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NU472 > Exam 1 > Flashcards

Exam 1 Flashcards

1
Q

Define family

A

A family is whoever the patient says they are.

They are concerned with all parts of a person’s life, and with meeting the individual’s basic human needs to promote health

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2
Q

Nuclear family

A

“traditional” family; a couple and their children

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3
Q

Extended family

A

those related to the members of a nuclear family

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4
Q

Blended family

A

2 single parents with children join to form a new family unit

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5
Q

Single-parent family

A

1 parent raising children d/t divorce, death, etc.

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6
Q

Skip-generation family

A

grandparents raising grandchildren

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7
Q

Family functions

A

Physical: provides a safe, comfortable environment for growth, development and rest

Economic: provides financial aid to family members

Reproduction: have and raise children

Affective and coping: providing emotional comfort and identity, especially during stress

Socialization: teaching values, transmitting beliefs and attitudes, teaching coping mechanisms, providing feedback and teaching problem-solving

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8
Q

Why is family-centered nursing care important?

A

Family is composed of interdependent members that affect one another

There is a strong relationship between the family and the health status of its members (members have similar health behaviors)

Level of health amongst family members can be improved through health promotion activities

Illness in one member may suggest the possibility of the same problem in the other (d/t genetics, learned behaviors)

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9
Q

Nursing interventions associated with family-centered care

A

Open, honest and respectful patient teaching

Therapeutic communication

Assessing and applying knowledge gained around family dynamics

Referring families to community health & financial resources

Involve family members in planning and implementing care

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10
Q

What is family-centered care?

A

a collaborative approach that includes patient family members to achieve optimal health

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11
Q

How does illness impact the family structure?

A

Roles and responsibilities are continuously changing to manage the needs of the ill member

Adaptation to stress is the family’s response to the crisis

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12
Q

Tasks for a couple and family with young children

A

Cope with loss of energy and privacy

Establish a satisfying marriage

Family planning

Adjust to cost of family life

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13
Q

Tasks for a family with adolescents and young adults

A

Maintain open communication

Support moral and ethical family values

Balance teens’ freedom with responsibility (allow them to move in and out of the family system as needed)

Maintain a supportive home base

Strengthen the marriage

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14
Q

Nursing interventions for a family with adolescents and young adults

A

Accident prevention programs

STI and sex education

Mental health programs

Screening for chronic illnesses

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15
Q

Lifestyle risk factors that may alter family health

A

Lack of sex education and edu around marital roles

Alterations in nutrition

Chemical dependency (drugs, alcohol)

Inadequate dental care

Unsafe home environment

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16
Q

Psychosocial risk factors that may alter family health

A

Inadequate childcare resources

Inadequate income to provide a safe home with food and clothing

Conflicts between family members

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17
Q

Environmental risk factors that may alter family health

A

Lack of knowledge/finances to provide a safe living condition

Stress (d/t work)

Air, water or food pollution

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18
Q

Developmental risk factors that may alter family health

A

Families with new babies, especially if support systems are unavailable

Older adults living alone or on a fixed income

Unmarried, young mothers who lack personal, economic and educational resources

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19
Q

Biologic risk factors that may alter family health

A

Birth defects

Intellectual disability

Genetic predisposition to certain chronic diseases

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20
Q

What is the best way to assess a family and its structure?

A

Interview the family (10-15 mins)

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21
Q

Common questions during a family assessment

A

What is the family’s structure? Who do you define as family?

What is the family’s socioeconomic status?

Cultural background? Religious affiliations?

Who cares for children?

Health practices of the family? (diet, immunizations, bedtime, exercise, smoking, alcohol)

How does the family define health?

How does the family cope with stress?

Any caregivers within the family?

Do you have a support system who can help if necessary?

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22
Q

Define ageism

A

the discrimination against older adults due to their age

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23
Q

Common causes of stress in older adults

A

Living arrangements

Financial resources

Feeling or being treated as “senile” –> forced retirement, pushed out of home, etc.

