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Using Rosdahl’s Textbook of Basic Nursing, 12th Edition
The Nature of Nursing
Personal and Environmental Health
Finance and Health Care Prevention and Health Care The Well-Illness Continuum Lifestyle and Risk Factors Health Education and Promotion Age-Related Health Concerns Categories of Diseases and Disorders. Health care at the national level Health care at the state level Health care at the local level Environment.
Development Throughout the Life Cycle
Structure and Function
Structure and function Cells of the nervous system Divisions of the nervous system Transmission of nerve impulse reflexes.
Nutrition and Diet Therapy
The Nursing Process
Safety In the Healthcare Facility
Client Care
Disinfection and sterilization Medical and surgical asepsis Sterile technique (Surgical asepsis) Procedures requiring sterile technique. Basic needs related to the experience of death Health care of the dying client's family Signs of approaching death.
Pharmacology and Administration of Medications
Antibiotics and other anti-infective agents Medications that affect the integumentary system Medications that affect the nervous system Medications that affect the endocrine system Medications that affect the sensory system Medications that affect the cardiovascular system Medications that affect the blood. Medicines that affect the immune system. Medicines that affect the respiratory system. Medicines that affect the gastrointestinal system. Medicines that affect the urinary system.
Maternal and Newborn Nursing
Complications of Labor and Delivery Umbilical Cord Complications Considerations regarding delivery complications during the postpartum period when a newborn dies. Nursing Considerations for the Potential Complications in High-Risk Neonates in High-Risk Hemolytic Disease of Newborns.
Pediatric Nursing
Blood and lymphatic diseases Respiratory diseases Gastrointestinal diseases Urinary tract disorders The reproductive system.
Adult Care Nursing
Common Medical Treatments Common Surgical Treatments The Eye and Vision Disorders Trauma to the Eye.
Gerontologic Nursing
Mental Health Nursing
Nursing in a Variety of Settings
Home Care Team Members Nursing Duties in Home Care Home Care Team Safety Tips for Primary Caregivers.
The Transition to Practicing Nurse
Summary of Special Displays
Nursing Procedures
64-7 Converting Continuous Intravenous (IV) Infusion to Intermittent Line (Saline Stop, Flushing Saline Stop; Administering Medications Via Saline Lock 1009. 64-10 Administering Intravenous Infusion Medications Via Piggyback Setup (Small Delivery System amounts, administration of drugs via Controlled volume infusion 1013.
Nursing Care Guidelines
54-4 Administer a lukewarm sponge to lower body temperature 794 56-1 Care of the client receiving anesthesia 817 56-2 Organizing preoperative nursing care 819. 87-2 Nursing priorities for the client receiving mechanical ventilation - 15 15 Ventilation 8 Care before and after barium studies 1585.
The Origins of Nursing
Learning Objectives
Important Terminology
Introduction
This textbook uses the term client because the term client reflects the roles of the nurse who actively interacts with individuals, families, and the health care system.
Nursing’s Heritage
Early Influences
Aesculapius was often depicted with a snake coiled around a rod or staff; this rod is a symbol of medicine. Another medical symbol is the caduceus, the staff of the Roman god Mercury, depicted as a winged staff with two serpents coiled around it.
The Influence of Hippocrates
Relatively unchanged from the beginning is the concept that the nurse must be aware of the whole client. The nurse is aware of the client's emotions, lifestyle, physical changes, spiritual needs and individual challenges.
The Roman Matrons
By emphasizing the importance of caring for the whole person (holistic health care), he helped lay the foundation for nursing and. The holistic approach translates into the nurse's attention to a client's personal needs from various perspectives.
Monastic and Military Nursing Orders
The Reformation
Fliedner in Kaiserswerth
Florence Nightingale
Her dedicated service both day and night, when she and her nurses went around with oil lamps, created a public image of the lady with the lamp. Today, many nursing schools display a model of the lamp or a picture of Florence Nightingale carrying a lamp.
Nightingale’s Definition of Nursing
Lamp of learning") is a sign of nursing and nursing education. The lamp represents the warmth of care.
The Nightingale School
Entrance exams and academic and personal requirements, including reference to marks Records of each student's progress - later known as the "Nightingale Plan", the model for current nursing programs. Graduate Employment Record or Formal Register - The Beginnings of Nursing Standards.
NCLEX Alert
Nursing in the United States
The First Nursing Schools
Notable American Nurses
She graduated in the early 1870s and organized the school of nursing at the Massachusetts General Hospital, then called the Boston. The Henry Street Settlement was a neighborhood nursing service that became a model for similar programs in the United States and other countries.
