Fundamentals of Nursing exam 1 PDF

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Fundamentals of Nursing Chapter 1 – Introduction of Nursing

EXAM REVIEW FROM CLASS* Box 1-2 pg.12 Health people 2020 guidelines: 4 Goals 1. 2. 3. 4.

High quality, longer lives free of preventable diseases, disability, injury, and premature death Health equity, eliminate disparities, and improve the health of all groups Create social and physical environments that promote good health for all Promote quality of life, healthy development, and healthy behaviors across all life stages

Leading Health Indicators • • • • • • • • • • • •

Access to health services Clinical preventive services Environmental quality Injury and violence Maternal, infant, and child health Mental health Nutrition, physical activity and obesity Oral health Reproductive and sexual health Social Determinants Substance abuse Tobacco

Health Literacy – degree which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions

END OF REVIEW FROM CLASS BELOW IS JUST EXTRA REVIEW* Nursing – person who nourishes, fosters, and protects and who is prepared to take care of the sick, the injured, aged, and dying people. *MAIN ROLE OF NURSE – CAREGIVER*

Development of Nursing in the 16th Century ❖ ❖ ❖ ❖ ❖

Theory of animism – explained the changes in bodily functions, belief that everything in nature was alive with invisible forces: Good spirts brought health and evil spirts brought sickness. Temples became the centers of medical care Mosaic Health Code for relationships, mental health, and disease control Nurses cared for sick people in home and were nurse midwives Beginning of 16th century western societies ties shifted from religious orientation to emphasis on warfare, exploration, and expansion on knowledge

Birth of Modern Nursing *Florence Nightingale - Founder of Modern Nursing

▪ ▪ ▪ ▪ ▪ ▪ ▪ ▪ ▪

First training school for nurses Standards eds for hospital management Nursing education Recognize the 2 components: Health & Illness Nutrition is important Occupational & Recreational Therapy Maintaining records, nursing research Defined Nursing as an art and science Meeting personal needs of the client within the environment

World War II – woman worked outside of home became more independent and assertive *Clara Barton - care for wounds in the Civil War. Established Red Cross in the US in 1882 *Mary Elizabeth Mahoney – first African American nurse *Isabel Hampton Robb – organized nursing school at John Hopkins Hospital. The first president of the Nurses associated alumnae of the US and Canada (American Nurses Association) *Dorothea Orem – self-care is a human need, nurses design interventions to provide or manage selfcare actions to sustain health 4 Broad Aims of Nursing Practice 1.

Promote Health – physical, social, and mental components, Nurses promote health by identifying, analyzing, and maximizing each patient's own individual strengths 2. Prevent Illness – teaching and personal examples 3. Restore Health- performing assessments that detect illness (BP, blood sugars), asking other health care providers questions. planning, teaching, and carrying out rehabilitation for illnesses such as heart attacks, arthritis, and strokes. 4. Facilitate coping with disability or death – maximizing the persons strengths, through teaching, and through referral to community support systems. • Nursing Process – assessing, diagnosing, planning, implementing, and evaluating • Compassion fatigue – loss of satisfaction from providing good patient care • Burnout – state of frustration with work environment that develops over time • Secondary Traumatic Stress – feeling of despair caused by the transfer of emotion tion distress from a victim to a caregiver, develops suddenly.

Ponte & Koppel STOP TECHNIQUE 1. 2. 3. 4.

S – stop and take a step back T – take a few breathes O – Observe inside yourself P – Proceed after your pause

BPTPR Technique 1. BP – being present

2. T – Tracking important number (BP, weight, blood sugar, lipid levels) 3. P - practicing health and wellness behaviors 4. R – refueling

Chapter 2 Theory, Research, and Evidence-Based Practice

EXAM REVIEW FROM CLASS* Deductive Reasoning – which one examines a general idea and then considers specific actions or ideas. Inductive Reasoning – the reverse process is uses- one builds from specific ideas or actions to conclusions about general ideas Nursing Theories o o o

General Systems Theory - (primary theorists Ludwig von Bertalanffy) - how to break whole things into parts and then learn how the part work together in “systems” Adaptation Theory – adjustment of living matter to other living things and to the environmental conditions. Human Adaption 1. internal 2. Social 3. Physical Developmental Theory – the process of growth and development of humans as orderly and predictable, beginning with conception and ending with death. Erikson (psychosocial Development) & Abraham Maslow (theory of human needs in terms of physical and psychosocial needs considered essential for human life)

Conceptual Framework – a set of concepts and propositions that follows an understandable pattern 4 Concepts in Nursing Theory 1. 2. 3. 4.

