EXAM#4 (CHPTS. 7, 12, 22, 23, 26, & 27) Flashcards
What is a case control study?
A study that compares two groups of people: those with the disease or condition under study (cases) and a very similar group of people who do not have the disease or condition (controls).
THERORISTS
FREUD — Psychosexual focus
ERICKSON — Stages of psychosocial development
MASLOW — Based on human needs
PIAGET — Development of cognition
KOHLBERG — Moral development
Difference between a teratogen, maturation, development, and growth
Teratogen: any agent that causes an abnormality following fetal exposure during pregnancy r/t defects
Maturation: the biological plan for the predictable milestones for growth and development. Physical growth and motor development are a function of maturation.
Development: an interaction of biological, sociological, and psychological forces. Development occurs gradually and refers to changes in skill and capacity to function. These changes are qualitative in nature and difficult to measure in exact units.
Growth: is the measurable aspect of a person’s increase in physical dimensions. Measurable growth indicators include changes in height, weight, teeth and bone, and sexual characteristics.
Psychomotor learning
Occurs when patients acquire skills that require the integration of knowledge and physical skills.
— Examples of psychomotor learning are learning how to administer insulin injections, use inhalers, and swipe a magnet across a vagal nerve stimulator (VNS)
Difference b/w affective learning and cognitive learning
Affective: includes a patient’s feelings, attitudes, opinions, and values. Research shows that you need to include the affective domain in teaching because it includes a patient’s personal attitudes, beliefs, behaviors, and emotions (Miller and Stoeckel, 2016). Learning objectives in the affective domain include influencing attitudes and motivating the learner.
Cognitive: includes what a patient needs to know and understand. All intellectual behaviors are in the cognitive domain, including:
* Acquisition of knowledge
* Comprehension (ability to understand)
* Application (using abstract ideas in concrete situations)
* Analysis (relating ideas in an organized way)
* Synthesis (recognizing parts of information as a whole)
* Evaluation (judging the worth of a body of information)
Nursing-sensitive outcome
— focuses on how patients and their health care problems are affected by nursing interventions
— look at the effects of interventions within the scope of nursing practice.
_______________
Examples of nursing-sensitive outcomes include:
* Symptoms (e.g., pain, fatigue, nausea).
* Functional status (e.g., activity tolerance, ability to perform activities of daily living).
* Safety (e.g., incidence of falls, infections, pressure injuries).
* Psychological distress (e.g., anxiety, depression).
What is a hypothesis?
— Predictions made about the relationship among study variables
Examples
— Characteristics or traits that vary among subjects).
QSEN competency skills for EBP
— Patient Values
— Clinical Expertise
— Values
_________________
Other QSEN skills: teamwork, collaboration, safety, quality
What type of journal could be used to review the latest information regarding hospital acquired infections?
PEER-REVIEWED
Reputable primary sources made by experts
Baby in the 2nd trimester
most organ systems are complete and able to function. The fetus weighs approximately 0.7 kg (1 1/2 lb) and is approximately 30 cm (12 inches) long.
NOTE:
On average, a pregnant woman needs 15% to 20% more kilocalories than she needs when not pregnant. This is equal to approximately 340 kcal/day extra beginning in the second trimester and 450 kcal/day extra during the third trimester
Know Erikson’s Psychosocial Development stages
Compassion fatigue
What are the milestones for a 1 year old?
What does exercise release?
Endorphins (hormone)
Definition of homeostasis
For evidence-based practice (EBP) when providing care, what should a nurse do first?
Ask clinical question
Preschool aged children
Ages 3-5 years
— ID shapes and colors
— “I’m hungry NOW!”
A 3-year-old can recognize people, objects, and events by their outward appearance. For example, 3-year-olds prefer having two nickels over a dime because it appears to be more. The continued egocentricity of early thinking makes it difficult to suggest acceptable alternatives to preschoolers. When they are hungry, they expect others also to be hungry, and they think they must eat now!
Spiritual Belief of Erickson’s middle-aged person
Middle-age person will review value systems during crisis
Reducing fear in school aged children
— Gently encourage your child to do things they’re anxious about, but don’t push them to face situations they don’t want to face.
— Wait until your child actually gets anxious before you step in to help.
— Praise your child for doing something they’re anxious about. Avoid criticising your child for being afraid or worried
Know Kubler-Ross’ 5 responses to loss
- Denial — act as though nothing has changed. They cannot believe or understand that a loss has occurred
- Anger — a person resists the loss, is angry about the situation, and sometimes becomes angry with God
- Bargaining — the individual begins to accept the reality and inevitability of loss and looks to the future
- Depression — the person feels overwhelmingly lonely or sad and withdraws from interactions with others
- Acceptance — the individual begins to accept the reality and inevitability of loss and looks to the future
Regression
Reactions according to General Adaptation Syndrome (GAS)
a three-stage set of physiological processes that prepare, or adapt, the body for danger so that an individual is more likely to survive when faced with a threat
(1) initial alarm, (2) resistance as a person attempts to compensate for changes induced by the alarm stage, and (3) a state of exhaustion if the person cannot adapt successfully during the stage of resistance or if stress remains unrelieved.
