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ADN001 Funds > Lecture 2 Exam Review Week 5 > Flashcards

Lecture 2 Exam Review Week 5 Flashcards

1
Q

State of complete mental, and social well being, not merely the absence of disease or infirmity

A

Health

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2
Q

Active state of being healthy by living a lifestyle promoting good physical, mental, and emotional health

A

Wellness

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3
Q

Medical term, referring to pathologic changes in the structure or function

A

Disease

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4
Q

Number of

A

Mortality

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5
Q

Attainment of the highest level of health

A

Health Equity

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6
Q

Particular type of health difference that is closely linked with social, economic, and environmental disadvantage

A

Health Disparity

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7
Q

Disparities are Influenced by:

A

Race and Ethnicity
Poverty
Sex
Age
Mental Health
Educational Level
Disabilities
Sexual Orientation
Health Insurance
Access to Healthcare

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8
Q

Conditions in the environment in which people are born, live, learn, work, play, worship, and age that affect wide range of health functioning, and quality of life outcomes and risks.

A

Social Determinants

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9
Q

Institutional or Structural Racism

A

Systemic Distribution of resources, power, and opportunity to benefit peoplewho are white and to the exclusion of people of color.

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10
Q

Inclusion

A

Giving everyone a sense of purpose and belonging

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11
Q

Equity

A

Ensuring that everyone has access to the conditions they need to thrive.

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12
Q

Unconscious or Implicit Bias

A

Prejudice in favor or against one thing, person, or group as compared to another, in a way that is considered unfair

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13
Q

Vulnerable Populations

A

Access to care, quality of care, health insurance status, specific sources of ongoing care, and quality and access to care for people with limited English proficiency. Recognize disparities do exist. Plan specific and individualized interventions for patients who are at most at risk

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14
Q

Things a person can change

A

Risk Factors that are modifiable

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15
Q

Nonmodifiable

A

Things that can not be changed

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16
Q

Human Dimensions

A

Interrelated factors influencing health- illness status

Physical
Emotional
Intellectual
Environmental
Sociocultural
Spiritual

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17
Q

How one feels about themselves

A

Self- Esteem

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18
Q

Perception of their Physical self

A

Body Image

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19
Q

Maslow’s of Hierarchy of Needs

A

Basic Human Needs

Physiologic
Safety and Security
Love and Belonging
Self- Esteem
Self- Actualization

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20
Q

People’s behaviors, feelings about self and others, values, and priorities all relate to what?

A

Physiologic and psychosocial needs

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21
Q

Basic human needs are common to all people. True or False

A

True.

Meeting these needs is essential for health and survival of all people.

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22
Q

A person can meet some needs independently, but……

A

Most needs require relationships and interactions with others for partial or complete fulfillment

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23
Q

Characteristics of Basic Needs

A

Their lack of fulfillment results in illness

Their fulfillment helps prevent illness or signals health

Meeting basic needs to restore health

Fulfillment of basic needs restores health

A person feels something is missing when a need is unmet

A person feels satisfaction when a need is met

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24
Q

Six Major Areas of Risk Factors

A

Age
Genetics
Physiologic Factors
Health Habits
Lifestyle
Environment

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25
Q

Physiologic

A

Must be met to maintain life

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26
Q

Safety and Security

A

Encouraging spiritual practices and independent decision making

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27
Q

Love and Belonging

A

Including family and friends and establishing caring relationships with Patients

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28
Q

Self Esteem

A

Respecting Patients values and beliefs and setting attainable goals

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29
Q

Self- Actualization

A

Provide a sense of direction and hope, maximize patient potential

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30
Q

Satisfying one’s needs often depends on the ?

A

Physical and social environment, especially one’s family and community.

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31
Q

Must be met minimally to maintain life

Oxygen water food

Balance between intake and elimination of fluids
Elimination
Temperature
Sexuality
Physical Activity
Rest

A

Physiological Needs

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32
Q

Safety and Security Needs

A

Second in priority
Have both physical and emotional components
Being protected from potential or actual harm

Examples:
Using proper Hand Hygiene
Using electrical equipment
Administering Medications knowledgeably
Skillfully moving and ambulating patients

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33
Q

Third in Priority and called Higher Level needs

Understanding and acceptance of others in both receiving and giving love

Feeling of belonging to groups such as family, peers, friends, and a neighborhood.

Unmet may lead to loneliness and isolation

A

Love and Belonging

Examples of Interventions

Including family in patient care and friends as well

Establishing a trusting nurse- patient relationship

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34
Q

Self- Esteem Needs

A

Need for a person to feel good about one’s self.

