NURS 170 > First Midterm > Flashcards

First Midterm Flashcards

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1
Q

3 components of the BScN program philosophy

A

Being, knowing and doing

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2
Q

MacEwan BScN philosophy: Being:

  • individuals, families, communities, organizations and planet
  • ___, knowledgeable and self-determining
  • have the right to ___ and ___
  • ___ (in and with- the world)
  • ___-___= non-binary, relational and embodied

-a ____ body of knowledge

  • full ____
  • the ____ of authentic connections
A
  • individuals, families, communities, organizations and planet
  • unique, knowledgeable and self-determining
  • have the right to respect and dignity
  • embodiment (in and with- the world)
  • well-being= non-binary, relational and embodied

-a distinct body of knowledge

  • full potential
  • the journey of authentic connections
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3
Q

MacEwan BScN philosophy: Knowing:

  • dynamic and continuous ___
  • ___ truths and perspectives
  • ___ may be ambiguous and in constant flux
  • ___ ___ utilizes ontological, anthropological, epistemological, and pedagogical knowing
  • ____ ___ provides a framework for sense-making and decision-making
  • ___ ____ for self-critique and critical reflection
A
  • dynamic and continuous pursuit
  • multiple truths and perspectives
  • contexts may be ambiguous and in constant flux
  • caring sciences utilizes ontological, anthropological, epistemological, and pedagogical knowing
  • complexity science provides a framework for sense-making and decision-making
  • deep knowing for self-critique and critical reflection
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4
Q

MacEwan BScN philosophy: Doing:

  • expressing ___
  • discovering ___-___ when we are in relationship
  • creating and sustaining ___ spaces
  • collaborating- ___ and ____
  • ____ in interdisciplinary and intersectoral approaches
  • ____ organizational processes
  • ____ structural barriers
  • _____ through nursing science
A

MacEwan BScN philosophy: Doing:

  • expressing authentically
  • discovering shared-meaning when we are in relationship
  • creating and sustaining brave spaces
  • collaborating- capacity and capability
  • engaging in interdisciplinary and intersectoral approaches
  • navigating organizational processes
  • mitigating structural barriers
  • transforming through nursing science
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5
Q

Axiology

A

values

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6
Q

Epistemology

A

knowledge or knowing

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7
Q

Ontology

A

nature or existence (life phenomena)

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8
Q

bodymindspirit

A

emphasizing the inseparable concept of body, mind, and spirit and caring for the holistic needs of the patient

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9
Q

Spirituality

A

is about loyalty to justice and compassion

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10
Q

Religion

A

At its best is spirituality in community

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11
Q

How to enhance spirituality

A
  • respecting boundaries
  • listening authentically
  • encouraging their story
  • understanding their interests
  • promoting connection
  • facilitating hope and meaning
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12
Q

Spiritual cues

A
  • able to listen for unspoken words
  • recognize unseen boundaries
    -familiar objects
  • behavioural cues
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13
Q

Purpose of a discipline

A

offers a unique perspective, a distinct way of viewing phenomena which ultimately defines the limits and natures of its inquiry

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14
Q

Criteria for a profession

A
  1. Organized body
    - Standards of practice
    - Permit
    - Discipline
  2. Unique body of knowledge
  3. Bachelor (BSN)
  4. Code of Ethics
  5. Specific service
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15
Q

Medical vs behavioural vs socioenvironmental approaches

A

Medical= focusing on the absence of diseases

Behavioral= Focusing on healthy lifestyle or individual behaviors associated with health

Socioenvironmental= looking at the social determinants of health and the impact it has on the health of groups or communities and factors that may not be in the individuals control

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16
Q

Concept of embodiment

A

recognizing that the mind-body split is artificial and that healing for both patient and family cannot occur unless “scientific knowledge and human compassion are given equal weight [and it is recognized that] emotion and feeling are as important to human life as physical signs and symptoms

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17
Q

Definition of Nursing

A

nursing integrates the art and science of caring and focuses on the protection, promotion and optimization of health and human functioning, prevention of illness and injury, facilitation of healing and alleviation of suffering through compassionate presence. Nursing is the diagnosis and treatment of human responses, and advocacy in the care of individuals, families, groups, communities, and in recognition of the connection of all humanity

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18
Q

Nursing science

A

no longer simply applying the knowledge of other disciplines (borrowed knowledge), nurses now began to acquire a unique body of knowledge about the practice of nursing

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19
Q

What are the interests/focus for nursing?

