Exam 3 Flashcards
What is at the center of thoughtful practice?
Patient/person
What are the 4 components of thoughtful practice?
Reflective practice, Nurse’s attributes, knowledge, & experience, Clinical reasoning, judgment, & decision making, & Patient-centered nursing process
What are the 5 steps of the nursing process?
Assessing, Diagnosing, Planning, Implementing, & Evaluating
What is assessing in the nursing process?
Collecting, validating, and communicating patient data
What is diagnosing in the nursing process?
Analyzing patient data to identify patient strengths & problems
What is planning in the nursing process?
Specifying patient outcomes & related nursing interventions
What is implementing in the nursing process?
Carrying out the care plan
What is evaluating in the nursing process?
Measuring extent to which patient achieved outcome
What is the biggest benefit of the nursing process?
Coordinates care
What are the 4 steps in concept mapping?
Collect pt problems & concerns, Connect & analyze the relationships, Create a diagram, & Keep key concepts in mind
What is the order of Maslow’s Hierarchy of Need? (bottom to top) (50
Physiological needs, Safety & security needs, Love & Belonging needs, Self-esteem needs, & Self-actualization needs (must be met in this order)
What are physiological needs according to Maslow?
The basic requirements for human survival, such as food, water, warmth, and rest.
What are safety needs according to Maslow?
The need for security and protection from physical and emotional harm, including health and financial stability.
What are love/belonging needs according to Maslow?
The emotional need for interpersonal relationships, affection, and social belonging.
What are esteem needs according to Maslow?
The need for self-esteem, recognition, and respect from others.
What are self-actualization needs according to Maslow?
The desire for personal growth, self-improvement, and to realize one’s full potential.
What is the definition of health?
A state of complete physical, mental, and social well-being, not merely the absence of disease or infirmity (financially stable)
What is the definition of illness?
The unique response of a person to a disease; an abnormal process involving changed level of functioning (pathology)
What is the definition of wellness?
An active state of being healthy by living a lifestyle promoting good physical, mental, and emotional health (the desire to be healthy)
What best describes health?
Individually described by each person
What are the 6 human dimensions composing the whole person?
Intellectual, Environmental, Spiritual, Sociocultural, Emotional, & Physical (nurses can treat all of these areas/ holistic care)
What is the best way to describe chronic illness?
Long term, long-standing disease (often predictable, no cure, only management) (exacerbation & remission)
What are the 4 characteristics of chronic illness?
Permanent change causes(ed by) irreversible alterations, requires special education, & requires a long period of care/support
What are the ranges for the health-illness continuum?
High-level wellness -> Good health -> Normal health -> Illness -> Death
What are the 6 risk factors for illness?
Age, Genetic factors, Physiologic factors, Health habits, Lifestyle, & Environment
What are the 4 factors that influence a person’s self-concept?
Past experiences, Interpersonal interactions, Physical & cultural influences, & Education
What is primary health promotion give examples?
Strategies and activities aimed at improving health and preventing disease before it occurs. Vaccinations, education, etc.
What is secondary health promotion give examples?
Strategies aimed at reducing the impact of a disease or injury that has already occurred. Screenings, risk assessments, etc.
What is tertiary health promotion give examples?
An approach aimed at helping individuals manage long-term, complex health problems to improve their quality of life (treatment). Rehabilitation, chronic disease management, etc.
What is Erickson (psychosocial) theory expand on?
Expanded on Freud to include cultural and social influences
What occurs in adolescents?
Puberty, searching for identity, trying out different roles, and self concept
What occurs in the young adult phase?
Relationships, choosing a vocation, setting long term goals, creative in thought, & objective/realistic
What are adolescents & young adults at risk for?
Injuries (MVA) (risk-taking behaviors), substance abuse, suicide, pregnancy/STDs, nutritional problems, & developmental & situational stressors
What occurs in the middle-age adult phase?
Hormonal changes, hair loss/color changes, hearing/vision changes, fatty tissue, mid life reassessment, & sandwhich generation
What does sandwhich generation mean?
a group of people who care for both their aging parents and their children simultaneously.
What is ageism?
Form of prejudice – stereotyped by characteristics found in only a few members of the group. View that older people are different
What are some issues that come with aging?
Social interaction, Living arrangements, Role reversal (used to provide care now the one cared for), chronic illness (polypharmacy), accidental injuries, dementia, Alzheimer’s disease, & sundowning syndrome
What is polypharmacy?
When a pt. takes multiple medications at the same time
What is sundowning syndrome?
a phenomenon in which individuals with dementia experience increased confusion and agitation in the late afternoon and evening
What are the 3 dimensions of self-concept?
Self-knowledge, Self-expectation, & Self-evaluation
What question describes self-knowledge?
“Who am I?”
