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Test bank for Professional Nursing Concepts and Challenges 7th Edition by Beth Black RN MSN PhD

Test bank for Professional Nursing Concepts and Challenges 7th Edition by Beth Black RN MSN PhD

Now in full color, this best-selling, easy-to-read text introduces you to the issues and trends you’re likely to encounter in any nursing practice setting. Each stand-alone chapter explores a specific topic and gives insightful discussions of issues such as the health care delivery system, professionalization in nursing, standards, and scope of practice, socialization and nursing theories surrounding the profession, and political action facing nurses. NEW! The most up-to-date information on responding to several critical and recent initiatives includes the Patient Protection and Affordable Care Act; the Carnegie Study – Educating Nurses: A Call for Radical Transformation; the IOM report on the Future of Nursing: Leading Change, Advancing Health; QSEN; and the ANA’s Health System Reform Agenda. NEW! Expanded content on social media’s impact on nursing offers insight into the legal issues, ethics, boundaries, and image of nursing involved in social media. NEW! Increased use of nurses’ narratives and real-life work examples helps paint an even clearer picture of the realities of nursing practice.

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Table of Content

Acknowledgments
Interactive Review – Professional Nursing
CHAPTER 1 Nursing today: A time of transformation
Learning outcomes
Status of nursing in the United States
Numbers
Gender
FIG 1-1 Distribution of women and men in the overall RN population. The great disparity between the percentage of women and men in nursing is clearly evident.
Age
Race and ethnicity
Education
FIG 1-2 RN and the U.S. populations by race/ethnicity, 2008. The proportion of nurses who are white, non-Hispanic is greater than their proportion in the U.S. population.
FIG 1-3 Initial nursing education of RNs working in nursing, 2008. ADN education accounts for almost half of RNs’ basic nursing education, although 55.6% of nurses report having a bachelor’s or higher degree as their highest education. NSSRN, National Sample Survey of Registered Nurses.
Employment opportunities for nurses
FIG 1-4 Although most nurses work in hospitals, nurses in home health settings often enjoy long-term relationships with their patients.
Hospital-based nursing
EVIDENCE-BASED PRACTICE NOTE
FIG 1-5 Hospital staff nurses work closely with the families of patients, as well as with the patients themselves.
Community health nursing
Nurse entrepreneurs
BOX 1-1 KAY WAGONER, PhD, RN
Kay Wagoner, PhD, RN (Cardiovascular Nurse Specialist).
Office-based nursing
Occupational and environmental health nursing
Military nursing
School nursing
FIG 1-6 School nurses manage a variety of students’ health problems, from playground injuries to chronic illnesses such as asthma and diabetes.
Hospice and palliative care nursing
Telehealth nursing
Faith community nursing
INTERVIEW
Nursing informatics
Nursing opportunities requiring advanced degrees
Nurse educators
Advanced practice nursing
FIG 1-7 Advance practice nurses by specialty area, 2008. Although most nurse practitioners work in single roles, some work in dual advanced practice roles.
Nurse practitioner
Clinical nurse specialist
BOX 1-2 SEBASTIAN WHITE, MSN, FNP, BC-ADM, RN
Sebastian White, MSN, FNP, BC-ADM, RN.
Certified nurse-midwife
Certified registered nurse anesthetist
Clinical nurse leader
Issues in advanced practice nursing
Employment outlook in nursing
Key points
Critical thinking questions
Activities
References
CHAPTER 2 The history and social context of nursing
Learning outcomes
Historical context of nursing
Mid–nineteenth-century nursing in england: The influence of florence nightingale
FIG 2-1 Florence Nightingale (1820–1910), founder of modern nursing.
1861–1873: The american civil war: An impetus for training for nursing
After the civil war: Moving toward education and licensure under the challenges of segregation
The first training schools for nurses and the feminization of nursing
FIG 2-2 Nurses training in the bacteriologic laboratory at Bellevue Hospital, New York City, circa 1900.
FIG 2-3 Mary Eliza Mahoney (1845–1926), the first trained African-American nurse in the United States.
Historical Note 2-1
Professionalization through organization
Nursing’s focus on social justice: The henry street settlement
FIG 2-4 Lillian Wald (1867–1940), nurse and social activist. Wald founded the Henry Street Settlement, which is still in operation today, and was one of the founders of the National Association for the Advancement of Colored People (NAACP).
FIG 2-5 Little deterred the Henry Street Settlement nurses from making their daily rounds on their patients in New York’s Lower East Side.
Historical Note 2-2
A common cause but still segregated
FIG 2-6 Jessie Sleet Scales, a visionary African-American nurse, was among the first to bring community health nursing principles to the slums of New York City around 1900.
War again creates the need for nurses: Spanish-american war
Professionalization and standardization of nursing through licensure
FIG 2-7 Red Cross nursing in the Spanish-American War, circa 1898. Nurses on deck of the hospital ship Relief near Cuba.
FIG 2-8 A World War I Red Cross nursing poster, 1918. “Not one shall be left behind!” by James Montgomery Flagg is typical of World War I recruitment posters. Nurses answered the call in record numbers.
1917–1930: The challenges of the flu epidemic, world war I, and the early depression era
FIG 2-9 Mary Breckinridge, founder of the FNS, on her way to visit patients in rural Kentucky.
