FINAL FINAL STUDY GUIDE

Fluid & Electrolytes​ 1

ECF vs ICF​ 1
Hyper & Hypo Volemia​ 2
Ions & Relation to Body​ 2
Electrolyte Function and Imbalances:​ 3
I&Os and Urine Collection​ 4
24 Hour Specimen Collection​ 4
I&Os​ 5
NPO (Nothing by Mouth)​ 5
Telemedicine​ 6
Integration Informatics​ 6
Ethical Considerations of Nursing​ 6
Freud’s Theory Vs. Erickson’s Theory​ 7
Ageism & Dementia​ 8
Adaptation Theory & Coping Mechanisms​ 8
Documentation​ 9
Different charting Methods​ 9
Teach-Back Method​ 9
HIPPA​ 9
According to HIPAA, patients have a right to​ 9
Ways to violate HIPPA​ 10
Nursing Delegation​ 10
Healthcare Services​ 10
Nursing Intervention vs. Nursing Diagnosis​ 12
Spirituality​ 13
Factors Affecting Spirituality​ 13
Patient Spirituality Assessment Guide​ 13
Ways Religion Interferes with Care​ 13

1
 FINAL FINAL STUDY GUIDE

Fluid & Electrolytes

ECF vs ICF
Two fluid compartments: Intracellular fluid(ICF) & Extracellular fluid(ECF)
●​ Intracellular fluid (ICF): the fluid within cells, constituting about 70% of the total body water or about
40% of the adult’s body weight
●​ Extracellular fluid (ECF): is all the fluid outside the cells, accounting for about 30% of the total body
water or about 20% of the adult’s body weight.
○​ ECF includes two major areas and one minor, the vascular (intravascular) and interstitial
compartments and the transcellular fluid compartment respectively .
■​ Intravascular fluid(plasma): the liquid component of the blood (i.e., fluid found
within the vascular system).
■​ Interstitial fluid: the fluid that surrounds tissue cells and includes lymph.
■​ Transcellular fluids: include cerebrospinal, pericardial, synovial, intraocular, and
pleural fluids, as well as sweat and digestive secretions.
Osmosis: A process in which water (the solvent) passes from an area of lesser solute concentration and more water to
an area of greater solute concentration and less water until equilibrium is established.

The capillary walls and cell membranes separate the intracellular and extracellular compartments.

Hyper & Hypo Volemia

​ ​ Definition ​ ​ ​ Causes​ ​ ​ ​ Symptoms

HYPERvolemia RETENTION of water and • 1 Water and sodium intake • Edema

sodium in the same • Malfunction of the kidneys • + Weight
proportion in the ECF space • Inability to excrete the excesses •个BP
• Heart failure • CHR
• Accumulation of fluid in the lungs • + CVP
and dependent parts of the body • Distended
Jugular Vein
body

HYPOvolemia LOSS of both water & solutes • GI (V/D) • + Weight

in the same proportion from • Hemorrhage • + BP
the ECF space • NG tube • 1 HR
• Trauma • Dry mucous
• Thoracentesis • membranes
• Diabetes • 1 Tugor
•diuretics • + Urine output
•↑Thirst
• 1 RR

2
 FINAL FINAL STUDY GUIDE

Ions & Relation to Body

Electrolytes: are substances that are capable of breaking into particles called ions. Ion: an atom or molecule carrying an
electrical charge.
Ions in ECF:​ ​ ​ ​ ​ Ions in ICF:

●​ sodium ●​ potassium
●​ chloride ●​ phosphorus
●​ calcium ●​ magnesium
●​ bicarbonate

Cations: ions that develop a positive charge

-​ sodium, potassium, calcium, hydrogen, and magnesium
Anions: ions that develop a negative charge
-​ chloride, bicarbonate, and phosphate

Electrolyte Function and Imbalances:

Electrolyte Functions Hyper- Hypo-

Sodium(Na) Regulates extracellular fluid Hypernatremia Hyponatremia

135-145 mEq/L volume and osmolality (1 Na>145 mEq/L): (v Na <135 mEq/L):
• Enables nerve impulse
transmission and muscle • Causes: Low fluid intake (older adults), • Causes: Vomiting, diarrhea,
contraction diarrhea, hyperventilation, burns, excess IV sweating, diuretics, SIADH
• Maintains acid-base balance (via sodium • Signs: Muscle cramps, weakness,
sodium bicarbonate) • Signs: Restlessness, agitation, T BP, thirst, confusion, lethargy, +
weakness, disorientation, seizures BP, seizures, dry skin
• Cells shrink → "BIG & BLOATED" • Cells swell → "LOW & SLOW"

Potassium (K) • Controls intracellular osmolality Hyperkalemia Hypokalemia

3.5-5.0 mEq/L and enzyme activity (1 K>5.0 mEq/L): (L K<3.5 mEq/L):
• Crucial for nerve and muscle
function, especially cardiac • Causes: Renal failure, acidosis, trauma, • Causes: Vomiting, gastric suction,
• Maintains acid-base balance via potassium-sparing diuretics alkalosis, diarrhea, diuretics
cellular exchange with H+ • Signs: Muscle weakness, paresthesia, • Signs: Muscle weakness, leg
• K+ and Mg* move together; K* paralysis, dysrhythmias, cardiac arrest cramps, fatigue, paresthesia,
and H* shift oppositely (severe) dysrhythmias
• "High pumps" - peaked T waves (DEADLY) • "Low pumps" — flat T waves

Calcium (Ca) • Most abundant mineral in bones Hypercalcemia Hypocalcemia

8.6-10.2 mg/dL and teeth (T Ca>10.2 mg/dL): (* Ca<8.6 mg/dL):
• Needed for nerve impulse
transmission, muscle contraction, • Causes: Cancer, hyperparathyroidism • Causes: Inadequate calcium or
and blood clotting • Signs: Nausea, vomiting, constipation, vitamin D, malabsorption, excessive
• Inverse relationship with lethargy, slurred speech, confusion, bone calcium loss
phosphate (Ca + PO) pain, excessive urination • Signs: Numbness, tingling, tetany,
• "LOW & SLOW" muscle cramps, seizures, THR, + BP
• "THINK TWITCH"

Magnesium • Regulates carbohydrate/protein Hypermagnesemia Hypomagnesemia

(Mg) metabolism (T Mg>2.3 mEq/L): (v Mg<1.3 mEq/L):
1.3-2.3 mEq/L • Maintains neuromuscular and
cardiac function • Causes: Renal failure, excessive Mg intake • Causes: Diarrhea, suctioning,
• Promotes vasodilation and (antacids/ laxatives) malnutrition, sepsis, alcoholism, burns
supports enzyme activity • Signs: Nausea, weakness, flushing, • Signs: Tremors, confusion, T DTRs,
• Moves with K+ lethargy, + DTRs, respiratory depression, tetany, seizures, dysrhythmias,
cardiac arrest paralysis
• "LOW & SLOW" • "HYPER pumps & twitches"

3
 FINAL FINAL STUDY GUIDE

Chloride (Cl) • Works with Na* to maintain Hyperchloremia (1 CI): Hypochloremia (+ Cl):
97-107 mEq/L osmotic pressure, acid-base
balance, and gastric juice formation • Causes: Metabolic acidosis, hypernatremia, • Causes: Vomiting, diarrhea,
Writing kidney dysfunction alkalosis, diuretics
• Found in extracellular fluid, • Signs: Tachypnea, weakness, + cognitive • Signs: Tetany, hyperexcitability of
regulated by aldosterone ability, hypertension, dysrhythmias muscles, v respirations, seizures,
coma

Phosphate (PO) • Aids acid-base balance and Hyperphosphatemia Hypophosphatemia

2.5-4.5 mg/dL energy storage (ATP) (f PO>4.5 mg/dL): (v PO<2.5 mg/dL):
• Supports bone and teeth
formation • Causes: Renal failure, hypoparathyroidism • Causes: Malnutrition, alcohol
• Inverse relationship with calcium • Signs: Hyperreflexia, muscle cramps, weak withdrawal, diabetic ketoacidosis,
bones, dysrhythmias hyperventilation
• Signs: Weakness, confusion,
paresthesia, respiratory failure,
seizures

