Diverse Client Terms
A set of beliefs, attitudes, and practices shared by a group of people or community that is accepted, followed, and passed down to other members of the group.
Culture
An assistive personnel reports a client's vital signs as tympanic temperature 98.8, pulse 92, RR 18, and B/P: 98/58.
1. B/P
2. Pulse
3. Temperature
4. RR
B/P
Subjective or objective data that gives the nurse a hint or indication of a potential problem, process, or disorder.
Cue
The nursing process steps are?
ADPIE
Assessment, diagnose, planning, implementation, evaluation
Recognize cue, analyze/prioritize, generate solutions, take action
Noticing, Interpreting, Responding, Responding
Hidden blood in the stool not visible to the naked eye.
Occult blood
The process of adopting or conforming to the practices, habits, and norms of a cultural group. As a result, the person gradually takes on a new cultural identity and may lose their original identity in the process.
Assimilation
Which statement or command made by the nurse is an example of the evaluation phase of the nursing process?
1. “Mr. Sullivan may be able to ambulate with the use of a walker and stand-by assistance.”
2. “Mr. Sullivan will be able to walk the length of the hallway before discharge.”
3. “Ambulate Mr. Sullivan in the hallway three times today, please.”
4. “I wish Mr. Sullivan were able to walk the length of the hallway by now, but he is not meeting this goal.”
4. “I wish Mr. Sullivan were able to walk the length of the hallway by now, but he is not meeting this goal.”
The assignment of the performance of activities or tasks related to patient care to unlicensed assistive personnel while retaining accountability for the outcome.
Delegation
"My pain is out of control" says the patient. What type of information is this?
Subjective Data
Also referred to as “overactive bladder”; urine leakage accompanied by a strong desire to void.
Urge urinary incontinence
A principle and moral obligation to act on the basis of equality and equity; a standard linked to fairness for all in society
Justice
A client who immigrated from Pakistan informs the nurse of his dietary request. The nurse responds to the special dietary needs by stating, “You are now living here, and you should try to start eating those foods common to our diet.” This inappropriate response is an example of:
1. Cultural blindness
2. Cultural imposition
3. Cultural assimilation
4. Cultural diversity
2. Cultural imposition
Interventions that require a prescription from a physician, advanced practice nurse, or physician’s assistant.
Dependent nursing interventions
This lab determines the glomerular filtration rate.
Creatinine clearance
A measurement of urine left in the bladder after a patient has voided by using a bladder scanner or straight catheterization.
Postvoid residual
The process of applying evidence-based nursing in agreement with the preferred cultural values, beliefs, worldview, and practices of patients to produce improved patient outcomes.
Cultural competency
A nurse is creating a discharge plan. Which of the following nursing statements indicates the nurse understands when discharge planning should be implemented?
1. “I will begin 48 hr before the client’s discharge.”
2. “I will begin once the client’s discharge order is written.”
3. “I will begin upon the client's admission to the facility.”
4. “I will begin once the client’s insurance company approves discharge coverage.”
3. “I will begin upon the client's admission to the facility.”
Statements of measurable action for the patient within a specific time frame and in response to nursing interventions. “SMART” outcome statements are specific, measurable, action-oriented, realistic, and include a time frame.
Expected outcomes
The patient is describing her daily meal regimen, grocery list, and how she maintains a balanced diet. What functional health pattern is this considered to be in?
Nutrition
Occurs in older adults who have normal bladder control but have a problem getting to the toilet because of arthritis or other disorders that make it hard to move quickly
Functional incontinence
Assuming that a person has the attributes, traits, beliefs, and values of a group because they are a member of that group.
Stereotyping
A nurse is receiving change of shift report for a group of assigned clients. The nurse anticipates which of the following activities first in delivering client care using the nursing process?
1. Critically analyze client data to determine priorities.
2. Collect and organize client data.
3. Set client centered, measurable, and realistic goals.
4. Determine effectiveness of interventions.
3. Collect and organize client data.
A disease or illness diagnosed by a physician or advanced health care provider such as a nurse practitioner or physician’s assistant.
Medical diagnosis
A high result in this test would indicate dehydration.
What is specific gravity.
At least 10 white blood cells in each cubic millimeter of urine in a urine sample that typically indicates infection. In some cases, pus may be visible in the urine.
Pyuria