Person Environment Health Nursing

Table 2-6 Research Journal Article Abstract – beginning of aritcle: summary Introduction – Review of literature and statement of purpose Method – subjects, design, data collection, data analysis: how the study was conducted Results – findings: words, charts, tables, or graphs Discussion (conclusion) - purpose of the study and literature review, suggestions for further research → References – article, books, and websites used

→ → → → →

END OF CLASS REVIEW OTHER IS EXTRA NOTES*

Sources of Knowledge 1. Traditional Knowledge – passed down from one generation to another 2. Authoritative Knowledge – from an expert and is accepted as truth based on the persons perceived expertise (EX: senior staff nurse) *most authoritative EBP 3. Scientific Knowledge – obtained through the scientific method (thorough research)

Nursing Theory in Clinical Practice – independence & self-governance NINR – funds research Methods of Conducting Nursing Research 1. Quantitative Research – involves es basic & applied research *NUMBERS* 2. Qualitative Research – analyzes words instead of numbers *QUALITY* Phenomenology – describe experiences as they are lived by the subjects being studied (EX: ▫ having a heart attack) ▫ Grounded Theory – how people describe their own reality and how their beliefs are related to their actions in a social scene (EX: coping with a sick child) ▫ Ethnography – examine issues of a culture that are of interest in nursing ▫ Historical – events in the past to increase understand of the nursing profession today Essential Elements of EBP 1. Integration of best research and other forms of evidence to guide practice 2. Viewing clinical expertise as a component in care effectiveness 3. Considering patients preferences, values, and engagement in care decisions

• • • • •

P – population/ patient or problem of interest (setting or subgroup) I – Intervention of interest (treatment, diagnostic test, predicting factor) C – comparison (treatment or standard care) O – Outcome T – Time

Systematic Review – summarize finding from multiple studies of a specific clinical practice question or topic, and recommend practice changes and future directions for research Theoretic Framework – advanced nursing knowledge & practice Concept – abstract idea or objects that relates to other abstract ideas or objects

Scientific Process & Nursing Research Order 1. 2. 3. 4. 5.

Identifying what ones needs to know or is curious about Deciding approach to finding the answer Devising plan Implementing plan Assessing Outcomes

Chapter 3 Health, Wellness, and Health Disparities

EXAM REVIEW FROM CLASS* Illness Behaviors • • • •

Stage 1: experience symptoms (rash, fever, bleeding, or a cough) Stage 2: assuming the sick role (choose OTC treatment, doctor, or nothing) Stage 3: Assuming the Dependent Role: decision to accept the diagnosis and follow the prescribed treatment plan Stage 4: Achieving Recovery and rehabilitation

Health Disparity – health difference that is linked with social, economic, and environmental disadvantages. → INFLUENCED BY: race, ethnicity, poverty, biological sex, age, mental health, education level, disabilities, sexual orientation, health insurance, and access to health care. The Health Promotion Model – developed to illustrate how people interact with their environment as they pursue health. I •

Incorporates individuals characteristics and experiences (good if person will incorporate and use health behaviors), behavior specific knowledge and beliefs to motivate health-promoting behaviors (that there will be a positive outcome), sociocultural factors (help predict given health related habit)

•

Nurses us to design and provide interventions to promote health for people, families, and communities

Health Promotion and Illness Prevention ➢ ➢ ➢ ➢ ➢ ➢ ➢ ➢ ➢ ➢ ➢ ➢

Weight Loss Diet Exercise Smoking cessation Reduced alcohol consumption Avoidance of illicit drugs Farm Safety Seat belts and child safety seats Immunizations Water treatment Safer sex practices Effective parenting

Secondary

➢

Screening for early detection of disease with diagnosis and treatment. Reduce severity

➢ ➢ ➢ ➢ ➢ ➢ ➢ ➢ ➢ ➢ ➢ ➢ ➢

Screenings (BP, cholesterol, glaucoma, HIV, Skin cancer) Pap smears Mammograms Testicular examinations Family Counseling Caring for wounds Medication Medical Therapy Surgical treatment Rehabilitation Physical Therapy Occupational therapy Job training Support Groups

Primary Promoting health and preventing development of disease processes or injury

Health-style self- test PCAM (patient centered assessment method) – tool nurses use to asses patients complexity using the social determinants of health that often explain why some patients engage and respond well managing their health while other with similar conditions do NOT. FACTORS: lifestyle, ability to enjoy daily activities, physical and mental health, social environment, economic status, culture

Tertiary After illness is diagnosed and to help rehabilitate patients to a maximum level of functioning.

