#1
Common barriers to effective communication (Anything that interferes with a clear, accurate exchange of information between the nurse and the client) include:
Medical jargon: Using complex healthcare terms that the client does not understand.
Cultural differences not acknowledged: Ignoring beliefs, values, language, or health practices.
Environmental noise: TV, alarms, hallway conversations, or interruptions.
Stereotyping or assumptions: Allowing bias to influence communication.
Lack of privacy: Discussing sensitive information in public areas.
Strong emotions: Anxiety, anger, fear, or pain interfering with understanding.
Language differences: Need a certified medical interpreter.
Tasks the PN Can Delegate to the UAP: NOTE: The PN Cannot delegate assessment, teaching, evaluation, unstable clients or clinical judgment. Retains accountability. Must ensure the UAP is trained and competent.
Examples: Activities of Daily Living (ADLs); Mobility & Positioning; Vital Signs, Height and Weight, Intake and Output, Collecting nonsterile specimens (urine, stool, sputum)
Subjective data is information the patient reports about their feelings, symptoms, or experiences — cannot be directly observed or measured by the nurse. It is based on the patient’s perception. Provide an example.
Examples: “My pain is a 7 out of 10.”
“I feel nauseated.” “I’m anxious about surgery.”
“I’m dizzy when I stand up.”
What is the purpose of the Nursing Code of Ethics?
The Code of Ethics outlines the nurse’s professional values, responsibilities, accountability, and ethical standards of practice. It includes professional expectations for nurses.
Quantitative Research
Research that focuses on numbers, measurements, and statistics. Purpose: To measure, test, and determine cause and effect.
Easy Memory Tip: Quantitative = Quantity = Numbers
Define the therapeutic communication techniques of 1. Active Listening 2. Open-Ended Questions 3.
Offering Self 4. Silence
Active Listening Fully focusing on and responding attentively to the client.
Open-Ended Questions Questions that require more than a yes or no answer.
Offering Self Making oneself available to show presence and support.
Silence Allowing purposeful quiet time for reflection or expression.
Actions by the nurse that decrease the chance of making a medication error.
Follow the Rights of Medication Administration
(Right patient, medication, dose, route, time, documentation, reason, response)
Use two patient identifiers
(Name and date of birth)
Scan the barcode before administering medication
Compare the medication to the medication record three times
Objective data is information the nurse can observe, measure, or verify through assessment. Provide Examples.
Examples: Blood pressure 148/92
Temperature 101.4°F Rash noted on arms
2+ pitting edema Oxygen saturation 88% on room air
What is falsification of documentation?
Documenting care that was not performed is falsification of the medical record.
Falsification: Is unethical; Is considered professional misconduct
Can result in disciplinary action by the Board of Nursing
May have legal consequences
Accurate documentation must reflect the care that was actually provided
Qualitative Research
Research that focuses on experiences, perceptions, and meanings. Purpose: To understand how people feel or interpret events. Memory Tip: Qualitative = Quality = Experiences
Techniques for communicating with a patient with hearing loss
What is a healthcare-associated infection (HAI)
An infection a patient develops while receiving care in a healthcare facility that was not present at the time of admission.
Common Examples of HAIs:
CAUTI – Catheter-Associated Urinary Tract Infection
CLABSI – Central Line-Associated Bloodstream Infection
VAP – Ventilator-Associated Pneumonia
Surgical Site Infection (SSI)
Clostridioides difficile (C. diff) infection
1st Step of the PN Nursing Process
Data Collection Gathering subjective and objective data about the client’s condition through observation, interview, and basic assessment.
(The PN contributes data but does not independently perform comprehensive assessments.)
A failure to follow the standard of care, professional duty, or legal responsibility.
Examples: Giving the wrong medication or dose; Failing to report abnormal findings; Charting care that was not provided; Breaking patient confidentiality; Not following safety policies
What does PICOT stand for? Purpose?
P – Population I – Intervention C – Comparison O – Outcome T – Time. PICOT helps nurses: Create a focused, searchable clinical question and Guides literature searches
What does each letter mean in ISBARR?
I – Introduction: Who you are and who the patient is.
S – Situation: What is happening right now.
B – Background: Relevant medical history or context.
A – Assessment What you think is going on (clinical findings).
R – Recommendation: What you need or suggest.
