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NR222 Health and Wellness Exam 2 Study Guide
Ethical Principles:
Autonomy- freedom from external control. Respect for patient autonomy refers to the
commitment to include patients in decisions about all aspects of care. Involving patients in
decisions about their care is now standard practice.
Veracity- devotion to the truth; in giving people information about their health care needs
facilitates autonomous choice and enhances personal decision-making. Health care professionals
may be tempted to withhold certain details when this is seen as serving the person’s best interests
or when family members demand it. It is sometimes difficult to determine how much and what
types of information will best serve a person’s needs.
Fidelity - the agreement to keep promises
Nonmaleficence- the avoidance of harm or hurt; not only the will to do good but the equal
commitment to do no harm.
Beneficence- taking positive actions to help others; implies that the best interests of the patient
remain more important than self-interest. It implies that nurses practice primarily as a service to
others, even in the details of daily work.
Justice- refers to fairness
Respect for People
Confidentiality- Act of keeping information private or secret; in health care the nurse only
shares information about a patient with other nurses or health care providers who need to know
private information about a patient to provide care for him or her; information can only be shared
with the patient's consent.
Levels of Health Prevention/Promotion- Preventive measures can be applied at any stage along the
natural history of a disease, with the goal of preventing further progression of the condition.
Primary – BEFORE the condition occurs. Purpose to decrease the vulnerability of the pt to
disease or dysfunction. True prevention (examples: Health education, immunization, nutritional
programs, and physical fitness activities).
Secondary- EARLY DIAGNOSIS and prompt treatment. Pt with health problems and risk for
developing complications or worsening conditions. (Screening techniques treating early stages of
disease to limit disability and averting or delaying the consequences of advanced disease).
Tertiary- RESTORATIN AND REHABILITATION. Restoring health or rehabbing to the maximum
level of functioning.
Nursing Process- The nursing process is a series of organized steps designed for nurses to provide
excellent care. A legal document to ensure it is written correctly
ADPIE
A) Assessment: nurse collects comprehensive data pertinent to the pt's health and/or situation (subjective
and objective). A physical examination of the patient.
1a. Subjective- That the pt, family member or witness informs you of pt condition.
Example: "pt stated I have pain in leg"
1b. Objective- Your scenes (look, touch, smell, and hear), the pts chart (pt history)
Example: "pt grimaced upon palpation of leg"
D) Diagnosis: Apply clinical judgment to the client's human response to actual or potential health problems
based on the assessment. nurse analyzes the assessment data to determine the diagnosis or issue.
~what is wrong with the patient?
~priorities that issues that pt has (acute, actual and risk/potential diagnosis).
Types:
Actual Problem-
Risks for Problems-
Wellness Issues-
Component /Parts - PES Statement
, Problem= diagnostic label or definition
Etiology = cause and contributing factors (related to)
Signs/ Symptoms = defining characteristics
P) Planning: Plan the steps to reach that goal. Nurse develops a plan that prescribes strategies and
alternative to attain expected outcomes. Nurse identifies expected outcomes for a plan individualized to
the pt or situation (what do I want to happen to my pt when I act on interventions based on diagnosis).
3a. Goals:
3b. Objective: SMART
Specific- "what is to be done"
Measurable-how will u know?
Achievable- "can I do it"
Realistic- "what will be the impact?"
Time-Oriented- "when will it be done?"
I) Implementation: Nurse implements the identified plan.
5a. Coordination of care: nurse coordinates care delivery.
5b. Health teaching and health promotion: nurse uses strategies to promote health and safe environment
5c. Conclusion: the graduate level-prepared specialty nurse or advanced.
5D. Prescriptive Authority and Treatment: nurse uses prescriptive authority, procedures, referrals,
treatments, and therapies in accordance with state and federal laws and regulations
E) Evaluation: nurse evaluates progress toward attainment of outcomes
Going back to outcomes and plan... have I achieved the outcome for the pt? If you have not met go back to
assessment.
Nursing Theories:
Orem’s Self-Care Theory - Dorothy Orem's Self Care Theory- Self-care deficit theory- Nursing
becomes necessary when client is unable to fulfill biological, psychological, developmental, or social
needs
Watson’s Human Caring Theory Nursing Theories - Jean Watson's Human Caring (science)
Theory- Relationship between pt and nurse. Role of the nurse is defining the pt as a unique human
being to be valued, respected, nurtured, understood and assisted. Important connections between
the nurse and pt.
Transcultural Theory - Madeleine M. Leininger's Trans-cultural Nursing and Human Care
Theory- Major area in nursing focused on the comparative study and analysis of diverse cultures
and subcultures in the world with respect to their caring values, expressions, health-illness benefits
and patterns of behavior.
Models of healthcare:
Health Promotion (Pender's)- The model focuses on the following three areas:
(1) individual characteristics and experiences;
(2) behavior-specific knowledge and affect; and
(3) behavioral outcomes, in which the patient commits to or changes a behavior
The HPM notes that each person has unique personal characteristics and experiences that affect
subsequent actions. The set of variables for behavioral-specific knowledge and affect have important
motivational significance.
Active Health Promotion- Individual becomes involved (ie: lifestyle changes - eating, physical
activity, etc)
Passive Health Promotion- promote public health with low participation from individual, with
greatest effect to society. Examples: government regulation (FDA, air cleanliness, sanitation)
Transtheoretical- individual feels confident that there are no risks for relaps
Pre-contemplative- Not considering change
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