Historical Note 2-3
1931–1945: Challenges of the great depression and world war II
World war II: Challenges and opportunities for nursing
Historical Note 2-4
1945–1960: The rise of hospitals: Bureaucracy, science, and shortages
1961–1982: The great society, vietnam, and the change in roles for women
FIG 2-10 The Vietnam War Women’s Memorial, dedicated in 1993, was established to honor women who served in Vietnam, most of whom were nurses.
1983–2000: Challenges for nursing: HIV/AIDS and life support technologies
2001–2015: The post–9/11 era, natural disasters, and health care reform
Social context of nursing
CRITICAL THINKING CHALLENGE 2-1
Gender
FIG 2-11 Despite their small numbers, men in nursing play an important role in the profession.
BOX 2-1 FROM FLIGHT MEDIC TO FLIGHT NURSE: ONE MAN’S STORY
Christopher McGrath, RN.
Image of nursing
The woodhull study on nursing and the media
The johnson & johnson campaign
FIG 2-12 An example of an advertisement that depicts men in nursing in a favorable way.
BOX 2-2 THE WOODHULL STUDY AT A GLANCE
Purpose of the study
Key study findings
Key study recommendations
The truth about nursing
FIG 2-13 Population projections, ages 65 to 84 years and ages 85 years and over: 2000–2050.
National population trends
Aging of america
BOX 2-3 CHECKLIST FOR MONITORING MEDIA IMAGES OF NURSES AND NURSING
Prominence in the plot
Demographics
Personality traits
Primary values
Sex objects
Role of the nurse
Career orientation
Professional competence
Education
Administration
Diversity
Diversity in the profession
Technologic developments
FIG 2-14 Advanced technology is used to enhance clinical decision making in novices. Here students use a human simulator in a laboratory setting to refine their skills.
FIG 2-15 National supply and demand projections for full-time equivalent (FTE) RNs, 2000–2020. In 2000 the national supply of FTE RNs was estimated at 1.89 million, whereas the demand was estimated at 2 million, a shortage of 110,000, or 6%. Based on what is known about trends in the supply of RNs and the anticipated demand, the shortage is expected to grow relatively slowly until 2010, by which time it will have reached 12%. At that point, demand will begin to exceed supply at an accelerated rate, and by 2015 the shortage will have almost quadrupled to 20%. If not addressed, and if current trends continue, the shortage is projected to grow to 29% by 2020. Factors driving the growth in demand include an 18% increase in population, a larger proportion of elderly persons, and medical advances that heighten the need for nurses.
Initiatives to provide a stable supply of registered nurses
Summary of key points
Critical thinking questions
Activities
References
CHAPTER 3 Nursing’s pathway to professionalism
Learning outcomes
Characteristics of a profession
FIG 3-1 According to experts, professionals are motivated by altruism, a desire to help others.
From occupation to profession
Professional preparation
Professional commitment
Interprofessionality
TABLE 3-1 COMPARISON OF CHARACTERISTICS OF OCCUPATIONS AND PROFESSIONS
Nursing’s pathway to professionalism
Kelly’s criteria
“The services provided are vital to humanity and the welfare of society.”
“There is a special body of knowledge that is continually enlarged through research.”
“The services involve intellectual activities; individual responsibility (accountability) is a strong feature.”
“Practitioners are educated in institutions of higher learning.”
“Practitioners are relatively independent and control their own policies and activities (autonomy).”
“Practitioners are motivated by service (altruism) and consider their work an important component of their lives.”
“There is a code of ethics to guide the decisions and conduct of practitioners.”
FIG 3-2 The Wheel of Professionalism in nursing.
BOX 3-1 THE FLORENCE NIGHTINGALE PLEDGE
“There is an organization (association) that encourages and supports high standards of practice.”
Miller’s wheel of professionalism in nursing
Standards established by the profession itself
Nursing’s social policy statement: The essence of the profession
A contract with society
Nursing: Scope and standards of practice
The code of ethics for nurses
BOX 3-2 SELF-ASSESSMENT: AM I A PATIENT-CENTERED NURSE?
Collegiality as an attribute of the professional nurse
Barriers to professionalism in nursing
Varying levels of education for entry into practice
BOX 3-3 POINTS ON PROFESSIONALISM
Gender issues
Historical influences
BOX 3-4 REPAVING THE PATH TO PROFESSIONALISM IN NURSING EDUCATION
Isabel Hampton Robb.
External conflicts
Internal conflicts
Nursing image and professionalism: Are these related?
CRITICAL THINKING CHALLENGE 3-1
Final comments
CRITICAL THINKING CHALLENGE 3-2
Summary of key points
Critical thinking questions
Activities
References
CHAPTER 4 Legal aspects of nursing
Learning outcomes
FIG 4-1 Branches of the U.S. federal government were established by the Constitution to provide for a balance of power.
American legal system
Nursing as a regulated practice
Statutory authority of state nurse practice acts
Executive authority of state boards of nursing
Licensing powers
Licensure examinations
Mobility of nurses: Licensure by endorsement
Nurse licensure compact
Legal risks in professional nursing practice
Malpractice
BOX 4-1 MALPRACTICE: PROFESSIONAL NEGLIGENCE
CRITICAL THINKING CHALLENGE 4-1
BOX 4-2 STANDARDS OF CARE: A CASE EXAMPLE
Delegation
BOX 4-3 SIX MAJOR CATEGORIES OF NEGLIGENCE THAT RESULT IN MALPRACTICE LAWSUITS
BOX 4-4 FIVE RIGHTS TO ENSURE SAFE DELEGATION
Informed consent
Confidentiality
FIG 4-2 Professional nurses may be called on to witness a patient’s signing of informed consent documents. The primary provider, however, is responsible for providing necessary information to the patient or legal guardian.
