Final Exam Flashcards
1
Q
5-phase disaster response continuum
A
Preparedness
Mitigation
Response
Recovery
Evaluation
2
Q
department of homeland security
A
Coordinate United States responses to US disasters
Ultimate responsibility for US safety
Assure immediate availability of preparedness, response, and recovery protocols
Uses civilian first response professionals
2004, Created National Incident Management System (NIMS) to coordinate efforts between responder agencies
3
Q
incident command system
A
Organizational structure facilitating an immediate response by establishing clear chain of command
Training required to understand NIMS
4
Q
phases of critical incident stress debriefing
A
Introductory
Fact
Thought
Reaction
Symptom
Teaching
Reentry
5
Q
characteristics of vulnerable children
A
Younger than 3 years
Perceived as different
Remind parents of someone they do not like
Product of an unwanted pregnancy
Interference with emotional bonding between parent and child
6
Q
characteristics of vulnerable older adults
A
Poor mental or physical health
Dependent on perpetrator
Female, older than 75 years, white, living with a relative
Elderly father cared for by a daughter he abused as a child
Elderly woman cared for by a husband who has abused her in the past
7
Q
active neglect
A
refusal/failure to fulfill care-taking obligations
8
Q
passive neglect
A
failing obligations, but not conscious or intentional attempt to inflict physical or emotional distress
9
Q
risk factors of abuse
A
family of origin (abusive, poor coping, dist of power in family)
traits of perpetrator
10
Q
traits of perpetrator
A
Inadequacy
low self esteem
immaturity
hostility
abused as a child
psychopathology
substance abuse
11
Q
clues of abuse
A
Bleeding injuries/head/face
Fractures
Burs
Miscarriages
Perforated ear drums
Depression
Repeat visits
“Probs” with partners
12
Q
assessment of abuse should include?
A
violence indicators
level of anxiety and coping responses
family coping patterns
support systems
suicide or homicide potential
drug and alcohol abuse
13
Q
intervention in abuse
A
discuss:
-tendency for abuse to escalate
-safety plan
-assistance to alleviate causes of abuse
-referral of pt and fam to appropriate services
unwilling and lacks capacity
adult protective services
financial mgt
guardianship
conservatorship
14
Q
primary prevention of abuse
A
Measures taken to prevent the occurrence of abuse
15
Q
secondary prevention of abuse
A
Early intervention in abusive situations to minimize their disabling or long-term effects
16
Q
tertiary prevention of abuse
A
Facilitating the healing and rehabilitative process
Providing support
Assisting survivors of violence to achieve their optimal level of safety, health, and well-being
17
Q
cycle of violence
A
Tension-building stage
Acute battering stage
Honeymoon stage
Repeat.
Periods of calm and safety diminish over time and repetition
18
Q
maturational crisis
A
New developmental stage is reached
Old coping skills no longer effective
Leads to increased tension and anxiety
Erikson 8 stages of ego growth and development
Each stage represents a time when physical, cognitive, instinctual and sexual changes prompt internal conflict or crisis
19
Q
situational crisis
A
Arise from events that are
-Extraordinary
-External
-Often unanticipated
Whether or not these events precipitate a crisis depends on factors
-degree of support
-general emotional and physical status
20
Q
adventitious crisis
A
Not part of everyday life
Caused by unplanned and accidental events by nature or human-made
Natural disaster
National disaster (terrorism, war, airplane crash)
Crime of violence (rape, assault, school or work murder, bombing)
21
Q
phase 1 of crisis
A
Conflict or problem
Self-concept threatened
Increased anxiety
Use of problem-solving techniques and defense mechanisms (sometimes resolves the problem)
22
Q
phase 2 of crisis
A
Defense mechanisms fail
Threat persists
Anxiety increases
