This is a series of post regarding notable nursing leaders who have given many contribution to nursing and their influence uplifted the nursing profession.
Nursing Leaders
Florence Nightingale, Clara Barton, Lillian Wald, Lavinia Dock, Margaret Sanger, and Mary Breckinridge are among the leaders who have made notable contributions both to nursing's history and to women's history. These women were all politically astute pioneers. Their skills at influencing others and bringing about change remain models for political nurse activists today. Contemporary nursing leaders, such as Virginia Henderson, who created a modern worldwide definition of nursing, and Martha Rogers, a catalyst for theory development.
Barton (1812-1912)
Clara Barton (Figure 1-10 • ) was a schoolteacher who volunteered as a nurse during the American Civil War. Her responsibility was to organize the nursing services. Barton is noted for her role in establishing the American Red Cross, which linked with the International Red Cross when the U.S. Congress ratified the Treaty of Geneva (Geneva Convention). It was Barton who persuaded Congress in 1882 to ratify this
treaty so that the Red Cross could perform humanitarian efforts in time of peace.
More About Clara Barton ( From American Red Cross)
Clarissa Harlowe Barton, Clara, as she wished to be called, is one of the most honored women in American history. She began teaching school at a time when most teachers were men and she was among the first women to gain employment in the federal government. Barton risked her life to bring supplies and support to soldiers in the field during the Civil War. At age 60, she founded the American Red Cross in 1881 and led it for the next 23 years. Her understanding of the needs of people in distress and the ways in which she could provide help to them guided her throughout her life. By the force of her personal example, she opened paths to the new field of volunteer service. Her intense devotion to serving others resulted in enough achievements to fill several ordinary lifetimes
Inspired by her experiences in Europe, Barton corresponded with Red Cross officials in Switzerland after her return to the United States. They recognized her leadership abilities for including this country in the global Red Cross network and for influencing the United States government to sign the Geneva Treaty. Armed with a letter from the head of the International Committee of the Red Cross, Barton took her appeal to President Rutherford B. Hayes in 1877, but he looked on the treaty as a possible “entangling alliance” and rejected it. His successor, President James Garfield, was supportive and seemed ready to sign it when he was assassinated. Finally, Garfield’s successor, Chester Arthur, signed the treaty in 1882 and a few days later the Senate ratified it.
In 1881—with the signing of the treaty in sight—Barton and a group of supporters formed the American Association of the Red Cross as a District of Columbia corporation. Reincorporated as The American National Red Cross in 1893, the organization was given charters by Congress in 1900 and in 1905. The 1905 charter and its amendments provide the basis for today’s American Red Cross and the close working relationship between the organization and the federal government.
The American Red Cross, with Barton at its head, was largely devoted to disaster relief for the first 20 years of its existence. The Red Cross flag flew officially for the first time in this country in 1881 when Barton issued a public appeal for funds and clothing to aid victims of a devastating forest fire in Michigan. In 1884, she chartered steamers to carry needed supplies up and down the Ohio and Mississippi rivers to assist flood victims. In 1889, she and 50 volunteers rode the first train into Johnstown, Pennsylvania, to help the survivors of a dam break that caused over 2,000 deaths.
In 1892, she organized assistance for Russians suffering from famine by shipping them 500 railroad cars of Iowa cornmeal and flour. After a hurricane and tidal wave left over 5,000 dead on the Sea Islands of South Carolina in 1893, Barton’s Red Cross labored for 10 months helping the predominantly African-American population recover and reestablish their agricultural economy. In 1896, Barton directed relief operations on behalf of victims of unrest in Turkey and Armenia, the sole woman and only Red Cross advocate the Turkish government allowed to intervene. During her last relief operation, in 1900, Barton distributed over $120,000 in financial assistance and supplies to survivors of the hurricane and tidal wave that struck Galveston, Texas, and caused more than 6,000 deaths.
Although Henry Dunant had suggested in 1864 that Red Cross societies provide disaster relief as well as wartime services, Barton became its strongest advocate in the years that followed. During the Third International Red Cross Conference in Geneva in 1884, the American Red Cross proposed an amendment to the Geneva Treaty calling for expansion of Red Cross relief to include victims of natural disasters. Although some national societies were dubious, the resolution passed and became known as the “American Amendment” to the Geneva Treaty of 1864. Because of work like this in support of the global Red Cross network, several countries honored Barton with decorations, such as the German Iron Cross for her relief work in the Franco-Prussian War and the Silver Cross of Imperial Russia for the supplies provided during the famine of 1892.
The American Red Cross moved in a new direction near the end of Barton’s tenure as head of the organization when we delivered supplies and services to Cuba during the Spanish-American War. Recipients of Red Cross aid included members of the American armed forces, prisoners of war, and Cuban refugees. This was the first time that the American Red Cross provided assistance to American armed forces and civilians during wartime.
Sunday, December 15, 2013
Thursday, December 12, 2013
Nursing Leader: Florence Nightingale
This is a series of post regarding notable nursing leaders who have given many contribution to nursing and their influence uplifted the nursing profession.
Nursing Leaders
Florence Nightingale, Clara Barton, Lillian Wald, Lavinia Dock, Margaret Sanger, and Mary Breckinridge are among the leaders who have made notable contributions both to nursing's history and to women's history. These women were all politically astute pioneers. Their skills at influencing others and bringing about change remain models for political nurse activists today. Contemporary nursing leaders, such as Virginia Henderson, who created a modern worldwide definition of nursing, and Martha Rogers, a catalyst for theory development.
Nightingale (1820-1910)
Florence Nightingale's contributions to nursing are well documented. Her achievements in improving the standards for the care of war casualties in the Crimea earned her the title "Lady with the Lamp." Her efforts in reforming hospitals and in producing and implementing public health policies also made her an accomplished political nurse: She was the first nurse to exert political pressure on government. Through her contributions to nursing education—perhaps her greatest achievement—she is also recognized as nursing's first scientist-theorist for her work Notes on Nursing: What It Is, and What It Is Not (1860/1969).