Collegiate Nursing Education
The History of Practical Nursing Education
Pioneer Schools
Ballard School
Thompson Practical Nursing School
Household Nursing School
American Red Cross Training
Practical Nursing in Vocational and Community Colleges
Other Milestones in Practical Nursing Education
Nursing During Wartime
Due to Densford's efforts, the student population at the University of Minnesota multiplied by five within weeks; more than 1200 cadets graduated from that school alone. Male nurses were not given equal rank with female nurses in the Armed Forces, however, until 1954.
Current Nursing Trends
Cadet Nurse Corps was established during World War II, with Lucile Petry Leone as Director. She promised to train extensive numbers of nurses within a short time, if the government abandoned the nurse draft.
Higher Client Acuity in Hospital and Long-Term Settings
World War II also marked the first time that men as well as women were actively recruited into nursing.
Shift to Community-Based Care
Technology
Social Factors
Lifestyle Factors and Greater Life Expectancy
Changes in Nursing Education
Autonomy
Nursing Insignia
Nursing Uniforms
The Nursing School Pin
STUDENT SYNTHESIS
KEY POINTS
CRITICAL THINKING EXERCISES
NCLEX-STYLE REVIEW QUESTIONS
The nurse caring for a client must be aware of the client's emotions, lifestyle, physical changes, spiritual needs and individual challenges. When attending to these needs, the nurse provides what type of care.
CHAPTER RESOURCES
Beginning Your Nursing Career
Identify the standards of the National Association of Licensed Nurses regarding each of the following: education, legal status, and practice. Explain the importance of nursing theory and how a theoretical framework helps nurses learn, understand and practice.
Acronyms
Factors affecting nursing activity include new discoveries in the biomedical field, development of new health care knowledge, changes in patterns of health services and payment, and the relationships between health care team members. This chapter discusses various nursing education programs, approval and accreditation, licensing, the role and image of the nurse, and nursing organizations.
Healthcare: A Multidisciplinary Approach
Physician Assistant (PA) – Academically and clinically trained in medicine under the supervision of a Doctor of Medicine or Osteopathy. Risk Manager—Identifies and remediates potential high-risk situations in healthcare. Social worker—trained to assess and improve social, emotional, and environmental problems associated with the health profession.
Types of Nursing Programs
Registered Nurses
Basic Education
Advanced Nursing Credentials
The American Nurses Association (ANA) awards several types of NP certifications and Clinical Nurse Specialist certifications, as well as many specialties. Examples of NP certifications include Family NP, Adult Gerontology, Acute Care NP, and Psychiatric Mental Health NP.
Practical Nurses/Vocational Nurses
Practical/Vocational Nursing Education
Approval and Accreditation of Nursing Programs
Approved Nursing Programs
Accredited Nursing Programs
If a nursing program is accredited, the program has met criteria set by that agency. As a nursing student, you should understand that there is a difference between approval and accreditation of a nursing program.
Licensure of Nurses
Health care consumers are protected because minimum levels of competency are established and enforced by state regulatory agencies (ie, State Boards of Nursing). However, each State Board of Nursing has its own fees that the individual pays for a license in that state.
The Nurse’s Pledge
The mandatory law defines the duties, tasks and responsibilities of a nurse and the use of the title "nurse". Many ethical principles are reflected in the Nurse's Pledge, which many students recite at graduation.
Florence Nightingale Pledge
The Practical Nurse’s Pledge
Theories of Nursing
Roles and Responsibilities of the Nurse
Contemporary Nursing Roles
Nurse Practitioners write care plans with input from other health care staff – many staff use this important plan. Nurses record information in daily reviews or nursing notes, record medications and treatments, and communicate with other members of the healthcare team in daily reports and team meetings to maintain continuity of care.
The Nurse’s Image
Nurses listen to and support clients' concerns; and report accurately to appropriate team members. Remember that many of the measures listed in Box 2-3 are important not only to project a professional image, but also to maintain maximum levels of safety, hygiene and protection for you and your customers.
Today’s Nursing Student
Mature learners may need to master new skills in addition to learning their nursing skills. For example, some adult learners have not worked much with computers, e-mail or the Internet.
Nursing Organizations
National Organizations
National Association for Practical Nurse Education and Service
National Association of Licensed Practical Nurses, Inc
It is the only organization run entirely by LVN/LPNs and for LVN/LPNs.
National League for Nursing
HOSA
American Nurses Association
State Affiliates of National Organizations
International Council of Nursing
There are differences in the training and level of nursing practice between RNs and LVN/LPNs. Call the state board of nursing to let them know you must practice in that state.
The Healthcare Delivery System
Define and discuss differences between acute care and extended care facilities and identify the types of health care services provided in each type of health care facility. The student and the consumer should be aware of different types of health care facilities and payment plans, as well as the general types of health care services.