Bicarbonate • Primary buffer that maintains Metabolic Alkalosis Metabolic Acidosis

(HCO3) acid-base balance (T HCO3* > 26 mEq/L) (V HCO3* < 22 mEq/L)
Normal Range: • Neutralizes hydrogen ions (H*)
25-29 mEq/L • Regulated by kidneys (metabolic Causes: Causes:
component of pH balance) • Vomiting, gastric suction, diuretic use, • Diabetic ketoacidosis, renal failure,
excessive bicarbonate intake diarrhea, lactic acidosis • • • Signs:
• Signs: Confusion, muscle twitching, Headache, confusion, drowsiness,
irritability, shallow respirations, hypokalemia Kussmaul respirations (deep/rapid),
hypotension

Causes of Excess Urination and Fluid Retention

Condition:​ Main Cause:​ ​ Hormonal Cause:​ Effect:

Polyuria Diabetes Mellitus, Diuretics, ↓ADH or Insulin Fluid loss, dehydration

↓ADH Deficiency

Fluid Retention Heart, Kidney, Liver ↑ADH/↑Aldosterone Fluid overload, swelling

(Edema) failure;↑Na intake

Muscle Mass, Adipose Tissue, Differences

Group Muscle Mass Body Fat Water %​ Rationale:

Men Higher Lower ~ 60% More water stored in muscle →

higher fluid reserve

Women Lower Higher ~ 50% Less water due to more adipose tissue

Older Adults Decreased Increased ~ 45% or less Higher dehydration risk due to less
total body water

4
 FINAL FINAL STUDY GUIDE

I&Os and Urine Collection

24 Hour Specimen Collection

1)​ Initiate a collection at a specific time (which is recorded) by asking the patient to empty the bladder.
2)​ Discard this urine and then collect all urine voided for the next 24 hours.
3)​ At the end of the 24 hours, ask the patient to void. Add this urine to the previously collected urine
*Average adult fluid input and output in 24 hours is 1500-3500 ml.*

I&Os

Steps for measuring I&O (in & outs)

1)​ Explain: Teach the patient and family why it's important to record all fluids taken in and excreted.
2)​ Communicate the Plan: Document the intake and output (I&O) monitoring plan in the patient's chart or plan of
care.
3)​ Visual Reminders: Post a sign in the patient's room and keep a bedside form to record all intake and output.
4)​ Measure: Avoid guessing; Always measure intake and output when possible for accuracy.
5)​ Record: Add totals for every 8-hour shift and again for the 24-hour period.

The “Ins” The “Outs”

●​ All fluids and foods that are liquid at room ●​ Urine; vomitus; diarrhea; drainage from fistulas,
temperature (ice cream, gelatin dessert [Jell-O], wounds, and ulcers; and drainage from
and the like) suctioning devices or other tubes.
●​ Sips of water or other fluids in between meals ●​ Urine or liquid feces in diapers or bed clothes
●​ Liquid medications or water taken with pills ●​ Vomitus on clothing or bed linens,
●​ Parenteral fluids ●​ wound drainage saturating dressings, and so
forth
Other fluids taken into the body: subcutaneous fluids, ●​ Heavy perspiration
gastrointestinal tube feedings and flushes; IV flushes ●​ Hyperventilation (water vapor loss) also noted
on the output record. Record the rate and depth
of respirations.

*Daily weight is the most reliable indicator of fluid balance. Intake and output are not always as accurate and may involve a
subjective component*

5
 FINAL FINAL STUDY GUIDE

NPO (Nothing by Mouth)

Reasons for NPO Diet: Comfort Measures: Considerations:

●​ A period before surgery or 1)​ Provide good oral hygiene ●​ Short-term NPO: Usually
diagnostic tests (to prevent 2)​ Offer ice chips or sips of well tolerated by
aspiration). water if allowed well-nourished patients.
●​ Severe nausea or vomiting. 3)​ Encourage distraction at ●​ Extended NPO (48-72
●​ Difficulty chewing or mealtimes - avoid watching hours or more):
swallowing. others eat; ○​ Can cause
●​ Acute or chronic GI nutritional deficits
conditions. and energy loss.
●​ Comatose states or labor
and delivery.