She was born to a wealthy and intellectual family. She believed she was "called by God to help others . . . [and] to improve the well-being of mankind" (Schuyler, 1992, p. 4). She was determined to become a nurse
in spite of opposition from her family and the restrictive societal code for affluent young English women. As a well-traveled young woman of the day, she visited Kaiserswerth in 1847, where she received 3 months' training in nursing. In 1853 she studied in Paris with the Sisters of Charity, after which she returned to England to assume the position of superintendent of a charity hospital for ill governesses.
When she returned to England from the Crimea, a grateful English public gave Nightingale an honorarium of £4500. She later used this money to develop the Nightingale Training School for Nurses, which opened in 1860. The school served as a model for other training schools. Its graduates traveled to other countries to manage hospitals and institute nurse-training programs.
Nightingale's vision of nursing, which included public health and health promotion roles for nurses, was only partially addressed in the early days of nursing. The focus tended to be on developing the profession within hospitals.
Tuesday, December 10, 2013
Historical Background of Nursing 1
This post pertains to the historical background of the nursing profession-on how nursing evolved from a mere responsibility of women before to an evolving discipline. From a being a job of slaves during the dzrk period in Europe to being a noble job today.
The contemporary nursing is far different from nursing as it was practiced years ago, and it is expected to continue evolving during the 21st century. To comprehend present-day nursing and at the same time prepare for the future, one must understand not only past events but also contemporary nursing practice and the sociological and historical factors that affect it.
HISTORICAL PERSPECTIVES
Nursing has undergone dramatic change in response to societal needs and influences. A look at nursing's beginnings reveals its continuing struggle for autonomy and professionalization. In recent decades, a renewed interest in nursing history has produced a growing amount of related literature. This section highlights only selected aspects of events that have influenced nursing practice. Recurring themes of women's roles and status, religious (Christian) values, war, societal attitudes, and visionary nursing leadership have influenced nursing practice in the past. Many of these factors still exert their influence today.
Women's Roles
Traditional female roles of wife, mother, daughter, and sister have always included the care and nurturing of other family members. From the beginning of time, women have cared for infants and children; thus, nursing could be said to have, its roots in "the home." Additionally, women, who in general occupied a subservient and dependent role, were called on to care for others in the community who were ill. Generally, the care provided was related to physical maintenance and comfort. Thus, the traditional nursing role has always entailed humanistic caring, nurturing, comforting, and supporting.
Religion
Religion has also played a significant role in the development of nursing. Although many of the world's religions encourage benevolence, it was the Christian value of "love thy neighbor as thyself' and Christ's parable of the Good Samaritan that had a significant impact on the development of Western nursing. During the third and fourth centuries, several wealthy matrons of the Roman Empire, such as Fabiola, converted to Christianity and used their wealth to provide houses of care and healing (the forerunner of hospitals) for the poor, the sick, and the homeless. Women were not, however, the sole providers of nursing services.
The Crusades saw the formation of several orders of knights, including the Knights of Saint John of Jerusalem (also known as the Knights Hospitalers), the Teutonic Knights, and the Knights of Saint Lazarus . These brothers in arms provided nursing care to their sick and injured comrades. These orders also built hospitals, the organization and management of which set a standard for the administration of hospitals throughout Europe at that time. The Knights of Saint Lazarus dedicated themselves to the care of people with leprosy, syphilis, and chronic skin conditions.
The deaconess groups, which had their origins in the Roman Empire of the third and fourth centuries, were suppressed during the Middle Ages by the Western churches. However, these groups of nursing providers resurfaced occasionally throughout the centuries, most notably in 1836 when Theodore Fliedner reinstituted
the Order of Deaconesses and opened a small hospital and training school in Kaiserswerth, Germany. Florence Nightingale received her "training" in nursing at the Kaiserswerth School.
Early religious values, such as self-denial, spiritual calling, and devotion to duty and hard work, have dominated nursing throughout its history. Nurses' commitment to these values often resulted in exploitation and few monetary rewards. For some time, nurses themselves believed it was inappropriate to
expect economic gain from their "calling."
War
Throughout history, wars have accentuated the need for nurses. During the Crimean War (1854-1856), the inadequacy of care given to soldiers led to a public outcry in Great Britain. The role Florence Nightingale played in addressing this problem is well known. She was asked by Sir Sidney Herbert of the British War
Department to recruit a contingent of female nurses to provide care to the sick and injured in the Crimea. Nightingale and her nurses transformed the military hospitals by setting up sanitation practices, such as hand washing and washing clothing regularly. Nightingale is credited with performing miracles; the mortality rate in the Barrack Hospital in Turkey, for example, was reduced from 42% to 2%..
During the American Civil War (1861-1865), several nurses emerged who were notable for their contributions to a country torn by internal strife. Harriet Tubman and Sojourner Truth provided care and safety to slaves fleeing to the North on the Underground Railroad. Mother Biekerdyke and Clara Barton searched the battlefields and gave care to injured and dying soldiers. Noted authors Walt Whitman and Louisa May Alcott volunteered as nurses to give care to injured soldiers in military hospitals. Another woman leader who provided nursing care during the Civil War was Dorothea Dix . She became the Union's Superintendent of Female Nurses responsible for recruiting nurses and supervising the nursing care of all women nurses working in the army hospitals.
The arrival of World War I resulted in American, British, and French women rushing to volunteer their nursing services. These nurses endured harsh environments and treated injuries not seen before. *A monument, entitled "The Spirit of Nursing," stands in Arlington National Cemetery . It honors the nurses who served in the U.S. Armed Services in World War I, many of whom are buried in Section 21 which is also called the "Nurses Section" (Military District of Washington, n.d.). Progress in health care occurred during World War I, particularly in the field of surgery. For example, there were advancements in the use of
anesthetic agents, infection control, blood typing, and prosthetics.
