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3001 > final > Flashcards

final Flashcards

1
Q

Complementary & Alternative Therapies

A

umbrella term to describe a broad
range of healing philosophies, therapies, and health care approaches considered
unconventional in North America

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2
Q

Allopathic medicine

A

treatment provided through surgery, radiation, drugs, surgery (think traditional western approaches)

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3
Q

Commonly used complementary/alternative therapy

A

Massage
Chiropractic care
Yoga
Relaxation techniques

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4
Q

Benefits of complementary therapy for chronic illness

A
  • prevention & wellness, not treating symptoms and preexisting conditions
  • alleviate severe side effects of prescribed medications
  • provides client a sense of control and increases feelings of hope
  • safe, noninvasive, effective, inexpensive
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5
Q

Role of complementary therapy in chronic illness

A
  • pain management
  • cancer: yoga has been found to improve stress tolerance by stimulating the PNS and reducing the activity of the SNS
  • mental health
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6
Q

Factors influencing chronic pain

A

sex, education, income, employment and restriction of activity

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7
Q

Natural Products

A

FDA - Natural Health Products
Natural Product Number (NPN) or Homeopathic Medicine Number (DIN-HM)
- Used with medical approval
- Ex. fish oil (reduces pain associated with swelling); Ginkgo biloba and ginseng can thin blood

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8
Q

Mind-body Interventions

A

Designed to teach individuals ways to change their behaviour to alter physical responses
to stress & improve symptoms such as muscle tension, GI discomforts, pain and sleep
disturbances
* Individual becomes actively involved in treatment
* Must practice techniques daily, commitment to therapy
(mindfulness, etc.)

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9
Q

Mind and Body Practices

A

Relaxation – deep breathing, breathing exercises
* Meditation – mindfulness, other types of meditation
* Biofeedback
* Neurofeedback
* Yoga
* Guided imagery
* Hypnotherapy
* Music therapy
* Animal-facilitated therapy
* Prayer
* Chiropractic therapy
* Pressure-point therapy (acupuncture, acupressure, reflexology)
* Massage therapy – nurses can provide gentle massage depending on patient preferences

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10
Q

Chiropractic Manipulation Risks

A

Herniated disk
○ Compression of nerves in the lower spinal column (cauda equina syndrome) - pain,
weakness, loss of feeling in your legs, and loss of bowel or bladder control
○ Vertebral artery dissection after neck manipulation

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11
Q

Complementary Therapies Regulation Issues

A

No policy, laws, regulations, or national programs exists in Canada – lies with the
provinces and territories
○ Certain practices are not regulated; patients should research background of
practitioner and therapy in general

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12
Q

Natural and Non-prescription Health Products Directorate (NNHPD)

A
  • all products subject to NHP regulations since 2004 in Canada
  • must be safe as OTC
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13
Q

Nurses’ Roles in CAT

A
  • understanding of the treatment and the rationale for their choice
  • informed choice
  • assessing the therapy’s appropriateness given health status
  • knowledge, skill, and judgement to competently provide the therapy
  • Facilitate, advocate, and promote best possible care for the patient
  • Respond to concerns regarding patient safety and wellbeing
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14
Q

Cultural Humility

A
  • learning about clients beliefs about alternative therapies
  • empowerment, mutual benefit, partnerships, respect, optimal care
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15
Q

Parkinson’s Disease & CAT

A
  • symptom management and symptom burden
  • CBD, massage, guided imagery, acupuncture, chiropractic therapy, relaxation strategies
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16
Q

Rehabilitation

A

“A set of interventions designed to optimize functioning and reduce disability in individuals with health conditions in interaction with their environment”

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17
Q

Overarching goal of rehabilitation

A

Maximizing human potential

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18
Q

Interpretive function

A

nurses help make sense of what has happened, what may be happening in the future (paint the whole picture)

19
Q

Consoling function

A

develop trusting relationships to provide emotional support

20
Q

Conserving function

A

nurses involved in maintaining normal bodily functions, emphasis on prevention and physical protection

21
Q

Integrative function

A

help integrate new learning, in relation to their ADLs, into their daily lives

22
Q

Case knowledge

A

generalized/objective, ex. anatomy & physiology, disease process, pharmacology

23
Q

Patient knowledge

A

how they are responding to their clinical situation

24
Q

Person knowledge

A

each person is unique, knowing their personal biography and understanding how actions make sense for that person

