. |
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Term
| Identify the purpose of incident/ variance reports: |
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Definition
| One tool used in risk management is the incident report or occurrence report. Occurrence reporting provides a database for further investigation in an attempt to determine deviations from standards of care and corrective measures needed to prevent recurrence and to alert risk management to a potential claim situations. Example: client or visitor falls or injury, failure to follow physician or health care provider orders. |
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Term
| State the legal implication for the nurse regarding the Good Samaritan Act: |
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Definition
| Good Samaritan Laws- Nurses act as Good Samaritans by providing emergency assistance at an accident scene. All states have Good Samaritan laws enacted to encourage health care professionals to assist in emergencies. Although provisions vary among states, these laws limit liability and offer legal immunity for nurses who help at the scene of an accident. Check your own state’s statute, because some states (Minnesota and Vermont) require nurses to stop and help in an emergency. |
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Term
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Definition
| Represent written documents that direct treatment in accordance with a client’s wishes in the event of a terminal illness or condition. With this legal document the client is able to declare which medical procedures he or she wants or does not want when terminally ill or in a persistent vegetative state. Living wills are often difficult to interpret and not clinically specific in unforeseen circumstances. Each state providing for living wills has its own requirements for executing them. If health care workers follow the directions of the living will, they should be immune from liability. |
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Term
| Durable Power of Attorney: |
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Definition
| A legal document that designates a person or persons of one’s choosing to make health care decisions when the client is no longer able to make decisions on his or her own behalf. This agent makes health care treatment decisions based on the client’s wishes. |
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Term
| the legal responsibility and obligations of the nurse regarding the ADA: |
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Definition
| A very broad civil rights statue. It protects the rights of disabled people. It is also the most extensive law on how employers must treat health care workers and clients infected with HIV. ADA protects health care workers in the workplace with disabilities such as HIV infection. Likewise, health care workers may not discriminate against HIV- positive clients. |
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Term
| the legal responsibility and obligations of the nurse regarding the EMTALA: |
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Definition
| As a result of clients’ being transferred from private hospitals to public hospitals without appropriate screening and stabilization ( referred to as patient dumping). This act provides that when a client comes to the emergency department or the hospital, an a0ppropriate medical screening occurs within the hospital’s capacity. If an emergency condition exists, the hospital is not to discharge or transfer the client until the condition stabilizes. |
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Term
| the legal responsibility and obligations of the nurse regarding the HIPAA: |
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Definition
| This law provides rights to clients and protects employees. It protects individuals from losing their health insurance when changing jobs by providing portability. Create client rights to consent to use and disclose protected health information, to inspect and copy one’s medical record, and to amend mistaken or incomplete information. It limits who is able to access a client’s record. It establishes the basis for privacy and confidentiality concerns, viewed as two basic rights within the U.S. health care setting; privacy and confidentiality. |
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Term
| the legal responsibility and obligations of the nurse regarding the PSDA: |
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Definition
| Requires health care institutions to provide written information to clients concerning the client’s rights under state law to make decisions, including the right to refuse treatment and formulate advance directives. The client’s record must contain documentation whether the client has signed an advance directive. In order for living wills or durable powers of attorney for health care to be enforceable, the client must be legally incompetent or lack decisional capacity to make decisions regarding health care treatment. |
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Term
| What are the (5) levels of communication & their uses in nursing: |
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Definition
| Intrapersonal, Interpersonal, Transpersonal, Small Group Communication, Public Communication |
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Term
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Definition
| (form of communication that occurs within an individual e.g., self talk, self verbalization, and inner thought) – To develop self awareness and a positive self concept that enhances appropriate self expression. Example of self instruction: mental rehearsal for difficult tasks or situations so individuals can deal with them more effectively. |
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Term
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Definition
| (one to one interaction between nurse and another person and is often face to face) Level most often used in nursing situations and lies at the heart of the nursing practice. Be cautious because meanings reside within a person and not in words. People can often misinterpret messages intended. |
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Term
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Definition
| (interaction that occurs within a persona spiritual domain) Nurses who value the importance of human spirituality often use this form of communication with clients and for themselves. Nurses have a responsibility to assess a client’s spiritual needs and intervene to meet those needs. |
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Term
| Small group communication: |
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Definition
| (interaction that occurs when a small group of persons meet together) Typically goal directed and requires an understanding of group dynamics. Nurses working on committees, lead client support groups, form research teams, or participate in client care conferences are using small group communication |
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Term
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Definition
| (interaction with an audience) Nurses whom speak to groups of consumers about health related topics, presenting scholarly work to colleagues at conferences or lead classroom discussions with peers or students that increases knowledge about health related topics, health issues, and other issues important to the nursing profession. |
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Term
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Definition
| (motivates one person to speak to another) Anything that initiated the communication |
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Term
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Definition
| (Sender is the person who encodes and delivers the message. They put ideas or feelings into a form that is transmitted and is responsible for the accuracy of its content and emotional tone. The sender’s message acts as a referent.) The receiver is the person who receives and decodes the message. They are responsible for attending to, translating and responding to the sender’s message. |
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Term
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Definition
| The content of the communication. It may contain verbal, nonverbal and symbolic language. Note that personal communication style can convey a different message although it may be the same message another nurse conveyed. |
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Term
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Definition
| The means of conveying and receiving messages through visual, auditory and tactile senses. Facial expressions send visual messages. Spoken words travel through auditory cannels. Touch uses tactile channels. Using more channels to convey messages help individuals to understand more clearly. Nurses use verbal, nonverbal, and mediated (technological) communication channels. Note that Nonverbal is more indicative |
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Term
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Definition
| The message the receiver returns. It indicates whether the receiver understood the meaning of the sender’s message. The nurse assumes primary responsibility in the nurse client relationship for seeking openness and clarification of the message. |
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Term
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Definition
| Factors within both the sender and receiver that influence communication. Each person senses, interprets and understands events differently. Some view nurses questions as caring and others view as invading privacy. Variables include gender, education, religion, values and belief. Pain, illness and medication effects are also variables. |
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Term
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Definition
| the setting for sender-receiver interaction. The environment should meet the needs for physical and emotional comfort and safety Nurses need to try to control the environment as much as possible to create favorable conditions for effective communication. |
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Term
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Definition
| Common courtesy – say hello, goodbye to clients, use self introduction, knock before entering, state purposes, say please and thank you to team members |
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Term
| Communication techniques for clients Who Cannot Speak Clearly(Aphasia, Dysarthria, Muteness): |
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Definition
• Listen attentively, be patient, and do not interrupt.