Feelings of extreme discomfort
Functioning disorganized
Trial-and-error attempt to solve problem and restore normal balance
23
Q
phase 3 of crisis
A
Trial-and-error attempts fail
Anxiety can escalate to severe level or panic
Automatic relief behaviors mobilized (i.e., withdrawal and flight)
Some form of resolution may be devised
(i.e., compromising needs or redefining situation)
24
Q
phase 4 of crisis
A
Problem is unsolved and coping skills are ineffective
Overwhelming anxiety
Possible serious personality disorganization, depression, confusion, violence against others, or suicidal behavior
25
robert's 7 stage model of crisis intervention
1) plan and conduct crisis assessment
2) establish rapport and rapidly establish relationship
3) identify major problems such as last straw
4) deal w feelings
5) generate and explore alternatives
6) develop and formulate an action plan
CRISIS RESOLVED
7) follow-up plan and agreement
26
primary care
Promotes mental health and reduces mental illness to decrease incidence of crisis
27
secondary care
Establish intervention during an acute crisis to prevent prolonged anxiety
After safety has been established then assess problem, support systems and coping styles
28
tertiary care
Provides support for those who have experienced a severe crisis and are now recovering from a disabling mental state
29
Sexual Assault Nurse Examiners (SANEs)
RNs with specialized training in caring for sexual assault patients
Demonstrated competency in conducting medical and legal evaluations
Ability to be an expert witness in court
30
Sexual assault response team (SART)
Ethics, legal, case management, social worker, nurses, psychiatrist, forensic lab
31
5 steps of examination for SA victim
1. Head-to-toe physical assessment for signs of injury
2. Detailed genital examination
3. Evidence collection and preservation
4. Documentation of physical findings (written quotes and photographic)
5. Treatment, discharge planning, and follow-up care
32
signs of progress from rape trauma
Sleep well with few nightmares or wake-ups
Eat as they did pre-rape
Retain normal levels of calm and relaxation
Get support from family and friends
Demonstrate positive self-regard
Experience little or no somatic reactions
Return to pre-rape sexual functioning and interest
Being able to date again, being vulnerable to another person, may take a very long time, other person must be mindful
33
major symptoms of rape trauma syndrome
re-experiencing the trauma
social withdrawal
avoidance behaviors and actions
increased physiological arousal characteristics
34
stages of rape trauma syndrome
acute
outward adjustment
underground
reorganization
renormalization
35
acute stage of RTS
The acute stage can begin days or weeks after a sexual assault and generally lasts for between a few days and a few weeks. Often, victims begin experiencing symptoms of the acute stage after the initial shock of an assault has worn off.
36
outward stage of RTS
begins when the Acute stage ends, and can last for between a few months and several years, if it is not interrupted. During this stage, the victim may outwardly appear to have “moved on” from an assault, but this stage is marked by serious inner turmoil.
37
underground stage of RTS
Victims may work to return to their more “normal” lives. This stage may last for years, with limited disruptions to daily life, although emotional issues surrounding the assault may continue to be unresolved.
38
reorganization stage of RTS
Can begin when there is an external trigger than moves a survivor from the Underground or Outward Adjustment stage, or when there is a life transition, or for other reasons that may not be clear to the survivor or their loved ones.
Reorganization is characterized by a return to internal and external emotional turmoil. Friends and family may be confused by a return of feelings and behaviors in the victim that they thought were resolved.