FIG 4-3 Nurses have an obligation for confidentiality but are not protected by privileged communication statutes. In some cases, nurses are required to report what a patient has told them.
The health insurance portability and accountability act of 1996
Social media: Maintaining confidentiality and hipaa standards
BOX 4-5 A CAUTIONARY TALE: THE FAR-REACHING EFFECT OF DIGITAL TECHNOLOGY
Assault and battery
Evolving legal issues and the nurse
Role changes in health care
Prescriptive authority
Supervision of unlicensed assistive personnel
EVIDENCE-BASED PRACTICE NOTE
Payment mechanisms for nurses
Patient self-determination act
Preventing legal problems in nursing practice
Practice in a safe setting
Communicate with other health professionals, patients, and families
Meet the standard of care
BOX 4-6 FOUR DOCUMENTS YOU SHOULD OWN
Carry and understand professional liability insurance
BOX 4-7 BASIC TYPES OF PROFESSIONAL LIABILITY INSURANCE POLICIES
Occurrence policies
Claims-made policies
BOX 4-8 GUIDELINES FOR PREVENTING LEGAL PROBLEMS IN NURSING PRACTICE
Promote positive interpersonal relationships
Summary of key points
Critical thinking questions
Activities
References
CHAPTER 5 Ethics: Basic concepts for nursing practice
Learning outcomes
BOX 5-1 TO BE GUARDIANS OF THE ETHICAL TREATMENT OF PATIENTS
Basic definitions
BOX 5-2 NURSES’ ETHICAL REASONING SKILLS MODEL
CRITICAL THINKING CHALLENGE 5-1
Approaches to moral reasoning
Kohlberg’s stages of moral reasoning
Gilligan’s stages of moral reasoning
EVIDENCE-BASED PRACTICE NOTE
Ethical theories
Deontology
Utilitarianism
Virtue ethics
Principalism
Ethical principles
Autonomy
Beneficence
Nonmaleficence
Justice
CULTURAL CONSIDERATIONS CHALLENGE
Fidelity
Veracity
BOX 5-3 THE FLORENCE NIGHTINGALE PLEDGE
Nursing codes of ethics
American nurses association’s code of ethics for nurses
BOX 5-4 INTERNATIONAL COUNCIL OF NURSES CODE OF ETHICS FOR NURSES: PREAMBLE
International council of nurses code of ethics for nurses
Ethical decision making
Ethical decision-making model
TABLE 5-1 COMPARISON OF NURSING PROCESS WITH ETHICAL DECISION-MAKING MODEL
CASE STUDY 5-1 YOUR HOSPICE PATIENT WANTS TO DIE … AND HE WANTS YOU TO HELP HIM
Navigating ethical dilemmas in nursing
Dilemmas resulting from personal value systems
BOX 5-5 CHILDHOOD VALUE MESSAGES
BOX 5-6 DISTRESS IN AN EXPERT LABOR AND DELIVERY NURSE
Dilemmas involving peers’ and other professionals’ behavior
BOX 5-7 ETHICAL USE OF SOCIAL MEDIA
Sociocultural influences posing ethical challenges: Social media and substance abuse
Dilemmas regarding patients’ rights
Patient self-determination act
Ethical issues related to immigration and migration
Dilemmas created by institutional and social issues
Dilemmas created by patient data access issues
Summary of key points
Critical thinking questions
Activities
References
CHAPTER 6 Becoming a nurse: Defining nursing and socialization into professional practice
Learning outcomes
Defining nursing: Harder than it seems
Why define nursing?
Definitions clarify purposes and functions
Definitions differentiate nursing from other health occupations
Definitions influence health policy at local, state, and national levels
Definitions focus educational curricula and research agendas
Evolution of definitions of nursing
Nightingale defines nursing
Early twentieth-century definitions
Post–world war ii definitions
Professional association definitions
American nurses association.
Royal college of nursing.
International council of nurses.
Definitions developed by state legislatures
CRITICAL THINKING CHALLENGE 6-1
Becoming a nurse: Shaping your professional identity
FIG 6-1 During formal socialization, students internalize the knowledge, skills, and beliefs of nursing in planned educational experiences and interactions with faculty and other nurses.
Education and professional socialization
Factors influencing socialization
A new factor influencing socialization: Distance learning
Models of professional socialization
Cohen’s model of basic student socialization
TABLE 6-1 COHEN’S MODEL OF BASIC STUDENT SOCIALIZATION
Benner’s stages of nursing proficiency (basic student socialization)
TABLE 6-2 BENNER’S STAGES OF NURSING PROFICIENCY (BASIC STUDENT SOCIALIZATION)
BOX 6-1 FROM NOVICE TO EXPERT: “HOW DID YOU KNOW THAT?”
Actively participating in one’s own professional socialization
BOX 6-2 A DO-IT-YOURSELF GUIDE TO PROFESSIONAL SOCIALIZATION
Socialization to the work setting
BOX 6-3 TIME MANAGEMENT SELF-ASSESSMENT
FIG 6-2 Setting priorities is an important aspect of time management. Use this grid to determine whether a task should go to the top, middle, or bottom of your daily “to do” list or whether it is a time-waster and should be ignored.