World War II casualties created an acute shortage of caregivers, and the Cadet Nurse Corps was established in response to a marked shortage of nurses (Figure 1-6 •). Also at that time, auxiliary health care workers became prominent. "Practical" nurses, aides, and technicians provided much of the actual nursing
care under the instruction and supervision of better prepared nurses. Medical specialties also arose at that time to meet the needs of hospitalized clients.
During the Vietnam War, approximately 90% of the 11,000 American military women stationed in Vietnam were nurses. Most of them volunteered to go to Vietnam right after they graduated from nursing school. This made them the youngest group of medical personnel ever to serve in wartime (Vietnam Women's Memorial Foundation, n.d.). Near the Vietnam Veterans Memorial ("The Wall") stands the Vietnam Women's Memorial . This monument was established to "honor the women who served and also for the families who
lost loved ones during the war . . . to let them know about the women who provided comfort, care and a human touch for those who were suffering and dying" (Vietnam Women's Memorial Foundation, n.d.).
Societal Attitudes
Society's attitudes about nurses and nursing have significantly influenced professional nursing.
Before the mid-1800s, nursing was without organization, education, or social status; the prevailing attitude was that a woman's place was in the home and that no respectable woman should have a career. The role for the Victorian middle-class woman was that of wife and mother, and any education she obtained was for the purpose of making her a pleasant companion to her husband and a responsible mother to her children. Nurses in hospitals during this period were poorly educated; some were even incarcerated criminals. Society's attitudes about nursing during this period are reflected in the writings of Charles Dickens. In his book Martin Chuzzlewit (1896), Dickens reflected his attitude toward nurses through his character Sairy Gamp. She "cared" for the sick by neglecting them, stealing from them, and physically abusing them (Donahue, 1996, p. 192). This literary portrayal of nurses greatly influenced the negative image and attitude toward nurses up to contemporary times.
In contrast, the guardian angel or angel of mercy image arose in the latter part of the 19th century, largely because of the work of Florence Nightingale during the Crimean War. After Nightingale brought respectability to the nursing profession, nurses were viewed as noble, compassionate, moral, religious, dedicated, and self-sacrificing.
Another image arising in the early 19th century that has affected subsequent generations of nurses and the public and other professionals working with nurses is the image of doctor's handmaiden. This image evolved when women had yet to obtain the right to vote, when family structures were largely paternalistic, and when the medical profession portrayed increasing use of scientific knowledge that, at that time, was viewed as a male domain. Since that time, several images of nursing have been portrayed. The heroine portrayal evolved
from nurses' acts of bravery in World War II and their contributions in fighting poliomyelitis—in particular, the work of the Australian nurse Elizabeth Kenney. Other, images in the late 1900s include the nurse as sex object, surrogate mother, tyrannical mother, and body expert.
During the past few decades, the nursing profession has taken steps to improve the image of the nurse. In the early 1990s, the Tri-Council for Nursing (the American Association of Colleges of Nursing, the American Nurses Association, the American Organization of Nurse Executives, and the National League for Nursing) initiated a national effort (titled "Nurses of America") to improve the image of nursing. More recently, the
Johnson & Johnson corporation contributed $20 million in 2002 to launch a "Campaign for Nursing's Future" to promote nursing as a positive career choice (Anonymous, 2003; Fitzpatrick, 2002). In addition, nursing schools and hospitals are targeting men in their recruitment efforts (Meyers, 2003).
The contemporary nursing is far different from nursing as it was practiced years ago, and it is expected to continue evolving during the 21st century. To comprehend present-day nursing and at the same time prepare for the future, one must understand not only past events but also contemporary nursing practice and the sociological and historical factors that affect it.
HISTORICAL PERSPECTIVES
Nursing has undergone dramatic change in response to societal needs and influences. A look at nursing's beginnings reveals its continuing struggle for autonomy and professionalization. In recent decades, a renewed interest in nursing history has produced a growing amount of related literature. This section highlights only selected aspects of events that have influenced nursing practice. Recurring themes of women's roles and status, religious (Christian) values, war, societal attitudes, and visionary nursing leadership have influenced nursing practice in the past. Many of these factors still exert their influence today.
Women's Roles
Traditional female roles of wife, mother, daughter, and sister have always included the care and nurturing of other family members. From the beginning of time, women have cared for infants and children; thus, nursing could be said to have, its roots in "the home." Additionally, women, who in general occupied a subservient and dependent role, were called on to care for others in the community who were ill. Generally, the care provided was related to physical maintenance and comfort. Thus, the traditional nursing role has always entailed humanistic caring, nurturing, comforting, and supporting.
Religion
Religion has also played a significant role in the development of nursing. Although many of the world's religions encourage benevolence, it was the Christian value of "love thy neighbor as thyself' and Christ's parable of the Good Samaritan that had a significant impact on the development of Western nursing. During the third and fourth centuries, several wealthy matrons of the Roman Empire, such as Fabiola, converted to Christianity and used their wealth to provide houses of care and healing (the forerunner of hospitals) for the poor, the sick, and the homeless. Women were not, however, the sole providers of nursing services.
The Crusades saw the formation of several orders of knights, including the Knights of Saint John of Jerusalem (also known as the Knights Hospitalers), the Teutonic Knights, and the Knights of Saint Lazarus . These brothers in arms provided nursing care to their sick and injured comrades. These orders also built hospitals, the organization and management of which set a standard for the administration of hospitals throughout Europe at that time. The Knights of Saint Lazarus dedicated themselves to the care of people with leprosy, syphilis, and chronic skin conditions.
The deaconess groups, which had their origins in the Roman Empire of the third and fourth centuries, were suppressed during the Middle Ages by the Western churches. However, these groups of nursing providers resurfaced occasionally throughout the centuries, most notably in 1836 when Theodore Fliedner reinstituted
the Order of Deaconesses and opened a small hospital and training school in Kaiserswerth, Germany. Florence Nightingale received her "training" in nursing at the Kaiserswerth School.