39
renormalization stage of RTS
Survivors reprocess their experience and are able to integrate it into their lives. The sexual assault or rape is no longer a central focus, and feeling such as guilt or shame resolve
40
DSM-V criteria for mild neuro disorders
Evidence of modest cognitive decline from previous level of performance in one or more cognitive domains
Cognitive deficits do not interfere with independence in everyday activities
Cognitive deficits do not occur exclusively in the context of delirium
Cognitive deficits are not better explained by another mental disorder (ruling out)
41
basic level of psychiatric nursing practice
Psychiatric mental health registered nurse (PMH-RN)
2 years full-time work, 2000 clinical hours, 30 hours continuing education, followed by certification exam to add “BC” to the RN title (RN-BC)
42
advanced practice psychiatric nursing practice
Psychiatric mental health advanced practice registered nurse (PMH-APRN)
Prescription writing privileges
Can perform certain interventions beyond nursing scope of practice
Master of Science or Doctorate
43
Advanced Practice Interventions (APRNs)
Cognitive therapy
Behavioral therapy
-Relaxation training
-Modeling
-Systematic desensitization
-Flooding
-Response prevention
-Thought stopping
Cognitive-behavioral therapy
44
PNHMP privilege
Can write prescriptions, pharmacological and nonpharmacological treatments
45
boundary crossing
-when the relationship slips into a personal context
-when the nurse’s needs (for attention, affection, and emotional support) are met at the expense of the patient’s needs
46
boundary violations
take advantage of the patient’s vulnerability and are ethically; characterized by a reversal of roles where the needs of nurse are being met rather than the patient
47
overinvolvement increases the risk of
Boundary crossings
Boundary violations
Professional sexual misconduct
Blurring of Roles
48
transference
patient unconsciously and inappropriately displaces onto nurse feelings and behaviors related to significant figures in patient’s past
Transference intensified in relationships of authority
49
countertransferrence
nurse displaces feelings related to people in nurse’s past onto patient
Patient’s transference to nurse often results in countertransference in nurse
Common sign of countertransference in nurse is overidentification with the patient
50
four coping styles
Health-sustaining habits: sleep, eat, being vaccinated
Life satisfactions: work, exercise, art, music, spiritual solace
Social supports: friends, spouse, family, nurse (with boundaries), social work
Effective and healthy response to stress: going to the gym, reading, writing, talking to someone, music
51
coping mechanism
way of adjusting to environmental stress without altering goals or purposes.
52
coping skills
skills that enable a person to develop healthier ways of looking at and dealing with stressors
53
coping styles
Discrete personal attributes that people have and can develop to help manage stress
54
defense mechanisms
displacement
rationalization
reaction formation
regression
repression
denial
55
displacement
discharging pent-up feelings of hostility onto less dangerous objects
ex: little girl's baby bro came home from hospital so she broke her doll
56
rationalization
justifying failures with socially acceptable reasons except for the real ones
ex. fox and sour grapes oh they were probably sour anyways
57
reaction formation
transforming anxiety-producing thoughts into their opposites in consciousness
ex. dressing pretty even tho u think ur ugly
58
regression
returning to more primitive levels of behavior
ex. acting like a baby bc ur jealous of the baby
59
repression
blocking a threatening memory from consciousness
ex. damn I don't remember getting abused
60
denial
refusing to admit there is a problem
ex. my son DOESN'T do drugs
61
short term effects of stress
decreased fluid loss, inflammation, and brain norepinephrine
increased glucose
62
chronic effects of stress
immunosuppression
atherosclerosis
depression
HTN
obesity
high blood lipids
protein breakdown in blood, bones, muscle, and immunoglobulin
63
neurotransmitter response to stress
Serotonin synthesis
More active
May impair serotonin receptor sites and brain’s ability to use serotonin
64
immune system response of stress
Interaction between nervous system and immune system during alarm phase of general adaption syndrome (GAS)
Negatively affects body’s ability to produce protective factors
65
Psychological Factors Affecting Medical Conditions
factors that:
Interfere with medical treatment
Pose health risks
Cause stress-related pathophysiological changes
psychological and medical conditions considered
66
generalized anxiety disorder
Excessive worry that lasts for months
So worried about something that is completely gets in the way of your responsibilities and activities (your worrying is affecting your life)
67
mild anxiety
Everyday problem-solving leverage
Grasps more information effectively
Can have just from being in the hospital
Be able to manage it or grow from it before it becomes moderate anxiety
Are not going to start to feel sympathetic nervous system response
68
moderate anxiety
Selective inattention
Clear thinking hampered
Still clear thinking, can make some decisions but be careful
Problem solving not optimal
Sympathetic nervous system symptoms begin seeks help from others when assuming responsibility for major areas of own life.
Seeking help for many things
69
severe anxiety
Perceptual field greatly reduced
May not be able to make eye contact, cannot focus
Difficulty concentrating on environment
Ex: patient who just learned the news of a diagnosis
Cannot concentrate on patient teaching
Confused and automatic behavior
Knee-jerk reactions, difficulty understanding simple directions
Somatic symptoms increase
Stomach upset, digestion issues, sphincter issues, release of cortisol
70
panic
Markedly disturbed behavior—running, shouting, screaming, pacing
Extremely impulsive
Know escalation policies:
security (code gray or rapid response)
Rescue medications: haldol (vitamin H) or ativan
1:1 (enhanced observations)
Change of location
Cohorting (roommate that also needs to be watched by PCA)
Concerned with patient safety
Patient can experience visual or auditory hallucinations
Unable to process reality; impulsivity
Panic attack or panic disorder (PD)
71
4 methods of behavioral therapy
Modeling
Systematic desensitization
Flooding
Thought stopping
72
cognitive therapy
examines how negative thoughts, or cognitions, contribute to anxiety.