CULTURAL CONSIDERATIONS CHALLENGE
“Reality shock”: When ideals and reality collide
FIG 6-3 Self-care is an important aspect of managing the stress of a new career.
Summary of key points
Critical thinking questions
Activities
References
CHAPTER 7 The education of nurses: On the leading edge of transformation
Learning outcomes
Development of nursing education in the united states
FIG 7-1 Florence Nightingale’s nurses in Scutari, Turkey during the Crimean War. Nightingale’s unstoppable spirit led to the development of education that transformed nursing.
Early studies of the quality of nursing education
FIG 7-2 Enrollments in basic RN programs by program type, 2008.
Educational pathways to becoming a registered nurse
Diploma programs
Baccalaureate programs
Influences on the growth of baccalaureate education
Baccalaureate programs today
FIG 7-3 Clinical experience is a vitally important aspect of every basic nursing program. This student is working with her elderly patient in a hospice setting.
Associate degree programs
BOX 7-1 WENDY WOITH, PhD, RN
Wendy Woith, PhD, RN.
FIG 7-4 St. Basil’s Cathedral on Red Square in Moscow, Russia. Dr. Woith and colleagues have traveled widely in Russia to do research and teach in collaboration with the Russian Nurses Association.
External degree programs
BOX 7-2 LANDMARKS IN THE HISTORY OF NURSING EDUCATION
Articulated programs
Alternative educational programs in nursing
Baccalaureate programs for registered nurses
Programs for second-degree students
Online and distance learning programs
Accreditation of educational programs
Graduate education in nursing
Master’s education
Doctoral education
History of doctoral education in nursing
Current status of doctoral education in nursing
BOX 7-3 A SAMPLE OF CERTIFYING ORGANIZATIONS IN NURSING*
Certification programs
BOX 7-4 AREAS OF CERTIFICATION OFFERED BY THE AMERICAN NURSES CREDENTIALING CENTER (ANCC) IN 2009
Nurse practitioner (NP) certification areas
Clinical nurse specialist (CNS) certification areas
Other advanced-level certification areas
Specialty certifications
Continuing education
Challenges in nursing education
Faculty and other resource shortages threaten nation’s supply of nurses
A step in the transformation of nursing education: Quality and safety education for nurses
BOX 7-5 CHANGING MEANINGS OF QUALITY AND SAFETY IN NURSING EDUCATION
Linda R. Cronenwett, PhD, RN, FAAN.
Summary of key points
Critical thinking questions
Activities
References
CHAPTER 8 Critical thinking, the nursing process, and clinical judgment
Learning outcomes
BOX 8-1 EXPERT CONSENSUS STATEMENT REGARDING CRITICAL THINKING AND THE IDEAL CRITICAL THINKER
Defining critical thinking
Critical thinking in nursing
BOX 8-2 USING CRITICAL THINKING SKILLS TO IMPROVE A PATIENT’S CARE
BOX 8-3 NOVICE THINKING COMPARED WITH EXPERT THINKING
Novice nurses
Expert nurses
BOX 8-4 SELF-ASSESSMENT: CRITICAL THINKING
Characteristics of critical thinkers: How do you measure up?
The nursing process: An intellectual standard
Phases of the nursing process
Phase 1: Assessment
Types of data
FIG 8-1 A face-to-face interview with a patient is a primary means of collecting data and requires good interviewing skills, observation, and listening.
Methods of collecting patient data
Organizing patient data
Confidentiality of patient data
Phase 2: Analysis and identification of the problem
Distinctions between medical and nursing diagnosis
BOX 8-5 WRITING NURSING DIAGNOSES
Writing nanda-i nursing diagnoses.
Prioritizing nursing diagnoses
BOX 8-6 BLOOM’S TAXONOMY
Phase 3: Planning
Writing patient goals and outcomes
CULTURAL CONSIDERATIONS CHALLENGE
Selecting interventions and writing nursing orders
Types of nursing interventions.
Writing the plan of care
FIG 8-2 The nursing process is a dynamic, nonlinear tool for critical thinking about human responses.
Phase 4: Implementation of planned interventions
Phase 5: Evaluation
Dynamic nature of the nursing process
BOX 8-7 NURSING PROCESS CASE STUDY OF A HIGH-PRIORITY DIAGNOSIS
Developing clinical judgment in nursing
BOX 8-8 CLINICAL JUDGMENT: NINE KEY QUESTIONS
BOX 8-9 SELF-ASSESSMENT: DEVELOPING SOUND CLINICAL JUDGMENT
Summary of key points
Critical thinking questions
Activities
References
CHAPTER 9 Communication and collaboration in nursing
Learning outcomes
Therapeutic use of self
The traditional nurse-patient relationship
The orientation phase
Developing trust.
Tasks of the orientation phase.
The working phase
The termination phase
BOX 9-1 DIFFERENCES IN SOCIAL AND PROFESSIONAL RELATIONSHIPS
Social relationships
Professional relationships
Developing self-awareness
Professional boundaries
Reflective practice
BOX 9-2 NURSE’S RELATIONSHIP WITH PATIENT RESULTS IN DISCIPLINARY ACTION
BOX 9-3 PRINCIPLES FOR DETERMINING PROFESSIONAL BOUNDARIES
BOX 9-4 MODEL FOR STRUCTURED REFLECTION
Avoiding stereotypes
Becoming nonjudgmental
Thinking differently about nurses and patients: Caring and human relatedness
Patient-centered care
FIG 9-1 Nonverbal communication consists of grooming, clothing, gestures, posture, facial expressions, tone and volume of voice, and actions. Nonverbal communication is particularly important to patients using mechanical ventilation or whose ability to speak is otherwise impaired.