Sense of accomplishment and to believe that others also respect and appreciate those accomplishments.

Positive self esteem facilitates the person’s confidence and independence.

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35
Q

Factors affecting Self Esteem

A

Role Changes
Body Changes

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36
Q

Self- Actualization

A

Highest Level of Needs
Acceptance of self and others
Ability to be objective
Feelings of happiness
Using creativity as guideline for solving
differentiate between good and evil

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37
Q

Family

A

Group of people who live together and depend on another for support.

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38
Q

Nuclear Family

A

Traditional Familyb

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39
Q

Extended Family

A

Includes Aunts and Uncles

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40
Q

Blended Family

A

Two parents and their unrelated children from previous

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41
Q

Single- Parent Family

A

May be separated, divorced, widowed, or never married

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42
Q

Cohabitating Adults

A

Unmarried Adults, communal or group marriages

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43
Q

Functions and Factors Affecting Family and Community

A

Family Functions
Community Factors Affecting Health
Risk Factors for Altered Family Health
Environmental Health

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44
Q

Family Functions

A

Physical
Economic
Reproductive
Affective and coping
Socialization

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45
Q

Risk Factors for Altered Family Health

A

Lifestyle
Psychosocial
Environmental
Developmental
Biologic risks

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46
Q

Community Factors Affecting Health

A

Social Supports Systems
Community Health Care Structure
Economic Resources
Effect on individuals and families

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47
Q

Environmental Health

A

Physical, chemical, and biologic, psychosocial factors in the environment
Quality of Air
Climate change/ actions
Reducing waste in clinical setting

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48
Q

Nurse and Environmental Health

A

Nurses are :
provide healing and safety
trusted sources
largest health care population
work with variety of cultures
Translate Information

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49
Q

Primary

A

Directed toward promoting health and preventing the development of disease and processes of injury

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50
Q

Secondary

A
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51
Q

Tertiary

A

Begins after an illness is diagnosed and treated, with the goal of reducing disability and helping rehabilitate PTs to max level of functioning.

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52
Q

Stages of Change Model

A

Prochaska and DiClemente

Used by counselors addressing behaviors including injury prevention, addiction and weight loss.

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53
Q

Health Belief Model

A

Rosenstock

Concerned with what people perceive to be true about themselves in relation to their health.

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54
Q

Health Promotion Model

A

Murdaugh

Developed to illustrate how people interact with their environment as they pursue health

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55
Q

Health- Illness Continuum

A

Views health as a constantly changing state with high- level wellness and death on opposite sides of a continuum

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56
Q

Coexistence of different ethnic, racial, and socioeconomic groups within on social unit

A

Cultural Diversity

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57
Q

Varying by:

A

Religion
Language
Physical Size
Sexual Orientation
Disability
Occupational Status
Geographical Location

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58
Q

Cultures

A

Shared system of beliefs, values, and behavioral expectations.

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59
Q

Cultures and Subcultures

A

Combination of body of belief and knowledge and behavior
Social structure for daily living
Influences roles and interactions with others and in families and communities
Apparent in the attitudes and institutions unique to particular groups

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60
Q

Dominant Group

A

Largest group

Most authority of control and values

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61
Q

Minority Group

A

Smaller group
Physical or cultural characteristic identifies the people as different from dominant group

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62
Q

Cultural Assimilation

A

Acculturation
Minorities living within a dominant group lose the characteristics that made different
Values replaced by those dominant culture

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63
Q

Culture Shock

A

Feelings a person experiences when placed in a different culture

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64
Q

Ethnicity and Race

A

Sense of Identification with a collective cultural group

Based on heritage

One can belong to an ethnic group through birth or adaptation

Share unique cultural and social beliefs and behavior patterns

Largely develops through day to day life with family and community

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65
Q

Race is based on

A

Specific characteristics

Skin pigmentation, body stature, facial features, hair texture

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66
Q

Physical Characteristics are

A

No longer considered a reliable way to determine a person’s race

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67
Q

stereotyping

A

Assigning characteristics to a group of people without considering specific individuality

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68
Q

Cultural Blindness

A

Ignoring difference in people and proceeding as though the differences do not exist

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69
Q

Culture Conflict

A

People become aware of the differences, feel threatened, respond by ridiculing the beliefs of others to increase their own security

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70
Q

Implicit Bias

A

Prejudice in favor or against one thing, in a way that is considered unfair. Unconscious bias occurs automatically in the brain.

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71
Q

Cultural Imposition

A

Imposing one’s beliefs. Believe them to better their values.