73
behavior therapy
examines how you behave and react in situations that trigger anxiety.
74
somatic symptom disorder
One or more distressing symptoms
Excessive thoughts, anxiety and behaviors around symptoms, or health concerns
Without significant physical findings*** and medical diagnosis
Suffering is authentic
High level of functional impairment
75
illness anxiety disorder (hypochondriacs)
Misinterpretation of physical sensations
Preoccupation with having or acquiring serious illness for at least 6 months
High anxiety about health
Excessive health-related behaviors or maladaptive avoidance
May be care-seeking or care-avoidant
76
conversion disorder
Neurological symptoms*** in the absence of a neurological diagnosis
Presence of deficits in voluntary motor or sensory functions
Common symptoms—paralysis, blindness, movement and gait disorders, numbness, paresthesias, loss of vision or hearing, or episodes resembling epilepsy
Trouble ambulating
“La belle indifférence” versus distress
77
where is SSD reported more
greeks and PRs
78
African stress management
burning of hands and feet
ants and worms on skin
79
3 types of factitious disorders
imposed on self
imposed on another (munchausen is parent to child)
malingering (for secondary gain)
80
Six Key Elements for Effective Treatment
1. Provide continuity of care.
2. Avoid unnecessary procedures.
3. Provide frequent, brief, and regular visits.
4. Always conduct a physical exam.
5. Avoid disparaging comments.
6. Set reasonable therapeutic goals.
81
alcohol
sedative creating an initial feeling of euphoria
82
alcoholism severity
Mild: 2–3 symptoms
Moderate: 4–5 symptoms
Severe: 5 or more symptoms
83
binge vs heavy drinking
binge: a lot at once
heavy: chronic
84
intoxication depends on what
person, weight, drink
85
who is at highest risk of alcohol use disorder
men and american Indians
86
comorbidities of alcohol use disorder
Bipolar disorders, schizophrenia, antisocial personality disorder, major depressive disorder
87
wernicke's encephalopathy and drinking
liver cannot break down ammonia, levels build up which makes them crazy, impacts the brain
Acute and reversible
Gait, several ocular motility abnormalities
IV Thiamine (low on vitamin B’s)
88
korsakoff syndrome
recovery 20%, chronic
low B1 r/t alcoholism
89
systemic effects of alcoholism
Peripheral neuropathy
-Treated by gabapentin, neurontin
Alcoholic myopathy and cardiomyopathy
-Heart works too hard and becomes enlarged
Esophagitis, gastritis, and pancreatitis
-Inflammation, eats away at epithelial lining
Alcoholic hepatitis
-Can still get this, even if you are not an alcoholic
Cirrhosis of the liver
Leukopenia
Thrombocytopenia
90
first sign of alcohol withdrawal
jitters 6-8h after
91
mild-mod signs of alcohol withdrawal
VS go up
92
12-24 hours without alcohol
seizures
93
first 72h of alcohol withdrawal
Delirium tremors
Autonomic hyperactivity
Watch dehydration
94
SBIRT
Screening, brief intervention, and referral to treatment
Comprehensive and integrated
95
AUDIT
Alcohol use disorders identification test
Developed for WHO, can self admin
8 or more for male, 7 or more for female
96
CAGE questionnaire
4 questions
2+ means ETOH dependence
C=cutting down
A=annoyed by criticism
G=guilty feelings
E=eye opener
97
narcan
for opioid overdose
stay with pt
short half life, keep administering! they will keep going into coma
98
disulfiram reaction
FLUSHING
SWEATING
NAUSEA, SEVERE VOMITING
NECK PAIN
THROBBING HEADACHE
BLURRED VISION
FAST, POUNDING HEART
CONFUSION; FEEL LIKE WILL PASS OUT
99
caffiene
Most widely used psychoactive substance in the world
Can result in intoxication and withdrawal
Would not expect this because it is legal, there is no limit to how much you can get
100
cannabis
Most widely used illegal drug in the world
Fourth most commonly used psychoactive drug in the United States after caffeine, alcohol, and nicotine (only one considered illegal in many countries)
Can be given to patients for pain relief (medical marijuana)
Recreational
101
hallucinogens
Cause a profound disturbance in reality
Ex: LSD, mushrooms, acid
-You can make some with things you have at home
Depending on the amount, people can be convinced by their disturbance in reality, putting their life at risk
102
inhalants
Solvents for glues and adhesives
Propellants
Thinners