Early religious values, such as self-denial, spiritual calling, and devotion to duty and hard work, have dominated nursing throughout its history. Nurses' commitment to these values often resulted in exploitation and few monetary rewards. For some time, nurses themselves believed it was inappropriate to
expect economic gain from their "calling."
War
Throughout history, wars have accentuated the need for nurses. During the Crimean War (1854-1856), the inadequacy of care given to soldiers led to a public outcry in Great Britain. The role Florence Nightingale played in addressing this problem is well known. She was asked by Sir Sidney Herbert of the British War
Department to recruit a contingent of female nurses to provide care to the sick and injured in the Crimea. Nightingale and her nurses transformed the military hospitals by setting up sanitation practices, such as hand washing and washing clothing regularly. Nightingale is credited with performing miracles; the mortality rate in the Barrack Hospital in Turkey, for example, was reduced from 42% to 2%..
During the American Civil War (1861-1865), several nurses emerged who were notable for their contributions to a country torn by internal strife. Harriet Tubman and Sojourner Truth provided care and safety to slaves fleeing to the North on the Underground Railroad. Mother Biekerdyke and Clara Barton searched the battlefields and gave care to injured and dying soldiers. Noted authors Walt Whitman and Louisa May Alcott volunteered as nurses to give care to injured soldiers in military hospitals. Another woman leader who provided nursing care during the Civil War was Dorothea Dix . She became the Union's Superintendent of Female Nurses responsible for recruiting nurses and supervising the nursing care of all women nurses working in the army hospitals.
The arrival of World War I resulted in American, British, and French women rushing to volunteer their nursing services. These nurses endured harsh environments and treated injuries not seen before. *A monument, entitled "The Spirit of Nursing," stands in Arlington National Cemetery . It honors the nurses who served in the U.S. Armed Services in World War I, many of whom are buried in Section 21 which is also called the "Nurses Section" (Military District of Washington, n.d.). Progress in health care occurred during World War I, particularly in the field of surgery. For example, there were advancements in the use of
anesthetic agents, infection control, blood typing, and prosthetics.
World War II casualties created an acute shortage of caregivers, and the Cadet Nurse Corps was established in response to a marked shortage of nurses (Figure 1-6 •). Also at that time, auxiliary health care workers became prominent. "Practical" nurses, aides, and technicians provided much of the actual nursing
care under the instruction and supervision of better prepared nurses. Medical specialties also arose at that time to meet the needs of hospitalized clients.
During the Vietnam War, approximately 90% of the 11,000 American military women stationed in Vietnam were nurses. Most of them volunteered to go to Vietnam right after they graduated from nursing school. This made them the youngest group of medical personnel ever to serve in wartime (Vietnam Women's Memorial Foundation, n.d.). Near the Vietnam Veterans Memorial ("The Wall") stands the Vietnam Women's Memorial . This monument was established to "honor the women who served and also for the families who
lost loved ones during the war . . . to let them know about the women who provided comfort, care and a human touch for those who were suffering and dying" (Vietnam Women's Memorial Foundation, n.d.).
Societal Attitudes
Society's attitudes about nurses and nursing have significantly influenced professional nursing.
Before the mid-1800s, nursing was without organization, education, or social status; the prevailing attitude was that a woman's place was in the home and that no respectable woman should have a career. The role for the Victorian middle-class woman was that of wife and mother, and any education she obtained was for the purpose of making her a pleasant companion to her husband and a responsible mother to her children. Nurses in hospitals during this period were poorly educated; some were even incarcerated criminals. Society's attitudes about nursing during this period are reflected in the writings of Charles Dickens. In his book Martin Chuzzlewit (1896), Dickens reflected his attitude toward nurses through his character Sairy Gamp. She "cared" for the sick by neglecting them, stealing from them, and physically abusing them (Donahue, 1996, p. 192). This literary portrayal of nurses greatly influenced the negative image and attitude toward nurses up to contemporary times.
In contrast, the guardian angel or angel of mercy image arose in the latter part of the 19th century, largely because of the work of Florence Nightingale during the Crimean War. After Nightingale brought respectability to the nursing profession, nurses were viewed as noble, compassionate, moral, religious, dedicated, and self-sacrificing.
Another image arising in the early 19th century that has affected subsequent generations of nurses and the public and other professionals working with nurses is the image of doctor's handmaiden. This image evolved when women had yet to obtain the right to vote, when family structures were largely paternalistic, and when the medical profession portrayed increasing use of scientific knowledge that, at that time, was viewed as a male domain. Since that time, several images of nursing have been portrayed. The heroine portrayal evolved
from nurses' acts of bravery in World War II and their contributions in fighting poliomyelitis—in particular, the work of the Australian nurse Elizabeth Kenney. Other, images in the late 1900s include the nurse as sex object, surrogate mother, tyrannical mother, and body expert.
During the past few decades, the nursing profession has taken steps to improve the image of the nurse. In the early 1990s, the Tri-Council for Nursing (the American Association of Colleges of Nursing, the American Nurses Association, the American Organization of Nurse Executives, and the National League for Nursing) initiated a national effort (titled "Nurses of America") to improve the image of nursing. More recently, the
Johnson & Johnson corporation contributed $20 million in 2002 to launch a "Campaign for Nursing's Future" to promote nursing as a positive career choice (Anonymous, 2003; Fitzpatrick, 2002). In addition, nursing schools and hospitals are targeting men in their recruitment efforts (Meyers, 2003).
“Success is most often achieved by those who don't know that failure is inevitable.”
- Coco Chanel
Sunday, December 8, 2013
Pre-Board Exam Drill: Fundamentals of Nursing 1
This is a 30 point Pre-Board Exam Drill on Fundamentals of Nursing SET A.