Communication theory
Levels of communication
Elements of the communication process
FIG 9-2 The five major elements of the communication process.
Operations in the communication process
Perception
Evaluation
Transmission
Factors influencing perception, evaluation, and transmission
How communication develops
Criteria for successful communication
Feedback
Appropriateness
Efficiency
Flexibility
Becoming a better communicator
Listening
BOX 9-5 COMMUNICATION PATTERNS SELF-ASSESSMENT
Using helpful responding techniques
FIG 9-3 Being an active listener is an important part of communication. Identify three things in this photograph that demonstrate active listening by the nurse.
Empathy
Open-ended questions
Giving information
Reflection
Silence
Communication across differing languages
BOX 9-6 MINIMIZING LANGUAGE BARRIERS: WORKING WITH A MEDICAL INTERPRETER
CULTURAL CONSIDERATIONS CHALLENGE
Avoiding common causes of communication breakdown
Failing to see the uniqueness of the individual
Failing to recognize levels of meaning
Using value statements and clichés
Giving false reassurance
Failing to clarify
Practicing helpful responses
CRITICAL THINKING CHALLENGE 9-1
Interaction one
Interaction two
Communication with professional colleagues
Effective use of electronic communication devices
Communication in today’s multicultural workplace
FIG 9-4 These two iconic figures—Donna Reed and Janis Joplin—were each emblematic of the sociohistorical and cultural contexts of their respective decades, just a few years apart.
BOX 9-7 SELECTED CHARACTERISTICS OF A MULTIGENERATIONAL NURSING WORKFORCE
Interprofessional collaborative practice: Prescription for improved patient outcomes
BOX 9-8 KEY COMPONENTS NECESSARY FOR EFFECTIVE INTERPROFESSIONAL COLLABORATION
Final comment
Summary of key points
Critical thinking questions
Activities
References
CHAPTER 10 Illness, culture, and caring: Impact on patients, families, and nurses
Learning outcomes
FIG 10-1 In times of illness, roles in families change. A daughter is caring for and comforting her elderly mother.
Illness
Acute illness
Chronic illness
BOX 10-1 TYPES OF ILLNESS
BOX 10-2 COMMENTS OF A PATIENT WITH A CHRONIC DISEASE: SYSTEMIC LUPUS ERYTHEMATOSUS
Adjustment to illness
Disbelief and denial
Irritability and anger
Attempting to gain control
Depression and grief
Acceptance and participation
BOX 10-3 STATES OF ACUTE ILLNESS
The sick role
BOX 10-4 INTERNAL AND EXTERNAL INFLUENCES ON ILLNESS BEHAVIOR
Illness behaviors
Internal influences on illness behaviors
Dependence and independence.
Coping ability.
CASE STUDY 10-1 Dependence vs. Independence
Example 1: Dependence
Example 2: Independence
Resourcefulness.
Resilience.
Spirituality.
FIG 10-2 In this illustration of a hospital scene during the Siege of Paris in 1870, two nuns pray for a dying man. Religion and nursing have been partners for centuries.
External influences on illness behaviors
Past experiences.
Culture.
The culturally competent nurse.
Stereotyping.
CASE STUDY 10-2 CULTURAL EXPRESSION OF PAIN
Communication.
Personal space and structure.
Values.
Role expectations.
Ethnopharmacology.
Ethnocentrism.
FIG 10-3 Nurses administering chemotherapy in an outpatient setting often see the same patients over time. A cultural assessment at the onset of treatment can be useful in helping the patient feel accepted and supported as she faces the challenges of having cancer.
CULTURAL CONSIDERATIONS CHALLENGE
Cultural assessment.
CULTURAL CONSIDERATIONS CHALLENGE
Etiquette and social customs
Nonverbal patterns of communication
Client’s explanation of problem
Nutrition assessment
Pain assessment
Medication assessment
Psychosocial assessment
INTERVIEW
Impact of illness on patients and families
Impact of illness on patients
Guilt
Anger
Anxiety
BOX 10-5 LEVELS OF ANXIETY
Mild anxiety
Moderate anxiety
Severe anxiety
Panic
Symptoms of anxiety.
Responses to anxiety.
Stress
Differentiating between stress and anxiety.
Internal, external, and interpersonal stressors.
Responses to stress.
Stress and illness.
Coping with stress.
BOX 10-6 BREATHING EXERCISES
BOX 10-7 RELAXATION EXERCISES
Neck and shoulders
Arms and hands
Head
Stomach
Legs and feet
Coping with stress through education.
BOX 10-8 PERSONAL STRESS INVENTORY
BOX 10-9 BARRIERS TO PATIENT LEARNING
BOX 10-10 PRINCIPLES OF ADULT LEARNING
Impact of illness on families
BOX 10-11 BASIC TEACHING TIPS FOR PATIENTS AND FAMILIES
BOX 10-12 POTENTIAL REACTIONS TO ILLNESS IN A FAMILY MEMBER
Impact of caregiving on nurses
Caring for self while caring for others
BOX 10-13 CREATE A BALANCED LIFE CARE PLAN FOR YOURSELF
Magnet recognition program
FIG 10-4 By spending time having fun outside of the hospital, these nurses are taking care of themselves. Self-care is crucial in creating a long and healthy nursing career.