Fuels
All have chemicals in them, you can buy them anywhere
103
opioids
Heroin and prescription drugs
Pharmacologic treatment: Methadone, buprenorphine, and naltrexone
104
cocaine withdrawal
no inpatient care; no drugs reduce symptoms
105
opioid intoxication
Cravings result in larger amounts, longer periods of use, increasing tolerance to its effects
Results in significant impairment in life roles, interpersonal conflict, and puts a person in physically hazardous situations
No longer give opioids mixed with tylenol (like percocet) = acute liver failure from acetaminophen toxicity
106
opioid overdose
Death usually due to respiratory arrest
Three things to look out for: Pinpoint pupils, respiratory depression, in a coma
Treatment: promote breathing; naloxone
Narcan (opioid antagonist)
107
pupils in opioid overdose
pinpoint
108
opioid withdrawal meds
methadone, clonidine, naloxone, lofexidine
109
benzo rule
short term
addictive
put in NG before gastric lavage if overdose
110
stimulants
Amphetamine-type, cocaine, or other stimulant drugs
Second only to cannabis as the most widely used illicit substances in the United States
111
tobacco withdrawal treatment
behavioral therapy (having a different plan in place of smoking), hypnosis, nicotine replacement therapies (patches, gums); bupropion or varenicline
Acupuncture is a good way to stop smoking
112
gambling disorder meds
SSRIs (prozac, lexapro), bupropion, mood stabilizers (lithium), and anticonvulsants
113
candy flipping
using uppers and downers, like hallucinogens and cocaine
114
early stages of dementia
MEMORY IMPAIRMENT
JUDGMENT LAPSES
SUBTLE PERSONALITY CHANGE
May not be able to realize at first
115
progression of dementia
MEMORY & LANGUAGE PROBS WORSEN
Actual tissue starts to degenerate
116
late stages of dementia
LOSE ABILITY TO CONTROL MOTOR FUNCTIONS
CAN’T RECOG FAMILY
CAN’T SPEAK
Excessive drooling
117
alzheimer's vs dementia
dementia is overall term
alzheimer's is actual disease
118
risk factors for dementia
Age and family history
Cardiovascular disease
Social engagement and diet
-Agoraphobic (isolated)
Head injury and traumatic brain injury
119
symptoms of alzheimers'
Memory impairment
-Wander guards (alarm on doors)
Disturbances in executive functioning “adulting”
Aphasia
Apraxia
Agnosia
120
aphasia
loss of language ability
121
apraxia
loss of purposeful movement
122
agnosia
loss of sensory ability to recognize objects
123
assessment of alzheimer's
Confabulation (creation of stories in place of missing memories to maintain self-esteem)
Perseveration (repetition of phrases or gestures long after stimulus is gone)
Agraphia (diminishing ability to read or write )
Hyperorality (tendency to put everything in the mouth)
Aphasia, apraxia, agnosia
Sundowning / sundown syndrome
Memory impairment (short to long term AND short term)
Disturbances in executive functioning
Diminishment of emotional expression
Diagnostic tests
-CT look for injury
-Positron emission tomography (PET): Check for cancer
Mental status questionnaires
Complete H&P (history and physical)
Complete medical and psychiatric history
Review of recent symptoms, meds, and nutrition (diet)
124
assessment guidelines for alzheimer's
current cognition level (baseline)
threats to safety
meds
family
resources
teaching
document caregiver
125
meds for cognitive symptoms
Cholinesterase inhibitors
-Side effects: dry mouth, dry eyes
Aricept: does not reverse, but they may slow down progression
Rivastigmine transdermal system (Exelon Patch)
N-methyl-D-aspartate (NMDA) receptor antagonist
Tegrital: seizure medication
126
meds for behavioral symptoms
antipsychotics used off-label and with extreme caution
Last resort (risks are high)
Benzodiazepine: ativan
127
integrative therapy for alzheimer's
omega-3
128
complex attention in dementia
sustained attention, divided attention, selective attention, processing speed
(Increased difficulty in environments with multiple stimuli; can’t attend unless input is simplified; probs holding new info in mind; unable to perform mental calculations; thinking takes longer)
Attention and how things are processed (be straight to the point)
129
executive function in dementia
planning, decision making,
Working memory, responding to feedback, error correction; overriding habits/inhibition