Test your knowledge on nursing concepts, test your test-taking skills and develop your attitude in attacking board exam questions. Answer these questions on a piece of paper. Check your answers and don't forget to review the rationale behind the correct answer. Good luck with your exam!
1. A staff nurse in the medical ward is preparing to move a male adult client who has right-sided paralysis from the bed to the wheelchair. Which statement describes the best action for the staff nurse to take?
a. position the wheelchair on the left side of the bed
b. keep the head of the bed elevated at 10 degrees
c. protect the client’s left arm with a sling during the transfer
d. bend at the waist while helping the client into a standing position
2. Which statement by the student nurse best indicates a correct understanding of “log rolling” when moving a client?
a. one nurse may perform this task alone
b. pillows are needed for positioning in order to provide support
c. the legs should be moved before the head is moved
d. keeping the neck in a straight position is the primary concern
3. The nurse is caring for a female client who has temperature of 105 F (40.5 C). The physician orders the application of a cooling blanket. Which of the following statements is true about the use of a cooling blanket?
a. cold application will increase the metabolic rate
b. vital signs should be monitored every 8 hours
c. the client should remain in one position to conserve energy
d. skin hygiene and protection of body surface areas is essential
4. A staff nurse of the pediatric wing is preparing to administer a sponge bath to an infant with a high fever. Administration of the bath should include:
a. large amounts of alcohol to increase evaporation of heat
b. adjustment of the water temperature to 60-70 0F
c. wet clothes applied to all areas where blood circulates close to skin surfaces
d. small areas of the body sponged at a time to avoid rapid heat loss
5. The nurse educator of the hospital is instructing the family of a home-bound bedridden client in the general prevention of pressure sores. Measures to include in the teaching include:
a. promoting lifting rather than dragging when turning the client
b. massaging directly over pressure sites
c. changing the client’s position every 4 hours
d. cleaning soiled areas with hot water
6. Which of the following findings would the nurse note when assessing a client with Stage I pressure ulcer? The ulcer displays:
a. superficial skin breakdown
b. deep pink, red, or mottled skin
c. subcutaneous damage or necrosis
d. damage to muscle or bone
7. An adult has developed a Stage II pressure ulcer. He is scheduled to receive wet to dry dressings every shift. The nurse realizes that the purpose of receiving this type of dressing is to:
a. draw in wound exudate and decrease bacteria
b. debride slough and eschar
c. promote healing by gas exchange
d. promote a moist environment and soften exudate
8. The nurse is performing a wound irrigation and dressing change. Which action, when taken by the nurse, would be a break in the technique?
a. consistently facing the sterile field
b. washing hands before opening the sterile set
c. opening the bottle of irrigating solution and pouring directly into a container on the sterile field
d. opening the sterile set so that the initial flap is opened away from the nurse
9. Total Parenteral Nutrition (TPN) is ordered for an adult client. The nurse expects the solution will contain all of the following nutrients except:
a. dextrose 10% c. electrolytes
b. trace minerals d. amino acids
10. The nurse caring for an adult client who is receiving TPN will need to monitor him for which of the following metabolic complications:
a. hypocalcemia and hypercalcemia
b. hyperglycemia and hypokalemia
c. hyperglycemia and hyperkalemia
d. hyperkalemia and hypercalcemia
11. The nurse is caring for a client who is receiving IV fluids. Which observation the nurse makes best indicates the IV has infiltrated?
a. pain at the site
b. a change in flow rate
c. coldness around the insertion site
12. Within 20 minutes of the start of transfusion, the client develops a sudden fever. The most appropriate initial response by the nurse is to:
a. force fluids
b. continue to monitor the vital signs
c. increase the flow rate of IV fluids
d. stop the transfusion
13. The nurse is caring for a client who has had a chest tube inserted and connected to water seal drainage. The nurse determines the drainage system is functioning correctly when which of the following is observed?
a. continuous bubbling in the water seal chamber
b. fluctuation in the water seal chamber
c. suction tubing attached to a wall unit
d. vesicular breath sounds throughout the lung fields
14. The nurse is caring for a client who has just had a chest tube attached to a water seal drainage system. To ensure that the system is functioning effectively the nurse should:
a. observe for intermittent bubbling in the water seal chamber
b. flush the chest tubes with 30-60 ml of NSS every 4-6 hours
c. maintain the client in an extreme lateral position
d. strip the chest tubes in the direction of the client
15. The nurse enters the room of a client who has a chest tube attached to a water seal drainage system and notices the chest tube is dislodged from the chest. The most appropriate nursing intervention is to:
a. notify the physician
b. insert a new chest tube
c. cover the insertion site with petroleum gauze
d. instruct the client to breathe deeply until help arrives
16. A patient is ordered oxygen via nasal prongs. The nurse administering oxygen via this low-flow system recognizes that this method of delivery:
a. mixes room air with oxygen
b. delivers a precise concentration of oxygen
c. requires humidity during delivery
d. is less traumatic to the respiratory tract
17. An adult is receiving oxygen by nasal prongs. Which statement by the client indicates that the client teaching regarding oxygen therapy has been effective?
a. “I was feeling fine so I removed my nasal prongs.”
b. “I’ve increased my fluids to six glasses of water daily.”
c. “Don’t forget to come back quickly when you get me out of bed; I don’t like to be without my oxygen for too long.”
d. “My family was angry when I told them they could not smoke in my room.”