Telemedicine
Telehealth nursing involves using technology to provide and manage nursing care remotely, improving efficiency, access,
and continuity of care for patients.
When conducting telehealth visits, nurses should:
●​ Present professionally: Dress appropriately and minimize background noise or clutter.
●​ Maintain privacy and focus: Ensure a quiet, interruption-free environment.
●​ Use effective communication: Demonstrate interest and empathy through nonverbal cues (eye contact,
nodding, leaning in).
●​ Listen actively: Strong listening skills are vital for accurate assessment and trust.
●​ Apply core competencies: Use clinical judgment, technical proficiency, and communication skills to prioritize,
initiate, and evaluate care remotely.

telehealth: the use of electronic information and telecommunications technologies to support and promote
long-distance clinical health care, patient and professional health-related education, public health, and health
administration.
telemedicine: the use of telecommunications technologies to support the delivery of all types of medical, diagnostic, and
treatment-related services, usually by physicians or nurse practitioners

Integration Informatics
Nursing Informatics (NI) is the specialty that combines nursing science with information and analytical sciences to
collect, manage, and communicate data, information, knowledge, and wisdom that support nursing practice and
decision-making.

Nurses must understand three major areas of data analytics:

1)​ Data Visualization: The use of graphs, charts, and visual displays to present information clearly.
○​ Helps nurses and healthcare teams quickly recognize patterns, trends, and problem areas to guide
better decisions.
2)​ Predictive Analytics: Uses statistical and historical data to forecast future outcomes.
○​ In healthcare, it identifies patients at risk for readmission or complications, allowing early
intervention and prevention.
3)​ Big Data - The large collection of health information from many sources (EHRs, devices, labs, etc.) that
technology converts into usable knowledge and wisdom.
○​ Supports evidence-based practice, quality improvement, and population health management.

6
 FINAL FINAL STUDY GUIDE

Ethical Considerations of Nursing

1)​ Balancing Benefits and Harms
Nurses’ close relationships with patients allow them to see beyond physical outcomes to include emotional,
social, and ethical effects of care decisions.

2)​ Disclosure, Informed Consent, and Shared Decision-Making

Three models of healthcare decision-making:
●​ Paternalistic: Clinicians decide and inform; patients comply.
●​ Patient Sovereignty: Patients make demands; clinicians comply.
●​ Shared Decision-Making (Preferred): Combines patient preferences with clinician expertise to reach
balanced, ethical choices.

3)​ Family Life and Context

Nurses who understand how illness affects families can bring valuable insight to the interdisciplinary team and
help shape care plans that reflect both patient and family needs.

4)​ Nurse-Patient Relationship

Moral distress often arises when nurses feel they cannot give the care they believe patients deserve due to
institutional limits.

5)​ Professional Integrity

The Nurses' primary duty is to the patient, but they also owe duties to themselves-to preserve integrity,
maintain competence, and pursue personal and professional growth.
Nurses should avoid sacrificing their moral or professional integrity to meet unrealistic demands.

6)​ Cost Effective

Healthcare resources are limited, creating ethical challenges of justice and fairness.
Nurses act as advocates, helping balance patient needs with institutional constraints and ensuring fair
distribution of care.

7)​ Cultural and Religious Variation

Conflicts often stem from differences in cultural or religious beliefs.
Nurses promote culturally respectful care by mediating misunderstandings and ensuring patient values are
honored within safe, ethical practice.

8)​ Power and Vulnerability

Illness and injury make patients vulnerable.
Nurses must remain alert to power imbalances in healthcare settings and challenge any abuse of
authority.