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72
Q

Dominant group

A

(usually largest group)
* Group has the most authority to control values and sanctions
of society

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73
Q

Minority group (smaller group)

A

A physical or cultural characteristic identifies the people as
different from dominant group

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74
Q

Cultural Assimilation

A

Minorities living within a dominant group lose the
characteristics that made them different
* Values replaced by those of dominant culture

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75
Q

Cultural Shock

A

The feelings a person experiences when placed in a different
culture
* May result in psychological discomfort or disturbances

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76
Q

Ethnicity

A

Sense of identification with a collective cultural group

Based on group’s common heritage

One can belong to ethnic group through birth or adoption of characteristics of that group

Largely develops on group’s common heritage

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77
Q

Race

A

Typically based on specific characteristics

Physical characteristics are no longer considered reliable way to determine a person’s race

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78
Q

Factors Inhibiting Sensitivity to Diversity

A

Stereotyping- Assigning characteristics to a group of people without considering specific individuality.

Implicit Bias- Prejudice in favor or against one thing, in a way that is considered unfair; unconscious bias occurs automatically as the brain makes quick judgements based on past experiences and backgrounds

Cultural Imposition-Tendency of some to impose their beliefs, practices and values on another culture because they believe them superior.

Cultural blindness
the ignoring of differences in people and proceeding as though the differences do not
exist

Culture conflict
*People become aware of differences, feel threatened, respond by
ridiculing the beliefs of others to increase their own security

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79
Q

Cultural Influences on Health Care, Health, and Illness

A

Physiologic Variations
Reactions to pain
Mental Health
Assigned Sex roles
Language Communication
Orientation to space and time
Food and Nutrition
Family Support
Socioeconomic Factors

Values and beliefs about health, illness, and health care are influenced by cultural groups, ethical, and religious.

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80
Q

Elements of Cultural Competence

A

Developing Self Awareness
Demonstrating knowledge and patients culture
Accepting and respecting cultural differences
Resist judgements
Being open to and comfortable with cultural encounters
Accepting responsibility for ones own cultural competency

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81
Q

Ethnocentrism

A

Belief that one’s ideas, beliefs, and practice are the best or superior or are most preferred to those of the others.

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82
Q

Cultural Humility

A

Recognition of diversity and power imbalances among individuals or communities, with the action of being open, self- aware, egoless, flexible, excluding respect and supportive interactions, focusing on both self and other to formulate a tailored response.

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83
Q

Guidelines for Nursing Care

A

Cultural Assessment
Transcultural Nursing
Develop cultural self- awareness
Develop cultural Knowledge
Accommodate cultural practices in health care
Respect cultural care

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84
Q

Cultural Assessment and Areas Nurses Need to Understand

A

Beliefs, values, traditions, and practices of a culture

Culturally defined, health related needs of individuals, families, and communities .

Attitude toward seeking help from health care.

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85
Q

Sexuality encompasses

A

Biologic Sex or sex at assigned at birth
sexual activity
gender identities vs roles
sexual orientation

Sexual Health represents the integration of the somatic, emotional, intellectual, and social aspects of sexual being in ways that are positive.

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86
Q

Sexual Identity

A

Self Identity
Biological Sex
Gender Identity
Gender Role
Sexual Orientation

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87
Q

Pedophilia is not

A

Adaptive must report abuse

State mandated

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88
Q

Sexual Expression

A

Ranges from adaptive to maladaptive

Between two consenting adults

mutually satisfying
not harmful
Conducted in private

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89
Q

Gender Identity

A

Gender Expression
Gender Diverse
Gender Dysphoria
Cisgender
Transgender
Gender Binary

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90
Q

Sexual Orientation

A

Heterosexual
Gay or lesbian
Bisexual
Asexual
Questioning

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91
Q

Sexual Expression

A

Ranges from adaptive to maladaptive
Between two adults consent
Not harmful
Lacking in force or coercion

Masturbation

Sexual Intercourse - Vaginal or anal

Oral- Genital stimulation

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92
Q

Factors Affecting Sexuality

A

Developmental Considerations

Culture

religion
Ethics
Lifestyle

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93
Q

Menstruations

A

Normal vaginal bleeding that prepares for the presence of fertilized Ovum

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94
Q

Four Phases of Mens.

