NR 226 Exam 1 Complete Study Guide With Questions And Answers (Summer 2022)

NR 226 Exam 1 Complete Study Guide With Questions And Answers (Summer 2022) Standards for client education Clients have a right to information Nurses have a legal mandate to provide client education -JC, Nurse Practice Acts, ANA, AHA Nurser Practice Acts Legally mandate client education by nurses ANA's standards of clinical nursing practice Nurses are responsible for "educating clients about their illness, treatment, health-promotion, and self-care activities" Patient Care Partnership (AHA) Clients have the right to make informed decisions about their care Purpose/Benefits of client education Help individuals, families, or communities achieve optimal levels of health -Wellness promotion -Disease/illness prevention -Restoration of health or function -Promotion of coping Client education also has cost containment benefits Teaching An interactive process that promotes learning Learning The purposeful acquisition of knowledge, skills, behaviors, and attitudes Nurse as a teacher Teaching is major aspect of nursing practice Teaching mostly informal Required skills: -Knowledge of subject matter -Teaching and communication skills -Empathy Domains of learning: Cognitive Includes all intellectual behaviors and requires thinking Domains of learning: Affective Deals with expression of feelings and acceptance of attitudes, opinions, or values Domains of learning: Psychomotor Involves acquiring skills that require integration of mental and muscular activity Pain An unpleasant sensory and emotional experience associated with actual or potential tissue damage Factors that facilitate learning Readiness Motivation Active involvement Relevance Feedback Nonjudgmental support Simple to complex Repetition Timing Factors that inhibit learning Physiological factors Psychological factors Cultural factors Environmental factors Socioeconomic factors Adult learning principles Malcolm Knowles -Adults learn best when there is a perceived need -Teaching of adults should progress from the known to the unknown -Teaching of adults should progress of simpler concepts to more complex -Adults learn best using active participation -Adults require opportunities to practice new skills -Adults need behavior reinforced -Immediate feedback and correction of misconceptions increases learning Teaching clients of different cultures -Do not use slang words or colloquialisms -Do not assume that a client who nods, uses eye contact, or smiles is indicating an understanding of what is being taught -Invite and encourage questions during teaching -When explaining procedures or functioning related to personal areas of the body, may be appropriate to have a nurse of the same gender do the teaching Autonomy Independence; self-determination Beneficence The ethical tenet that the physician has a responsibility to act in the patient's best interest. -To do good Non-maleficence To do no harm Justice Fairness; rightfulness Fidelity Faithfulness to obligation, duty, or commitment Professional nursing code of ethics -Established by American Nurses Association (ANA) -Last revised in 2015 -Serves as guide to assist nurses when questions arise about correct action or behavior Nursing related principles Advocacy Responsibility Accountability Confidentiality Advocacy Support of the cause of the client regarding health, safety, and personal rights Responsibility A willingness to accept an obligation and be accountable or an action or situation Accountability A willingness to answer for your actions and decisions Confidentiality Holding information in confidence, not to be released to unauthorized individuals Ethical dilemma -Can be distressing to the patient as well as the healthcare team -Must be addressed via a methodical approach, while negotiating with differences in opinion -No clear cut right or wrong answer; pros and cons to both sides of the issue How to process an ethical dilemma Ask the question, is this an ethical dilemma? Gather information relevant to the case Clarify values Verbalize the problem Identify possible courses of action Negotiate a plan Evaluate the plan over time Legal issues in nursing Need to understand the legal limits influencing your practice: -Scope of practice -Nurse practice act (state level) -Standards -Credentialing Good samaritan laws Legal stipulation for protection of those who give first aid in an emergency situation Negligence Elements include: -Duty -Breech of duty -Injury occurred -Proximate cause -Actual loss or damage resulting from the conduct Malpractice Negligence by a professional- not up to standards -Professional failure to carry out or perform duties that result in the injury of another -Scope of practice Reporting incidents or near misses at the clinical site Complete name of person and names of witnesses Factual account of incident Date, time, and place of incident Pertinent characteristics of person involved Any equipment or resources being used Any other important variables Documentations by physician of medical examination of person involved Process will vary from institution to institution Incident reports Not part of the patient's medical record! Importance of communication Can be life saving or life threatening Can improve or damage nurse-patient relationships - subsequent trust Can inhibity or enhance the patient being forthcoming with information valuable to patient care Can support or negate reimbursement Communication Exchange of information, opinions, ideas, or feelings -Interactive process -Process of sending and receiving verbal and non-verbal messages -Means for establishing a therapeutic nurse-patient relationship Factors Affecting Communication Posture and position Space and territoriality Physiological factors Psychosocial factors Factors Affecting Communication: Posture and position Where is the nurse sitting? What is therapeutic posture? Factors Affecting Communication: Space and territoriality Appropriate use of personal space Maintaining a comfort zone Factors Affecting Communication: Physiological factors Pain Altered cognition Impaired hearing Factors Affecting Communication: Psychosocial factors Stress Grieving Breakdown in communication Top contributor to errors in the workplace and threatens professional credibility Therapeutic communication Specific responses that encourage the expression of feelings and ideas Conveys acceptance and respect -Active listening (SOLER) -Sharing observances