7
 FINAL FINAL STUDY GUIDE

Freud’s Theory Vs. Erickson’s Theory

Stage​ ​ Freud’s Psychosexual​ ​ Erickson Psychosocial

Infancy to Oral stage (0 - 3y): Trust versus mistrust (infant): Uncertainty; development of
Toddler Focus on sucking, biting, hope
chewing, and swallowing
Autonomy versus shame and doubt (toddler): Exploration of the
Anal stage (8m - 3y): limits of abilities; development of will
Focus on bowel and bladder
control; anus becomes the
center of gratification

Preschool to Phallic stage(3y - 7y) Initiative versus guilt: Development of interpersonal skills
Early School Resolving Oedipal/Electra through activities with others; development of purpose
Years complex

School years Latent stage (7y - 12y) Industry versus inferiority: Self-esteem based on feedback
No meaningful focus from others; development of competence

Adolescent to Genital stage (12y - 20y) Identity versus role confusion (adolescence): Exploration for
adult years Reaching full sexual maturity personal identity and a sense of self; development of fidelity

Intimacy versus isolation (young adulthood): Development of

happy relationships and a sense of commitment, safety, and
caring; development of love

Middle adult Generativity versus stagnation:

years Establishment of career, relationships, family, and societal
engagement; development of care

Later adult years Ego integrity versus despair:

Change in productivity goals and evaluation of success;
development of wisdom

Ageism & Dementia

Dementia refers to various organic disorders that progressively affect cognitive functioning. Dementia is chronic and
usually develops gradually.
●​ Alzheimer’s disease (AD): is the most common degenerative neurologic illness and the most common cause of
cognitive impairment. It is irreversible and progresses from deficits in memory and thinking skills to an
eventual inability to perform basic self-care.
●​ Sundowning Syndrome: in which an older adult habitually becomes confused, restless, and agitated after dark.
Wandering may occur, and coping may be negatively affected by hallucinations, delusions, or paranoia.

Ageism: is a form of prejudice, like racism or sexism, in which older adults are stereotyped and discriminated against.
Fundamental to ageism is the view that older people are incapable and do not experience the same desires, needs, and
concerns as younger adults.

8
 FINAL FINAL STUDY GUIDE

Adaptation Theory & Coping Mechanisms

Adaptation theory: defines adaptation as the adjustment of living matter to other living things and to environmental
conditions.

Adaptation is a continuously occurring process that effects change and involves interaction and response. Human
adaptation occurs on three levels: the internal (self), the social (others), and the physical (biochemical reactions).

Coping mechanism: behaviors used to decrease stress and anxiety. Many coping behaviors are learned, based on a
person’s family, past experiences, and sociocultural influences and expectations.
●​ Crying, laughing, sleeping, cursing
●​ Physical activity, exercise
●​ Taking a deep breath, using practiced mindfulness/centering exercises
●​ Verbally debriefing with another person, journaling
●​ Engage in an enjoyable activity as a distraction
●​ Smoking, drinking
●​ Lack of eye contact, ignoring the stressor, withdrawal
●​ Limiting relationships to those with similar values and interests
●​ Denial of problem

Documentation

Different charting Methods

-​ Progress Notes: Notes written to inform caregivers of the progress a patient is making toward achieving
expected outcomes
-​ Narrative Notes: notes written by nurses in a source-oriented record, they address routine care, patient data,
and patient problems identified in the care plan.
-​ Source-Oriented Record: Each discipline keeps its own notes → fragmented info.
-​ POMR: (Problem-OrientedMedical Record) Organized by patient problems; promotes collaboration.
-​ SOAP: used to organize entries in the progress notes of the POMR: Subjective, Objective, Assessment, Plan.
-​ SOAPIE / SOAPIER: Adds Intervention, Evaluation, Revision.
-​ PIE: Does not develop a separate care plan. The care plan is incorporated into the progress notes, which
identify problems by: Problem, Intervention, Evaluation - ongoing documentation.
-​ Focus Charting (DAR): Focus on patient concerns instead of a list of diagnoses: Data, Action, Response.
-​ Charting by Exception (CBE): Only abnormal findings charted; saves time.
-​ Case Management Model: Uses care maps and pathways; tracks progress, notes variances.