Developing and maintaining a life-work balance
Summary of key points
Critical thinking questions
Activities
References
CHAPTER 11 The science of nursing and evidence-based practice
Learning outcomes
FIG 11-1 Florence Nightingale’s painstaking detailing of mortality statistics in the Crimean War demonstrated the effectiveness of nursing care over the course of a year. The area of each colored wedge, measured from the center, is proportional to the statistic being represented. Blue wedges represent deaths from contagious diseases such as cholera and typhus; pink wedges, deaths from wounds; and gray wedges, deaths from all other causes. Originally from Nightingale’s book Notes on Matters Affecting the Health, Efficiency and Hospital Administration of the British Army, published in 1858.
Science and the scientific method
Basic, clinical, and translational science
Inductive and deductive reasoning
Limitations of the strict definition of scientific method in nursing
What is nursing research?
TABLE 11-1 COMPARISON OF RESEARCH AND PROBLEM SOLVING
TABLE 11-2 PICO AS A TOOL FOR EVALUATING INTERVENTIONS (WITH EXAMPLE)
Evidence-based practice: Bridging the gap between research and practice
BOX 11-1 NATIONAL INSTITUTE OF NURSING RESEARCH: MISSION, GOAL, AND INVESTMENT IN THE SCIENCE OF HEALTH
BOX 11-2 SIGMA THETA TAU INTERNATIONAL
The research process
Identification of a researchable problem
Review of the literature
Formulation of the research question or hypothesis
Design of the study
Data-collection instruments
Data-collection protocol
BOX 11-3 NURSING RESEARCH
BOX 11-4 NURSING RESEARCH
Data analysis plan
Participant selection
Informed consent and institutional review
CULTURAL CONSIDERATIONS CHALLENGE
Implementation of the study
Data collection
Data analysis
Drawing conclusions based on findings
Discussion and/or clinical implications
Dissemination of findings
Relationship of nursing research to nursing theory and practice
Financial support for nursing research
Roles of nurses in research
TABLE 11-3 LEVELS OF EDUCATIONAL PREPARATION AND PARTICIPATION IN NURSING RESEARCH
Summary of key points
Critical thinking questions
Activities
References
CHAPTER 12 Conceptual and philosophical bases of nursing
Learning outcomes
FIG 12-1 This is the foundation of nursing—its concepts and subconcepts basic to the profession.
Systems
FIG 12-2 Major components of a general systems model.
Components of systems
Examples of systems
Open and closed systems
BOX 12-1 KEY CONCEPTS ABOUT SYSTEMS
Dynamic nature of systems
Application of the systems model to nursing
Person
FIG 12-3 Maslow’s hierarchy of needs. Understanding this hierarchy helps nurses prioritize their care.
Human needs
Maslow’s hierarchy of needs
Assumptions about needs
Adaptation and human needs
Homeostasis
Environment and suprasystem
Family systems
Nuclear and extended families
Single-parent families
Cultural systems
CULTURAL CONSIDERATIONS CHALLENGE
Social systems
Social change
Social support
Poverty
BOX 12-2 RECENT LIFE CHANGES QUESTIONNAIRE
Community, national, and world systems
Nurses’ potential impact on the environment/suprasystem
FIG 12-4 The health-illness continuum—a holistic health model.
Health
Defining health
A national health initiative: Healthy people 2020
BOX 12-3 HEALTHY PEOPLE 2020: TOPIC AREAS AND LEADING HEALTH INDICATORS
Health beliefs and health behaviors
FIG 12-5 People of all ages are recognizing the benefits of regular exercise.
Health beliefs model
Self-efficacy and health-related behaviors
Locus of control and health-related behaviors
Nurses and health beliefs models
“Dr. google” and the influence of the internet
BOX 12-4 ASSESSING HEALTH-RELATED SITES ON THE INTERNET
Devising a personal plan for high-level wellness
Putting it all together: Nursing
Holistic nursing
BOX 12-5 SELF-ASSESSMENT: DEVELOPING A PERSONAL PLAN FOR HIGH-LEVEL WELLNESS
Beliefs
FIG 12-6 Professional nurses maintain a posture of acceptance and calm, even when patients appear to be angry or upset. This man may simply be very sad or anxious.
Three categories of beliefs
Values
Nature of human values
Process of valuing
BOX 12-6 PROFESSIONAL NURSING VALUES
Values clarification
BOX 12-7 CLARIFYING YOUR VALUES
Choosing freely
Choosing among alternatives
Choosing after considering the consequences
Complement to other values
Prize and cherish
Public affirmation
Action
Values undergirding nursing’s social policy statement
Philosophies and their relationship to nursing care
Branches of philosophy
Philosophies of nursing
Individual philosophies
Collective philosophies
BOX 12-8 DEVELOPING YOUR OWN PHILOSOPHY OF NURSING
Use this guide to write your own your philosophy of nursing.
Philosophy of nursing in a hospital setting.
Philosophy of a school of nursing.
Developing a personal philosophy of nursing
Summary of key points
Critical thinking questions
Activities
References
CHAPTER 13 Nursing theory: The basis for professional nursing
Learning outcomes
BOX 13-1 NURSING THEORY AND THE PROFESSIONAL NURSE
TABLE 13-1 THREE PHILOSOPHIES OF NURSING: THREE DIFFERENT RESPONSES TO THE SAME PATIENT SITUATION
Philosophies of nursing
Nightingale’s philosophy
FIG 13-1 Virginia Henderson.