• Ask simple questions that require “yes” or “no” answers.
• Allow time for understanding and response.
• Use visual cues (e.g., words, pictures, and objects) when possible.
• Allow only one person to speak at a time.
• Do not shout or speak too loudly.
• Encourage the client to converse.
• Let client know if you have not understood him or her.
• Collaborate with speech therapist as needed.
Use communication aids:
• Pad and felt-tipped pen or Magic Slate Communication board with commonly used words, letters, or pictures denoting basic needs
• Call bells or alarms
• Sign language
• Use of eye blinks or movement of fingers for simple responses (“yes” or “no”) |
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Term
| Communication techniques for clients Who Are Cognitively Impaired: |
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Definition
• Reduce environmental distractions while conversing.
• Get client’s attention before speaking.
• Use simple sentences, and avoid long explanations.
• Ask one question at a time.
• Allow time for client to respond.
• Be an attentive listener.
• Include family and friends in conversations, especially in subjects known to client. |
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Term
| Communication techniques for clients Who Are Hearing Impaired: |
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Definition
• Check for hearing aids and glasses.
• Reduce environmental noise.
• Get client’s attention before speaking.
• Face client with mouth visible.
• Do not chew gum.
• Speak at normal volume—do not shout.
• Rephrase rather than repeat if misunderstood.
• Provide a sign language interpreter if indicated. |
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Term
| Communication techniques for clients Who Are Visually Impaired: |
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Definition
• Check for use of glasses or contact lenses.
• Identify yourself when you enter room, and notify client when you leave room.
• Speak in a normal tone of voice.
• Do not rely on gestures or nonverbal communication to convey messages.
• Use indirect lighting, avoiding glare.
• Use at least 14-point print. |
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Term
| Communication techniques for clients Who Are Unresponsive: |
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Definition
• Call client by name during interactions.
• Communicate both verbally and by touch.
• Speak to client as though he or she could hear.
• Explain all procedures and sensations.
• Provide orientation to person, place, and time.
• Avoid talking about client to others in his or her presence.
• Avoid saying things client should not hear. |
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Term
| Communication techniques for clients Who Do Not Speak English: |
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Definition
• Speak to client in normal tone of voice (shouting may be interpreted as anger).
• Establish method for client to signal desire to communicate (call light or bell).Provide an interpreter (translator) as needed.
• Avoid using family members, especially children, as interpreters.
• Develop communication board, pictures, or cards.
• Translate words from native language into English list for client to make basic requests.
