Holistic Care of the Patient and Family

Question 1

What are the 5 stages of loss according to Kübler-Ross and Kessler?

Answer 1

Denial, Anger, Bargaining, Depression, and Acceptance

Question 2

What is the benefit of the denial stage?

Answer 2

it may protect the patient against the emotional impact of the illness and conserve energy by removing worrying

Question 3

What are the stages of bargaining, depression, and acceptance characterized by?

Answer 3

an attempt to regain control

Question 4

Are Kübler-Ross’s stages fixed?

Answer 4

no. It is a dynamic process and patients may regress to earlier stages during periods of heightened anxiety

Question 5

What is the first priority for many family members of patients that are in the ICU?

Answer 5

communication

Question 6

A client was involved in a motor vehicle crash and sustained multiple lower-extremity fractures. He will need additional surgery and prolonged physical therapy. The nurse finds the client drawing plans for remodeling his porch to accommodate a wheelchair. This behavior reflects which stage of illness?

Answer 6

Acceptance

Question 7

When interacting with a client in denial, what is the nurse’s best strategy?

Answer 7

Function as a noncritical listener

Question 8

What is an appropriate nursing intervention for a client experiencing shock and disbelief about his or her diagnosis?

Answer 8

Providing accurate information

Question 9

Which changes can induce anxiety in the high-acuity client?

Answer 9

Weaning from mechanical ventilation
Increasing mobility
Changing monitoring

Question 10

What are some contraindications to massage therapy?

Answer 10

advanced osteoporosis, bone fractures, burns, DVT, eczema, phlebitis, and skin infections

Question 11

How may complementary and alternative therapies be used?

Answer 11

In lieu of standard medical treatment
As a complement to standard medical treatment

Question 12

What best describes the use of humor as therapy?

Answer 12

Humor is a CAT that can be used with high-acuity clients.

Question 13

Guided imagery may be a useful strategy for clients with which conditions?

Answer 13

Anxiety
Depression
Pain

Question 14

What is the initial goal in treating high acuity patients?

Answer 14

to decrease stress and promote comfort rather than to increase knowledge

Question 15

Which patients are at the most risk for a low level of health literacy?

Answer 15

those older than 65, members of minority groups, immigrants, those of a lower socioeconomic status, or those suffering from chronic illness

Question 16

When might patients begin to experience periods of low health literacy?

Answer 16

During times of depression, uncontrolled pain, or complex medical situations

Question 17

When is the optimal time to transfer a patient out of the ICU?

Answer 17

during the daytime

Question 18

Why are family members restricted from visiting during invasive procedures and CPR?

Answer 18

the family might lose control, the unpleasantness of what families might see, insufficient room at the bedside, and increased risk of litigation

Question 19

What are the advantages of families being present during CPR?

Answer 19

the family is better equipped to make decisions regarding resuscitative efforts, the family can say goodbye, witnessing the procedure provides a sense of control, the family gets closure, the family can preserve the patient’s dignity, and they express fewer symptoms of PTSD than those who cannot be present

Question 20

What are the 4 core components of family-centered care?

Answer 20

Dignity and respect, information sharing, participation, and collaboration

Question 21

When teaching high-acuity clients, what are the initial goals?

Answer 21

To reduce stress
To promote comfort

Question 22

Which strategy should the nurse use to reduce transfer anxiety?

Answer 22

Introduce the client and family to the receiving nurse before the transfer occurs.

Question 23

What is the effect of unrestricted visiting hours on some clients?

Answer 23

Fewer hallucinations

Question 24

Family presence during CPR contributes to which result?

Answer 24

Ability of family to say goodbye

Question 25

What is the pneumonic used in order to develop cultural competence?

Answer 25

CRASH

Question 26

What does CRASH stand for?

Answer 26

Consider Culture, show Respect, Assess and Affirm differences, Show Sensitivity and Self-Awareness, and provide care with Humility

Question 27

Describe cultural diversity

Answer 27

Cultural diversity plays an important role in the care of the high-acuity client

Question 28

How can the nurse enhance communication with clients?

Answer 28

Speaking in small units of speech

Question 29

Which term describes a set of social, cultural, and political beliefs held by a group of individuals?

Answer 29

Ethnicity

Question 30

Which nursing skills demonstrate cultural competence?

Answer 30

Showing respect
Assessing and affirming differences
Showing sensitivity
Providing care with humility

Question 31

What may occur if a patient is exposed to noise for continuous periods?

Answer 31

sensory overload

Question 32

What does the WHO recommend for sound levels in patient rooms?

Answer 32

levels of 35dB or less

Question 33

What are common features of delirium?

Answer 33

an acute onset of fluctuating awareness, impaired ability to attend to environmental stimuli, and disorganized thinking

Question 34

What factors can contribute to inability of hospitalized patients to get adequate sleep and rest?

Answer 34

Alterations in the light or dark cycle, pain, environmental noise, caregiver interruptions, and stress

Question 35

What have sedative hypnotics been linked to?

Answer 35

increase in falls, delirium, and functional decline in patients (particularly in the elderly)

Question 36

What are the benefits of REM sleep?

Answer 36

facilitates protein anabolism, restores the immune system, and promotes healing

Question 37

Which noise do high-acuity clients report as being most annoying?

Answer 37

Staff’s loud voices

Question 38

Which nursing interventions would support the client’s REM sleep?

Answer 38

Dimming lights during normal sleep time
Reducing environmental noise
Providing opioid analgesia at bedtime

Question 39

What are common characteristics of delirium?

Answer 39

Inability to attend to environmental stimuli
Acute onset
Disorganized thinking
Agitation