18. An adult client has a nasogastric tube in place to maintain gastric decompression. Which nursing action will relieve discomfort in the nostril with the NG tube?
a. remove any tape and loosely pin the tube to his gown
b. lubricate the NG tube with viscous xylocaine
c. loop the NG tube to avoid pressure on the nares
d. replace the NG tube with a smaller diameter tube
19. An adult client has just returned to his room following a bowel resection and end-to-end anastomosis. The nurse can expect the drainage from the NG tube in the early post-op period to be:
a. Clear
b. Mucoid
c. Scant
d. Discolored
20. The physician inserts a central venous catheter; the nurse should assist the client to assume which of the following positions?
a. supine
b. trendelenburg’s
c. reverse trendelenburg’s
d. high fowler’s
21. The major dietary treatment for ascites calls for:
a. high protein
b. increased potassium
c. restricted fluids
d. restricted sodium
22. The nurse is to give medication to an infant. What is the best way to assess the identity of the infant?
a. ask the mother what the child’s name is
b. look at the sign above the bed that states the client’s name
c. compare the bed number with the bed number of the care plan
d. compare the ankle band with the name on the care plan
23. The nurse is caring for a client who has been placed in cloth wrist restraints. To ensure the client’s safety, the nurse should:
a. remove the restraints every 2 hours and inspect the wrists
b. wrap each wrist with gauze dressing beneath the restraints
c. keep the head of the bed flat at all times
d. tie the restraints using a square knot
24. The nurse is preparing a client for IVP tomorrow. The client ells the nurse that she gets a rash and becomes short of breath after eating lobster. Given this information, the nurse knows that the client:
a. should be visited by a dietitian while in the hospital
b. is not a candidate for IVP
c. is at risk for an allergic reaction
d. will require an antihistamine before her IVP
25. The nurse is caring for a client who is to have a lumbar puncture. How should the client be positioned during the procedure?
a. prone with head turned to the left
b. side lying in a fetal position
c. sitting at the edge of the bed
d. Trendelenburg position
26. An adult client has a central line placed for IV fluids. When the nurse enters the room the IV bag is dry, the IV line is full of air, and the client is dyspneic. What is the best initial nursing action?
a. notify the physician and administer oxygen via nasal cannula immediately
b. hang another IV bag as soon as possible, then remove the air from the IV line
c. clamp the tubing and place the client on the left side with head down
d. begin CPR and call the code team
27. An adult client is to receive a unit of whole blood. The client’s vital signs before starting the transfusion are BP 120/70, P 80, and T 98.40F. Five minutes after the transfusion was started the vital signs are BP 100/70, P100 and T 99.40F. What should the nurse do initially?
a. slow down the rate of the transfusion, reassess the client in 15 minutes
b. stop the transfusion, keep vein open with normal saline
c. slow down the infusion, notify the physician immediately
d. administer acetaminophen (Tylenol), continue to monitor closely throughout the transfusion
28. The nurse is administering medication in an extended care facility. What is the best way for the nurse to correctly identify the client before administering the medications?
a. check with picture identification on the file
b. check the arm band
c. check the name on the bed
d. check the name on the room door
29. A client is scheduled to undergo an exploratory laparotomy in one hour. The nurse has just received the order to administer his pre-operative medication. What assessment is essential for the nurse before administering the medication?
a. the client’s ability to cough and deep breathe
b. any drug hypersensitivity or allergy
c. the patient's understanding of the surgical procedure
d. whether patient's family is present and supportive
30. An adult client has been on bed rest for several months. Which statement best describes the relationship between complications of prolonged bed rest and nursing interventions to prevent these complications?
a. turning and positioning will help decrease the potential for calcium loss from bones
b. adequate fluid intake is vital to decrease the risk of brittle bones
c. leg exercises are important to decrease the loss of calcium from the bones and the risk of pathological fractures
d. encouraging milk intake will help decrease the loss of calcium from the bones
Test your knowledge on nursing concepts, test your test-taking skills and develop your attitude in attacking board exam questions. Answer these questions on a piece of paper. Check your answers and don't forget to review the rationale behind the correct answer. Good luck with your exam!
1. A staff nurse in the medical ward is preparing to move a male adult client who has right-sided paralysis from the bed to the wheelchair. Which statement describes the best action for the staff nurse to take?
a. position the wheelchair on the left side of the bed
b. keep the head of the bed elevated at 10 degrees
c. protect the client’s left arm with a sling during the transfer
d. bend at the waist while helping the client into a standing position
2. Which statement by the student nurse best indicates a correct understanding of “log rolling” when moving a client?
a. one nurse may perform this task alone
b. pillows are needed for positioning in order to provide support
c. the legs should be moved before the head is moved
d. keeping the neck in a straight position is the primary concern
3. The nurse is caring for a female client who has temperature of 105 F (40.5 C). The physician orders the application of a cooling blanket. Which of the following statements is true about the use of a cooling blanket?
a. cold application will increase the metabolic rate
b. vital signs should be monitored every 8 hours
c. the client should remain in one position to conserve energy
d. skin hygiene and protection of body surface areas is essential
4. A staff nurse of the pediatric wing is preparing to administer a sponge bath to an infant with a high fever. Administration of the bath should include:
a. large amounts of alcohol to increase evaporation of heat
b. adjustment of the water temperature to 60-70 0F
c. wet clothes applied to all areas where blood circulates close to skin surfaces
d. small areas of the body sponged at a time to avoid rapid heat loss
5. The nurse educator of the hospital is instructing the family of a home-bound bedridden client in the general prevention of pressure sores. Measures to include in the teaching include:
a. promoting lifting rather than dragging when turning the client
b. massaging directly over pressure sites
c. changing the client’s position every 4 hours
d. cleaning soiled areas with hot water
6. Which of the following findings would the nurse note when assessing a client with Stage I pressure ulcer? The ulcer displays:
a. superficial skin breakdown
b. deep pink, red, or mottled skin
c. subcutaneous damage or necrosis
d. damage to muscle or bone
7. An adult has developed a Stage II pressure ulcer. He is scheduled to receive wet to dry dressings every shift. The nurse realizes that the purpose of receiving this type of dressing is to:
a. draw in wound exudate and decrease bacteria
b. debride slough and eschar
c. promote healing by gas exchange
d. promote a moist environment and soften exudate
8. The nurse is performing a wound irrigation and dressing change. Which action, when taken by the nurse, would be a break in the technique?
