NURS 111 (Final)

jasmine's version from 2015-12-07 06:30

Section 1

Question Answer
Strategies to promote behavioral change for each stage of changePre-contemplation, Contemplation, Preparation, Action, Maintenance, and Termination
Pre-contemplationAssess confidence, importance, and readiness for change; Discuss positive and negative aspects of behavior to assist person to consider change; Provide information in caring, non-threatening manner
ContemplationAsk client what information is needed; Assist client to increase awareness of behavior examining pros and cons of change
PreparationContinue to discuss pros and cons of behavior change; Provide support and guidance for the client
ActionContinue to discuss benefits with client; Continue positive reinforcement; Encourage client
MaintenanceContinue positive reinforcement of desired behavior; Continue to remind client of previous success; Encourage client to be aware
TerminationInform client of terminators and lifetime maintenance such as healthy lifestyle, temptation, etc.

Section 2

Question Answer
Values essential for the professional nurseAltruism, autonomy, human dignity, integrity, and social justice
AltruismA concern for the welfare and well-being of others
AutonomyThe right to self-determination
Human DignityRefers to the inherent worth and uniqueness of individuals and populations
IntegrityActing in accordance with an appropriate code of ethics and accepted standards of practice
Social JusticeRefers to the upholding of justice, or what is fair, on a social scale
Example of Autonomy and CultureFamily members, rather than the client, receive information on the client's condition and take primary responsibility for decision-making. Chinese, Koreans, Mexican Americans, and Bosnian Americans may see: family and community as affected by the client's condition and decisions as much as the individual is affected
Example of Veracity and CultureThe client and/or family prefer that the client not to be told directly of a life-threatening condition: Hispanics, Asians, Pakistanis, Bosnian Americans, Italian Americans, Canadian Aboriginals
Example of Non-Maleficence and CultureDiscussion of advance directives and issues such as cardiopulmonary resuscitation are viewed as physically and emotionally harmful to the client: Filipino, Native American, Chinese
Example of Beneficence and CultureHealth care providers should promote client's well-being and hope: Asian cultures, Native Americans, Russians

Section 3

Question Answer
The processes that may help clients clarify their valuesList alternatives, examine possible consequences of choices, choose freely, feel good about the choice, affirm the choice, act on the choice, and act with a pattern
List AlternativesMake sure client is aware of all alternative actions
Examine possible consequences of choicesMake sure client has thought about the possible results of each action
Feel good about the choiceDetermine how the client feels by asking on a neutral basis
Affirm the choiceDetermine how the client may discuss their choice with others such as friends and family
Act on the choiceDetermine how the client may act on the planned decision
Act with a patternDetermine whether the client may behave the same or has tried the approach before

Section 4

Question Answer
Nursing implications with comfort Assess own assumptions or biases surrounding narcotic use, assess understanding of clients pain levels, ask for support from a supervisor or peers when advocating for appropriate client care, and plan on further assessment of such clients postoperatively
Nursing implications with teaching and learningAssess client's learning needs on admission, Plan appropriate teaching interventions for the client and appropriate teaching methods, Assess own assumptions and values about receiving care information and the best way to receive such information
Nursing implications with communicationEnsure that access to client information, such as online charting, is only made available to appropriate staff members, Discuss with the client how you ensure confidentiality
Nursing implications with advocacyMake sure pre-operative interventions are clearly discussed with client by medical staff to ensure appropriate consent, Discuss the plan of care with the client and allow self-determination, such as which client medication dosage to try first, as appropriate, Recognize the client's right to refuse treatment/procedures

Section 5

Question Answer
Assessment for dying clientsAssess client comfort and anxiety levels regularly. Pain assessment should be assessed at least twice daily. Assess client's spiritual and social needs. Assess vital signs often, watching for hypotension, abnormal pulse rates, and cooling of skin and body temperature. Nurse informs family of any or no changes
Diagnosis for dying clientsFear, death anxiety, and grieving related to impending death are some of these
Planning for dying clientsFacilitate client's wishes to the greatest extent possible, considering the best interests of the client's. Appropriate outcomes may include: The client will maintain dignity, free of pain, will participate in decision-making process as long as competent to do so, family will receive emotional support needed
Implementation for dying clientsResponsible for caring interventions to prevent impairments in skin integrity, prevent and alleviate pain, and maintain client hygiene. Additional supportive interventions may include: refer clients and families to social services and other agencies, provide bedside activities and distractions to decrease boredom and to limit obsessing about death (i.e., organize volunteers to play cards or board games, sit, pray, or to simply listen to music
Evaluation for dying clientsClients should never have to fear dying in pain. Desired outcomes may be a client expressing fears related to death or the dying process, client informs nurse about increase of pain, client is made comfortable, and client's family remains informed of any or no changes

Section 6

Question Answer
Define Total Quality ManagementUsed to improve quality & productivity by utilizing data & statistics to improve systems processes
Define Continuous Quality ImprovementA structured organizational process for involving personnel in planning & executing a continuous flow of improvements to provide quality health care that meets or exceeds expectations
What is a Plan-Do-Study-Act (PDSA)A system of quality improvement that involves the plan, the doing, the study, and the act
PlanObjective, predictions, plan to carry out the cycle (who, what, where, when), and plan for data collection
DoCarry out the plan, document observations, and record data
StudyAnalyze data, compare results to predictions, and summarize what was learned
ActWhat changes are to be made? Next cycle?
Define VeracityIndividuals who always tell the truth. This is a principle of timely & accurate documentation of nursing interventions. It also is the principle behind giving complete information before obtaining a client's informed consent for any procedure, which can prove to be challenging if family members or significant others want information withheld
Example of Veracity and CultureThe client and/or family prefer that the client not to be told directly of a life-threatening condition: Hispanics, Asians, Pakistanis, Bosnian Americans, Italian Americans, Canadian Aboriginals

Section 7

Question Answer
Nursing profession depends on two major codes of ethicsThe American Nurses Association (ANA) Code of Ethics for Nurses and the International Council of Nurses (ICN) Code of Ethics
International Council of Nurses (ICN) Code of Ethics comprises of Nurses and people (i.e., primary responsibility is to people requiring nursing care), Nurses and Practice (i.e., carries personal responsibility and accountability for nursing practice, and for maintaining competence by continual learning), Nurses and the Profession (i.e., assumes major role in determining and implementing acceptable standards of clinical nursing practice, management, research, and education), and Nurses and co-workers (i.e., sustains a collaborative and respectful relationship with co-workers in nursing and other fields)