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24
Q

Common living arrangements for older adults

A 
90% live in the community
81% live in their own home
Living with family
Retirement communities
Assisted living
Long-term care facilities
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25
Q

Nursing considerations regarding “nontraditional” families

A

Shift away from heterosexism!!!!

Be aware and educated about LGBTQ+ health issues

Use appropriate language and identification –> always ask how patients wish to be identified (pronouns)

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26
Q

Define group therapy

A

Clients participate in sessions with a group of people who share a common purpose and are expected to contribute to the group

Group rules are often established, including confidentiality

27
Q

Define family therapy (goals, how to start)

A

A type of group therapy in which the client and the family members participate; often used to treat psychiatric disorders

Goals: assess family dynamics; identify strengths and weaknesses; mobilize resources; strengthen problem-solving skills

Always start by encouraging each family member to share their perceptions of the problem

28
Q

Define family education

A

a 12 week family-to-family education course designed by NAMI which focuses on MH disorders like schizophrenia, bipolar, depression, panic disorder, and OCD

Goals:
Pt and family education on clinical treatment
Coping skills for the family

29
Q

Framework of Family Assessment (3 components)

A

Structure - internal, external and context

Development - beginning/ marriage - family in retirement

Function - instrumental; affective and socialization; expressive; healthcare

30
Q

Assessing internal structure of a family

A

Composition - use a genogram

Gender roles - “what are the expectations of males in the family? females?”

Rank order - sibling chronological rank

Boundaries that separate subsystems within the family (rigid > less support and comunication; diffuse > less individuation)

Power - who has the power over family processes/functions

31
Q

Assessing external structure of a family

A

outside groups/things to which the family is connected;

Extended family
External systems (health centers, schools, jobs, religious centers)
32
Q

Assessing family context

A

Race/ethnicity – how does the family identify their culture?’

Socioeconomic status - what are the parents occupations?

Religion

Environment (home, neighborhood)

Family can be a context too when caring for only one member of the family

33
Q

Genograms

A

Used to illustrate family composition

Illustrates names, relationships, ages, marriages and divorses, adoptions, and other health data

Males = squares, females = circles

34
Q

Ecomaps

A

Used to assess external systems that the family interacts with

35
Q

What are the functions of a family?

A

Instrumental - the ability of a family to carry out ADLs in health and during illness

Affective and socialization - family’s response to members’ need for support, caring, closeness, while balancing separateness and connectedness; socializing children in a healthy manner

Expressive - communication patterns within a family (well-functioning families express a broad range of both negative and positive emotions)

Health care - what family members believe about health and illness (etiology, treatment, roles of HCPs, familial roles)

36
Q

Differentiation of self & how it is assessed

A

how the connections and balance of cognition and emotions/feelings impact a person’s social functioning

Assessed in relation to the boundaries of the subsystems in the family

A better balance between thinking and feeling > higher differentiation of self > better anxiety management

37
Q

Characteristics of families with high differentiation of self

A

Adult members are flexible,
seek to support other members,
understand that each member is unique
encourages members to develop differently from one another

38
Q

Characteristics of families with low differentiation of self

A

Adult members are
impulsive
cannot analyze a situation before reacting
cannot maintain intimate interpersonal relationships

39
Q

Triangles

A

relational patterns or emotional configurations that exist among 2 family members and another person, object or issue

During stress, the third person/object may be used to avoid stress

i.e. cheating, pulling a kid in, overworking

40
Q

Define communication

A

individuals interact with one another by sending and receiving verbal and nonverbal messages

41
Q

Define circular communication

A

reciprocal communication between two people as A speaks and B listens; then B reacts while A listens

Positive = supportive of feelings –> expression of feelings

Negative = criticisms and avoidance

42
Q

Tasks related to Beginning Families

A

Establish a satisfying marriage
Align with extended family
Family planning

43
Q

Tasks related to Childbearing Families

A

Creating a stable unit, integrating new babies into the family

Reconciling conflicting needs of various family members

Maintaining a satisfactory marriage

Expanding relationships with extended family

44
Q

Tasks related to Families with Preschool Kiddos

A

Meet family member needs for adequate housing, space, privacy and safety

Socialize the children (manners, new friends, etc.)

