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PRIMARY FOCUS OF MED SURGENURSING CARE IS
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MEET THE
1)
BILOGIC2) PSYCHOSOCIAL3) CULTURAL4) SPIRITUAL
NEEDS OF THE ADULT PT IN A MUTUALLY1) TRUSTING2) RESPECTFUL3) CARING
RELATIONSHIP (THESE BASIC NEEDS ARE REFERRED TO ASCONCEPTS )
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MED SURGE NURSES MUST USE
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1) EXPERT CLINICAL JUDGEMENT
TO INSURE1) PT. SAFETY AS THE PRIORITY IN PRATICE
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NIGHTINGALE 1946
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Putting the patient in thebest condition for nature
to act
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Assisting the client in theperformance of activitiescontributing to wellness or
recovery with the optimal goalbeing independence
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Medical Dictionary, 2010
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The provision, at various levels ofpreparation, of services essential to orhelpful in the promotion, maintenance,and restoration of health and well-being or in prevention of illness
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ANA, 2003
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Diagnosis and treatmentof human responses to
actual and potential healthproblems
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NURSING FOCUS
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Self-care
Physiologic processes Comfort Emotional
Understanding of health & illness Decision making Perceptual orientation Transitions across the lifespan Relationships
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Delivery of Nursing Care
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Team Nursing
Groups LTC (Long term care)
Primary Nursing Acute Care Settings
Managed Care Community Settings
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Meeting Client Needs
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Maslows Hierarchy
Self-actualization Esteem & self-respect Belongingness & affection
Safety & security Physiologic needs
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Health
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State of completephysical, mental, andsocial well-being
not merely theabsence of diseaseand infirmity (WHO,
2006).
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Wellness
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Capacity to perform Ability to adjust Perception of well-
being Harmonious feeling(Hood & Leddy,2007)
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Influences on NursingPractice
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Population : Aging population & increase in
chronic conditions.
Culture : More diverse; includes ethnicity &economic shifts.
Disease : Increase in communicable diseasesuch as TB, AIDS, STDs (Smelter et al.,2010).
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Influences on NursingPractice
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Technology: Advances in IS, diagnostics, &
genetics.
Payor Sources: Managed Care (HMO, PPO),Medicare, Medicaid.
Best Practices: CMS & JCAHO influencetreatment and reimbursement.
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Nurse Practitioner Leadership Research Education Care Delivery
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Critical Thinking
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Thinking Like a Nurse: Abstract Concept Metacognition Outcome-oriented Developed over time
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Benner s Theory:Novice to Expert (Benner, 1984):
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Novice Advanced beginner Competent Proficient Expert
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Noticing Interpreting Responding
Reflecting
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Ethics in Nursing
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Ethical Issues
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Confidentiality Restraints Trust Refusal of care End-of-life Advance directives
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Nursing Process
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Assessment
Diagnosis
PlanningImplementation
Evaluation
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The Plan of Care
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Nursing Diagnosis NANDA PES format Goal Statement Clients perspective SMART criteria NOC (www.nursing.uiowa.edu/noc)
Interventions EPB NIC (www.nursing.uiowa.edu/cnc) Collaborative
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SMART Criteria:
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Specific
Measurable Attainable
Relevant
Time Specific
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Health Education &Promotion
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The public has a right to know about important health
information Nurses have a duty to educate and collaborate with
others to encourage optimal compliance with healthregime
Outcomes rely heavily on the clients readiness to learnand apply knowledge
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Patient TeachingTechniques
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One-on-One Group Learning Style Teaching Aids
Barriers Reinforcement (Smeltzer et al,2010)
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Learning Styles
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Visual-Aural-
Read/write-
Kinesthetic-
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Health Promotion
Components
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Self-responsibility Nutritional Awareness
Stress Management Physical Fitness
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Precontemplative Contemplative Decision making
Action Maintenance Termination
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History
Physical Head -to -toe Systems
Nutritional
Inspect Palpate Percuss Auscultate
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