A
  • as a method, nursology requires that the nurse cut through the defences and fears that prevent self-knowledge. The nurse tries to know the patient on an intuitive, subjective level and then, using reflection, on an objective, scientific level
  • focusing on the patient experience across their entire health journey
  • being in-relationship
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20
Q

Importance of nursing theory

A
  • defines “What is nursing?”
  • provides a framework for making decisions (being) guide our practice
  • articulates relationships between concepts
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21
Q

Patterns of knowing

A
  1. empirics
  2. personal
  3. aesthetics
  4. ethics
  5. emancipatory
  6. unknowing
  7. synoptic
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22
Q

When the knowledge you apply to your practice arises from exploratory, descriptive, or inferential studies about key findings that influence aspects of practice, you will generate knowledge to guide your clinical decision-making process around one of your patterns of knowing referred to as ___ ____

A

When the knowledge you apply to your practice arises from exploratory, descriptive, or inferential studies about key findings that influence aspects of practice, you will generate knowledge to guide your clinical decision-making process around one of your patterns of knowing referred to as empirical knowing

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23
Q

Aesthetic knowing

A

This relates to how you, as a unique individual, choose to respond in a patient situation. It is a reflection of your personality and your creativity

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24
Q

Personal knowing

A

Knowledge that we bring into our nursing understanding that has been accumulated from experiences in our lives to date