END OF CLASS REVIEW OTHER IS EXTRA NOTES* Holistic Health Care – care the addresses many dimensions: must understand and respects each person own definition of health and response to illness Morbidity – how frequently a disease occurs Mortality – numbers of death resulting from a disease Disease - medical term, the pathologic changes in the structure or function of the body or mind Illness – the response of the person disease (Signs & Symptoms) Remission – disease is present but the person does not experience symptoms Exacerbation – the symptoms of the disease disappear

Health Equity – attainment of the highest level of health for all people Social Determinants of Health – conditions of environments in which people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality of life outcomes Vulnerable Populations – racial and ethnic minorities, those living in poverty, women, children, older adults, rural and inner-city residents, people with disabilities.

*HUMAN DIMENSIONS* → Physical Dimensions – genetic inheritance, age, developmental level, race, and biological sex → Emotional Dimensions – how the mind affects the body functions and responds to body conditions. → Intellectual Dimensions – cognitive abilities, educational background, and past experiences → Environmental Dimensions – housing, sanitation, climate, and pollution of air, food, and water → Sociocultural Dimensions – health practices and beliefs are strongly influenced by a person economic level, lifestyle, family, and culture → Spiritual Dimensions – spiritual beliefs and values are important components of a person’s health and illness behaviors

Chapter 4 – Health of the Individual, Family, and Community

EXAM REVIEW FROM CLASS* Developmental Tasks of Families Duvall (1984) - identified the critical family developmental task and stages in a family life cycle. Based on Erikson theory of psychosocial development. Duvall states that all families have certain basic tasks for survival and continuity, as well as specific tasks related to developmental stages throughout the life of the family. (Table 4-2, Pg.73) Family – basic unit of human society *Nuclear Family - traditional family – composed of two parents and the children *Extended Family – aunts, uncles, and grandparents *Blended Family – another form of nuclear family, when parents bring unrelated children from previous relationships together to form a new family

Basic Human Needs *Physiologic Needs (physical) – Oxygen is most important. Nurses assess oxygen by skin color, vital signs, anxiety levels, Responses to activity, restlessness, and mental responsiveness *Safety and Security (environmental): sterile techniques, administere medications properly, and correctly moving patients *Love and Belonging (sociocultural): understand of acceptance and receiving love *Self-Esteem (emotional): person to feel good about himself/herself. Nurses can help by respecting values and beliefs *Self- Actualization (Intellectual and spiritual): reach full potential EX: feelings of happiness, acceptance of self, respect

END OF CLASS REVIEW OTHER IS CLASS NOTES* *Community– specific population of people living in the same geographic area under similar regulations and having common values, interests, and needs. EX: neighborhood within a city or large rural area *Community Health Nursing – focuses on whole populations within a community. *Community-Based– focuses on individuals and familied in that population. Provide interventions to manage acute and chronic health problems, promote health, and facilitate care. Holistic Approach to Health: Physical, emotional, spiritual, and well-being Friedman – identified the importance of family-centered nursing care.