25
Q

Rehabilitation as an intervention

A

recovery, adaptation, compensation, prevention

26
Q

Challenges of Rehabilitation

A

Rising care costs,
Caregiver burden,
Inequities among disabled Canadians,
Stigma of disability,
ethical and legal issues,
Cultural competency,
Formal and informal caregiver issues

27
Q

Rehabilitation: long-term goals

A

Returning to pre-injury or pre-illness life,
Identifies what is important to the person,
Can help move person from pre-contemplation to action,
A mechanism to enhance person ownership and engagement in rehabilitation

28
Q

Rehabilitation: short-term goals

A

Converting long term goals into short-term clinical goals requires negotiation;
Discuss and educate the person and family about the use of goals can be a first step in rehabilitation;
Helpful to articular short-term goals as SMART

29
Q

Powerlessness

A
  • the inability to affect an outcome … situationally determined
  • When an individual is controlled by the environment rather than the individual controlling the environment
    Ex. uncertainty of outcome, failure of therapy, loss of relationships, physical deterioration
30
Q

Influencing powerlessness

A

Ability to maintain control and perceptions of control,
Relationships,
Degree of physical limitation,
Anticipated prognosis,
Ability to manage symptoms

31
Q

Model of Empowerment

A

Client Antecedents: motivation to change (transition phase), competencies (ability to communicate and knowledge to problem solve), active participation
Context: time, caring environment
Nurse Antecedents: feels empowered, communicates effectively, surrenders control, goal focussed
Client Consequences: inner strength and transformation, positive self-concept, motivated
Nurse Consequences: transformation through blurring of boundaries with patient, professionally satisfying

32
Q

Interventions to Promote Empowerment

A

Health coaching, discharge planning, collaboration, self-management and self-determination, client and family education, advocacy

33
Q

Continuum of LTC

A

Institutional: nursing facility, group home, assisted living, retirement communities, hospice
Community: adult day care, senior centre, meal programs
Home: home-health nursing, home-delivered meals

34
Q

Challenges in LTC

A

Ethical issues: client autonomy vs. dependancy
Custodial care: POA
End-of-life decision making
abuse and neglect of vulnerable adults

35
Q

Dementia risk factors

A

chronic inflammation, stroke, cellular damage from free radicals, alcoholism, Parkinson’s

36
Q

Assessment of Caregivers

A

role strain: caregiver strain index, caregiver assessment tools
previous grief and loss experiences
Establish which family carer is the legal substitute decision-maker

37
Q

The Ottawa Decision Support model

A

Decisional Needs: decisional conflict (uncertainty), knowledge & expectations, values, support & resources, decision: type, timing, stage, learning, personal/clinical characteristics
Decision Quality: informed, values-based; Actions-delay, continuance; Impact-values based health outcomes, regret & blame, appropriate use & costs of services
Decisional support: clarify decisions & needs, provide facts, probabilities, clarify values, guide in deliberation & communication, monitor/facilitate progress

38
Q

Eligibility for MAID

A
  • Eligible for publicly funded health care service in Canada
  • At least 18 years of age
  • Capable of making decisions with respect to their health
  • Have a serious and incurable illness, disease, or disability, irreversible decline
  • Have made a voluntary request for MAID
  • Give informed consent to receive MAID
39
Q

MAID Safeguards

A
  • Request made in writing; signed and dated by the individual after they have been
    informed by a medical practitioner or NP that they have a grievous and irremediable medical condition
  • Request signed by one independent witness (independent of healthcare process)
  • Person informed that request may be withdrawn at any time in any way
  • medical practitioners involved are independent
40
Q

Steps to MAID

A
  • written request
  • 1st assessment
  • 2nd assessment
  • main procedure is completed
  • ability to rescind request at any time in the process
41
Q

MAID Procedure Medications

A
  • Midazolam/Versed - sedation
  • Lidocaine – local anesthetic
  • Propofol – coma-inducing agent
  • Rocuronium – neuromuscular blocker
42
Q

Oral (self-administered) protocol

A
  • Metoclopramide and ondansetron
  • Phenobarbital
  • Chloral hydrate
  • Morphine sulfate
43
Q

Spiritual Assessment HOPE

A

H: Sources of hope, meaning, comfort, strength, peace, love, and connection
O: Organized religion
P: Personal spirituality and practices
E: Effects on medical care and end-of-life issues

44
Q

Perceived Barriers to Spiritual Care

A

Perceived time constraint
Lack of knowledge of the issues
Lack of confidence about spiritual conversations
Challenges in articulating spirituality
Uncertainty as to what spiritual care entails
Multiplicity of beliefs, ideologies, religions, philosophies

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