What question describes self-expectation?
“Who or what do I want to be?”
What question describes self-evaluation?
“How well do I like myself?”
What are the three major self-evaluation feelings?
Pride, Guilt, & Shame
What is pride based on?
Based on positive self-evalution
What is guilt based on?
Based on behaviors incongruent with the ideal self
What is shame associated with?
Associated with low global self-worth
What is self-concept learned from?
From the environement and family
What are factors affecting self-concept?
History of success & failure, Developmental considerations, culture, internal & external resources, crisis or life stressors, aging, illness, & trauma
What are 4 aspects of assessing self-concept?
Personal identity, Body image, Self-esteem, & Role performance
What aga group does the Intamcy vs. Isolation phase apply to?
Young Adult
What aga group does the Generativity vs. Stagnation phase apply to?
Middle Age Adult
What age group does the Integrity vs. Despair phase apply to?
Older Adult
What are the positive outcomes for the Erikson phase for young adult?
Intimacy and strong relationships established
What are the positive outcomes for the Erikson phase for mild age adult?
Development of a sense of generativity, contributing to society and feeling productive.
What are the positive outcomes for the Erikson phase for older adult?
Achieving a sense of integrity and fulfillment in life.
What are the negative outcomes for the Erikson phase for young adult?
Struggles with intimacy, feelings of isolation, and difficulty establishing meaningful connections.
What are the negative outcomes for the Erikson phase for mild age adult?
Feelings of stagnation, unproductive contributions to society, and a lack of personal fulfillment.
What are the negatve outcomes for the Erikson phase for older adult?
Experiencing despair and regret over unachieved goals.
What are some examples of physiologic stressors?
Chemical agents, Physical agents, Infectious agents, Nutritional imbalance, Hypoxia, & Genetic or immune disorders
What are chemical agents of stress?
Substances that can cause physiological stress in the body, including drugs and illnesses.
What are physical agents of stress?
Environmental factors that can lead to physiological stress, such as extreme temperatures or mechanical forces.
What are infectious agents of stress?
Pathogens such as bacteria, viruses, or parasites that can induce stress on the body.
What is hypoxia?
A condition where there is a deficiency of oxygen in the tissues, causing stress.
What are some examples of psychosocial stressors?
Accidents, Stressful/traumatic experience of family and friends, Horrors of history, Fear of aggression or mutilation, Events of history, & Rapid changes in the world
What are the primary control of the physiological homeostasis coping mechanisms?
Autonomic nervous systems & endocrine system
What are the secondary control of the physiological homeostasis coping mechanisms?
Respiratory, cardiovascular, GI, & the renal systems
What is homeostasis?
The property of a system to regulate its internal environment to maintain stable conditions. (back to normal)
What is the local adaption syndrome?
Involves only one specific body part (ex. Reflex pain response & inflammatory response)
What is the general adaptation syndrome?
A biochemical model of stress (ex. Alarm reaction, Stage of resistance, & Stage of exhaustion) (Fight or flight)
What is the alarm reaction?
The initial response to stress that activates the body’s defense mechanisms
What is the stage of resistance?
The body’s adaptation to prolonged stress after the alarm reaction. Hormone levels rise, body prepares to react. (adapt to stressor)
What is the stage of exhaustion?
The final stage of the general adaptation syndrome, occurring when the body’s resources are depleted.
T/F The inflammatory response is a response of the central nervous system to pain.
False
Rationale: The reflex pain response is a response of the central nervous system to pain.
What are 6 nursing strategies to identify personal strengths?
Identify pt.’s strengths, help at-risk pt. maintain sense of self, replace self-nagation, notice & reinforce pt. strengths, encourage pt. to will strengths for themselves, and help pt. cope w/necessary dependency
What is the sympathetic nervous system?
A part of the autonomic nervous system that prepares the body for stressful or emergency situations, often referred to as the ‘fight or flight’ system. (Ex. Increase HR & cardiac output)
What is the parasympathetic nervous system?
A part of the autonomic nervous system responsible for conserving energy and promoting rest-and-digest functions. (Decreases HR back to normal)
What is the most common emotional response to stress?
Anxiety
What is the mind-body interaction?
The relationship between physical health and emotional well-being.
What level of anxiety can be beneficial?
Mild Anxiety
What is the best way to describe moderate anxiety?
A level of anxiety that makes it difficult to focus
What is the best way to describe severe anxiety?
A level of anxiety that significantly impacts daily life
What is the best way to describe panic?
An intense and overwhelming fear that can occur during extreme stress
T/F Mild anxiety narrows a person’s perceptual fields so that the focus is on immediate concerns, with inattention to other communications and details.
False
Rationale: Moderate anxiety narrows a person’s perceptual fields so that the focus is on immediate concerns, with inattention to other communications and details.