Integrating new children while meeting the needs of other children

Maintaining health relationships in and outside of the family

45
Q

Generation sandwich

A

When middle-aged adults provide support to their children who are either becoming independent or have returned home, while also caring for aging parents

Can be extremely stressful

46
Q

COPE Model

A

Goal: to include the patient’s family in patient teaching

C - creativity - helping the family to overcome obstacles and generate alternatives

O- optimism - help caregivers learn to view their situation with confidence

P- Planning - help the family learn to plan for future problems and develop contingency plans

E - expert info - help the family learn to seek expert information in certain situations

47
Q

Therapeutic interventions during family assessments

A

Manners!

Therapeutic conversation –> invite family members to accompany the patient to the unit (with patient’s consent)

Genograms/ecomaps prn

Therapeutic questions

Commendations (1-2) - offer praise for families on what they are doing well :)

48
Q

Assessing internal structure: Determine gender roles

A

“what are the expected behaviors for men in your family? for women?”

49
Q

Assessing internal structure: Evaluate rank order

A

Spousal rank order can play a role in family harmony

“What rank order did you have in your childhood family?”

Determine if spouses’ birth ranks are complementary or competitive

Complementary birth order of spouses (i.e. oldest marries youngest)

50
Q

Assessing internal structure: Subsystems and boundaries

A

Permeable boundaries present

Subgroups are present and healthy (not excessively strong or exclusive)

51
Q

Assessing external structure: extended family

A

“Are extended family members available to help support your immediate family?”

Extended family provides emotional and other support

52
Q

Assessing context

A

Is religion important to the family? (can produce conflict or provide support)

What is the family’s race/ethnicity?

Does race/ethnicity or socioeconomic class impact interactions with neighbors?

Race/ethnicity differences from the neighborhood can create stress

53
Q

Assessing family function: Instrumental

A

“Does a family member’s illness affect the family’s ability to carry out ADLs?”

54
Q

Assessing family function: Expressive

A

Ask questions and observe interactions to assess emotional communication

Do all members express both positive and negative emotion?

55
Q

Maternal emotional responses: ambivalence

A

= fluctuating responses (pride and excitement with fears and anxiety)

common in 1T

normal feeling when preparing for lifestyle changes and new roles

56
Q

Maternal emotional responses: introversion

A

= focusing on oneself and the fetus

common in 1T and 3T

may seem passive to family/friends, but this is normal

57
Q

Maternal emotional responses: acceptance/”binding in”

A

= the pregnant person begins to verbalize positive feelings about the pregnancy and conceptualizes the fetus

common @ quickening, which usually occurs ~20 weeks (2T)

NI: offer support and validation to mom at prenatal visits

58
Q

Maternal emotional responses: mood swings

A

hormonal changes cause a rollercoaster of emotions

common throughout pregnancy; edu that this is NORMAL

tough on partners

59
Q

Maternal emotional responses: changes in body image

A

some women embrace the changes, others feel extremely uncomfortable

All feelings around body changes are normal at this time

60
Q

Couvade Syndrome

A

a common, sympathetic response to to a partner’s pregnancy that may cause weight gain, n/v, mood swings, ambivalence, etc.

normal!!! educate the partner too

61
Q

When do partners begin acceptance of their partner’s pregnancy?

A

Typically at quickening, alongside the partner experiencing the pregnancy

62
Q

Sibling responses to pregnancy

A

Age-dependent

Toddlers may regress in toilet training
School-aged kids may ignore the new child or spend more time out of the house

REINFORCE WITH LOTS OF LOVE AND CARING TO REDUCE FEARS OF REPLACEMENT

63
Q

Preparing a toddler for a new sibling

A

Promise normal “special” routines will not change

Buy a doll for the child to care for as mom cares for the new baby

Include the toddler in daily activities for the baby (diaper change, feeding)

64
Q

Preparing children for a new sibling in the prenatal period

A

Allow children to feel belly, fetal movement, heart rate, etc.

NU472 (5 decks)

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