Exam 2 Flashcards
Theory
Mental viewing
Proposed idea or plan
Statement that explains observable phenomenon
Model
Small copy or imitation of a design
Hypothetical description based on analogy
Explains concept or object it represents
Seeing all parts as a whole
Systems Theory
Ludwig Von Bertanlanfty
Studying human behavior through “wholes” that fiction “holistically” because of their interdependence of their parts
System
Whole that functions as a whole due to interdependent parts
Equifinality
Systems from simple to complex
Energy pool
Source of power that is needed for systems to function
Nonsummativity
Degree of interrelatedness among systems parts
⬆️ nonsummativity = ⬆️ interdependence of components
Systems need to function
Focal unit
Particular part of system interest in studying
Ex. Cell, two people interacting
Microsystem
Looks at one small focal unit
Mezzosystem
Looks at several Microsystems
Macrosystem
Looks at large or complex interrelationships
Ex. How nervous system and enforcing system interact
Subsystem
One of the lesser systems that make up total
Suprasystem
Any subsystem that is outside the system under study
Open system
Ongoing dynamic exchange of data with the environment and other systems
Closed system
Does not exchange data with environment
Self-contained
Slow to change
Ex. Chemical reactions, rocks
Interface
Space outside system acts as medium to transfer info, energy, etc (environment)
Entropy
System to become disorganized and nonfunctional
Negentropy
System maintains itself homeostasis
Dynamic process
Input/output channels
Ways the system exchanged data with the environment
Throughput
Allows input to enter and output to leave through semipermeable membrane
Outer edge of system
Feedback loop
Both positive and negative feedback enter and leave the system
Positive feedback
Lead to change
Goal: improvement
Negative feedback
System reaches peak in functioning
Maintains level
Adaptive behavioral response
Coping process
Allows person to adjust to stimuli (input)
Maintain state of health
Nonadaptive behavioral response
Noneffective
Person unable to cope with stimuli
And state of illness
Focal stimuli
Produce direct response
Direct cause
Contextual stimuli
Environmental factors
May affect focal stimuli at same time
Residual stimuli
Not obvious
May be subconscious (values and upbringing)
Cannot validate
Four modes of assessment
How person adapts to stimuli
Physiological mode
Persons physical response to stimuli
Self-concept mode
Persons thoughts and feelings about himself or herself
role-function mode
How persons role of roles change as a result of the stimuli
Interdependence mode
Support systems
Religious beliefs
Interactions
Dependency on others
Roy model
Man (person, patient, client) is center
Bio, psycho, social, spiritual being in constant state of adaption to environment
Can be family, community, or as a whole
Two parts of man: Regulator
autonomic biological responses to stimuli
neuroendocrine response
Not under conscious control
Two parts of man: Cognator
Mind and will
Person able to think and consciously manipulate the stimuli
Assigns values to events in life
Person (man)
Hostility being who reacts to everything around them
Thinking or intellectual skill (cognator)
Feelings and emotions (regulator)
Reflection and memory(cognator)
Makes choices, free will (cognator)
Environment
Effects person on inside and outside
Health
Persons ability to adapt to stimuli
Person and environment interaction to live to fullest potential
Frees energy in areas of life and maintain adaption
Continuum, not absolute state
QUALITY OF LIFE ***
Nursing
Art and science of caregiving
Focuses on persons positive adaption to environment (health)
Promotes integrity
Nursing process
Assessment
Analysis
Planning
Implementation
Evaluation
Dorothea E. Orem’s model
Health care is own responsibility
Helping clients direct and carry out activities that help to maintain or improve health
Client
Biological, psychological, social being with capacity for self-care
Self-care
Universal: everyday life that support and encourage normal growth, development and functioning
Health deviation self-care: six self care activities
Six activities to maintain state of health
Air, water, food
Excretion of waste
Activity and rest
Solitude and social interactions
Avoiding hazards to life and well-being
Being normal mentally under universal self-care
Environment
Generally viewed as negative
Factors detract ability to provide self-care
- personal systems
- interpersonal systems
- social systems
Three levels of nursing care
Wholly compensated
Partially compensated
Supportive developmental
King Model of Goal Attainment
Nursing function in 3 system levels
Basic- highest
- Personal (client -nurse relationship)
- Interactional (small groups share like goals)
- Social (personal and interpersonal systems necessary function working larger social system)
Care of individual main focus!