R- Readback
RACE – priority order for a fire in a healthcare setting
R – Rescue: Remove clients in immediate danger. A – Alarm: Activate the fire alarm and notify others. C – Contain: Close doors and windows to limit oxygen supply. E – Extinguish / Evacuate: Use extinguisher if safe OR evacuate per policy.
2nd Step of the PN Nursing Process
Planning Assisting in formulating goals for a positive outcome and contributing to the established plan of care in collaboration with the RN.
Role of The Board of Nursing?
The Board of Nursing (BON):
Enforces the Nurse Practice Act (NPA)
Issues and renews licenses
Investigates complaints
Takes disciplinary action when necessary
Protects the public
What is EBP - 3 things!
1. Best research evidence; 2. Clinical experience 3. Patient values and preferences
Malpractice
Professional negligence — failure of a licensed health care professional to meet the standard of care, resulting in harm.
Applies specifically to licensed professionals (nurses, providers, etc.). Example: A nurse administers the wrong medication dose because they did not check the medication rights, and the client experiences harm.
PASS - How to use a fire extinguisher
P – Pull the Pin; A – Aim at the Base; S – Squeeze the Handle; S – Sweep Side to Side
3rd Step of Nursing Process
Implementation Performing nursing interventions and delegated tasks that support the plan of care.
What is advocacy in nursing?
Nurse advocacy is supporting, protecting, and speaking up for a client’s rights, wishes, and best interests. It means ensuring the client’s voice is heard — especially when they are vulnerable.
Elements - Steps to EBP
1. Ask a question – Identify the problem. 2. Search for evidence – Find reliable sources. 3. Review the evidence – Decide if it is strong and useful. 4. Implement/Apply the evidence – Make changes to care if needed. 5. Evaluate the results – Did it improve outcomes? 6. Share the results – Tell others what worked.
Negligence
Failure to act as a reasonably careful person would in a similar situation, resulting in harm.
Can apply to any person, not just professionals.
Example: A nurse forgets to put the bed in the lowest position. The client falls and is injured.
Sentinel event? Give Examples.
A serious, unexpected event in a health care setting that results in death, permanent harm, or severe temporary harm and requires immediate investigation. Examples:
Wrong-site, wrong-patient, or wrong-procedure surgery
Infant discharged to the wrong family
Patient death or serious injury from elopement
Stage 3 or 4 pressure injuries acquired after admission
4th Step of the Nursing Process
Evaluation Observing the client’s response to care and reporting findings to the RN to determine if goals are being met or if the plan needs revision.
Clinical Judgment Model
Recognize Cues ➜ Identify relevant and important information (assessment findings, labs, vitals, history).
Analyze Cues ➜ Interpret the data. What does it mean? What patterns are present?
Prioritize Hypotheses ➜ Decide which problem is most urgent or likely (think ABCs, safety, Maslow).
Generate Solutions ➜ Determine possible nursing actions.
Take Action ➜ Implement the best intervention.
Evaluate Outcomes ➜ Did the intervention work? Is the client improving, stable, or worsening?
Highest Level of Evidence
A systematic review is a research study that collects, evaluates, and summarizes all high-quality research studies on a specific question using a structured, organized process.
Maslow's Hierarchy of Needs - List in order of priority
1️ Physiological Needs: Basic survival needs.
Air, breathing, food, water, sleep, elimination, pain control. 2️ Safety and Security: Feeling safe and protected. Freedom from harm, stable environment, security. 3️ Love and Belonging: Feeling connected to others. Relationships, family, friendship, acceptance. 4 Esteem: Feeling valued and confident.
Self-respect, achievement, recognition. 5. Self-Actualization Reaching personal potential. Growth, purpose, becoming your best self.
Social Determinants of Health
Social determinants of health are the conditions in which people are born, live, work, learn, and age that affect their health and quality of life.
They influence a person’s ability to stay healthy or access care.
Health Disparity
A health disparity is a difference in health outcomes or access to care between groups of people, often related to social, economical or environmental factors.
Code of Ethics outlines:
Code of ethics outlines rules for nurses that include maintaining client confidentiality, protecting client rights, and being accountable for one’s actions.
Acute versus Chronic Priority Framework
Acute = New, sudden, or life-threatening problems. ➡️ Treat these first.
Chronic = Long-term, ongoing conditions that are stable. ➡️ Treat after acute problems are addressed.