Teach-Back Method
Teach-Back: A method that assesses health literacy, seeking to confirm that the learner understands the health
information received from the health professional
●​ Patients and family/caregivers have the opportunity to repeat back to the health care provider the key points
they understand from a teaching session.

9
 FINAL FINAL STUDY GUIDE

HIPPA

According to HIPAA, patients have a right to:

●​ see and copy their health record.
●​ update their health record.
●​ get a list of the disclosures that a health care institution has made independent of disclosures made for the
purposes of treatment, payment, and health care operations.
●​ request a restriction on certain uses or disclosures.
●​ choose how to receive health information.

Ways to violate HIPPA:

●​ Discussing patient information in public areas.
●​ Leaving medical records, documents, or computer(not logged off) unattended ,accessible or public places.
●​ Sharing or revealing passwords to others.
●​ Copying, removing, or providing patient data to unauthorized individuals for any reason unrelated to one's job.
●​ Accessing, reviewing, or releasing records of patients not under one's care-whether out of curiosity
●​ Using patient information for personal relationships or interests.
●​ Accessing or sharing records of public figures for personal gain or to sell information to the media.
●​ Disclosing sensitive information that could harm the organization or anyone associated with it.
If making a mistake on paper charting, do not erase as it is a HIPPA violation, strike through and write “error” with initials.

Nursing Delegation
The RN CANNOT DELEGATE: initial patient assessment, discharge planning, health education, care planning, triage,
interpretation of patient data, care of invasive lines, and
administering parenteral medications

The RN CAN DELEGATE tasks such as assistance with basic care activities, collecting patient data such as vital signs
and I&O, simple dressing changes, transfers, and postmortem care.

The nurse is responsible for both undelegated and delegated tasks

Not Unstable patients: Evaluation: Assessment: Teaching:

Delegate • New admission Trending / Initial, First, Primary Initial, First, &
• Returning to floor after Interpreting data assessments Primary Education
procedure Evaluation
• "Post-Operative" after • Lab Values, Pain, • New admission
surgery Vital Signs • Post-Operative
• Unstable blood sugar, vitals,
Lab values
• Change RR, neuro status.

Delegate • Vitals • Ambulation • Position • Eating

changes/bathing • Recording I&0

10
 FINAL FINAL STUDY GUIDE

Healthcare Services
Physician: 👩‍⚕️
Diagnoses and treats illnesses through examination, testing, and prescribing or performing medical and surgical
procedures.

Advanced Practice Registered Nurse (APRN): 👨‍⚕️

A master's or post-master's-prepared nurse who provides advanced, often primary, care such as diagnosis, treatment,
and prevention for specific populations.

Physician Assistant (PA): 🧑‍⚕️

Works under a physician's supervision to perform exams, diagnose, and treat patients; may suture, order tests, and
prescribe medications depending on state regulations.

Nurse: 🩺
Coordinates and provides direct care, educates patients and families, and promotes quality, cost-effective care through
collaboration and research.

Physical Therapist (PT): 🤸

Restores movement and function or prevents further disability using exercise, massage, heat, or electrical stimulation;
motivates patients through psychological support

Occupational Therapist (OT): 👨‍🦯

Helps patients regain independence in daily activities by teaching self-care techniques, evaluating home safety, and
recommending adaptive equipment.

Speech Therapist (ST): 🗣️

Assists patients with speech, language, and swallowing disorders, often after stroke or injury, and helps them
communicate effectively.

Social Worker: 💵
Supports patients and families with emotional, social, and financial challenges; connects them with community
resources and assists in discharge planning.

Pharmacist: 💊
Prepares, dispenses, and monitors medications; ensures safe drug use, prevents medication errors, and provides
education about medications.

Respiratory Therapist (RT): 😮‍💨

Improves lung function through treatments, oxygen therapy, and ventilator management; educates patients on
respiratory care techniques.

Dietitian (RD): 🥑
Develops individualized nutrition plans, manages dietary needs, and educates patients and staff on healthy and
therapeutic diets.