Using nightingale’s philosophy in practice
Henderson’s philosophy
BOX 13-2 REMEMBERING VIRGINIA HENDERSON
Using henderson’s philosophy in practice
BOX 13-3 HENDERSON’S 14 BASIC NEEDS OF THE PATIENT
BOX 13-4 WATSON’S 10 CARITAS PROCESSES
Watson’s philosophy
Using watson’s philosophy in practice
Clinical example: Watson’s philosophy of caring
Conceptual models of nursing
TABLE 13-2 THREE MODELS OF NURSING: THREE DIFFERENT RESPONSES TO THE SAME PATIENT SITUATION
Orem’s self-care model
Orem and nursing practice
King’s interacting systems framework and theory of goal attainment
Using king’s model in practice
Roy’s adaptation model
Using roy’s model in practice
Clinical example: Roy’s adaptation model
TABLE 13-3 THREE THEORIES OF NURSING: THREE DIFFERENT RESPONSES TO THE SAME PATIENT SITUATION
Theories of nursing
Peplau’s theory of interpersonal relations in nursing
Using peplau’s theory in practice
Orlando’s nursing process theory
Using orlando’s theory in practice
Leininger’s theory of culture care diversity and universality
Using leininger’s theory in practice
FIG 13-2 Leininger’s sunrise model, created to facilitate the application in practice of the Theory of Culture Care Diversity and Universality.
Clinical example: Leininger’s theory of culture care diversity and universality
Middle-range theories of nursing
CULTURAL CONSIDERATIONS CHALLENGE
The theoretical challenges for nursing education, practice, and research
Theory-based education
BOX 13-5 IMPORTANCE OF THEORY AT FOUR LEVELS OF NURSING EDUCATION
CRITICAL THINKING CHALLENGE 13-1
Theory-based practice
Theory-based research
Summary of key points
Critical thinking questions
Activities
References
CHAPTER 14 Health care in the United States
Learning outcomes
Today’s health care system
FIG 14-1 Healthy People 2020 Framework. U.S. Department of Health and Human Services, Office of Disease Prevention and Health Promotion. Available at www.healthypeople.gov.
BOX 14-1 EXAMPLES OF HEALTH PROMOTION AND MAINTENANCE, EARLY DETECTION, AND ILLNESS PREVENTION ACTIVITIES
Health promotion/maintenance
Early detection
Illness prevention
Major categories of health care services
Health promotion and maintenance
Illness prevention
Diagnosis and treatment
Rehabilitation and long-term care
Classifications of health care agencies
Governmental (public) agencies
Federal agencies.
State agencies.
Local agencies.
Voluntary (private) agencies and non-governmental organizations
Not-for-profit or for-profit agencies
Level of health care services provided
Primary care services.
Secondary care services.
Tertiary care services.
Subacute care services.
Organizational structures within health care agencies
Organizational structure
BOX 14-2 BOARD OF DIRECTORS RESPONSIBILITIES (NOT-FOR-PROFIT ORGANIZATIONS)
Board of directors.
Chief executive officer.
Medical staff.
Medical staff governance.
Nursing staff.
Nursing organization governance.
Maintaining quality in health care agencies
FIG 14-2 This is a simple version of an organizational chart showing lines of responsibility in a large health care setting.
Accreditation of health care agencies
Continuous quality improvement and total quality management
A continuing challenge: Health care disparities
CULTURAL CONSIDERATIONS CHALLENGE
1. Infant mortality
2. Cancer screening and management
3. Cardiovascular disease
4. Diabetes
5. Human immunodeficiency virus infection/AIDS
6. Immunizations
The health care team
Physicians
Physician assistants
Unlicensed assistive personnel
Licensed practical nurses/licensed vocational nurses
Dietitians
Pharmacists
FIG 14-3 An important part of the work of pharmacists is consulting with patients about their medications.
FIG 14-4 Collection and safe management of blood are critical aspects of care in the hospital.
Technologists
Respiratory therapists
Social workers
Therapists
Administrative support personnel
The nurse’s role on the health care team
Provider of care
TABLE 14-1 KEY ELEMENTS OF THE ROLE OF NURSE ADMINISTRATOR
Educator
Manager
Researcher
Collaborator
Patient advocate
Nursing care delivery models
BOX 14-3 PRINCIPLES FOR SELECTING A CARE DELIVERY MODEL
BOX 14-4 ADVANTAGES AND DISADVANTAGES OF TEAM NURSING
Advantages
Disadvantages
Team nursing
FIG 14-5 Sick infants and those born prematurely frequently have long stays in neonatal intensive care units, where primary nursing is often practiced.
Primary nursing
Case management nursing
BOX 14-5 ADVANTAGES AND DISADVANTAGES OF PRIMARY NURSING
Advantages
Disadvantages
BOX 14-6 ADVANTAGES AND DISADVANTAGES OF CASE MANAGEMENT NURSING
Advantages
Disadvantages
Patient-centered care
BOX 14-7 ADVANTAGES AND DISADVANTAGES OF PATIENT-CENTERED CARE
Advantages
Disadvantages
Financing health care
Basic economic theory
Supply and demand
Principles of the free-market economy
Price sensitivity in health care
Additional influences on the health care market
Economics of nursing care
EVIDENCE-BASED PRACTICE NOTE
History of health care finance
Current methods of payment for health care
Private insurance
Medicare
Medicaid
TABLE 14-2 FACTS ABOUT MEDICARE AND MEDICAID
Personal (out-of-pocket) payment
Workers’ compensation
Nurses’ role in managing health care costs
FIG 14-6 How the U.S. health care dollar is spent: Hospital care and physician/clinical services account for more than half of health care expenditures.