Health is primary goal
King Model of Goal Attainment: how health is achieved
Adjusting to environment stressors
Ppl reach highest level of functioning
Maximizing available resources
Setting and achieving goals for one’s role in life
Watson Model of Human Caring
Phonological approach rather than systems
Balance between impersonal aspects of nursing care and personal and interpersonal elements
Watson Model of Human Caring: Client
Has needs
Grows and develops throughout life
Eventually reaches state of internal harmony
Total person more important to care than injury or disease process
Watson Model of Human Caring: Illness
Clients inhabiting to integrate life experiences
Failure to achieve full potential or inner harmony
Not synonymous to disease process
Watson Model of Human Caring: Curing
Goal of treatment and elimination of disease
Watson Model of Human Caring: Values
All ppl are inherently valuable because they are human
Nurses: faith and hope in people because of human potential for development
Watson Model of Human Caring: Caring
Relationship of help and trust
Encouragement for both positive and negative feelings with acceptance
Supportive, protective, corrective environment
Johnson behavioral system model
Client behavior is key to preventing & restoring illness
Influenced by input factors from environment and output on turn affects of environment
Johnson behavioral system model: client
Viewed as behavioral system organized and integrated whole
Whole is greater than sum
Johnson behavioral system model: 7 distinct subsystems
Security
Dependency
Taking in
Elimination behavior
sexual behavior
Self-protection
Achievement
Johnson behavioral system model: Health
Balance and steady state
Maintaining balance
Balance disturbed by: disease, injury, emotional crisis
Out-of-balance state=state of illness
Johnson behavioral system model: Environment
Internal and external elements
Internal: bodily processes, psychological states, religion, political orientation
External: air temp, humidity
Sociological: family, neighborhood, society
Johnson behavioral system model: Nursing
Activity helps individual achieve and maintain optimal level of behavior
Manipulation and regulation of environment
Johnson behavioral system model: Environment 4 activities
Restricting harmful environmental factors
Defending client from negative environmental influences
Inhibiting adverse elements from occurring
Facilitating positive internal factors for recovery
The Neuman Health-Care Systems model
Individual and his or her environment
Health-care disciplines apart from nursing
Systems and stress theory
The Neuman Health-Care Systems model: Client
Open system interacts with internal and external environment through systems boundaries ⬇️
Lines of defense and resistance
Series of concentric circles surround basic core of individual
Control input and output
The Neuman Health-Care Systems model: Health
Internal functioning of client
Optimal health: client maintain high state of wellness/stability
Continuum reflects clients internal stability while moving from wellness to illness and back
The Neuman Health-Care Systems model: Illness
Clients core structure is unstable
Environmental facilities overwhelm and defeat lines of defense and resistance
STRESSORS
The Neuman Health-Care Systems model: Environment
Internal and external stressors that produce change or response in client
Helpful or harmful
Relationship w/core of client-system
Outside: extrapersonal stressors
The Neuman Health-Care Systems model: Nursing
At what level or boundary disruption in clients internal stability
Ability to aid client in activities to strengthen and restore integrity of boundary
** identify stressors to prevention
Middle Range Theories and Models
Hypothesis found in everyday nursing research and well-developed nursing theory
Less comprehensive
Focused on major nursing theories
Do not have all 4 elements
No large number variables
Focus: 2 problems that are linked
Deal with ppl or populations with health-care conditions
EBP!