Healthcare Trends in the 21st Century
In the 21st century, health care involves discussion between a variety of doctors, insurance providers who agree to pay for the treatment or therapy, and the client. Hospitalizations are of shorter duration, and as a result the client is often discharged while still in need of health services.
The Affordable Care Act
The Nurse’s Role
Employment for nurses in all these areas is expected to increase in the future. As a nurse, you must understand and articulate the value of a well-trained workforce to 21st century healthcare.
Healthcare Settings and Services
Acute Care Facilities
Acute Care Hospitals
Intensive Care Units
Subacute Care Facilities
Outpatient Care Centers
Specialized Hospitals
Home Healthcare
Home health nursing and hospice care have greatly improved the quality of health care available in the home. The older adult clients who have dementia may have difficulty driving at home without assistance.
Hospice
Home health agencies and social services can help with discharge planning and arrange home care or public health nursing visits. Hospice care focuses on the transition from life to death and works with the client, family and significant others.
Respite Care
This service may also be part of the services offered by an acute care facility or a separate private agency.
Telehealth
Extended Care Facilities
Community Health Services
Healthcare in School and Industry
Quality Assurance
Hospital Accreditation
Components of Quality Care
Standards for Quality Assurance
Client Representatives or Advocates
In preparation for discharge, the attorney can make sure the family knows where to purchase necessary supplies and.
Organization and Ownership of Healthcare Facilities
Hospital Organization
It is critical that the nurse uses the appropriate system for communication (ie, chain of command) with peers and supervisors. While in your nursing program, your chain of command begins with your instructor.
Hospital Ownership and Funding
To provide care, members of the health care team collaborate in the assessments, planning, and delivery of their care. Team members communicate with each other and with clients so that services are neither duplicated nor skipped.
Governmental Ownership
Profit-Oriented—Proprietary
Nonprofit—Voluntary
Nonprofit—Government
Private Ownership
Financing Healthcare
Mainstreaming school-aged children with physical, emotional and mental challenges; provision of health services to these children as needed.
Insurance and Healthcare
Individual Private Insurance
Individual policies can be obtained through the Health Insurance Marketplace or through various health insurance companies or health insurance agencies.
Group Insurance
Fee-for-Service Plans
Health Maintenance Organizations
The provider is responsible for managing the client in the most appropriate and cost-effective manner to achieve desired outcomes. Just as with any individual plan, HMO members can choose to see any doctor or seek any medical service that is not part of the HMO network.
Features and Services Most HMOs Include
Treatment: When diseases or disorders occur, they are treated, but the HMO makes decisions about the type of treatment. Usually, the co-pay is much higher in the emergency room if urgent care is provided at the same time.
Preferred Provider Organizations
We encourage employees to be examined in an urgent care center instead of in the emergency room for routine illnesses.
Point-of-service Plans
Medicare
Medicaid
People who qualify for Medicare and Medicaid can supplement one program with the other. Be aware of the impact of these changes on clients, their families and healthcare institutions.
Prospective Payment
The program is supported by taxes; thus, people receiving Medicaid benefits do not pay monthly premiums. Medicaid pays for inpatient and outpatient services, including physician or advanced practice nurse services; laboratory and x-ray services; and.
Diagnosis-Related Groups
Impact of Changes in Third-Party Payment
Greater need for outpatient care because procedures previously done in the hospital are done on an outpatient basis. Greater need for collaboration between departments to maximize resources Mergers of several hospitals or nursing homes to form a large corporation Expanded use of computers for data collection and information processing.
Complementary Healthcare
Chiropractic, Physical, and Occupational Therapy
Holistic Healthcare
Holistic health care teaches that individuals can be in control of their own lives and health, and that people can largely determine the quality of their lives. By genuinely caring about your clients and respecting their way of life, you can strengthen their feelings of self-respect and dignity.
Herbalists and Vibrational Remedies
Acupuncture and Acupressure
Acupuncture therapy involves the use of very fine needles inserted into specific energy points under the skin to balance the body's energy flow. It allows the body to heal naturally and does not involve the use of drugs, although herbal extracts and vitamins may be used.
Relaxation and Imagery
Acupuncture views health and its functions as energy balance – and disease as imbalance – in the body. The use of this procedure is increasing in Western culture and is becoming more accepted by traditional allopathic medicine.
Meditation
It can be used for health promotion, such as weight control or smoking cessation, as well as for treatment.
Therapeutic Touch
Consumer Fraud
IN PRACTICE
Key Points
The insurance company refuses to keep the client in the hospital during this course of treatment.
Legal and Ethical Aspects of Nursing
Define and describe the legal and ethical standards of health care and how they relate to nursing. This chapter further explores legal and ethical issues and relates them to the concepts of nursing and health care.
Legal Issues of Nursing Practice
Legal Terminology
A nurse may be liable if a client receives the wrong medication and is harmed (“act of service”). For example, if you cannot safely leave a customer alone, you may be liable if a customer you have is injured while unattended.
