Test 1: Nursing Theory, Holism, Caring – Flashcards
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Objective: Identify common implication of evidence based practice (EBP).
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EBP is black and white, focuses on problem/solution. Research is often done in controlled environments, not like real world. EBP ignores significance of life events- doesn't see client as individual person. Implementing EBP may not take into consideration organizational culture and and resources.
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Describe a holistic perspective of the client as a person.
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Includes bio/psycho/soical. Client is not named by their illness. Use the growth model (caring and complexity), not the medical model (disease focused).
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Describe concept of "caring".
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Moral, interpersonal, therapeutic, client focused. Central to all helping professions. Caring practice involves connection, mutual recognition, and involvement between nurse and client. Enables peoples to create meaning in their lives.
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Caring Theorist: Madeleine Leininger
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Emphasizes that human caring, although a universal phenomenon, varies among cultures in its expressions, processes, and patterns; it is largely culturally derived. Nurses must understand different cultures to function effectively.
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Caring Theorist: Ray
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Theory of Bureaucratic Caring. Theory suggest that caring in nursing is contextual and is influenced by organizational structure.
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Caring Theorist: Boykin & Schoenhofer
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Nurses must know who they truly are- and then they can care for others. Through knowing self as a caring person, the nurse can be authentic to self, freeing oneself to truly be with other.
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Caring Theorist: Watson
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Theory of Human Care- views caring as the essence and moral ideal of nursing. The nurse and the client are coparticipants in the client's moved towards health and wholeness. Nurses contribution to society lies in moral commitment to human care.
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Caring Theorist: Swanson
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"A nurturing way of relating a valued 'other', toward whom one feels a personal sense of commitment and responsibility. Focuses on caring processes as nursing interventions (making beds, doing IVs, changing dressings).
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Caring Theorist: Benner & Wrubel
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Caring is the essence of EXCELLENCE in nursing.
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What is the metaparadigm of Nursing? Describe four parts.
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Framework for theories of nursing. Most abstract- In late 20th century, much of the theoretical work in nursing focused on articulating relationships among these four parts: client, health, environment, nursing. -Client: center- recipient of nursing care. -Environment: Internal/External. PEST. -Health: subjective- degree of wellness or well-being the client experiences. Client experience. -Nursing: attributes, characteristics, actions and roles of the nurse providing care.
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Compare the dominant view and emerging view of nursing.
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Dominant view: uses stability model: all about systems and stress/adaptation. Emerging view: Growth model- caring (concept of caring needs to be present in order for growth to occur) and complexity (recognizes human and environment as very complex.
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Identify characteristics of self which influence the process of becoming a client-centered, professional nurse.
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Understand/acknowledge your own biases and experiences. Be present/ be with. Be empathetic/ be competent. Empower: identify and build on strengths (yours and the client). Enable: do for client when they cannot. Assist: when client needs help. Give client independence with teaching, advocacy.
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Identify four types of knowledge in nursing and describe each.
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Empirical Knowing, The Science of Nursing: factual, observable phenomena (anatomy, phys, chem) to theoretical analysis (developmental theory, adaptation theory). Person Knowing, The Therapeutic Use of Self: knowing, encountering, actualizing of the concrete, individual self. Promotoes wholeness and intergrity. Ethical Knowing, the Moral Component: conservation of life, alleviation of suffering, and promotion of health. Goes beyond simply following ethical codes. Aesthetic Knowing, the Art of Nursing: expressed by the individual nurse through his or her creativity in meeting the needs of clients.
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Define theory.
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system of ideas that is presumed to explain a phenomenon. Think of a theory as a major, very well-articulated idea about something important.
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Define phenomenon.
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An event, thing happening.
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Define conceptual framework.
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Group of related ideas, statements, concepts. Piece together to form a theory. (Think of cues coming together to form inferences).
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Nursing Theorist: Nightingale.
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Environment: establish an environment that allows person to recover from illness. Sanitation. Crimean War.
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Nursing Theorist: Henderson.
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14 human needs. Acknowledges that nurses deal with client even when recover is not feasible.
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Nursing Theorist: Rogers.
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Unitary man.
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Nursing Theorist: Orem.
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Self-care (refers to those activities an individual performs independently throughout life to promote and maintain well-being), self-care defecits, and nursing systems.
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Nursing Theorist: Roy.
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Adaptation- focuses on individual as biopsychosocial adapative system.
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Discuss relationship of nursing theories to non-nursing theories.
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Nursing theories influence knowledge development and practice as well as influencing other theories. Non-nursing theories will not try to disprove nursing theories, rather build on them.
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Identify non-nursing theories and the use of each in nursing.
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Marx's Theory of Alientation. Freud's Theory of the Unconscious. Darwin's Theory of Evolution. Einstein's Theory of Relativity. Piaget's Theory of Development: helpful with communication to children and different ages/development. Skinner's Behavioral Theory.
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Define practice discipline.