Health care reform and universal access
Summary of key points
Critical thinking questions
Activities
References
CHAPTER 15 Political activism in nursing: Communities, organizations, government
Learning outcomes
FIG 15-1 The State of the Union address is delivered once a year by the President of the United States to a joint session of Congress and is attended by the justices of the Supreme Court and members of the President’s Cabinet. All three branches of government are represented at this important address.
FIG 15-2 President Barack Obama at a White House signing ceremony of the SCHIP legislation 2 weeks after taking office in January, 2009. He said, “I refuse to accept that millions of our children fail to reach their full potential because we fail to meet their basic needs.”
Policy and politics
Power, authority, and influence
Policy
Politics
Linking practice, policy, and politics
Professional organizations
Joining a professional organization
Types of associations
Purpose and activities of organizations
Nurses and unions
Benefits of belonging to professional associations
Developing leadership skills
FIG 15-3 “When nurses are on the outside, there’s something wrong on the inside.” – So noted DeAnne McEwen, Co-President of the CNA at a rally and 1-day RN strike on September 22, 2011. Twenty-three thousand RNs, members of the CNA/NNU, were protesting proposed cuts in nurses’ health care coverage and retiree benefits and widespread cuts in patient care services. Nurses carried signs that read, “Some cuts don’t heal.”
Certification and continuing education
BOX 15-1 ATTRIBUTES AND COMPETENCIES NEEDED BY FUTURE NURSE LEADERS AND MANAGERS*
Political activism
Practice guidelines and position statements
Other benefits
Deciding which associations to join
Political activism in the governmental arena
BOX 15-2 NATIONAL STUDENT NURSES ASSOCIATION’S CODE OF ACADEMIC AND CLINICAL CONDUCT
Preamble
A code for nursing students
Becoming active in politics: “The personal is political”
FIG 15-4 Gale Adcock, MSN, RN, FNP.
BOX 15-3 A NURSE’S VOICE IN LOCAL POLITICS
Getting involved
BOX 15-4 COMMUNICATION IS THE KEY TO INFLUENCE
FIG 15-5 Lillian Wald was an early nurse activist who is credited with establishing public health nursing. Her tireless work on behalf of impoverished immigrants in New York City embodied her belief that the work of nurses was significant in improving the health of vulnerable people. She was also a member of the founding group of the National Association for the Advancement of Colored People.
Nurse citizens
Nurse activists
BOX 15-5 KEY QUESTIONS FOR NURSES WHO WANT TO MAKE A DIFFERENCE IN HEALTH POLICY
FIG 15-6 Rep. Eddie Bernice Johnson (D-Texas), nurse in Congress.
FIG 15-7 Rep. Carolyn McCarthy (D-N.Y.), nurse in Congress.
Nurse politicians
FIG 15-8 Rep. Lois Capps (D-Calif.), nurse in Congress.
FIG 15-9 Sen. Richard Durbin (D-Ill.), friend of nursing.
FIG 15-10 Sen. Barbara Mikulski (D-Md.), friend of nursing.
We were all once novices
Nursing awaits your contribution
Summary of key points
Critical thinking questions
Activities
References
CHAPTER 16 Nursing’s challenge: The call for transformation
Learning outcomes
FIG 16-1 “One is silver and the other gold.” We can honor the best of our past and traditions, yet transform nursing to meet the exciting challenges of the changing times.
FIG 16-2 From the “Unsung Heroes” Project, artist Stacey Bentley created this badge that symbolizes the story of Nurse Annette Barwick, a charge/triage maternity nurse at the Royal Infirmary. Nurse Barwick related her pride in her nursing caps, first wearing disposable paper caps as a student (represented at the top), then getting the blue stripe on her nursing cap at graduation (in the middle), and finally receiving her “real” cap with a stripe at graduation (bottom). This project honors the material traditions of nursing.
The challenge: Care of self
The challege: Care of the profession
Joining professional organizations
Protecting the image of nursing
Maximizing your education
Promoting civility
FIG 16-3 The continuum of incivility goes from simple acts such as being distracting and eye-rolling to aggressive behaviors and bullying.
The challenge: Care of the environment
FIG 16-4 Sea ice thickness comparison (10-year average), using 1955 as the baseline and projecting to 2050.
The natural environment
The work environment
Genetics and genomics
The final challenge: Focus, unite, act
Summary of key points
Critical thinking questions
Activities
References
NANDA Approved Nursing Diagnosesmedia
Epilogue
Glossary
A
B
C
D
E
F
G
H
I
J
K
L
M
N
O
P
Q
R
S
T
U
V
W
Y
Index
A
B
C
D
E
F
G
H
I
J
K
L
M
N
O
P
Q
R
S
T
U
V
W
The code of ethics for nurses
Provision 1.
Provision 2.
Provision 3.
Provision 4.
Provision 5.
Provision 6.
Provision 7.
Provision 8.
Provision 9.
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Test bank for Professional Nursing Concepts and Challenges 7th Edition by Beth Black RN MSN PhD