Know PICO(T)
Purpose: how much time does it take to demonstrate an outcome (e.g., the time it takes for the intervention to achieve an outcome or how long participants are observed)?
P = patient population or area of interest
—ID your patients (family, clinical staff) by age, gender, ethnicity, disease, and experience or health problem
I = intervention of interest
— Which intervention do you want to use in practice (e.g., a treatment, diagnostic test, educational approach)?
C = comparison of interest
— What is the usual standard of care or current intervention that you now use in practice?
O = outcome
— What result do you wish to achieve or observe as a result of an intervention (e.g., change in patient/family caregiver behavior, physical finding, patient perception)?
T = time
— How much time does it take to demonstrate an outcome (e.g., the time it takes for the intervention to achieve an outcome or how long participants are observed)?
For nausea, what beverage could be offered?
Ginger ale
Know the differences b/w actual loss, perceived loss, situational loss, maturational loss, reminiscence, grief and mourning
Actual: when they can no longer touch, hear, see, or have near them valued people or objects. Examples include the loss of a body part, pet, friend, life partner, or job.
Perceived loss: is uniquely experienced by a grieving person and is often less obvious to others. A perceived loss is very real to the person who has had the loss.
Situational: occurs as a result of an unpredictable life event. A situational loss often involves multiple losses. For example, a divorce begins with the loss of a life companion but often leads to financial strain, changes in living arrangements, less contact with one’s children, and loss of friends who were part of the couple’s married life.
Maturational: as they go through a lifetime of normal developmental processes.
Know types of ego defense mechanisms
Compensation
— Making up for a deficiency in one aspect of self-image by strongly emphasizing a feature considered an asset. (Example: A person who is a poor communicator relies on organizational skills.)
Conversion
— Unconsciously repressing an anxiety-producing emotional conflict and transforming it into nonorganic symptoms (e.g., difficulty sleeping, loss of appetite).
Denial
—Avoiding emotional conflicts by refusing to consciously acknowledge anything that causes intolerable emotional pain. (Example: A person refuses to discuss or acknowledge a personal loss.)
Displacement
— Transferring emotions, ideas, or wishes from a stressful situation to a less anxiety-producing substitute. (Example: A person transfers anger over a job conflict to a malfunctioning computer.)
Identification
— Patterning behavior after that of another person and assuming that person’s qualities, characteristics, and actions.
Dissociation
— Experiencing a subjective sense of numbing and a reduced awareness of one’s surroundings.
Regression
— Coping with a stressor through actions and behaviors associated with an earlier developmental period.
What is the next step in EBP after implementing a practice change?
What are maladaptive coping strategies + examples?
What studies have the best evidence?
Evidence-based practice
— The best scientific evidence comes from well-designed, systematically conducted research studies found in scientific, peer-reviewed journals.
Example of a loss of a ‘known environment
Loss occurs through maturational or situational events and with injury or illness. Loneliness in an unfamiliar setting threatens self-esteem and makes grieving difficult.
_____________
_Examples: moving from a neighborhood, hospitalization, a new job, moving to a long-term care facility
What is the definition of a maladaptive coping strategies + examples?
Actions for postmortem care
care of body after death
— Because a body undergoes many physical changes after death, provide postmortem care as soon as possible to prevent tissue damage or disfigurement of body parts.
______________
Example
— Immediately after death, elevate the head of the bed to 30 degrees or place the patient’s head on pillows to prevent pooling of blood, which can discolor the face.
General Adaptation Syndrome
a three-stage set of physiological processes that prepare, or adapt, the body for danger so that an individual is more likely to survive when faced with a threat
Signs of Impending Death
- Minimal intake of food or water
- Increased sleeping and decreased consciousness
- Disorientation and restlessness
- Decreased urinary output and/or incontinence
- Cool hands and feet
- Noisy breathing
- Irregular breathing patterns with long pauses
- At the time of death, you will note:
- Absence of breathing and heartbeat
- Bowel and bladder release
- Unresponsiveness
- Eyes fixed on a certain spot
- Dilated pupils
Know Worden’s 4 Tasks of Mourning
Describe how individuals help themselves through mourning and ask others for help. Although the time needed varies from person to person, moving through Worden’s tasks typically takes at least 1 year.
— Task I: Accept the reality of the loss.