a. consistently facing the sterile field
b. washing hands before opening the sterile set
c. opening the bottle of irrigating solution and pouring directly into a container on the sterile field
d. opening the sterile set so that the initial flap is opened away from the nurse
9. Total Parenteral Nutrition (TPN) is ordered for an adult client. The nurse expects the solution will contain all of the following nutrients except:
a. dextrose 10% c. electrolytes
b. trace minerals d. amino acids
10. The nurse caring for an adult client who is receiving TPN will need to monitor him for which of the following metabolic complications:
a. hypocalcemia and hypercalcemia
b. hyperglycemia and hypokalemia
c. hyperglycemia and hyperkalemia
d. hyperkalemia and hypercalcemia
11. The nurse is caring for a client who is receiving IV fluids. Which observation the nurse makes best indicates the IV has infiltrated?
a. pain at the site
b. a change in flow rate
c. coldness around the insertion site
12. Within 20 minutes of the start of transfusion, the client develops a sudden fever. The most appropriate initial response by the nurse is to:
a. force fluids
b. continue to monitor the vital signs
c. increase the flow rate of IV fluids
d. stop the transfusion
13. The nurse is caring for a client who has had a chest tube inserted and connected to water seal drainage. The nurse determines the drainage system is functioning correctly when which of the following is observed?
a. continuous bubbling in the water seal chamber
b. fluctuation in the water seal chamber
c. suction tubing attached to a wall unit
d. vesicular breath sounds throughout the lung fields
14. The nurse is caring for a client who has just had a chest tube attached to a water seal drainage system. To ensure that the system is functioning effectively the nurse should:
a. observe for intermittent bubbling in the water seal chamber
b. flush the chest tubes with 30-60 ml of NSS every 4-6 hours
c. maintain the client in an extreme lateral position
d. strip the chest tubes in the direction of the client
15. The nurse enters the room of a client who has a chest tube attached to a water seal drainage system and notices the chest tube is dislodged from the chest. The most appropriate nursing intervention is to:
a. notify the physician
b. insert a new chest tube
c. cover the insertion site with petroleum gauze
d. instruct the client to breathe deeply until help arrives
16. A patient is ordered oxygen via nasal prongs. The nurse administering oxygen via this low-flow system recognizes that this method of delivery:
a. mixes room air with oxygen
b. delivers a precise concentration of oxygen
c. requires humidity during delivery
d. is less traumatic to the respiratory tract
17. An adult is receiving oxygen by nasal prongs. Which statement by the client indicates that the client teaching regarding oxygen therapy has been effective?
a. “I was feeling fine so I removed my nasal prongs.”
b. “I’ve increased my fluids to six glasses of water daily.”
c. “Don’t forget to come back quickly when you get me out of bed; I don’t like to be without my oxygen for too long.”
d. “My family was angry when I told them they could not smoke in my room.”
18. An adult client has a nasogastric tube in place to maintain gastric decompression. Which nursing action will relieve discomfort in the nostril with the NG tube?
a. remove any tape and loosely pin the tube to his gown
b. lubricate the NG tube with viscous xylocaine
c. loop the NG tube to avoid pressure on the nares
d. replace the NG tube with a smaller diameter tube
19. An adult client has just returned to his room following a bowel resection and end-to-end anastomosis. The nurse can expect the drainage from the NG tube in the early post-op period to be:
a. Clear
b. Mucoid
c. Scant
d. Discolored
20. The physician inserts a central venous catheter; the nurse should assist the client to assume which of the following positions?
a. supine
b. trendelenburg’s
c. reverse trendelenburg’s
d. high fowler’s
21. The major dietary treatment for ascites calls for:
a. high protein
b. increased potassium
c. restricted fluids
d. restricted sodium
22. The nurse is to give medication to an infant. What is the best way to assess the identity of the infant?
a. ask the mother what the child’s name is
b. look at the sign above the bed that states the client’s name
c. compare the bed number with the bed number of the care plan
d. compare the ankle band with the name on the care plan
23. The nurse is caring for a client who has been placed in cloth wrist restraints. To ensure the client’s safety, the nurse should:
a. remove the restraints every 2 hours and inspect the wrists
b. wrap each wrist with gauze dressing beneath the restraints
c. keep the head of the bed flat at all times
d. tie the restraints using a square knot
24. The nurse is preparing a client for IVP tomorrow. The client ells the nurse that she gets a rash and becomes short of breath after eating lobster. Given this information, the nurse knows that the client:
a. should be visited by a dietitian while in the hospital
b. is not a candidate for IVP
c. is at risk for an allergic reaction
d. will require an antihistamine before her IVP
25. The nurse is caring for a client who is to have a lumbar puncture. How should the client be positioned during the procedure?
a. prone with head turned to the left
b. side lying in a fetal position
c. sitting at the edge of the bed
d. Trendelenburg position
26. An adult client has a central line placed for IV fluids. When the nurse enters the room the IV bag is dry, the IV line is full of air, and the client is dyspneic. What is the best initial nursing action?
a. notify the physician and administer oxygen via nasal cannula immediately
b. hang another IV bag as soon as possible, then remove the air from the IV line
c. clamp the tubing and place the client on the left side with head down
d. begin CPR and call the code team
27. An adult client is to receive a unit of whole blood. The client’s vital signs before starting the transfusion are BP 120/70, P 80, and T 98.40F. Five minutes after the transfusion was started the vital signs are BP 100/70, P100 and T 99.40F. What should the nurse do initially?
a. slow down the rate of the transfusion, reassess the client in 15 minutes
b. stop the transfusion, keep vein open with normal saline
c. slow down the infusion, notify the physician immediately
d. administer acetaminophen (Tylenol), continue to monitor closely throughout the transfusion
28. The nurse is administering medication in an extended care facility. What is the best way for the nurse to correctly identify the client before administering the medications?
a. check with picture identification on the file
b. check the arm band
c. check the name on the bed
d. check the name on the room door
29. A client is scheduled to undergo an exploratory laparotomy in one hour. The nurse has just received the order to administer his pre-operative medication. What assessment is essential for the nurse before administering the medication?
