Exam I Flashcards
What is the self-determination theory of motivation and who constructed it?
This theory demonstrates the relevance of behavior can be an outcome of two distinct motivating features
_____ leadership has been described as a process that changes or transforms individuals. These leaders communicate an organizational vision moving them to accomplish more than expected.
Transformational
What are the attributes of motivation?
Self-determination, Desire, Compelled, Aspiration, Preference for challenge, Energizing force, Persistence, Internal dispositions
What are the nursing interventions for breathing pattern change? Slowed circulation to the brain may cause breathing pattern to become shallow, irregular, apneac (cheyne-stokes), or shallow
Elevate person’s head, Position on side
What are the five principles of time management
Goal setting, Time analysis, Priority setting, Interruption control, Evaluation
What are the exemplars of comfort care (actively dying)?
- interventions for symptom management
- provide patient and family reassurance
- reduction in physical functioning
_____ power results when followers identify with or aspire to be like their leader
Referent
_____ motivation is a need for a connection, social approval, or self-esteem.
Social
What are the exemplars of palliative care (not actively dying)?
-aggressive symptom management such as dysphonia, fatigue, anxiety, depression -prevention of disease exacerbations -promote activity, increasing physical functioning -rehabilitation
_____ _____ is the active total care of patients whose disease is non-responsive to curative treatment. Control of pain, of other symptoms, and of psychological, social and spiritual problems is paramount
Palliative care Not actively dying
What are the exemplars of supportive care?
-aggressive use of laboratory analysis -blood transfusions -bone marrow stimulating factors -referral to specialty physicians to manage pulmonary disease and symptoms -used in long cancer patients undergoing oncology care
List the five things important to consider when delegating tasks
Assess the knowledge and skills of the delegatee, Match tasks to the delegatee’s skills, Communicate clearly, Listen attentively, Provide feedback
____ motivation is driven by anxiety. And individual who uses this type of motivation is willing to do most anything to prevent harm to him/her self
Avoidance
_____ leaders focus on daily operations of an organization and develop an exchange relationship with their followers.
Transactional Rewards are given for performance and corrections are given when necessary
What are the four goals to support people with concurrent multiple chronic conditions?
- Provide better tools and information to healthcare and social service workers who deliver care 2. Maximize/encourage use of self-care management and other services 3. Foster healthcare and public health system changes to improve health 4. Facilitate research to fill knowledge gaps for patients with multiple chronic conditions
Clear _____ is central to effective leadership
Communication
Provide examples of chronic health problems that can lead to disability
Stroke, Coronary artery disease, Cancer, COPD, Asthma, Arthritis
What does this EKG strip denote?
Premature Ventricular Contractions
What are the nursing interventions for coolness of extremities? Circulation decreased; Skin may become mottled or discolored
Cover person with blanket *do not use electric blanket, hot water bottle or heating pad
_____ motivation refers to doing something because it is inherently interesting or enjoyable
Intrinsic Motivation with self determination
What are the goals of palliative care?
-To prevent or treat symptoms or side effects caused by treatment as early as possible -to prevent or treat psychological, social, and spiritual problems related to disease -to help patients with chronic or life-threatening disease live more comfortably
_____ is focused on maintaining order in organizations-planning, organizing, staffing, directing, and controlling a work group
Management
What is the theory of achievement motivation and who constructed it?
This theory is based on whether an individual is positively or negatively motivated to achieve a goal based upon the perception of the ability or lack of ability to achieve that goal John Atkinson
What are the exemplars of end-of-life care?
-admission to hospice care -do not resuscitate order -expectation of death will occur within six months of admission into hospice care -patient no longer seeks aggressive disease management -symptom management
_____ motivation refers to doing something because it leads to a separable outcome
Extrinsic Motivation without self-determination
_____ is about change in organizations and is focused on helping followers achieve a vision or goal.
Leadership
_____ _____ is not having one’s final wishes followed at the end of life; pain, abandonment, isolation
Bad death
_____ power provides the ability of one person to reward another for compliance with expectations
Reward
_____ _____ motivations is based on needs such as achievement and competence.
Task mastery
_____ care typically uses medical interventions to prevent, control, and/or relieve the complications of disease and the associated side effects of specific therapies.
Supportive care Acute management
_____ is the relief or management of symptoms without providing a cure.
Palliation
What is the drive reduction theory of motivation and who constructed it?