• Have dictionary (English/Spanish and so forth) available if client can read |
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Term
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Definition
| Self introduction including your title! Recognition of client makes them feel that you care, use eye contact and smile! Address client by last name. (no sweetie, honey, etc) |
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Term
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Definition
| Demonstrate warmth, consistency, reliability, honesty, competency and respect. Never share personal information or gossip about others |
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Term
| Autonomy and Responsibility: |
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Definition
| Accept responsibility for your actions! Take initiative in problem solving and communicate in a manner that reflects the importance and purpose of therapeutic conversation. Recognize your patient does not want to lose control of decisions that influence how they live! |
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Term
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Definition
| Do not judge or hurt others. Communicate self assurance while also communicating respect for the other person. Nurses teach assertiveness skills to others as a means for promoting personal health. |
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Term
| Describe Physical and Emotional Factors influencing the communication process: |
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Definition
| (The internal factors that influence communication) It is especially important to assess the psychophysiological factors that influence communication. Many altered health states and human responses limit communication. |
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Term
| Describe Developmental factors influencing the communication process |
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Definition
| Aspects of a client’s growth and development influence communication. Age determines how a nurse communicates with a client. (children: including parent, using communication techniques, toys etc.) (older client box 24-7 page 350) |
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Term
| Describe Sociocultural factors influencing the communication process |
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Definition
| Culture influences communication. Nurses should practice cultural sensitivity and try not to interpret messages through your cultural perspective and try to consider the context of the message within the context of the sender’s background. |
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Term
| Describe Gender factors influencing the communication process |
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Definition
| Males are less verbal but are more likely to initiate communicate and address issues more directly and talk about issues. Females disclose more personal information, use more active listening, respond with responses that encourage more conversation. Male nurses communicate more directly while female nurses communicate in a more round about manner. Avoid conversations of sexual overtones, gender denigrating jokes and male-female stereotyping. Note Communication is more effective when the nurse and client are of the same gender |
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Term
| Psychophysiological Context; The internal factors influencing communication: |
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Definition
• Physiological status (e.g., pain, hunger, weakness, dyspnea)
• Emotional status (e.g., anxiety, anger, hopelessness, euphoria)
• Growth and development status (e.g., age, developmental tasks)
• Unmet needs (e.g., safety/security, love/belonging)
• Attitudes, values, and beliefs (e.g., meaning of illness experience)
• Perceptions and personality (e.g., optimist/pessimist, introvert/extrovert)
• Self-concept and self-esteem (e.g., positive or negative) |
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Term
| Relational Context factors that influence communication; The nature of the relationship between the participants: |
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Definition
• Social, helping, or working relationship
• Level of trust between participants
• Level of caring expressed
• Level of self-disclosure between participants
• Shared history of participants
• Balance of power and control |
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Term
| Situational Context factors that influence communication; The reason for the communication: |
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Definition
• Information exchange
• Goal achievement
• Problem resolution
• Expression of feelings
• Environmental Context
• Information exchange
• Goal achievement
• Problem resolution
• Expression of feelings
• Environmental Context |
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Term
| The physical surroundings in which communication takes place that influence communication: |
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Definition
• Privacy level
• Noise level
• Comfort and safety level
• Distraction level |
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Term
| Cultural Context factors that influence communication; The sociocultural elements that affect the interaction: |
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Definition
• Educational level of participants
• Language and self-expression patterns
• Customs and expectation |
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Term
| Therapeutic communication techniques: |
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Definition
| are specific responses that encourage the expression of feelings and ideas and convey acceptance and respect. |
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Term
| Nontherapeutic communication techniques: |
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Definition
| hinder or damage professional relationships. Often referred to as blocking techniques. They often cause recipients to activate defenses to avoid being hurt or negatively affected. |
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Term
| Examples of therapeutic communication techniques: |
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Definition
| active listening; sharing observations; sharing empathy; sharing hope; sharing humor; sharing feelings; using touch; using silence; providing information; clarifying; focusing; paraphrasing; asking relevant questions; summarizing; confrontation |
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Term
| Examples of nontherapeutic communication techniques: |
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Definition
| asking personal questions; giving personal opinions; changing the subject; automatic responses; false reassurance; sympathy; asking for explanations; approval or disapproval; defensive responses; passive or aggressive responses; arguing |
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Term
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Definition
| is an interactive process that promotes learning. It consists of a conscious, deliberate set of actions that help individuals gain new knowledge, change attitudes, adopt new behaviors, or perform new skills. A teacher provides information that prompts the learner to engage in activities that lead to a desired change. |
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Term
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Definition
| is the purposeful acquisition of new knowledge, attitudes, behaviors, and skills. Complex patterns are required if the client is to learn new skills, change existing attitudes, transfer learning to new situations, or solve problems. A new mother exhibits learning when she demonstrates to the nurse how to bathe her newborn. The mother shows transfer of learning when she uses the principles she learned about bathing a newborn when she bathes her older child. Generally, teaching and learning begin when a person identifies a need for knowing or acquiring an ability to do something. Teaching is most effective when it responds to the learner’s needs. The teacher assesses these needs by asking questions and determining the learner’s interests. Interpersonal communication is essential for successful teaching to occur |
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Term
| Identify nursing diagnosis, outcomes, and interventions that are focused on the learning needs of the client: |
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Definition
Examples of additional nursing diagnoses that indicate a need for education include the following:
• Ineffective health maintenance
• Health-seeking behaviors
• Impaired home maintenance
• Ineffective therapeutic regimen management
• Ineffective community therapeutic regimen management
• Ineffective family therapeutic regimen management
• Noncompliance |
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Term
| When is teaching inappropriate? |
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Definition
| When the nurse identifies conditions that cause barriers to effective learning (e.g., nursing diagnosis of acute pain or activity intolerance), teaching is inappropriate. In these cases delay teaching until the nursing diagnosis is resolved or the health problem is controlled. |
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Term
| When is the diagnostic statement is deficient knowledge appropriate? |
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Definition
| When the nurse can manage or eliminate health care problems through education. |
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Term
| Planning and client teaching: |
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Definition
| After determining the nursing diagnoses that identify a client’s learning needs, develop a teaching plan, determine goals and expected outcomes, and involve the client in selecting learning experiences (see care plan). Expected outcomes (or learning objectives) guide the choice of teaching strategies and approaches with a client. Client participation ensures a more relevant, meaningful plan. |
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Term
| Client Teaching Goals and Outcomes: |
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Definition
Goals of client education indicate that the client better understands information provided and is able to attain health or better manage illness. Include the client if possible when establishing learning goals and outcomes. Outcomes often describe a behavior that identifies the client’s ability to do something upon completion of teaching.