a. the client’s ability to cough and deep breathe
b. any drug hypersensitivity or allergy
c. the patient's understanding of the surgical procedure
d. whether patient's family is present and supportive
30. An adult client has been on bed rest for several months. Which statement best describes the relationship between complications of prolonged bed rest and nursing interventions to prevent these complications?
a. turning and positioning will help decrease the potential for calcium loss from bones
b. adequate fluid intake is vital to decrease the risk of brittle bones
c. leg exercises are important to decrease the loss of calcium from the bones and the risk of pathological fractures
d. encouraging milk intake will help decrease the loss of calcium from the bones
Saturday, December 7, 2013
Fundamentals Lecture 1: Development of Nursing
Nursing, like every discipline, evolved from its primitive form to a developing branch of professional discipline. In this Fundamentals of Nursing Lecture, we will tackle on key happenings that led to the evolution of nursing as a science and an art.
This lecture note is in an outline form to compliment your classroom discussion. This are compiled notes of the author. Care is taken in synthesizing the compiled notes.
Early times
Nursing was untaught and instinctive
Performed out of compassion for others and desire to help others
Beliefs and Practices of Prehistoric Man
Nursing was a function that belonged to women taking care of the children, the sick and the aged.
Believed that illness causes the invasion of evil spirit through the use of black magic or voodoo.
Believed that medicine man was called shaman or witch doctor having the power to heal using white magic.
They also practiced “trephining” or drilling a hole in the skull with a rock or stone without anesthesia as a last resort to drive evil spirits from the body.
Contributions to Medicine and Nursing
Babylonia
o Code of Hammurabi provided laws that covered every facet of Babylonian life including medical practice and recommended specific doctors for each disease and gave each patient the right to choose between the use of charms, medications or surgical procedures.
Egypt
o Introduced the art of embalming
o Developed the ability to make keen observation and left a record of 250 recognized diseases
o Slaves and patient’s families nursed the sick
Israel
o Moses was recognized as the “Father of Sanitation” and wrote in Old Testament which:
Emphasized the practice of hospitality to strangers and acts of charity
o Promulgated laws of control on the spread of communicable disease and the ritual of circumcision of the male child
o Referred to nurses as midwives, wet nurses or child’s nurses whose acts were compassionate and tender
China
o Believed that in using girl’s clothes for male babies keep evils away from them
o Prohibited the dissection of dead human body as a worship to ancestors
o They gave the world knowledge of material medica (pharmacology)
India
o Men of medicine built hospitals, practiced an intuitive form of asepsis and were proficient in the practice of medicine and surgery
o Sushurutu made a list of function and qualifications of nurses. This was the first reference to nurse’s taking care of the patient’s.
Ancient Greece
o Nursing was the task of untrained slave
o Introduced caduceus, the insignia of medical profession today
o Hippocrates was given the title of “Father of Scientific Medicine”. He made major advances in medicine by rejecting the belief that diseases had supernatural causes. He also developed assessment standards for clients, established overall medical standards, recognized a need for nurses.
Rome
o The Romans attempted to maintain vigorous health, because illness was a sign of weakness
o Care of the ill was left to the slaves or Greek physicians. Both groups were looked upon as inferior by Roman society.
o Fabiola made her home the first hospital in the Christian world through the help of Marcella and Paula
Period of Apprentice Nursing
- Also called the period of “on the job” training.
- Nursing care was performed without any formal education and by people who were directed by more experienced nurses
- Religious orders of the Christian church were responsible for the development of this kind of nursing.
- Founding of religious nursing orders to 1836 when Kaiserwerth Institute for the training of Deaconesses in Germany was established
Crusades
- Military religious orders established hospitals staffed with men
- Knights of Lazarus was founded and primarily for the nursing care of lepers in Jerusalem after the Christians had conquered the city.
Rise of Secular Orders
- Religious taboos and social restrictions influenced nursing at the time of the Religious Nursing orders
- Hospitals were poorly ventilated and the beds were filthy
- There was overcrowding of patients: 3 or 4 patients regardless of diagnosis or whether dead or alive, may have shared one bed.
- Practice of environmental sanitation and asepsis were non-existent
- Older nuns prayed with and took good care of the sick, while younger nuns washed soiled linens, usually in the rivers.
- St. Catherine of Siena. The first “Lady with a Lamp”. She was a hospital nurse, prophetess, researcher and a reformer of society and the church.
- In 16th century, hospitals were established for the care of the sick where hospitals were gloomy, cheerless, airless and unsanitary. People entered hospitals only under compulsion or as a last resort.
Dark Period of Nursing
(17th to 19th century)
- There were no provisions for the sick, no one to care for the sick
- Nursing became the work of the least desirable of women---women who took bribes from patients, who stole the patient’s food and who used alcohol as a tranquilizer.
- They worked seven days a week slept in cubbyhole near the hospital ward or patient and ate scraps of food when they could find them.
Period of Educated Nursing
(From June 15, 1869 when Florence Nightingale School of Nursing was opened until World War II)
- The development of nursing during this period was strongly influenced by trends resulting from wars, from an arousal of social consciousness, from the emancipation of women and from the increased educational opportunities offered to women
- Popularization of the philosophy of the Nightingale System
o Importance of nursing education
o Hospital affiliation
o Nurses teaching students
o Health teaching as critical responsibility
o Enforced written physician orders
o Expansion in no. of schools to North America
o Specialization developed
Period of Contemporary Nursing
(Period after World War II up to present)
- Scientific and technological developments as well as social changes mark this period
- Establishment of WHO
- Use of atomic/nuclear energy for medical diagnosis and treatment
- Utilization of computers
- Use of sophisticated equipment for diagnosis and therapy
- Health is perceived as a fundamental human rightNursing involvement in community health is greatly intensified
- Development of the expanded role of nurses
- Professionalization of nursing
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