A biological theory based on the concept of homeostasis and that the body has compensatory mechanisms that maintain biological balance Clark Hull
_____ _____ uses evidence-based practice to support the specific pharmacologic interventions to manage symptoms of chronic disease and the dying process
Symptom management Acute management
_____ power is based on the leader’s ability to influence followers to act by using clear logical, rational argument, and information
Informational
_____ care is the care of the patient and family receive in the actively dying, terminally ill, or near death phase of life
End-of-life care Weeks to days of life
What are the nursing interventions for disorientation? Decreased metabolism and slowed circulation to the brain
Identify yourself when speaking to the person, Reorient the person when needed, Speak softly, clearly, truthfully
_____ care is the biomedical approach to chronic disease management
Curative The purpose is to alter or attempt to eradicate the disease process
What are the nursing interventions for incontinence? Perineal muscles relax
Keep perineal area clean and dry, Use disposable underpads, chux, disposable undergarments, Consider foley
What is the criteria for making advanced directives?
-Ability to receive information, -Ability to evaluate, deliberate, and mentally manipulate information, -The ability to communicate a treatment preference
_____ care emphasizes the relief of discomfort rather than the cure of illness or prolongation of life
Comfort care Weeks to days of life
_____ Power uses the threat of punishment to get followers to respond
Coercive
Palliative care is used to treat which diseases?
Chronic renal failure, COPD, CHF, And other diseases with no cure
What are the nursing interventions for food and fluid decrease? Metabolism needs have decreased
Do not force food or drink, Offer small sips of liquids or ice chips if alert enough to swallow, Oral care
An _____ is your judgement or interpretation of cues
Inference i.e. Patient crying implies fear or sadness
_____ power results when followers respond to their leaders direction because they perceive that the leader knows best
Expert
What are the nursing interventions for increased sleeping? Metabolism is decreased
Spend time sitting quietly with the person, Do not force person to stay awake, Talk to the person normally, even if no response
A _____ is information obtained through use of senses
Cue i.e. Patient crying
What are the three perspectives of disease trajectory?
-short period of evident decline (cancer) -prolonged dwindling (frailty and dementia) -Long term limitations w/intermittent serious episodes (heart & lung failure)
To enhance active listening… What does the acronym SOLER stand for ?
S-sit facing patient O-observe an open posture L-lean toward the patient E-establish and maintain intermittent eye contact R-relax
What are the nursing considerations/interventions for someone on supportive care?
Fluid replacement therapy, Blood transfusions, Psychological or spiritual needs of the patient/family, Focus is not on symptom management but on physical issues
Who can write DNR orders?
Patient as part of advanced directives, Spouse, when patient is unable, Joint family decision
What are the four categories of motivation?
Achievement motivation, Power motivation, Affiliative motivation, Avoidance motivation
_____ motivation is often indicated with those whose personality type includes non-assertiveness and dependence on others
Affiliative
_____ occurs when patient’s behavior lacks intentionality and a sense of personal causation. The patient does not value in activity or feel confident to complete it, or they do not believe it will obtain the desired outcome
Amotivation i.e. If a patient does not believe physical therapy sessions will help recovery, they are amotivated
What are the nursing interventions for congestion and gurgling? Unable to cough up secretions effectively
Position on side, Administer meds to decrease production of secretions, Provide suction for comfort
What is the humanistic theory of human motivation and who constructed it?
This Siri suggest that a person must feel satisfied that essential physiological needs such as food, water, oxygen, and shelter must be met before the individual will feel compelled or motivated to strive for higher needs such as safety, loving and belonging, self-esteem, self respect, and respect for others Maslow
What is the field theory of motivation and who constructed it?
Influences of an individual’s total situation must be taken into account, value was placed upon a specific goal and the probability that an individual will follow through and achieve the goal Kurt Lewin
To _____ is to reduce the severity of an actual or potential life-threatening condition or a chronic debilitating illness.
Palliate
What are the three types of DNR?
-Slow code: dr/nurse slow to initiate life saving measures(no longer used) -Chemical code: medication only, no intubation, no CPR -Full DNR: no life saving measures taken
_____ leadership occurs when the leader involves Star Wars in the decision-making process. This is also referred to as participatory leadership.
Democratic
What are the physical signs of death?
Coolness of extremities, Increased sleeping, Fluid and food decrease, Incontinence, Congestion and gurgling, Breathing pattern change, Disorientation, Restlessness
What are the four most common, life-threatening ventricular dysrhythmias ?
Premature ventricular complexes, Ventricular tachycardia, Ventricular fibrillation, Ventricular asystole
_____ leadership is associated with work teams and shared leadership, employees are empowered to distribute leadership within the group.
Shared
What are the nursing considerations/interventions for someone on comfort care?
Physical, social, and emotional needs are priority, High dose pain medication may have the effect of hastening death, Patient is actively dying, Positioning, oral care, skin care, Comfort management not symptom management
What are the four conditions that must be met before a person is motivated to learn, according to John Keller?
Attention, Relevance, Confidence, Satisfaction
An _____ _____ is the me so state that allows the learner to focus on and comprehend a learning activity.