What are coping mechanisms?
Strategies used to manage stress and emotional challenges.
What are the 3 types of task-oriented reactions to stress?
Attack behavior, Withdrawal behavior, & Compromise behavior
What are types of defense mechanisms?
Compensation, denial, displacement, introjection, projection, rationalization, reaction formation, regression, repression, sublimation, & undoing
What is the compensation defense mechanism?
A defense mechanism where an individual attempts to make up for a perceived deficiency or weakness.
What is the denial defense mechanism?
A defense mechanism that involves refusing to accept reality or facts.
What is the displacement defense mechanism?
A defense mechanism that shifts emotional responses from the original object to a safer substitute.
What is the introjection defense mechanism?
A defense mechanism where an individual internalizes the beliefs or attitudes of others.
What is the projection defense mechanism?
A defense mechanism that involves attributing one’s own unacceptable feelings or thoughts to someone else.
What is the rationalization defense mechanism?
A defense mechanism that offers logical explanations for behaviors that are actually motivated by irrational factors.
What is the reaction formation defense mechanism?
A defense mechanism characterized by converting unwanted or dangerous thoughts into their opposites. (little boy like little girl, so he pulls her pigtails)
What is the regression defense mechanism?
A defense mechanism where an individual reverts to behaviors characteristic of an earlier stage of development.
What is the repression defense mechanism?
A defense mechanism that involves unconsciously blocking out painful or unwanted thoughts and feelings.
What is the sublimation defense mechanism?
A defense mechanism that channels unacceptable impulses into socially acceptable behaviors.
What is the undoing defense mechanism?
A defense mechanism that involves attempting to reverse or negate a thought or feeling by performing a contrary action.
Which defense mechanism is portrayed in the following scenario? After throwing his lunch tray on the floor, a patient complains to the nurse manager about the quality of the food he is being fed during his hospital stay.
Rationalization
What are some of the effects of long-term stress?
Affect physical status, increase risk of disease or injury, compromises recovery, & is associated with specific diseases
What is caregiver burden?
the physical, emotional, and financial strain experienced by individuals providing care to someone who is ill, disabled, or elderly
What are the 3 factors affecting stress and adaptation?
Sources of stress, Types of stressors experienced, & Personal factors
When does developmental stress occur?
Occurs when person progresses through stages of growth and development
What is true about how situational stress occur?
Does not occur in predictable patterns
T/F An example of situational stress is the stress related to a marriage or divorce.
True
Rationale: An example of situational stress is the stress related to a marriage or divorce.
What are stressful activities in nursing profession?
Assuming responsiblities while unprepared, working with unqualifies personnel, Working in an environment w/unsupportive supervisors, Caring for pt. in cardiac arrst or dying, and Experiencing conflict with peers
What are some health activities of daily living?
Exercise, Rest and sleep, Nutrition, Use of support systems, & Use of stress management techniques
What are 6 stress management techniques?
Relaxation, Mediation, Anticipatory guidance, Guided imagery, Biofeedback, & Crisis intervention
What is anticipatory guidance?
A proactive approach to preparing patients and their families for expected developmental milestones and potential challenges.
T/F In the stress management technique known as anticipatory guidance, a person creates a mental image, concentrates on the image, and becomes less responsive to stimuli.
False
Rationale: In the stress management technique known as guided imagery, a person creates a mental image, concentrates on the image, and becomes less responsive to stimuli.
What are the 5 elements of crisis intervention?
Identify the problem, List alternatives, Choose from alternatives, Implement the plan, & Evaluate the outcome
What kind of skill is communication?
Technical
What are the 5 parts of the communication process?
Stimulus or referent, Sender or source of message (encoder), Message itself, Medium or channel of communication, & Receiver (decoder)
What determines the type of vocabulary used in communication?
The status of the sender
What are the 4 levels of communication?
Intrapersonal, Interpersonal, Small group, & Organizational
What is intrapersonal talk?
self-directed conversation or dialogue that occurs within an individual.
What is interpersonal talk?
communication and conversation that takes place between two or more individuals.
What are the 7 characteristics of effective & ineffective groups?
Group identity, Cohesiveness, Patterns of interaction, Decision making, Responsibility, Leadership, & Power
What are the 8 factors influencing communication?
Development level, Gender, Sociocultural differences, Roles & responsibilities, Space & territoriality, Physical, mental, & emotional state, Values, & Environment
What needs to align in order for you to been seen as honest?
Verbal and Nonverbal communication
What are the 3 phases of the helping relationship?
Orientation (purpose), Working (delivering care), & Termination (leave)
What are the 4 dispositional traits?
Warmth & friendliness, Openness & respect, Empathy (not sympathy), & Honest, authentic, & caring
What are the 4 rapport builders?
