Nursing Chapter 13 – Flashcards
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Metaparadigm
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refers to the most abstract aspect of the structure of nursing knowledge.
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consists of the major concepts of the discipline: person, environment, health & nursing
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Metaparadigm
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Philosophy
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refers to a set of beliefs about the nature of how things work & how they should be viewed.
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ties together the concepts of nursing's metaparadigm
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Philosophy
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Model/ framework
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a more specific organization of nursing phenomena than a philosophy.
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implies an organizational structure that makes clearer connections between concepts
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model/ framework
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Florence Nightingale's philosophy of nursing:
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1. provided a broad, general view that clarifies values and answers broad disciplinary questions: what is the profession of nursing. what is the nature of human caring?
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Florence Nightingale's philosophy of nursing focused on:
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1. health illness & the nurse's role in caring for the patients. focused the profession on person, health (not illness), & nursing (not medicine).
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according to Nightingale, health is related to:
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patient's environments, clean water, environment, adequate ventilation & balanced diet.
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Nightingale recognized nursing role in protecting patients (patient advocate) by expressing the importance of:
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shielding from harm, not discussing upsetting news, not tiring the patient. changing patients' environments could positively affect their health.
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Virginia Henderson's philosophy of nursing focused on:
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the unique function of the nurse is to assist the individual, sick or well, in the performance of those activities contributing to health of its recovery (or a peaceful death) that he would perform unaided if he had the necessary strength, will or knowledge.
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Specified the role of the nurse in relation to the patient.
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Virginia Henderson.
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Virginia Henderson linked her definition of nursing that emphasized the functions of the nurse with a list of basic patient needs that are the focus of nursing care:
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14 Basic needs
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14 basic needs are:
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1. easily applicable to a variety of patient care settings. 2. brief outpatient encounters with a limited number of needs. 3. complex settings such as intensive care where patients are extremely vulnerable.
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Jean Watson's philosophy of nursing focused on:
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1. emphasized a return to the earlier values of nursing & emphasized the caring aspects of nursing. 2. proposed 10 "carative factors"(caritas processes) to differentiate nursing from medicine. 3. believes that nursing is a human to human relationship.
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founded the center of Human Caring at the university of Colorado.
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Jean Watson
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Caritas processes
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guide nurses by specifying the meaning of the relationship of nurse & patient as human beings.
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Conceptual models of nursing
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provides organizational structures for critical thinking about the processes of nursing. they are less abstract & more formalized than philosophies.
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Dorothea Orem's conceptual model of nursing focuses on 3 interrelated theories:
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1. Theory of self- care 2. Theory of self- care deficit 3. Theory of nursing system.
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In Orem's model, appropriate care for patients is developed through a series of 3 operations:
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1. diagnostic 2. prescriptive 3. regulatory
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Diagnostic
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used to determine the patient's ability to provide effective self-care. begins with the establishment of the nurse-patient relationship.
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Prescriptive
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occurs when therapeutic self-care requisites are determined & nurse reviews various methods, actions, and priorities with the patient. this is the planning stage for formulating a plan of care.
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Regulatory
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this is where the nurse designs, plans and produces a system for care. Range from wholly compensatory or supportive- educative plans.
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Imogene King's Theory of nursing systems, concepts, process focuses in :
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1. people, their interpersonal relationships & their social contexts. 2. Referred to as the personal, the interpersonal system & the social system.
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King's Model of the nursing concept is not linear, steps occur simultaneously as the nurse & patient work together. T/F
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True
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Using King's model, nurses focus on...
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goal attainment for & by the patient.
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what is the purpose of the steps of the nursing process according to King's model?
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to describe the action the nurse is taking.
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in King's model care is guided by what?
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the concepts at each system level.
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King's process provided what?
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a structure for the nurse to monitor the relationship's progress toward the goal of the patient regaining health.
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Sister Callista Roy's uses ________ model to focus on individuals as a biopsyschosocial ________ system.
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Adaptation, adaptive system.
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JOINT GOAL SETTING: care was based on interpersonal relationship between nurse & patient.