HIPAA and Client Privacy
All clients or their dependents are required to sign a HIPAA release upon admission to a healthcare facility, whether inpatient or outpatient. As a nursing student or nurse, you will most likely be asked to sign a HIPAA Privacy Statement each year.
Failure to Comply with These Standards May Result in Civil or Criminal Penalties
Requires healthcare facilities to write policies that allow clients access to their own personal health information. Effective January 2009, the Patient Safety and Quality Improvement Act of 2005, also known as the Patient Safety Act, establishes a voluntary reporting system that improves and enhances increased safety for clients.
Release of Client Information
No Information” Status
The Alias
Examples of clients who are admitted under an alias are politicians, film or rock stars, people who have committed violent crimes and other famous people. If a person is registered under an alias, it is important to use the alias when addressing them, even if you know their first name.
The AKA
Sometimes it is possible to identify a person based on their date of birth. In this case, it is also not known exactly how old the person is, because their age can differ by almost a year.
John Doe Admissions
Some people simply do not know their date of birth and do not know how old they are.
Special Healthcare Concerns
Regulations of Nursing Practice
Legislation for the Practice of Nursing: the Nurse Practice Act
State Boards of Nursing
Councils are subject to legal parameters, but usually they have some leeway in interpreting aspects of the Nursing Practice Act. The law or Nursing Practice Act in each state, province or territory defines regulations for practical and registered nursing.
Cause for Revoking or Suspending a License
For example, a facility may declare that only specially trained nurses may perform certain procedures—even if the Nursing Practice Act states that the nurse may legally perform that procedure. These advanced courses are generally not part of your nursing program and are not listed as educational requirements by the Nursing Practice Act.
The Licensing Examination: the NCLEX
The number of units or hours required is determined by your State Board of Nursing and is typically required for license renewal.
Legal Responsibilities in Nursing
Safeguards for the Nurse and Student
Commonsense Precautions
Follow Accepted Procedures
Be Competent in Your Practice
Ask for Assistance
Document Well
Of course, you will be held liable for committing an illegal or negligent act, whether you document it or not.
Do Not Give Legal Advice to Clients
Do Not Accept Gifts
Do Not Help a Client Prepare a Will
Consider a Malpractice Insurance Policy
Seek the help of an attorney who specializes in medical/nursing malpractice at the first sign that you are involved in an illegal or negligent act or that you may be named in a lawsuit. Malpractice insurance only covers nurses if they act “as any sensible nurse would.” In other words, if you intentionally commit an illegal act or are negligent, barring accidental mistakes, your malpractice insurance and that of your employer are probably not valid.
Legal Concerns of Emergencies
Professional Boundaries
Evaluating every interaction you have with customers is essential to ensure that the relationship is useful and that you are not over or over. If you have questions, your nursing instructor or the facility's nursing supervisor can assist you.
Advance Directives
Nursing Responsibilities Include
Living Will
In the absence of documented evidence to the contrary, the healthcare team uses all available means to keep a person alive. Without living wills or other advance directives, a full "code" is called on all those suffering from cardiac arrest and full resuscitation efforts are made.
Directive to Physicians
Durable Power of Attorney for Healthcare
Mental Health Advance Declaration
Without a living will or other advance directive, a full "code" is called on anyone who suffers a cardiac arrest, and full resuscitation efforts are made. . neuroleptics). Even if the person refusing these treatments is committed as mentally ill or mentally ill and dangerous, these treatments may not be given without a specific court order.
Vulnerable Persons
Definitions of Death
In some cases, one or more electroencephalograms (EEG) are performed to confirm the diagnosis of clinical death. Due to technological interventions, death is defined more as a process of irreversible brain function than a specific state of clinical death.
Exceptions
Before removing organs or tissues for donation, especially when a person's vital processes are maintained artificially, the wishes of the client and family must be harmonized with legal regulations. Severe central nervous system (CNS) depression following an overdose of a central nervous system depressant such as a barbiturate.
Ethical Standards of Healthcare
Prejudice, Personal Values, and Nursing
Quality of Life
Part of the discussion about who receives treatment centers around the expected quality of life after treatment. The client can refuse to provide information, but in this case the quality of treatment may be limited by the lack of information.
Nurses’ Role Regarding Ethics
Ethical Issues in Treatment
Organ Transplantation
Criteria and Questions
Refusal of Treatment
Withholding Treatment
Termination of Treatment
Euthanasia
The Ethics Committee
Clients’ Rights and Responsibilities
Clients’ Rights
Clients’ Responsibilities
The nurse is caring for a client who is confused and climbing out of bed. The nurse can access the electronic medical record (EMR) to find out what the client's diagnosis is.
