Nursing Fundamentals: Ethical Principles, Clinical Judgment, and Patient Safety, Exams of Medicine

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Hondros Nur 205 Exam 1

Classification of safety events - ✔️ ✔️ Never miss event-error that could have caused harm but didn't Adverse event-error that results in moderate to sever harm (medication administration) Sentinel event- serious error that results in patient death Care Coordination - ✔️ ✔️ a process connecting both services and resources involving patient, providers and families with the goals of optimal patient outcomes Fidelity - ✔️ ✔️ Act in ways that are loyal keeping promises doing what is expected of you performing your duties and being trustworthy Justice - ✔️ ✔️ treating people equitably fairly and appropriately Beneficence - ✔️ ✔️ obligation to do good by acting in ways the promote the welfare and best interest of others Nonmaleficence - ✔️ ✔️ Act to avoid harm to others inflicting the least harm possible to reach a beneficial outcome. Respect for person's - ✔️ ✔️ treat with respect dignity and value, always tell the truth Leadership - ✔️ ✔️ interactive process that provides necessary guidance and direction three attributes are leader follower and situation Forms of Leaders - ✔️ ✔️ autocratic-makes all decisions wants to accomplish goal democratic-involve their followers in decisions Laissez faire- do not interfere with followers transactional-focus on daily operations of organization authentic-helps followers adjust to follow new roles shared- followers share leadership responsibilities Code of Ethics - ✔️ ✔️ concepts of right and wrong foundation for morality and moral behavior Influenced by families, beliefs,values and ideas Ethical Principals - ✔️ ✔️ respect for persons nonmaleficence beneficence justice and fidelity

Clinical Judgement - ✔️ ✔️ a conclusion or interpretation about a patients need, concerns,or problems and the response taken to modify the issue RN decides what data is to be collected, makes interpretation of data, arrives at a nursing diagnosis and identifies appropriate nursing actions Health Care Quality - ✔️ ✔️ those who want healthcare should have access to healthcare Attributes- safe, effective, timely,patient centered, efficient, and equitable Professional Identity - ✔️ ✔️ sense of self influenced by characteristics, norms, and values of the nursing discipline that result in individual thinking acting and feeling like a RN Attributes of professional identity - ✔️ ✔️ doing, being, acting ethically, flourishing, changing identifies Prioritization - ✔️ ✔️ to decide which patient needs or problems require immediate attention and what can be delayed 3 levels of priority ABC's, VS, mental status, other health problems 4 P's of delegation - ✔️ ✔️ purpose for the care picture of the patients current condition plan or envision outcomes of care Part played by each team member Delegation - ✔️ ✔️ Transferring a selected nursing task to a competent individual that falls within their scope of practice. The RN retains accountability for delegation of the task and care provided RN obligated to delegate based on prioritization of clinical situation, pt situation, personnel available and must provide ongoing assessment Negligence - ✔️ ✔️ Failure to use reasonable prudent care in the smart to similar circumstances ties in with healthcare law or tort law Elements that must occur to establish liability of negligence - ✔️ ✔️ Duty-professional duty of reasonable care to pt that a reasonable prudent nurse would perform in same circumstance Breach of Duty-falling below standard of care causing injury Causation-breach of care causing direct harm Injury/harm- may be physical or combination of physical mental emotional or financial

Nurse Practice Act - ✔️ ✔️ Permits individual to obtain licensure to perform professional duties based on demonstrated qualifications and competency to perform actions which are illegal without a license Scope of Practice - ✔️ ✔️ Range of permissible activity defined by law or defines what a RN can or cannot do Ex- Ohio board of nursing writes scope of practice for nurses in Ohio Tort Law - ✔️ ✔️ Most common basis for liability of nurses, physicians, and other health care providers Civil tort is an action or omission that results in harm to a person Unintentional- negligence Intentional-intentionally harming or violating rights Healthcare Law - ✔️ ✔️ collection of laws having direct impact on delivery of healthcare or between deliverers and recipients of healthcare EX HIPAA 1996 Development - ✔️ ✔️ complex process of physical, psychological, cognitive and developmental changes through life from birth to death Culture - ✔️ ✔️ pattern of shared attributes or beliefs self definitions, norms, roles and values that can occur among those who speak a particular language or live in a defined geographical region Spirituality - ✔️ ✔️ A belief, principle, experience or attitude Nurse should assess and integrate in care by communication and listening skills Involves recognizing honoring beliefs and practices of others Communication - ✔️ ✔️ Process of interaction using symbols to create, exchange and interpret messages Learned skin develops overtime Complementary exchange-a sender transmitting a message to a receiver Collaboration - ✔️ ✔️ development of partnerships to achieve best possible outcomes that reflects the particular needs of a patient types of collaborations - ✔️ ✔️ Nurse Nurse- intraprofessional, mentoring Nurse Patient-partake as members of healthcare team Interprofessional-team of different health providers Interorganizational- regional, national, international level