— Task II: Work through the pain of grief
— Task III: Adjust to the environment in which the deceased is missing
— Task IV: Emotionally relocate the deceased and move on with life
Early childhood/toddler major development theories of childhood
Age — 18 months to 3 years
___________________________________
Developmental stage —
Freud (Psychosexual devel.) —
Erickson (Psychosocial) —
Piaget (logical, cognitive, and moral) —
Kohl berg (moral reasoning) —
Infancy major development theories
Age — birth to 18 months
___________________________________
Freud (Psychosexual devel.) — Oral stage
Erickson (Psychosocial) — Trust vs. mistrust; ability to trust others
Piaget (logical, cognitive, and moral) — sensorimotor period; Progress from reflex activity to simple repetitive actions
Kohl berg (moral reasoning) — N/A
Preschool major development theories
Age — 3-5 years
___________________________________
Freud (Psychosexual devel.) — Phallic stage
Erickson (Psychosocial) — Initiative vs. guilt | Highly imaginative
Piaget (logical, cognitive, and moral) — Use of symbols; egocentric
Kohl berg (moral reasoning) — Preconventional level | Premoral | Instrumental orientation
Childhood major development theories
Age — 6-12 years
___________________________________
Freud (Psychosexual devel.) — Latent stage
Erickson (Psychosocial) — Industry vs. inferiority | Engaged in tasks and activities
Piaget (logical, cognitive, and moral) — Concrete operations period | Logical thinking
Kohl berg (moral reasoning) — Conventional level | Good-boy, nice-girl orientation
Adolescence major development theories
**Age — 12-19 years **
___________________________________
Freud (Psychosexual devel.) — Genital stage
Erickson (Psychosocial) — Identity vs. role confusion | Sexual maturity, “Who am I?”
Piaget (logical, cognitive, and moral) — Formal operations period | Abstract thinking
Kohl berg (moral reasoning) — Postconventional level | Social contract orientation
Young adulthood major development theories
Age —
___________________________________
Freud (Psychosexual devel.) — N/A
Erickson (Psychosocial) — Intimacy vs. isolation | Affiliation and love
Piaget (logical, cognitive, and moral) — N/A
Kohl berg (moral reasoning) — N/A
Adulthood major development theories
Age —
___________________________________
Freud (Psychosexual devel.) — N/A
Erickson (Psychosocial) — Generativity vs. stagnation | Production and care
Piaget (logical, cognitive, and moral) — N/A
Kohl berg (moral reasoning) — N/A
Age —
___________________________________
Freud (Psychosexual devel.) — N/A
Erickson (Psychosocial) — Ego integrity vs. despair | Renunciation and wisdom
Piaget (logical, cognitive, and moral) — N/A
Kohl berg (moral reasoning) — N/A
Definition of appraisal regarding nursing
Many EBP committees use critical appraisal guides or useful checklists for evaluating studies (Spruce et al., 2016). A guide lists questions about essential elements of research (e.g., purpose, sample size, setting, method of study).
Know Bowlby’s 4 Phases of Mourning
- shock-numbness
- yearning-searching
- disorganization-despair
- reorganization
Signs/Symptoms of compassion fatigue
a combination of secondary traumatic stress and burnout experienced by professional and la
— feelings of helplessness and powerlessness in the face of patient suffering.
— reduced feelings of empathy and sensitivity.
— feeling overwhelmed and exhausted by work demands.
— feeling detached, numb and emotionally disconnected.
— loss of interest in activities you used to enjoy.
Distinguish the difference b/w intensity, scope, duration and predictability
Know Erickson’s developmental stages compared to the spiritual beliefs
8 Stages of development; individuals need to accomplish particular tasks before successfully completing a stage
Trust vs Mistrust — Infancy (birth to 18 months)
Autonomy vs. Shame & Doubt — early childhood/toddler (18 months to 3 years)
Initiative vs. Guilt — Preschool (3-5 years)
Industry vs Inferiority — Childhood (6-12 years)
Identity vs. Role Confusion — Adolescence (12-19 years)
Intimacy vs. Isolation — Young adulthood (20-35 years)
Generativity vs. Stagnation — Adulthood (35-65 years)
Ego Integrity vs. Despair — Maturity (65 to death)
Full term neonate’s length, weight and head circumference
The average full-term neonate weighs 3.4 kg (about 7 1/2lb), is 50 cm (20 inches) in length, and has a head circumference of 35 cm (14 inches). Neonates lose up to 10% of their birth weight in the first few days of life, primarily through fluid losses by respirations, urination, defecation, and low fluid intake. They usually regain the weight by the end of the second week of life.
Stages of General Adaptation Syndrome (GAS)
a three-stage set of physiological processes that prepare, or adapt, the body for danger so that an individual is more likely to survive when faced with a threat
Know Freud’s Psychosexual Development stages
psychoanalytic model of personality development is grounded in the belief that two internal biological forces drive the psychological change in a child: sexual (libido) and instinctive forces. The theory describes a series of five stages, each associated with a pleasurable zone serving as the focus of gratification.
Oral — infancy
Anal — early childhood/toddler
Phallic — preschool
Latent — childhood
Genital — adolescence
Adulthood major development theories
**Age — **
___________________________________
Developmental stage — N/A
Freud (Psychosexual devel.) — N/A
Erickson (Psychosocial) —
Piaget (logical, cognitive, and moral) —
Kohl berg (moral reasoning) —
Adulthood major development theories
Age —
___________________________________
Developmental stage — N/A
Freud (Psychosexual devel.) — N/A
Erickson (Psychosocial) —
Piaget (logical, cognitive, and moral) —
Kohl berg (moral reasoning) —