Attentional set
_____ Power recognizes that formal leaders have the power over their followers because of the position they hold
Legitimate
_____ _____ is free from avoidable stress and suffering for patients, families, and caregivers; consistent with clinical practice standards.
Good death
_____ health problems are physical or mental health/behavioral health problems that cause disability
Disabling
_____ leadership occurs when the leader does not interfere with the employees in their work. These later stand at a distance, getting followers freedom to make decisions and accomplish the work. They provide minimal information and have a little communication
Laissez-Faire These leaders typically wait until there is a crisis to make decisions
What is the social learning theory of motivation?
This theory describes how behaviors are learned and focuses on the learning that occurs within a social context.
What is stages of change model and who constructed it?
This theory is based on people moving through five stages in the change process. The model explains and predicts how when when people reject for healthcare choices and adapt healthy choices. Prochaska, DiClemente
Who are the members of the interprofessional team?
Nursing, social services, physician, spiritual care, ancillary services
_____ leadership is when the leader makes all decisions. These leaders generally are most concerned with the task to be accomplished and maintain distance from their followers.
Autocratic They often use threats of punishment as motivation but may also offer rewards as incentives
_____ motivation is often indicated with those whose personality type includes assertiveness and aggressiveness
Power
What are the nursing consideration/interventions for someone on end-of-life care?
Used synonymously with hospice care, Symptom management, Comfort care, Weeks to days of life, Medicare coverage: prognosis of less than 6 months
_____ health problems exist for at least 3 months
Chronic
What are the four goals outlined by USDHHS to supporting persons with concurrent multiple chronic conditions?
-provide better tools and information to healthcare and social services workers -maximize the use of proven self-care management and other services -foster healthcare and public health system changes to improve health -facilitate research to fill knowledge gaps about individuals with multiple chronic conditions
What are the five rights of delegation
Right task, Right circumstances, Right person, Right direction/communication, Right supervision/evaluation
What are the nursing interventions for restlessness? Decreased metabolism and slowed circulation to the brain
Play soothing music; aroma therapy, Do not restrain, Massage persons forehead, Reduce number of people in the room, Talk quietly/keep noise down, Keep room dimly lit, Consider sedation if necessary
What are the influence factors for intrinsic motivation?
- age
- cognitive/education level
- emotional readiness/fear of failure
What does this EKG strip denote?
Ventricular tachycardia
What does this EKG strip denote?
Ventricular Fibrillation
What does this EKG denote?
Premature Ventricular Contractions
What are the influence factors for extrinsic motivation?
- cultural values/family
- accessibility of facilities/readiness of healthcare team
What are the influential characteristics of motivation: Personal traits
- age
- emotional readiness
- high expectation
- anxiety/self confidence
- fear of failure
What are the influential characteristics of motivation: Environmental Factors
- resource availability
- level of difficulty of task
- rate of progression
What are the influential characteristics of motivation: Relationships
- cultural expectations and customs
- need for love and acceptance from others
- role in the community
Which theory involves homeostasis and the belief that the body has many compensatory mechanisms that function to maintain biological balance?
Drive Reduction Theory: Clark Hull
Which theory focuses on physiological needs such as food, water, oxygen, and shelter needs being met before one is motivated to strive for higher needs such as safety, loving/belonging, and self-esteem?
Humanistic Theory: Maslow
Which theory believes an individual’s total situation must be taken into account and value is placed on a specific goal and the probability of follow through to reach a goal?
Psychology and its relationship to motivating behaviors: Lewin
One’s belief in their own ability to complete tasks and reach goals is called _____ _____
Self efficacy
Clinical associations for this type of dysrythmia include stimulants (caffeine, alcohol, nicotine), Digoxin, electrolyte imbalance, hypoxia, fever, and disease states (MI, mitral valvue prolapse, HF, CAD)
Premature Ventricular Contractions (PVCs)
What is the treatment for PVCs?
Oxygen therapy for hypoxia,
Electrolyte replacement,
Administer Beta blockers
Clinical associations for this type of dysrythmia are MI, CAD, Electrolyte Imbalance, Cardiomyopathy, mitral valve prolapse, Digitalis toxicity, CNS Disorders.
Ventricular Tachycardia
What is the treatment for ventricular tachycardia?
Identify precipitating associations (hypoxia),
Hemodynamically stable: IV procainamide,sotalol, amiodarone, lidocaine
Hemodynamically unstable: IV amiodarone or Lidocaine followed by cardioversion
Clinical associations for this type of dysrythmia are Acute MI, CAD, Cardiomyopathy, accidental electrical shock, hyperkalemia, hypoxia, acidosis, drug toxicity
Ventricular Fibrillation
What is the treatment for Ventricular Fibrillation?
CPR, Defibilation, definitive drug therapy