Evidence based practice - ✔️ ✔️ problem solving model to clinical practice that integrates the conscientious use of best practice in combination with a clinicians expertise and patient preferences and values in making decisions about patient care Autonomy - ✔️ ✔️ the initiation of independent nursing interventions without medical orders Advocate - ✔️ ✔️ protect patients human and legal rights and provide assistance in asserting these rights, act on behalf of the pt and secure you its health care rights Patient centered care - ✔️ ✔️ primary goal is to provide individual care and restore an emphasis on personal relationships it aims to elevate quality for all patients Culture competence - ✔️ ✔️ Cultural desire-wanting to understand differences Self awareness-identify and understand own identity Knowledge=expose self to other cultures be motived to learn Skill-acquired throughout time and using therapeutic communication Clinical Reasoning - ✔️ ✔️ the thinking process by which nurse reaches clinical judgement Safety - ✔️ ✔️ prevention of healthcare errors and elimination of patient injury due to healthcare errors-National Patient Safety Foundation 4 types of errors- diagnostic, treatment,preventitive, communication Active errors-made by health professional Latent errors-flaw related to organizational design Self Management - ✔️ ✔️ individuals ability to manage Sx and Tx Self Efficacy- having knowledge and confidence to reach outcome Pt engagement- participation through knowledge skills ability and willingness Health Education-knowledge skills ability through learning experience Patient provider- patient responsibility health provider to instill optimal self management Disease management- goal is to improve health by interventions of chronic diseases that require significant self management Functional Ability - ✔️ ✔️ Able to perform activities of daily living to meet needs Attributes- defining characteristics of functional ability Antecedents- events that must happen before functional ability can exist Plan care by functional ability, physical emotional, cognitive and communication ex- cerebral palsy, autism, alzheimers Mobility - ✔️ ✔️ state of being mobile Nero-all movement by brain Musculokeletal-bones

Age related differences-appendicular grows faster than axial skeleton Management-primary:activity ideal weight and nutrition secondary: screening ex Osteoarthristis,RA National Patient Safety Foundation - ✔️ ✔️ collaboration with patient and families through ongoing engagement can transform safety activities Health Reliability Organization - ✔️ ✔️ manage work that involves hazardous environments Exhibit sensitive to operations Preoccupied with failure and focused on predicting or eliminating errors Reluctance to simplify Exhibit deference, person with most knowledge of situation Commitment to reliance Health Disparities - ✔️ ✔️ A particular type of health difference that is closely linked with social, economic, and environmental disadvantage Inequality between the health status of a disadvantage group such as people with law incomes and wealth and a advantage group such as people with high incomes and weath Tanners Model - ✔️ ✔️ Noticing- Identifying S/S, gathering data, assessing, predicting complications, identifying assumptions Interpreting-comparing and contrasting, clustering info, recognizing inconsistencies, checking accuracy, relevant vs irrelevant, importance of information, judging range of values, managing potential complications Responding-Delegating and setting priorities Reflecting- Evaluation data and correcting data Objective Data - ✔️ ✔️ can be measured or observed ex temperature, HR,BP,RR, wound appearance Subjective Data - ✔️ ✔️ what the patient feels that cannot be measured by senses Diarthrosis Joint - ✔️ ✔️ a freely moveable joint Ex. elbow joint

Amphiarthrosis joint - ✔️ ✔️ a slightly moveable joint Synarthrosis joint - ✔️ ✔️ a type of joint which permits very little or no movement under normal conditions proprioception - ✔️ ✔️ mechanism that provides a sense of position and movement Allows for accuracy in the degree of movement with muscle contraction Hematocrit Hct - ✔️ ✔️ Male 42-52% Female 37-47% Glucose - ✔️ ✔️ 70 - 100 mg/dL Creatinine Cr - ✔️ ✔️ 0.6-1.2 mg/dL Co2 - ✔️ ✔️ 23 - 30 mEq/L BUN - ✔️ ✔️ 10 - 20 mg/dL ABG's - ✔️ ✔️ PH 7.35-7. PaCo2 35- 45 PaO2 80- 100 Hco3 22- 26 Sodium - ✔️ ✔️ 135 - 145 mEq/L Potassium - ✔️ ✔️ 3.5-5.0 mEq/L Platelets - ✔️ ✔️ 150,000-400,000 cells/mcl Prothrombin Time PT - ✔️ ✔️ 11 - 14 seconds Partiel thromboplastin time PTT - ✔️ ✔️ 25 - 35 seconds Magnesium - ✔️ ✔️ 1.5-2.5 mg/dL Hemoglobin - ✔️ ✔️ 12 - 18g/dL Attributes of a leader - ✔️ ✔️ vision-statement of desired goal communication-function to be effective on going conversation decision making-critical feature of a good leader social power-influence over another collaboration-teamwork ethical-right vs wrong