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25
Ethical knowing
- moral knowledge - guides and directs how nurses conduct their practice - focus is on: matters of obligation (what ought to be done), right, wrong, responsibility, ethical codes, confronting and resolving conflicting values/norms/interests or principles
26
Unknowing
curiosity, openness, respect, I never thought about it that way
27
Empancipatory
doing what is right for that particular person, recognizing that some people will need more and some less (social justice perspective), want equity not equality
28
Synoptic knowing
courage to integrate all knowledge
29
Metaparadigm
- advances the discipline of nursing (theory development) - identifies the relevant phenomena (concepts) which matter to nursing - fosters "nursing voice" - promotes a domain of inquiry (research)
30
Parts of nursing metaparadigm
person, health, environment, nursing
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Person in metaparadigm
- person receiving nursing - system of interacting parts, competing human needs, or an entity with biological, psychological, social and spiritual dimensions
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Environment in metaparadigm
- environment within which the person exists - involves the person's family, social ties, community, health care system, geopolitical
33
Health in metaparadigm
more than simply the absence of disease/injury but rather an ideal state of optimal health or total well-being toward which all individuals could strive
34
Nursing in metaparadigm
- nursing actions - encompasses the knowledge, skills, and attitudes required to provide care
35
Criticisms of the metaparadigm
- lack of consensus - not a scientific approach - lack of caring/relationship - a barrier for disciplinary advancement (encourages group think) - colonial (excludes many people)
36
Evolution of the metaparadigm
Person ---> human beings (individuals we are called to care for) Environment --> global environment (encompasses natural world- air, water, vegetation, animals and humans Health --> planetary health (how the health of the world affects our health) Nursing --> Nursolgists' Activities (expression of axiology, epistemology and ontology for a nurse)
37
Parts of the McGill Model of Nursing
nursing, patient, environment and health
38
McGill Model of Nursing
focus on health rather than illness and treatment, on all family members rather than the patient alone, on family goals rather than on the nurse's goals and on family strengths rather than deficits
39
Parts of the Orem's Self-Care Theory
nursing, humans, environment, health and self-care
40
Orem's Self-care model
focused on individuals' role in maintaining health. Nurses act temporarily for patient until patient can resume more independent role in self-care
41
Which model is a deficit model: Orem's or McGill?
Orem's- it attributes failures to a personal lack of effort from the patient
42
Objective vs subjective
Objective= 5 senses, things that are repeatable, universal truths, external process subjective= what the patient says it is IT IS, cannot measure very well (individual), internal process
43
Deductive vs Inductive
Deductive= generating facts or details from a theory/generalization Inductive= pattern recognition and making sense of them
44
Coming to know process
- grounded in relationships - listening - critical reflexivity (the capacity to see one's own perspective and assumptions and understand how one's perspective, assumptions and identity are socially constructed through critical reflection) - curiosity - possibilities
45
Sense-making
- different framings (using not only our knowledge but patients and families) - multiple insights (collaborative- nurses, doctors, social workers etc.) - intuitive (nursing gut, emotional response) - collective (what the patient wants is most important) - openness
46
Critical thinking is central to professional nursing practice because...
it allows you to test and refine nursing approaches, learn from success and failures, apply nursing research findings, and ensure holistic patient-centred care
47
Critical thinking
purposeful process that is reflective, consecutive, and goes beyond recognition of an initial thought
48
Levels of critical thinking
basic: concrete, absolute rules/principles, right and wrong, prescriptive complex: creative, alternative options, grey areas, flexibility commitment: anticipate the issue/concern, context to assess viability, growth as a clinician
49
Critical skills and dispositions
- interpretation - analysis - inference - evaluation - explanation - self-regulation - truth-seeking - open-mindedness - analyticity - systematicity - self-confidence - inquisitiveness - maturity
50
Nursing process
- cyclic - dynamic nature - client centeredness - focus on problem-solving and decision-making - interpersonal and collaborative style - universal applicability - use of critical thinking and clinical reasoning
51
Advantages of the nursing process
- framework - novice clinician - fosters consistency - quality care - patient-centered
52
Challenges of the nursing process
- Decision-making over sense-making - individual focus and not system - missed care/ biomedical focus - power dynamics/ colonial - impersonal relationship
53
ADPIE of nursing process
A= assessment D= diagnosis P= planning I= implementation E= evaluation
54
Nursing process: Assessment
- gathers, sorts and analyzes information (objective and subjective) with verification - nursing model/theory/framework - bodymindpsirit -types: environment. cultural, physical, psychological, safety and psychosocial
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Nursing process: Nursing Diagnosis
- focused on the experience of the individual, family, and/or community "lived experience" - risk, promotion, or wellness focus - related to a nursing care plan - collaborative with client
56
Nursing process: Planning
- priority setting: Christine's CURE (critical, urgent, routine and extra) - goals and outcomes - standardized plans of care
57
Nursing process: Implementation
- independent nursing actions= assessment - dependent nursing actions= administering a medication - collaborative interventions= interdisciplinary team - maslow's hierarchy of needs
58
Nursing process: Evaluation
- did anything unanticipated occur? - has the patient's condition changed? - were the expected outcomes and their time frames realistic? - are the nursing diagnosis accurate for this patient at this time? -are the planned interventions appropriately focused on supporting outcome attainment? - what barriers were experienced as interventions were implemented? - does ongoing assessment data indicate the need to revise diagnoses, outcome criteria, planned interventions, or implementation strategies? - are different interventions required?
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type of reasoning that goes from general principle to special case
deductive reasoning
60
type of reasoning that goes from special case to general principle
inductive reasoning
61
6 steps of the NCSBN (Clinical Judgment Measurement Model)
1. Recognize Cues 2. Analyze cues 3. Prioritize hypotheses 4. Generate solutions 5. Take action 6. Evaluate outcomes
62
NCSBN (Clinical Judgment Measurement Model): Recognize Cues
- assessment - sources of information (families, clients, other health care professionals, clinical environments or electronic health records) - filtering (nurses should determine which data are relevant or directly related to client outcomes or the priority of care, and which data are irrelevant) - types of knowledge: subjective and objective
63
NCSBN (Clinical Judgment Measurement Model): Analyze Cues
- relationships or connections - co-interpreting (analyze and verify with the patient) - needs, concerns and problems
64
NCSBN (Clinical Judgment Measurement Model): Prioritize Hypotheses
- establishing priorities e.g. Christine's CURE and Maslow's Hierarchy of Needs - evaluating and ranking - client's real or perceived health problems (what is going through the patient's mind)
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NCSBN (Clinical Judgment Measurement Model): Generate Solutions
- planning stage - identify "what we want" as an outcome/goal - choose nursing interventions to reach goals
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NCSBN (Clinical Judgment Measurement Model): Take Actions
- appropriate - highest to lowest priority - promote, maintain, or restore health - safety
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NCSBN (Clinical Judgment Measurement Model): Evaluate Outcomes
- client's response (bodymindspirit) - degree of "met" - comparison of expected to observed outcomes
68
Environmental Factors
- settings, situation and environment e.g. safety considerations, equipment, surroundings - client observation e.g. age, symptoms of health alteration - resources e.g. staffing, supplies, beds, care partners - health records e.g. history, labs and diagnostic tests, medications and treatments - time pressure e.g. STAT medication, change in client condition - cultural considerations e.g. language, literacy, religion, gender - task complexity e.g. level of difficulty, complicated vs simple action, number of people involved, delegation - risk assessment e.g. identifying and finding ways to remove or minimize harm to promote safety and health
69
Individual factors
- nursing factors e.g. knowledge, skills, specialty - nurse characteristics e.g. attitudes, prior experience, level of experience - cognitive load e.g. demands on the nurse, stress, problem-solving ability, memory
NURS 170
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