In some health care settings, nurses develop written teaching plans. The teaching plan includes topics for instruction, resources (e.g., equipment, teaching booklets, and referrals to special educational programs), recommendations for involving family, and objectives of the teaching plan. Some plans are very detailed, whereas others are in outline form. |
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Term
| Identify the purposes of client education: |
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Definition
| The goal of educating others about their health is to assist individuals, families, or communities in achieving optimal levels of health. |
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Term
| 11. Identify the purposes of client education. |
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Definition
The goal of educating others about their health is to assist individuals, families, or communities in achieving optimal levels of health.
• Maintenance and Promotion of Health and Illness Prevention
• Restoration of Health
• Coping With Impaired Functions |
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Term
| Identify the three (3) domains of learning: |
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Definition
| Learning occurs in three domains: cognitive (understanding), affective (attitudes), and psychomotor (motor skills). |
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Term
| What is cognitive Learning? |
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Definition
Cognitive learning includes all intellectual behaviors and requires thinking. In the hierarchy of cognitive behaviors the simplest behavior is acquiring knowledge, whereas the most complex is evaluation.
Cognitive learning includes the following:
• Knowledge: learning new facts or information and being able to recall them
• Comprehension: the ability to understand the meaning of learned material
• Application: using abstract, newly learned ideas in a concrete situation
• Analysis: breaking down information into organized parts
• Synthesis: the ability to apply knowledge and skills to produce a new whole
• Evaluation: a judgment of the worth of a body of information for a given purpose |
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Term
| What is affective Learning? |
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Definition
Affective learning deals with expression of feelings and acceptance of attitudes, opinions, or values. Values clarification is an example of affective learning. The simplest behavior in the hierarchy is receiving, and the most complex is characterizing.
Affective learning includes the following:
• Receiving: being willing to attend to another person’s words
• Responding: active participation through listening and reacting verbally and nonverbally
• Valuing: attaching worth to an object or behavior demonstrated by the learner’s behavior
• Organizing: developing a value system by identifying and organizing values and resolving conflicts
• Characterizing: acting and responding with a consistent value system |
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Term
| What is psychomotor Learning: |
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Definition
Psychomotor learning involves acquiring skills that require the integration of mental and muscular activity, such as the ability to walk or to use an eating utensil. The simplest behavior in the hierarchy is perception, whereas the most complex is origination.
Psychomotor learning includes the following:
• Perception: Being aware of objects or qualities through the use of sense organs.
• Set: A readiness to take a particular action. There are three sets: mental, physical, and emotional.
• Guided response: The performance of an act under the guidance of an instructor involving imitation of a demonstrated act.
• Mechanism: A higher level of behavior by which a person gains confidence and skill in performing a behavior that is more complex or involves several more steps than a guided response.
• Complex overt response: Smoothly and accurately performing a motor skill that requires a complex movement pattern.
• Adaptation: The ability to change a motor response when unexpected problems occur.
• Origination: Using existing Psychomotor learning involves acquiring skills that require the integration of mental and muscular activity, such as the ability to walk or to use an eating utensil (Redman, 2007). The simplest behavior in the hierarchy is perception, whereas the most complex is origination.
Psychomotor learning includes the following:
• Perception: Being aware of objects or qualities through the use of sense organs.
• Set: A readiness to take a particular action. There are three sets: mental, physical, and emotional.
• Guided response: The performance of an act under the guidance of an instructor involving imitation of a demonstrated act.
• Mechanism: A higher level of behavior by which a person gains confidence and skill in performing a behavior that is more complex or involves several more steps than a guided response.
• Complex overt response: Smoothly and accurately performing a motor skill that requires a complex movement pattern.
• Adaptation: The ability to change a motor response when unexpected problems occur.
• Origination: Using existing psychomotor skills and abilities to perform a highly complex motor act that involves creating new movement pattern |
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Term
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Definition
| The capability for learning and the type of behaviors that children are able to learn depend on the child’s maturation. Without proper physiological, motor, language, and social development, many types of learning cannot take place. However, learning occurs in children of all ages. Intellectual growth moves from the concrete to the abstract as the child matures. Therefore information presented to children needs to be understandable, and the expected outcomes must be realistic, based on the child’s developmental stage. Use teaching aids that are developmentally appropriate. Learning occurs when behavior changes as a result of experience or growth. |
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Term
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Definition
| Teaching adults differs from teaching children. Adults are able to critically reflect on their current situation and sometimes need help to see their problems and change their perspectives. Because adults become independent and self-directed as they mature, they are often able to identify their own learning needs. Learning needs come from problems or tasks that result from real-life situations. Although adults tend to be self-directed learners, they often become dependent in new learning situations |
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Term
| The following physical characteristics are necessary to learn psychomotor skills: |
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Definition
• Size (height and weight match the task to perform or the equipment to use [e.g., crutch walking])
• Strength (ability of the client to follow a strenuous exercise program)
• Coordination (dexterity needed for complicated motor skills, such as using utensils or changing a bandage)
• Sensory acuity (visual, auditory, tactile, gustatory, and olfactory; sensory resources needed to receive and respond to messages taught) |
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Term
| Identify principles of effective teaching: |
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Definition
• Maintain learning attention and participation.
• Build on existing knowledge.
• Select teaching approach.
• Incorporate teaching with nursing care.
• Select appropriate instructional methods.
• Illiteracy and other disabilities.