Values
Concepts, ideas, behaviors, meaning to personal lives
Morals
Standards of right and wrong internalized by process of learning inherent in human socialization
Laws
Man-made rules of conduct that protect society
Ethics
Valued behaviors and beloveds that declare right or wrong or what ought to be
Ethical code
Framework or decision making
Identified group
Ethical dilemma: Autonomy
Right of self-determination, independence, freedom of decision
Right to die
Ethical dilemma: Standard of best interest
Decision made abt persons health when unable to make decision for themselves
Beneficence vs paternalism
Paternalism
Health-care provider knows “what’s best” for the patient
Patient should not question care
Substitute judgement
Same as if person made decision for himself or herself
Advance directives
Decisions made by competent individuals about future health care
No longer able to make own health care decision
Living will
Written by advance directive
Treatments, Procedure, Tests
Enforceable under law
Often poorly written and too general
Durable power of attorney for health care (DPOAHC)
Person legally designated to make health-care decisions for an individual who is no longer able to make decisions for themselves
Ethical dilemma: Distributive justice
Right for person to be equally treated equally regardless of race, sex, marital status, diagnosis, social standing, economic level, or religious belief
Ethical dilemma: Fidelity
Obligation of individual to be faithful to commitments made of self and others
Ethical dilemma: Beneficence
Primary goal of health care and nursing is to do good for others
Ethical dilemma: Nonmaleficence
Requirements that health care provider do no harm
Ethical dilemma: veracity
Truthfulness
Cannot deceive or mislead
Abandonment
Without adequate notice
Utilitarianism
Good
Ends justify means
No set rules or principles
Decisions depend on situation
Deontology
Discovery and confirmation of set of morals or rules
Principles absolute and unchanging
Focuses on right from wrong
Uniform anatomical gift act
Passed to increase supply of donor organs and reduce confusion
List of people who need organs
True emergency
Person either die or have permanent injury if not treated immediately
Consent is implied
Children under 18
Statute of limitation
Malpractice suit can no longer be filed
2 yrs after discovery injury
In children up to age 21
Expert witness
Person called to provide special info or opinions in case that requires special study or experience
Suit-prone patients
Demanding
Dependent
Critical of nurses
Filed lawsuits before
Suit-prone nurses
Insensitive to patients needs
Undereducated
Overconfident
Authoritarian
Pre-occupied personal issues
Watson model: 5 key elements
Action: behaviors
Reaction: behaviors produced by action
Interaction: client and nurse
Transaction: life situation perceives and encountered
Feedback: change occurs as result of interaction and transaction process
Watson model of human caring: philosophical approach
Balance interpersonal aspects of nursing care
technological and scientific
Personal and interpersonal elements grow from humanistic belief
Neuman Health-Care Systems Model
Primary -prevent causes of environmental stressors
Secondary- treating symptoms
Tertiary- restore client system to balance by adapting to negative stressors
Organ donation
Donor, donors family, medical and nursing, recipient and his/her
ALL HAVE RIGHTS AND OBLIGATIONS
3 sources of organ donation
Living related donors
Living unrelated donors
Cadaver donors
Ethical dilemma principles
Autonomy
Justice
Fidelity
Beneficence
Nonmaleficence
Veracity
Standard of best interest
Obligations
Ethical dilemma: obligations
Demand made on individual, profession, society, gvt
Legal and moral
Legal obligations
Formal statements of law
Nurses provide safe and adequate care for clients assigned to them
Moral obligations
Moral or ethical principles
Not enforceable under law
Advantages of utilitarianism
Easy to use
Based on individuals happiness
No rules
Disadvantages of utilitarianism
“Means justify ends”
Raises subjective questions: to whom does happiness concern?
Deontology advantages
Holds ethical decision based principles
Consistent
Emphasis on rights, duty, principles, obligation
Forms basis for code of ethics
Deontology disadvantage
Difficult to make decisions when principle conflict
No exceptions
Where do principles originate?
Passive euthanasia
Allow person to die without intervention or extraordinary measures
Active euthanasia
assisted suicide, mercy killing
Performing help to hasten persons death