Chaplain/Spiritual Care Provider: 👼

Provides emotional and spiritual support to patients, families, and staff, addressing faith-related or existential needs.

Assistive Personnel (AP): 🧼

Performs basic patient-care tasks under nurse supervision, including bathing, feeding, and vital-sign monitoring; may
hold titles such as CNA, orderly, or technician.

11
 FINAL FINAL STUDY GUIDE

Qualitative vs. Quantitative Research

Quantitative Research: A systematic method that collects and analyzes numerical data to identify patterns, test
theories, and establish cause-and-effect relationships. The following shows examples:
●​ Descriptive: Explores and describes events or relationships in real-life situations; generates new knowledge
where little exists.
●​ Correlational: Examines relationships between two or more variables and determines the strength and
direction (from -1 to +1).
●​ Quasi-Experimental: Studies cause-and-effect relationships in real-world or clinical settings without full
experimental control.
●​ Experimental: Tests cause-and-effect relationships under highly controlled (often laboratory) conditions.

• Variable: Anything measurable that can change.

• Dependent Variable: The outcome being studied.
• Independent Variable: The factor manipulated to determine its effect.
• Hypothesis: Statement predicting the relationship between variables.
• Data: Numeric information collected from subjects.
• Instruments: Reliable and valid tools used for data collection (e.g., rating scales, tests).

Qualitative Research: A research approach that seeks to understand human experiences and meanings through words,
perceptions, and narratives rather than numbers.
●​ Phenomenology: Describes lived experiences to understand how people perceive their own reality (e.g.,
experience of illness).
●​ Grounded Theory: Builds a theory from data collected about how people define their reality and act within
social contexts (e.g., coping with chronic illness).
●​ Ethnography: Studies cultural groups to understand shared beliefs, practices, and behaviors using observation
and interviews.
●​ Historical: Examines past events to understand trends, leaders, and development in nursing (e.g., evolution of
nursing practice).

Advocacy: is the protection and support of another’s rights. Nurses who advocate:
○​ Stay loyal to your workplace, but always put the patient first.
○​ Focus on what's best for the individual patient, not society as a whole.
○​ Balance respect for the patient's independence with concern for their well-being.

12
 FINAL FINAL STUDY GUIDE

Nursing Intervention vs. Nursing Diagnosis

Nursing Intervention: any treatment based upon clinical judgment and knowledge that a nurse performs to enhance
patient/client outcomes.
-​ The outcome identification/outcome and planning portion of ADPIE
-​ Interventions are guided by the nursing diagnosis and aim to achieve the desired patient/ client results.
Nursing Diagnosis: a cluster of significant patient data indicating a health problem that can be treated by independent
nursing interventions, a nursing diagnosis
-​ three types of nursing diagnoses: problem focused, risk, and health promotion.
-​ Problem-Focused: actual health problems.
-​ Risk: potential problems the patient may develop.
-​ Health Promotion: readiness to enhance health or wellness.

Spirituality
Spirituality: anything that pertains to a person’s relationship with a nonmaterial life force or higher power
Spiritual beliefs: associated with all aspects of a person’s life, including health and illness
Religion: an organized system of beliefs about a higher power that often includes set forms of worship, spiritual
practices, and codes of conduct.
Faith: a confident belief in something for which there is no proof or material evidence.
Spiritual needs:
1.​ Need for meaning and purpose
2.​ Need for love and relatedness
3.​ Need for forgiveness

Factors affecting spirituality

-​ developmental considerations
-​ family
-​ ethnic background
-​ formal religion
-​ life events
Patient Spirituality Assessment Guide:
H — Sources of Hope, meaning, comfort, strength, peace, love, and connection
O — Organized religion
P — Personal spirituality and practice
E — Effects on medical care and end-of-life issue

Ways Religion Interferes with Care

Refusal of medical treatment, Gender roles and modesty practices. Religious observances and timing.
medical or surgical procedures (E.g (E.g. preference for same-sex provider or (E.g. prayer times, fasting periods )
refusing blood transfusions, pork- nurse)
containing medication)

13