(abandons complex projects,focus on one task at at time, relies on others to plan ADL’s or make decisions
“Adulting”
They look to others to plan their ADL’s or plan out their day, may not try because they have a hard time grasping concepts of activities
Ex: food shopping, cooking
130
language in dementia
expressive language (including naming, word finding, fluency, grammar and syntax) and receptive language
Significant difficulties with expressive /receptive language, uses general terms rather than specifics; may not recall names of close friends and family; grammatical errors, lack of spontaneity
Wernicke’s and Broca in the brain
131
learning and memory in dementia
immediate memory, recent memory, long term memory
(Repeats self in conversation, often within same conversation; can’t keep track of short list of items when shopping or of plans for the day. Requires frequent reminders to orient to task at hand)
Most trouble with recent memories
As a nurse, try to help with reorientation but encourage autonomy
132
perceptual/motor cognition in dementia
visual perceptions, perceptual-motor…
(Significant difficulties with previously familiar activities, often more confused at dusk [sundowning: witching hour, call bells go off, do not know what they will do, unfamiliar environment])
Unaware of what they should do with everyday objects
Especially unfortunate if they use specific tools throughout life (ex: crocheting) and then they do not know what to do with it
133
social cognition in dementia
recognition of emotions
(behavior out of acceptable social range; insensitivity to social standards/modesty in dress/political, religious or sexual topics of conversation; focuses excessively on a topic despite group’s disinterest or direct feedback, makes decisions without regard for safety, has little insight into these changes)
Do not pick up social cues
134
dementia key ideas
insidious onset; confabulates to make up for memory lapses, is the condition
1. Primary: no underlying condition causing sxs
2. Secondary: due to an underlying medical condition, i.e. AIDs dementia, neurological disorder, Thiamine deficiency [Wernicke's-Korsakoff Disorder)
135
delirium key ideas
acute onset; due to an underlying medical condition
1. Substance withdrawal
2. Infection, etc (ie., UTI, pneumonia, etc)
136
depression key ideas
mood d/o- probs with concentration due to preoccupation;upset by this;
1. Acute onset: Major Depressive Disorder
2. Insidious onset: Persistent Depressive Disorder (dysthymia)
137
signs of approaching death
Growing weakness (asthenia)
Loss of appetite
Increasing drowsiness
Change in mentation
Circulatory changes (increased heart rate, decreased blood pressure)
Pulse may become bounding and then weak, thready, eventually absent
Mottling of skin (grayish-blue splotches on knees, ankles, feet)
Peripheral cyanosis
Decrease in urine production
Breathing changes (Cheynes-Stokes respirations), long periods of apnea
Possible agitation and delirium (some antipsychotic medications, liquid morphine - sublingual)
138
power of attourney for healthcare
Appoints another to make medical decision if you cannot
139
advance directive
Statement of how you want medical decisions to be made if you cannot make them yourself
Conversations about these should start before entering hospital (people should know your wishes)
140
living will
Legal document outlining use of care that keeps you alive, including pain management and organ donation (more specific)
141
provider orders for life-sustaining treatment
Based on the patient’s preferred code status in the case of cardiopulmonary arrest
NYS we have MOLST (m for medical)
Pink form, can travel with patient
Can be found on refrigerator in people’s homes (DNI, DNR) for if paramedics arrive in the home
142
usual rule of grieving
1 month for every year together
143
interdisciplinary approach
everyone is involved
144
hospice trained staff
may go to pts house
145
euthanasia
Putting an individual to death to prevent prolonged pain and suffering
146
physician assisted suicide
Physician provides patient-requested means to end life but does not act as the direct delivery agent
147
persistent vegetative state
Chronic condition in which all basic systems function except cognitive function, which cannot be restored. Reflexes but not awareness of self are intact.