• Cultural diversity.
• Using different teaching tools.
• Special needs of children and older adults. |
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Term
| Questions to ask when evaluating client education include the following: |
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Definition
• Were the client’s goals or outcomes realistic and observable?
• Did the client value the information provided?
• Was the client willing to change an existing or adopt a new behavior?
• What barriers prevented learning or change in behaviors?
• Is the client able to perform the behavior or skill in the natural setting (e.g., home)?
• How well is the client able to answer questions about topic?
• If the client is completing a log, how well does the log match what was taught?
• Does the client continue to have problems understanding the information or performing a skill? If so, how can the nurse change the interventions to enhance knowledge or skill performance? |
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Term
| Identify the legal and ethical considerations related to documentation: |
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Definition
| Nurses are legally and ethically obligated to keep information about clients confidential. They have a responsibility to protect records from all unauthorized users. HIPPA is the Health Insurance Portability and Accountability Act, which took effect in April 2003. It governs all areas of information management. |
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Term
| Identify purposes of a health care record: |
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Definition
| A record is a valuable source of data for all members of the health care team. Its purposes include communication, documentation, financial billing, education, research, and auditing-monitoring. |
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Term
| Describe the legal guidelines for effective documentation and reporting: |
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Definition
• Do not erase, apply correction fluid, or scratch out errors made while recording.
• Do not write retaliatory or critical comments about client or care by other health care professionals. Do not write personal opinions.
• Correct all errors promptly.
• Record all facts.
• Do not leave blank spaces in nurses’ notes.
• Record all entries legibly and in black ink. Do not use felt tip pens or erasable ink.
• If order is questioned, record that clarification was sought.
• Chart only for yourself.
• Avoid using generalized, empty phrases such as “status unchanged” or “had good day.”
• Begin each entry with date and time, and end with your signature and title.
• For computer documentation keep your password to yourself. |
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Term
| Describe the types of documentation: |
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Definition
• Narrative documentation- the traditional method for recording nursing care. Simply it is the use of a story like format to document information specific to client conditions and nursing care.
• Problem-Oriented Medical Record (POMR)- a method of documentation that emphasizes the client’s problems. Data are organized by problem or diagnosis. The POMR has the following major sections:
o Database- contains all available assessment information pertaining to the client.
o Problem List- After analyzing data, health care team members identify problems and make a single problem list.
o Nursing Care Plan- disciplines involved in the client’s care develop a care plan for each problem.
o Progress Notes- health care team members monitor and record the progress of a client’s problems.
• Source Records- the client’s chart has a separate section for each discipline (nursing, social work, medicine, respiratory therapy) to record data. See TABLE 26-3, pg. 392.
• Charting by Exception (CBE)- focuses on documenting deviations from the established norm or abnormal finding. This approach reduces documentation time and highlights trends or changes in the client’s condition. |
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Term
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Definition
| the traditional method for recording nursing care. Simply it is the use of a story like format to document information specific to client conditions and nursing care. |
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Term
| Problem-Oriented Medical Record (POMR): |
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Definition
a method of documentation that emphasizes the client’s problems. Data are organized by problem or diagnosis. The POMR has the following major sections:
o Database- contains all available assessment information pertaining to the client.
o Problem List- After analyzing data, health care team members identify problems and make a single problem list.
o Nursing Care Plan- disciplines involved in the client’s care develop a care plan for each problem.
o Progress Notes- health care team members monitor and record the progress of a client’s problems. |
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Term
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Definition
| the client’s chart has a separate section for each discipline (nursing, social work, medicine, respiratory therapy) to record data. |
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Term
| Charting by Exception (CBE): |
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Definition
| focuses on documenting deviations from the established norm or abnormal finding. This approach reduces documentation time and highlights trends or changes in the client’s condition. |
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Term
| Discuss the role of computerization in documentation: |
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Definition
Software programs allow nurses to enter assessment data. Computers generate nursing care plans and document care. Nursing informatics is defined by the ANA as a specialty that integrates nursing science, computer science, and information science to manage and communicate data, information, and knowledge in nursing practice.
Advantages include:
o Increased time to spend with clients
o Better access to information
o Enhanced quality of documentation
o Reduced errors of omission
o Reduced hospital costs
o Increased nurse job satisfaction
o Compliance with TJC and other accrediting agencies.