Privacy, Environment, Pacing, & Specific objectives
What are open-ended questions (interviewing techniques)?
Questions that allow for a free-form response rather than a simple yes or no.
What are closed questions (interviewing techniques)?
Questions that can be answered with a simple yes or no.
What are validating questions (interviewing techniques)?
Questions that seek to confirm understanding or feelings.
What are clarifying questions (interviewing techniques)?
Questions that aim to clear up confusion or gain more detail.
What are reflective questions (interviewing techniques)?
Questions that encourage the responder to think back on their experiences.
What are sequencing questions (interviewing techniques)?
Questions that ask for information in a specific order or series.
What are directing questions (interviewing techniques)?
Questions that guide the conversation toward a specific topic or response.
What is the most important characteristic of assertive nurse’s self-presentation?
Admitting mistakes & taking responsibility for them
What are some blocks to communication?
Using clichés, Using questions containing the words “why” & “how” (puts blame on pt.), Giving false assurance, Using judgemental comments, Failure to listen, etc.
What are the 4 aims of teaching and counseling?
Maintaining and promoting health, Preventing illness, Restoring health, & Facilitating coping
What are the 2 overall goals of teaching?
Have the pt. learn & create new behaviors
What are the 3 focus points of patient education?
Preparation for receiving care, preparation before discharge from a health care facility, & documentation of pt. education activity
What does the acronym T.E.A.C.H. stand for?
Tune into the pt.
Edit pt. info
Act on every teaching moment
Clarify often
Honor the pt. as a partner in education process
What are the 3 learning domains?
Cognitive, Psychomotor, & Affective
What is cognitive learning?
Storing & recalling of new knowledge in the brain (ex. Lecture)
What is psychomotor learning?
Learning a physical skill (ex. Lab)
What is affective learning?
Changing attitudes, values, & feelings (ex. Role modeling)
What are the assessment parameters (learning/teaching)?
Knowledge, attitudes, and skills needed to be independent, Readiness to learn, Ability to learn, & Learning strengths
What are the 5 steps to providing culturally competent pt. education?
Develop understanding, Work w/multicultural team, Be aware of assumptions, biases, & prejudices, Understand core cultural values, & Develop written material in pt. preferred language
What are the 6 teaching plan for older adults?
Id learning barriers, Allow extra time, Plan short teaching sessions, Accommodate for sensory deficits, Reduce environmental distractions, & Relate new info to familiar activities or info
What are some key points to effective communication?
Avoid too much detail & stick to the basics, listen and do no interrupt, use simple vocabulary, ask for questions, be sincere & honest, etc.
What is the gold standard for obtaining feedback about learning?
The teach-back method
What are the 4 parts of documentation of the teaching-learning process?
Summary of the learning need, The plan The implementation of the plan, & Evaluation results (did the pt. understand?)
What are the 2 types of power?
Explicit and implied
What the 5 steps to achieving self-knowledge?
Identify strengths, Evaluate how you accomplish work, Clarify your values, Determine where you belong and what you can contribute, & Assume responsibility for relationships
What is the autocratic leadership style?
A leadership style characterized by individual control over all decisions and little input from group members.
What is the democratic leadership style?
A leadership style that encourages group participation in the decision-making process.
What is the Laissez-faire leadership style?
A leadership style that allows team members to make decisions and complete their work independently. (not very effective)
What is the servant leadership style?
A leadership style focused on serving others and prioritizing the needs of team members.
What is the quantum leadership style?
A leadership style that adapts to changes quickly and encourages innovation. (data driven)
What is the transactional leadership style?
A leadership style based on a system of rewards and punishments.
What is the transformational leadership style?
A leadership style that inspires and motivates team members to achieve their fullest potential.
What are the 3 steps of Lewin’s Theory of Change?
Unfreezing, Change, & Refreezing
What is the unfreezing phase?
The first stage in Lewin’s Theory of Change where existing behaviors are challenged and prepared for change.
What is the change phase?
The phase in Lewin’s Theory of Change where new behaviors and practices are developed and implemented.
What is the refreezing phase?
The final stage in Lewin’s Theory of Change where new behaviors are solidified and made a permanent part of the organization.
What are the 5 steps for using time effectively?
Establish goals, Evaluate goals, Establish time line, Evaluate success, & Use results to direct priorities & time line
What are the 6 factors to consider prior to delegating pt. care?
Qualifications & capabilities of the UAP, Stability of the pt. condition, Complexity of the activity to be delegated, The potential for harm, The predictability of the outcome, & The overall context of other pt. needs (know when, how, & why to delegate)
What can not be delegated?
Responsibility (only tasks can be delegated)
Who is responsible & accountable for nursing practice?
The RN
What is the purpose of UAP?
To work in supportive role to the RN