148
minimally conscious state
Evidence of patient’s self-awareness or awareness of environment; patients tend to improve but may be limited
149
brain death
Loss of function of the entire cerebrum and brainstem, resulting in coma, no spontaneous respiration, and loss of all brainstem reflexes, though spinal reflexes may remain. No recovery is possible
150
bereavement
the period of grieving following a death.
151
grief
a response to bereavement that occurs after a loved one has died. Grief is a reaction to a loss
Feelings: emptiness and loss
Intensity: intense sadness and anger that occurs in waves and gradually subsides
Self-esteem: intact; reorganization tasks may impact sense of self (e.g., “Who am I without him?”)
Thoughts of death: may focus on someday reuniting with the deceased
152
mourning
refers to things people do to cope with grief.
Wearing black, certain things you eat or bring
153
major depressive disorder
Feelings: depressed mood and anhedonia (void of emotion, reduced ability to experience pleasure)
Intensity: depressed mood is constant
Self-esteem: worthlessness and self-loathing
Thoughts of death: focused on ending the pain of depression; may develop a plan for death
154
complicated grief
Distress accompanying bereavement fails to follow normative expectations
Manifests in functional impairment, which may compromise health
155
disenfranchised grief
Grief experience not congruent with a socially recognized and sanctioned relationship
156
cultural awareness
Examine beliefs, values, and practices of own culture
Recognize that during a cultural encounter, three cultures are intersecting
Culture of the patient, nurse, and setting
Identify your own bias/ethnocentric beliefs
157
cultural knowledge
Learn by attending cultural events and programs
Forge friendships with diverse cultural groups
Learn by studying
Learning cultural differences helps nurse
Establish rapport (establishes trust)
Ask culturally relevant questions
Identify cultural variables to be considered
158
cultural encounters
Deter nurses from stereotyping
Help nurses gain confidence in cross-cultural interactions
Help nurses avoid or reduce cultural pain
159
cultural skill
Ability to perform a cultural assessment in a sensitive way
Use professional medical interpreter to ensure meaningful communication
Use culturally sensitive assessment tools
Goal
A mutually agreeable therapeutic plan
Culturally acceptable
Capable of producing positive outcomes
Accommodating and negotiating with the patient (cannot light candle, can keep it in the room though)
160
cultural desire
Genuine concern for patient’s welfare
Willingness to listen until patient’s viewpoint is understood
Patience, consideration, and empathy
161
western tradition
Identity found in individuality
Values
Autonomy
Independence
Self-reliance
Mind and body separate entities
Disease has a cause, and treatment is aimed at the cause
Time is linear
Success is obtained in preparing for the future
162
eastern tradition
Family basis for identity
Body-mind-spirit one entity
Spirit = chi
Time is circular and recurring
Born into a fate; duty to comply (similar to religion)
Disease caused by fluctuations in opposing forces
163
indigenous culture
Places significance on place of humans in natural world
Basis of identity is the tribe
Person is an entity only in relation to others
Disease—lack of harmony between individual and environment
164
biofeedback
Biofeedback is a type of mind-body technique you use to control some of your body's functions, such as your heart rate, breathing patterns and muscle responses. During biofeedback, you're connected to electrical pads that help you get information about your body.
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deep breathing
Deep breaths are more efficient: they allow your body to fully exchange incoming oxygen with outgoing carbon dioxide. They have also been shown to slow the heartbeat, lower or stabilize blood pressure and lower stress
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progressive muscle relaxation
Progressive muscle relaxation is a method of deep muscle relaxation that does not involve any medications, meaning it is a non-pharmacological intervention. The idea behind progressive muscle relaxation is that there is a relationship between a person's mind and body.