o Development of a common clinical database |
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Term
| What are the various forms used to supplement documentation: |
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Definition
Admission Nursing History Forms
Flow Sheets and Graphic Records
Client Care Summary or Kardex
Acuity Records
Standardized Care Plans
Discharge Summary Forms |
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Term
| Admission Nursing History Forms: |
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Definition
| A nurse completes a nursing history form when a client is admitted to a nursing care unit. The history form guides the nurse through a complete assessment to identify relevant nursing diagnoses or problems (see Chapter 16). Data on history forms provide baseline data to compare with changes in the client’s condition. |
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Term
| Flow Sheets and Graphic Records: |
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Definition
| Flow sheets are forms that allow nurses to quickly and easily enter assessment data about the client, including vital signs and routine repetitive care, such as hygiene measures, ambulation, meals, weights, and safety and restraint checks. Flow sheets use a coding system for data entry. If an occurrence on a flow sheet is unusual or changes significantly, enter a focus note. For example, if a client’s blood pressure becomes dangerously high, complete a focus assessment and record this, as well as action taken, in the progress notes. Flow sheets provide a quick, easy reference for the health care team members in assessing a client’s status. Critical care and acute care units commonly use flow sheets for all types of physiological data. |
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Term
| Client Care Summary or Kardex: |
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Definition
The client care summary or Kardex includes the following information:
• Basic demographic data (e.g., age, religion)
• HIPAA code word
• Physician’s or health care provider’s name
• Primary medical diagnosis
• Medical and surgical history
• Current treatment orders from health care provider to be carried out by the nurse (e.g., dressing changes, ambulation, glucose monitoring)
• Nursing care plan
• Nursing orders (e.g., education sessions, symptom relief measures, counseling)
• Scheduled tests and procedures
• Safety precautions to be used in the client’s care
• Factors related to activities of daily living
• Nearest relative/guardian or person to contact in an emergency
• Emergency code status
• Allergies |
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Term
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Definition
| Acuity records offer a way to determine the hours of care and staff required for a given group of clients. A client’s acuity level is based on the type and number of nursing interventions (e.g., intravenous [IV] therapy, wound care, or ambulation assistance) required over a 24-hour period. The acuity level rates clients in comparison with one another. For example, an acuity system might rate bathing clients from 1 to 5 (1 is totally dependent, and 5 is independent). A client returning from surgery requiring frequent monitoring and extensive care may be listed with an acuity level of 1, compared with another client awaiting discharge after a successful recovery from surgery who has an acuity level of 5. Accurate acuity ratings justify overtime and the number and qualifications of staff needed |
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Term
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Definition
| Many institutions have made documentation easier for nurses with standardized care plans. The plans, based on the institution’s standards of nursing practice, are preprinted, established guide-lines that are used to care for clients who have similar health problems. After completing a nursing assessment, the staff nurse identifies the standard care plans that are appropriate for the client and places the plans in the client’s medical record. The nurse modifies standardized plans in ink to individualize the therapies. Most standardized care plans also allow the nurse to write in specific goals or desired outcomes of care and the dates by which these outcomes should be achieved. One advantage of standardized care plans is establishment of clinically sound standards of care for similar groups of clients. These standards are useful when conducting quality improvement audits. Another advantage is education. Nurses learn to recognize the accepted requirements of care for clients. The standardized care plans can also improve continuity of care among professional nurses. The use of standardized care plans is controversial. The major disadvantage is the risk that the standardized plans inhibit nurses’ identification of unique, individualized therapies for clients. When standardized care plans are used in a health care facility, the nurse remains responsible for an individualized approach to care. Standardized care plans cannot replace the nurse’s professional judgment and decision making. In addition, care plans need to be updated on a regular basis to ensure that content is current and appropriate. |
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Term
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Definition
TJC (2007) has standards for client education necessary for effective discharge planning:
• Instruction in potential food-drug interactions, nutrition intervention, and modified diets
• Rehabilitation techniques to support adaptation to and/or functional independence in the environment
• Access to available community resources
• Under what circumstances clients should obtain further treatment or follow-up care
• Methods of obtaining follow-up care
• The client’s and family’s responsibilities in the client’s care
• Medication instructions, including when to take each medication and why, the dose, the route, precautions, and possible adverse reactions, and when and how to get prescriptions refilled. |
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Term
| Describe the purpose of a change-of-shift report: |
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Definition
| At the end of each shift nurses report information about their assigned clients to the nurses working on the next shift. The report provides continuity of care among nurses who are caring for a client. For example, if one nurse finds a certain pain relief measure effective for a client, it is important that the information be relayed to the next nurse caring for the client so that pain-control interventions can be continued. |
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Term
| Describe information to be included in the shift report: |
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Definition
| An effective report describes each client’s health status and lets staff on the next shift know what care the clients will require. A change-of-shift report should not simply be the reading of documented information. Instead, nurses review significant information about clients (e.g., the condition of wounds or episodes of chest pain) to provide a baseline for comparison during the next shift. Data about clients need to be objective, current, and concise. An organized report follows a logical sequence. To prepare for a report, gather information from work sheets, the client’s records, and the client’s care plan. A systematic approach such as using the nursing process can provide staff with critical information that is needed to continue care. |
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Term
| Describe how illness and/or stress impact self concept. |
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Definition
Self concept is an individual’s conceptualization of himself or herself. It is a subjective sense of self and a complex mixture of unconscious and conscious thoughts, attitudes, and perceptions. It directly affects self esteem; how one feels about themselves.
Illness: a clients belief in personal health often enhances his/hers self concept. Statements such as “I can get through anything” or “I’ve never been sick a day in my life” indicate positive thoughts about personal health. The way individuals think and how they feel about themselves affects the way in which they care for themselves physically and emotionally as well as the way they care for others.
Stress: a self concept stressor is any real or perceived change that threatens indentity, body image or role performance. An individual’s perception of the stressor is the most important factor in determining his or her response. Ability to reestablish balance following a stressor is r/t numerous factors including the number or stressors, duration of the stressor and health status. |
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Term
| Describe ways to enhance client self-esteem: |
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Definition
The nurses acceptance of a client with an altered self concept helps promote positive change. Nurses need to remain aware of their own feeling, ideas, values, expectations and judgments. Self awareness is critical in understanding and accepting others. Clients with change of body appearance or function are extremely sensitive to the verbal and nonverbal responses of the health care team..