Chapter 5 Cultural Diversity

EXAM REIVEW FROM CLASS Table 5-1 Common Health Problems in Specific Populations → Native American/Alaska Natives – Heart disease, Cirrhosis of the liver, Diabetes Mellitus, Fetal Alcohol Syndrome → African Americans – hypertension, Stroke, Sickle Cell Anemia, Lactose Intolerance, Keloids

→ Asians – Hypertension, Cancer of the Liver, Lactose Intolerance, Thalassemia (blood disorder, body make abnormal or inadequate hemoglobin → Hispanics - Diabetes Mellitus, Lactose Intolerance → Whites – Breast Cancer, Heart Disease, Hypertension, Diabetes Mellitus, Obesity → Eastern European Jews – Cystic Fibrosis, Gauchers Disease (lipid storage disease), Spinal Muscular Atrophy (loss of motor neurons and progressive muscle wasting), Tay-Sachs Disease (Metabolic Disorder – lipids accumulate in the brain) Poverty Culture ▪ ▪ ▪ ▪ ▪ ▪ ▪

Feeling of despair, resignation, and fatalism Day-to-day attitude towards life, no hope for the future Unemployment and need government assistance Unstable family structure Decline in self respect Lead to higher crime rates Psychological Problems such as schizophrenia, alienation, and feeling of worthlessness

Concepts of Cultural Diversity and Respect Cultural Diversity – coexistence of different ethnic, biological sex, racial, and socioeconomic groups within one social unit (different religion, language, physical size, sexual orientation, age, disability, occupational status, and geographic location) Cultural Respect – enables nurses to deliver services that are respectful of and responsive to the health beliefs, practices, and cultural and linguistic needs of diverse patients Culture – shared systems of beliefs, values, and behavioral expectations that provides social structure for daily living •

Culture is learned by each new generation through both formal and informal life experiences

Subculture – large group of people who are members of the larger cultural group but who have certain ethnic, occupational, or physical characteristics that are not common to the larger culture. EX: nursing is a subculture in the health care system • •

Dominant Culture Group – control the values and sanctions *most times the largest group in the society Minority culture groups – physical or cultural characteristics (race, religious beliefs, or occupations)

Cultural Assimilation – when a minority groups lives within a dominant groups they may lose the cultural characteristics that made them different and take on the values of the dominant culture. → Mutual Cultural Assimilation – obtaining both when moving to a new culture Culture Shock – when places in different culture that the person perceives strange – can lead to frustration, anxiety, and loss of self-esteem Ethnicity – sense of identification with a collective cultural group, largely based on the groups’ members common heritage

Race – based on physical characteristics such as skin pigmentation, body stature, facial features, and hair texture. Cultural Competence – developing awareness of ones own existence, sensations, thoughts, and environment. Demonstrate knowledge and understanding of ones cultures. Accept Cultural differences. Do NOT assume health care beliefs, being open and comfortable with cultural encounters. Linguistic Competence – ability to do something successfully and efficiently. Purnell Model – Global Society – Family – Person > (Pregnancy (postpartum, birthing) > (Nutrition (rituals, common foods, limitations) > (High Risk Behaviors (tobacco, alcohol, drugs, safety) > (Biocultural Ecology (genetics, skin color, heredity) > (Workforce Issues (autonomy, language barriers) > (Family roles and organizations (priorities, lifestyle, social status ) > (Communication (dominate language, eye contact, greetings) > (Overview/Heritage (politics, education) > (Health Care Providers ( perceptions of practitioners) > (Health Care Practices (responsibly, religious beliefs, mental health, traditonal practices) > (Spirituality (meaning of life, prayer) > ( Death Rituals (bereavement) END OF CLASS REVIEW OTHER IS EXTRA NOTES Factors Inhibiting Sensitivity to Diversity     

Stereotyping – Negative: racism, ageism, and sexism. Beliefs that someone of a race is superior Cultural Imposition – belief that everyone else should conform to your own belief system Cultural Blindness – when one ignores the differences and proceeds as though they do not exist Cultural Conflict – when people become aware of differences, feel threatened. Ethnocentrism – believes that’s ones’ ideas, beliefs, and practice are the best or superior

Reactions to Pain  Holding or applying pressure to the painful area  Avoiding activities that intensify the pain  Uncontrollable expressions  Spontaneous Expressions of discomfort – facial grimacing & moaning Linguistic Competence – the ability of caregivers and organizations to understand and effectively respond to linguistic needs of patients and their families in health care encounter Health Disparities – refers to health differences between groups of people, they can affect how frequently a disease affects a group, how many people get sick, or how often the disease causes death Cultural Competence – ability to understand, communicate with and effectively interact with people across cultures

ESFT MODEL E –Explanatory Model of Health & illness → → →

What do you think caused your problem? What worries you most? What kind of treatment do you think you should receive?

S – Social and Environmental Factors → →

How do you get your medications? Are th...