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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
Nursing considerations regarding "nontraditional" families
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)
26
Define group therapy
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
Define family therapy (goals, how to start)
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
Define family education
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
Framework of Family Assessment (3 components)
Structure - internal, external and context Development - beginning/ marriage - family in retirement Function - instrumental; affective and socialization; expressive; healthcare
30
Assessing internal structure of a family
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
Assessing external structure of a family
outside groups/things to which the family is connected; ``` Extended family External systems (health centers, schools, jobs, religious centers) ```
32
Assessing family context
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
Genograms
Used to illustrate family composition Illustrates names, relationships, ages, marriages and divorses, adoptions, and other health data Males = squares, females = circles
34
Ecomaps
Used to assess external systems that the family interacts with
35
What are the functions of a family?
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
Differentiation of self & how it is assessed
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
Characteristics of families with high differentiation of self
Adult members are flexible, seek to support other members, understand that each member is unique encourages members to develop differently from one another
38
Characteristics of families with low differentiation of self
Adult members are impulsive cannot analyze a situation before reacting cannot maintain intimate interpersonal relationships
39
Triangles
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
Define communication
individuals interact with one another by sending and receiving verbal and nonverbal messages
41
Define circular communication
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
Tasks related to Beginning Families
Establish a satisfying marriage Align with extended family Family planning
43
Tasks related to Childbearing Families
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
Tasks related to Families with Preschool Kiddos
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
Generation sandwich
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
COPE Model
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
Therapeutic interventions during family assessments
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
Assessing internal structure: Determine gender roles
"what are the expected behaviors for men in your family? for women?"
49
Assessing internal structure: Evaluate rank order
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
Assessing internal structure: Subsystems and boundaries
Permeable boundaries present Subgroups are present and healthy (not excessively strong or exclusive)
51
Assessing external structure: extended family
"Are extended family members available to help support your immediate family?" Extended family provides emotional and other support
52
Assessing context
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
Assessing family function: Instrumental
"Does a family member's illness affect the family's ability to carry out ADLs?"
54
Assessing family function: Expressive
Ask questions and observe interactions to assess emotional communication Do all members express both positive and negative emotion?
55
Maternal emotional responses: ambivalence
= fluctuating responses (pride and excitement with fears and anxiety) common in 1T normal feeling when preparing for lifestyle changes and new roles
56
Maternal emotional responses: introversion
= focusing on oneself and the fetus common in 1T and 3T may seem passive to family/friends, but this is normal
57
Maternal emotional responses: acceptance/"binding in"
= 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
Maternal emotional responses: mood swings
hormonal changes cause a rollercoaster of emotions common throughout pregnancy; edu that this is NORMAL tough on partners
59
Maternal emotional responses: changes in body image
some women embrace the changes, others feel extremely uncomfortable All feelings around body changes are normal at this time
60
Couvade Syndrome
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
When do partners begin acceptance of their partner's pregnancy?
Typically at quickening, alongside the partner experiencing the pregnancy
62
Sibling responses to pregnancy
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
Preparing a toddler for a new sibling
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
Preparing children for a new sibling in the prenatal period
Allow children to feel belly, fetal movement, heart rate, etc.

NU472 (5 decks)

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