Example: the body image of a woman who has had a mastectomy is influenced in a positive way by showing acceptance of the mastectomy scar. On the other hand, a nurse who has a shocked or disgusted facial expression will contribute to the woman developing a negative body image. Clients closely watch the reaction of others to their wounds and scars and it is very important for the nurse to monitor responses toward the client. Statements such as “this wound is healing nicely” or this tissue looks healthy” are very affirming for body image. |
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Term
| Discuss the four components of self-concept: |
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Definition
A. Identity : involves the internal sense of individuality, wholeness, and consistency of a person over time and in different situations. Implies being distinct and separate from others. Being “oneself”.
B. Body image: involves attitudes related to the body including physical appearance, structure, or function. Feelings about body image include those r/t sexuality, femininity, and masculinity, youthfulness, health and strength. Mental images are not always consistent with a person’s actual physical structure or appearance.
C. Role performance: is the way in which individuals perceive their ability to carry out significant roles. This includes roles such as parent, supervisor, or close friend. Role that individuals follow in given situations involve socialization to expectations or standards of behavior. Successful adults learn to distinguish between ideal role expectations and realistic possibilities.
D. Self esteem: an individuals overall feeling of self worth or the emotional appraisal of self concept. The most fundamental self evaluation because it represents the overall judgment of personal worth or value. Positive when one feels capable worthwhile and competent. |
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Term
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Definition
| involves the internal sense of individuality, wholeness, and consistency of a person over time and in different situations. Implies being distinct and separate from others. Being “oneself”. |
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Term
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Definition
| involves attitudes related to the body including physical appearance, structure, or function. Feelings about body image include those r/t sexuality, femininity, and masculinity, youthfulness, health and strength. Mental images are not always consistent with a person’s actual physical structure or appearance. |
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Term
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Definition
| is the way in which individuals perceive their ability to carry out significant roles. This includes roles such as parent, supervisor, or close friend. Role that individuals follow in given situations involve socialization to expectations or standards of behavior. Successful adults learn to distinguish between ideal role expectations and realistic possibilities. |
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Term
|
Definition
| an individuals overall feeling of self worth or the emotional appraisal of self concept. The most fundamental self evaluation because it represents the overall judgment of personal worth or value. Positive when one feels capable worthwhile and competent. |
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Term
| Discuss the relationship of stress and anxiety to health issues: |
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Definition
| Stress: disruptive forces operating within or on any system, appraisal is how people interpret the impact of the stressor on themselves, of what is happening and what they are able to do about it. When stress overwhelms a person’s existing coping mechanisms, disequilibrium occurs and a crisis result. If symptoms of stress persist beyond the duration of the stressor a person has experiences a trauma. |
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Term
| Differentiate the stages of the General Adaptation Syndrome: |
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Definition
GAS is a 3 stage reaction to stress. Describes how the body responds to stressors through the alarm reaction, the resistance stage and the exhaustion stage. Triggered either directly or indirectly by psychological event
Alarm reaction: rising hormone levels result in increased blood volume, blood glucose levels, epinephrine and norepinephrine amounts, heart rate, and blood flow to muscles, oxygen intake and mental alertness. Pupils of eye dilate to produce a greater visual field. Prepares an individual for fight or flight and last from 1 minute to many hours. If stressor poses an extreme threat to life or remains for a long time the person progresses to the second stage resistance
Resistance stage: the body stabilizes and responds in an opposite manner to the alarm reaction. Hormone levels, heart rate, blood pressure, and cardiac output return to normal, and the body repairs any damage that has occurred. However, if stressor remains and the body does not adapt the person enter the third stage..exhaustion
Exhaustion stage: occurs when the body is no longer able to resist the effects of the stressor and when the body has depleted the energy necessary to maintain adaptation. The physiological response has intensified, but with a compromised energy level the persons adaptation to the stressor diminishes. The body cannot defend itself against the impact of the event, physiological regulation diminishes, and, if the stress continues, death results. |
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Term
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Definition
| is a 3 stage reaction to stress. Describes how the body responds to stressors through the alarm reaction, the resistance stage and the exhaustion stage. Triggered either directly or indirectly by psychological event |
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Term
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Definition
| rising hormone levels result in increased blood volume, blood glucose levels, epinephrine and norepinephrine amounts, heart rate, and blood flow to muscles, oxygen intake and mental alertness. Pupils of eye dilate to produce a greater visual field. Prepares an individual for fight or flight and last from 1 minute to many hours. If stressor poses an extreme threat to life or remains for a long time the person progresses to the second stage resistance |
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Term
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Definition
| the body stabilizes and responds in an opposite manner to the alarm reaction. Hormone levels, heart rate, blood pressure, and cardiac output return to normal, and the body repairs any damage that has occurred. However, if stressor remains and the body does not adapt the person enter the third stage..exhaustion |
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Term
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Definition
| occurs when the body is no longer able to resist the effects of the stressor and when the body has depleted the energy necessary to maintain adaptation. The physiological response has intensified, but with a compromised energy level the persons adaptation to the stressor diminishes. The body cannot defend itself against the impact of the event, physiological regulation diminishes, and, if the stress continues, death results. |
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Term
| Physiological symptoms of anxiety: |