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Imogene King
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philosophy/ concepts. Goal: help patients to care for themselves.
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Dorothea Orem
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using Roy's model in practice, nurses, ....
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assess the environmental stimuli of both internal & external environments. then assess a patient's adaptive behavior that results from the stimuli. Next they develop nursing diagnoses as a result.
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using Roy's model in practice, these guide goal- setting & interventions aimed at promoting adaptation
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Nursing diagnoses
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Grand theory
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a very broad conceptualization of nursing phenomena
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Middle-range theory
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narrower in focus and makes connections between grand theories & nursing practice.
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Hildegard's theory of interpersonal relations in nursing states that:
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all nursing is based on the interpersonal process & the nurse- patient relationship
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The relationship between the patient & the nurse is the focus of attention, rather than the patient only as the unit of attention.
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Hildegard's theory of interpersonal relations in nursing
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Peplau's 6 roles of the nurse, included in the four-pronged process:
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1. counselor 2. resources 3. teacher 4. technical expert 5. surrogate 6. leader
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observe, listen, confirm
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Orlando's nursing process theory.
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The Dynamic Nurse-Patient Relationship: function Process & Principles
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The goal of the nurse is to determine & meet patients' immediate needs & to improve their situation by relieving distress & discomfort.
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This theory emphasizes deliberate action, rather than automatic action, based on observation, which lead to inferences.
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Orlando's dynamic nurse-patient relationship: function process & principles, theory.
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Theory that specifies how the patients are involved in the nurse's decision making
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Orlando's theory
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This theory guides interactions toward predictable outcomes
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Orlando's theory
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Using Orlando's theory, nurses individualize care for each patient by:
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1. attending to behavior 2. confirming with the patient ideas and inferences 3. identifying pressing needs
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This theory saves time & energy for both nurse & patient because nurses get to the bottom line more quickly when observing , listening to & confirming along with patient.
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Orlando's theory
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Another name for Leininger's theory of Culture Care Diversity, & Universality is?
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Transcultural nursing
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The goal of Transcultural nursing
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planning nursing care based on specific knowledge that is culturally define, classified and tested.
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This is used to provide care that is culturally congruent for patients
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Transcultural nursing
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According to Leininger's theory, what is the essence of nursing?
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Care
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Patients must be viewed in the context of their culture in order to provide good care:
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1. respecting the culture of the patient 2. recognizing importance of it's relationship to nursing care 3. assessing cultural data to understand its influence on patient.
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3 things that nursing is focused on in culture care
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1. preservation 2. accommodations 3. repatterning
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Middle- Range Theory of Nursing:
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1. neither overly broad nor narrow. 2. usually incorporate a limited number of concepts. 3. focus on a specific aspect of nursing. 4. based on empirical research. 5. often embedded larger theory. 6. typically merge practice & research. 7. sometimes developed from other disciplines.
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Examples of Middle- Range Theory of Nursing
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1. Swanson's 1991 Caring Theory 2. Mishel's 1988 Uncertainty in illness theory 3. Dobratsz's 2001 Psychological adaptation in death & dying.
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To continue forward movement in nursing & to improve quality of nursing care, nurses must engage in:
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1. Theory-based practice 2. Theory-testing research 3. Theory-generating research
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Theory-based education:
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1. Curricula are built on one or more conceptual models. 2. it is important for students to understand that their coursework is based on a philosophy or a conceptual model that shapes the way nursing is taught.
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Theory-based practice
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occurs when nurses intentionally structure their practice around a particular nursing theory & use it to guide them.
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Using Theory-based practice, nurses do 5 things:
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1. assess 2. plan 3. diagnose 4. intervene 5. evaluate nursing care
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Theory- Based Research
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tests and refines the knowledge base of nursing
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the findings from theory based research enables nurses to:
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1. improve the quality of care. 2. understand how evidence-based practice influences improved patient outcomes.
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this is vital to the future of nursing
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Research
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Nursing researchers are increasingly meeting the challenge of using nursing theory to structure nursing research that:
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1. tests theory 2. develops theory qualitative research
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