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Used for fields of study in which the central focus is performance of a professional role.
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Define paradigm.
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Refers to a pattern of shared understandings and assumptions about reality and the world. Include our notions of reality that are largely unconscious or taken for granted.
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Nursing Theorist: Neuman.
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Developed model based on the individual's relationship to stress, the reaction to it, and the reconstitution factors that are dynamic in nature. (Reconstitution is the state of adaptation to stressors.
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"A supposition or system of ideas that is proposed to explain a given phenomenon"
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Theory.
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"A group of related ideas or statements"
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Conceptual Framework
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"A set of shared understandings and assumptions about reality and the world"
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Paradigm
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Which provides the best explanation for describing nursing as a practice discipline? 1. Nursing focuses on performing the professional role. 2. It takes time and experience to become a competent nurse. 3. Research and theory development is a central focus. 4. Nurses function as members of a team who form a practice group.
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Number 1 is the correct answer. Rationale: Practice disciplines are fields of study which the central focus in performance of a professional role. Option 2: Time and experience are necessary for developing proficiency in any profession or career. Option 3: Research and Theory development do not have performance as their primary focus. The primary focus of nursing is providing quality service to humans. Option 4: Team or group practice can be a part of many other careers.
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Person, environment, health, and nursing constitute the metaparadigm for nursing because they do which of the following? 1. Provide a framework for implementing the nursing process. 2. Can be utilized in any setting when caring for a client. 3. Can be utilized to determine applicability of a research study. 4. Focus on the needs of a group of clients.
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Number 2 is the correct answer. Rationale: person/client, environment, health, and nursing are relevant when providing care for any client whether in the hospital, at home, in the community.
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Which is an accurate statement about the role of nursing theory? 1. Practice theories assist nurses to reflect on the effectiveness of what they do. 2. Midlevel theories, describing the interrelationships among a broad range of concepts within nursing, have been well test through nursing research. 3. All schools of nursing in the US are organized around one of the conceptual models described in this chapter. 4. Nursing theory guides the direction of research but not that of education or practice.
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Number 1 is the correct answer. Rationale: Practice theories assist the nurse to reflect on nurse care. Option 2: Theories describing the interrelationships among a broad range of concepts within nursing are grand theories, not midlevel. Option 3: Schools may or may not be organized around any theory or conceptual model. Option 4: Nursing theory guides the direction of research and education and practice.
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The purpose of theory in science is to 1. Build a rationale for programs of research. 2. Explain why scientists do what they do. 3. Help scientists interpret phenomena. 4. Distinguish science from art.
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Number 3 is the correct answer.
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Define Holism.
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Combined mental, emotional, spiritual, relationship, and environmental components.
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A client ask the nurse the differences between traditional therapies and alternative therapies. What is the best response? 1. Alternative therapies cost less than traditional. 2. Alternative therapies are used if traditional therapies are ineffective. 3. Alternative therapies can be as effective as traditional therapies for some conditions. 4. Alternative therapies utilize products from nature but traditional therapies do not.
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Answer: Number 3. Although the effectiveness of alternative therapies is sometimes not scientifically established, many people report significant benefit from them for a wide variety of conditions.
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Before meeting with a client with a terminal illness, a new graduate nurse reviews information on spirituality. Which is best explanation of spirituality? 1. That which gives people purpose and meaning in their lives. 2. A formalized religious dogma. 3. A nondemoninational community service 4. People being responsible for their life patterns.
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Answer: Number 1.
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Which nursing action is most likely to create a healing environment? 1. Use technology to prevent HAI's. 2. Empower clients to make healthy decisions for themselves. 3. Assist clients to obtain a safe and comfortable place to live. 4. Ensure that primary care providers' order are carried out.
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Answer: Number 2. Healing environments are created when nurses empower clients to make healthy decisions.
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A client asks a nurse to state one of the primary principles associated with naturopathy. Which of the following is the best response? 1. A higher being guides the learning needed to treat disease. 2. It focuses on environmental causes when treating illness. 3. It focuses on early detection and treatment of disease. 4. It is a way of life to maintain health and prevent disease.
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Answer: Number 4. Naturopathy focuses on the total person.
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From the perspective of traditional Chinese medicine, which is the best definition of disease? 1. Imbalance or disruption in food digestion. 2. Imbalance or interruption in the flow of qi. 3. Imbalance or disruption in key social relationships. 4. Imbalance or disruption in thoughts or emotions.
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Answer: Number 2. Qi is the flow of energy in the body that must be uninterrupted for a person to be in a healthy state.
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A client asks how herbs are similar to prescribed medications. What is the nurse's best answer? 1. "They are nothing alike. You should ask your doctor these types of questions." 2. "Thirty percent of current prescriptions drugs are derived from plants." 3. "Medications are much more effective than herbs." 4. "Herbs are more dangerous than prescribed medications."
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Answer: Number 2. Thirty percent of current prescriptions drugs are derived from plants.