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Definition
| A prolonged state of stress causes diseases. Stress makes people ill as a result of (1) increased levels of powerful hormones that change our bodily processes; (2) coping choices that are unhealthy, such as not getting enough rest or a proper diet or use of tobacco, alcohol, other substances, or caffeine; and (3) neglect of warning signs of illness or adhere to prescribed medicines or treatments. |
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Term
| Psychologic symptoms of anxiety: |
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Definition
| Evaluating an event for its personal meaning is primary appraisal. Appraisal of an event or circumstance is an ongoing perceptual process. If primary appraisal results in the person identifying the event or circumstance as a harm, loss, threat, or challenge, the person experiences stress. If stress is present, secondary appraisal focuses on possible coping strategies. Balancing factors contribute to restoring equilibrium. According to crisis theory, feedback cues lead to reappraisals of the original perception. Therefore, coping behaviors constantly change as individuals perceive new information. Coping is the person’s effort to manage psychological stress. Effectiveness of coping strategies depends on the individual’s needs. A person’s age and cultural background influence these needs. For this reason, no single coping strategy works for everyone or for every stress. |
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Term
| Identify behaviors related to specific ego defense mechanisms. |
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Definition
Compensation
Conversion,
Denial
Displacement
Identification
Dissociation
Regression |
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Term
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Definition
| is making up for deficiency in one aspect of self image by strongly emphasizing a feature considered an asset. (ex. A person who is a poor communicator relies on organizational skills) |
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Term
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Definition
| is unconsciously repressing an anxiety producing emotional conflict and transforming it into nonorganic symptoms. (ex. Difficulty sleeping, loss of appetite) |
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Term
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Definition
| is avoiding emotional conflicts by refusing to consciously acknowledge anything that causes intolerable emotional pain. (ex. A person refuses to discuss or acknowledge a personal loss) |
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Term
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Definition
| is transferring emotions, ideas, or wishes from a stressful situation to a less anxiety producing substitute. (ex. A person transfers anger over an interpersonal conflict to a malfunctioning VCR) |
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Term
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Definition
| is patterning behavior after that of another person and assuming that person’s qualities, characteristics, and actions |
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Term
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Definition
| is experiencing a subjective sense of numbing and a reduced awareness of one’s surroundings |
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Term
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Definition
| is coping with a stressor through actions and behaviors associated with an earlier developmental period. |
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Term
| Discuss types of coping and coping strategies: |
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Definition
| Coping is the person’s effort to manage psychological stress. Effectiveness of coping strategies depends on the individual’s needs. A person’s age and cultural background influence these needs. For this reason no single coping strategy works for everyone or for every stress. In stressful situations most people use a combination of problem focused coping and emotion focused coping strategies. Lazarus suggests that not only does the type of stress make a difference, but that people’s goals, their beliefs about themselves and the world, and personal resources determine how they cope with stress. Resources include intelligence, money, social skills, supportive family and friends, physical attractiveness, health and energy, and ways of thinking, such as optimism. |
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Term
| Relate the use of defense mechanisms in controlling anxiety: |
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Definition
| Defense mechanisms are used to regulate emotional distress and thus give a person protection from anxiety and stress. Occasionally a defense mechanism becomes distorted and no longer assists the person in adapting to a stressor. However, people find them very helpful in coping and use them spontaneously. |
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Term
| Describe nursing interventions to decrease anxiety and modify stress: |
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Definition
-Assist client in identification of stress overload during vulnerable life events
-Listen actively to descriptions of stressors and stress response.
-Help clients modify or mitigate stressors identified as modifiable
-Help clients distinguish between short term, chronic, and secondary stressors.
-Explore possible therapeutics approaches such as cognitive behavior therapy, biofeedback, neurofeedback, acupuncture, pharmacologic agents, and complementary and alternative therapies.
-Assist the client to mobilize social supports for dealing with recent stressors |
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Term
| Describe stress management techniques: |
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Definition
Exercise: a regular exercise program improves muscle tone and posture, controls weight, reduces tension, and promotes relaxation.
Support Systems: a support system of family friends, and colleagues who will listen, offer advice, and provide emotional support benefits a client experiencing stress.
Time management: techniques include developing lists of prioritized tasks.
Guided imagery and visualization: guided imagery is based on the belief that a person significantly reduces stress with imaginations. It’s a relaxed state in which a person actively uses imagination in a way that allows visualization of a soothing, peaceful setting.
Progressive muscle relaxation: in the presence of anxiety provoking thoughts and events, a common physiological symptom is muscle tension. You diminish physiological tension through a systemic approach to releasing tension in major muscle groups. Typically an individual achieves a relaxed state through deep chest breathing. Once the client is breathing deeply, you direct the client to alternately tighten and relax muscles in specific groupings.
Assertive training: assertiveness comprises skills for helping individuals communicate effectively regarding their needs and desires. Teaching assertiveness in a group setting increases the benefits of the experience.
Journal writing: provides therapeutic outlet for stress, and it is well within the realm of nursing to suggest journal keeping to clients experiencing difficult situations.
Stress management in the workplace: “Burnout” occurs as a result of chronic stress. To relieve it, identify the limits and scope of your responsibilities at work. |
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