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What is a rationale for assessment of clients' use of herbs? 1. There are potential adverse interactions between some herbs and some medications. 2. Clients should not take anything that is not prescribed by the primary care provider. 3. These data will contribute to the body of knowledge on the use of herbs. 4. It is important to establish a pattern that clients tell nurses everything.
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Answer: Number 1. There can be serious interactions between herbs and medications.
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Which oils may be placed directly on the skin? 1. rose and orange 2. green apple and jasmine 3. clary sage and rosemary 4. lavender and tea tree
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Answer: Number 4. The oils is option 1, 2, and 3 will burn the skin if they are not diluted.
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What are the effects of massage as a manual healing method? Select all that apply. 1. Communication and caring. 2. mental and physical relaxation 3. increased muscle strength 4. speeds the removal of waste products 5. Lowers blood pressure and heart rate.
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Answer: Number 1, 2, 4, and 5. Massage does not increase muscle strength.
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Which example best illustrates the principle of knowing the client? 1. The nurse provides a back rub to help client relax, and then makes the bed with clean linen. 2. The nurse listens as the client describes how he has been caring for his diabetes at home. 3. The nurse administers a piggyback antibiotic for a client with pneumonia. 4. The nurse collects a urine specimen to send to the lab, and explains to the client the reason for the test.
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Answer: Number 2. This assessment activity gathers more information to help the nurse know the clients self-care practices. Option 1 aims to provide comfort; option 3 is a therapeutic, not an assessment, activity; option 4 does not meet the aim of knowing the client.
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The nurse teaches a client with diabetes how to make decisions about insulin management after discharge. This teaching most clearly reflects which caring activity? 1. Empowering the client. 2. Compassion 3. Knowing the client. 4. Nursing presence.
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Answer: Number 1. Teaching the client to make self-care decisions at home empowers him to care for his illness.
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Mayeroff described allowing the other to grow in his own way and time. This behavior most clearly reflects which major ingredient of caring? 1. Humility 2. Knowing 3. Patience 4. Courage
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Answer: Number 3.
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Leininger's theory, culture care diversity and universality, would provide the best framework for assessing which nursing situation? 1. The Indonesian parents of an infant preferred to use hot/cold therapies to prevent seizures and withheld the prescribed seizure medication. 2. Staff nurses on a hospital unit discuss how to reorganize client care to provide more continuity of staff with clients. 3. Nurses in a community agency search for learning resources about intravenous therapy in the home setting. 4. A nurse manager explores ways to assist new nursing graduates to develop clinical skills on the hospital unit.
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Answer: Number 1. In this situation, culture care diversity addresses the differences between Indonesian medical practice and traditional American practices.
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In a reflective journal, a nursing student writes this statement about a comatose client on the hospice unit: "The Do-Not-Resuscitate order was on the chart, and none of the nurses knew what measure should be taken if the client stopped breathing." This statement most clearly reflects which of the four ways of knowing? 1. Empirical 2. Personal 3. Ethical 4. Aesthetic
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Answer: Number 3. This represents an ethical dilemma. Options 1, 2, and 4 are ways of knowing less clearly related to the situation.
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The nurse sits with the client and holds the client's hand as his pain decreases. This situation is an example of which caring practice? 1. Nursing presence 2. Assessment 3. Knowing the client 4. Empowering
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Answer: Number 1. The nurse's presence is most significant in this situation.
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Which nursing theory is depicted by a model with spiritual-ethical caring in the center, surrounded by technological, physical, legal, political, economic, social-cultural, and education systems? 1. Nursing as caring 2. Theory of bureaucratic caring 3. Caring, the human mode of being 4. Theory of Human Care
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Answer: Number 2.
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The nursing student reviews the pathophysiology of myocardial infarction in preparation for the next day's clinical experience. This activity is an example of which type of knowledge development? 1. Empirical Knowing 2. Aesthetic Knowing 3. Personal Knowing 4. Ethical Knowing
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Answer: Number 1. Empirical knowing is gained from studying scientific models and theories.
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A nurse, sitting quietly in a chair, breathing deeply, and focusing on the mental image of a crystal is using which mind-body therapy? 1. Storytelling 2. Yoga 3. Music therapy 4. Meditation
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Answer: Number 4.
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A 40-year-old client who comes to the clinic for a routine physical exam as the nurse how much exercise is recommended for a healthy lifestyle. Which answer is most appropriate? 1. Moderate activity for 10 minutes daily. 2. Moderate activity for 20 minutes two to three times a week. 3. Vigorous activity for 20 minutes on three days a week. 4. Vigorous activity for 30 minutes daily.
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Answer: Number 3. This is the recommendation for a healthy lifestyle.
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Define grand theories.
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Those that articulate a broad range of the significant relationships among the concepts of a discipline.
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Define midlevel theories.
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Nursing research is more often informed by midlevel theories that focus on the exploration of concepts such as pain, self-esteem, learning, and hardiness.