A

Follicular
Proliferation
Luteal
Secretory

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95
Q

Menarche

A

First Period

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96
Q

Menopause

A

Cessation of menstrual activity

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97
Q

Causes of menstrual irregularities

A

Pregnancy
Breast feeding
Eating Disorders
Extreme weight loss
PCOS
Premature ovarian failure

98
Q

Name STI

A

HIV
Chlamydia
Genital Herpes
Gonorrhea
HPV
Trichomoniasis
Syphilis

99
Q

STI Information

A

Delaying sexual relationships
Have regular checkups for STIs
Learn the common symptoms of STIs
Avoid sex during menstruation
Avoid anal intercourse
Avoid douching

100
Q
A
101
Q

Sexual Dysfunction

A

Males
Erectile Dysfunction
Premature Ejaculation
Delayed Ejaculation

Females

Inhibited Sexual Desire
Dyspareunia
Vaginismus
Vulvodynia

102
Q

Quid pro Quo

A

Withheld in exchange for something else

103
Q

Sexual Harassment

A

Unwelcome behavior that is based on a person’s sex or gender

104
Q

Hostile Environment

A

Unwelcome sexually oriented and gender based behaviors
Sexual joking
Sexual bantering
Offensive pictures and languages
Sexual Behavior

105
Q

Responding to Harassment in the Nursing Environment

A

Be Self Aware

Confront and Provide Feedback

Set limits

Enforce Limits Report and document the incident. Submit to Supervisor

106
Q

Nursing History and Physical Assessment

A

Reproductive History
History of STIs and Sexual Dysfunction
Sexual behaviors , self concept, and functioning

107
Q

Interventions for Physical Sexual Assessment

A

Physical Exam

Annual Exam

Suspected STI or Pregnancy
Work up for infertility
Unusual lump or discharge

108
Q

BETTER acronym

A

B ring up topic
E xplain
Tell
T timing
E ducate
R record

109
Q

Patient Outcomes Regarding Sexuality

A

Define sexuality
Establish open patterns of communication
Develop self awareness and body awareness
Practice responsible sexual expression

110
Q

Implementation

A

Establish trust relationship
Teach about sexuality
Promote responsible sexual expression
Contraception
Advocating for patients sexual needs
Healthcare needs for all people

111
Q
A
112
Q

Meeting Spiritual Needs

A

Offering compassionate

Facilitating patient’s expression of religious or spiritual beliefs and practices

113
Q

Spirituality

A

Anything that pertains to the person’s relationships with a nonmaterial life force or higher power

114
Q

Faith

A

Confident belief in something for which there is no proof or evidence

115
Q

Religion

A

Organized system of beliefs about a higher power

116
Q

Hope

A

Ingredient in life responsible for positive outlook

117
Q

Love

A

Connectedness with others

118
Q

Suffering

A

Specific state of distress that occurs when the intactness or integrity of the person is threatened

119
Q

Elements of Spirituality

A

Experienced as a unifying force, life principle, and essence of being

experienced in and through connectedness with nature, earth, environment, and cosmos

Shapes the self becoming and is reflected in ones being, knowing, and doing

Provides purpose, meaning, strength, and guidance

120
Q
A
121
Q
A
122
Q

Factors Affecting Spirituality

A

Developmental considerations
Family
Ethnic Background
Formal Religion
Life Events

123
Q

Nursing History and Observation

A

H Sources of hope
O organized religion
P personal practice
E effects on medical care and end of life

Observe for significant or sudden changes in spiritual practices, mood changes, sudden interest in matters, and disturbed sleep

124
Q

Focused Spirituality Assessment

A

Spiritual beliefs and practices
Relation between spiritual beliefs and everyday living
Spiritual Needs
Need for meaning and purpose
Need for love and relatedness
Need for forgiveness

125
Q

PT Goals and Outcomes Spiritual Distress

A

Explore the origin of spiritual beliefs and practices

Identify factors in life that challenge beliefs
Identify spiritual supports
Report or demonstrate decreased spiritual distress after intervention

126
Q

Implementing Spiritual Care

A

Ethical and professional boundaries
Offering supportive or healing presence
Facilitating PTs practice of religion
Praying
Conseling patients

127
Q
A
128
Q

Facilitating the Practice of Religion

A

Familiarize the PT with pastoral and religious services within the institution

Respect privacy during prayer

Assist to obtain devotional objects

Arrange for sacraments if needed
Meet religious dietary restrictions if needed

129
Q

Counseling Patients Spiritually

A

Have the Patient articulate beliefs
Explore the origin of the PT spiritual beliefs and practices
Identify life factors that challenge PTs beliefs
Develop spiritual beliefs that meet the need for meaning purpose, care, and relatedness, and forgiveness

130
Q

Room Preparation for Counselor Visit

A

Make sure the room is orderly and free of unnecessary equipment

Provide a seat for the counselor near the patient’s bed

Clear the top of the bedside table and cover with a clean white cloth for sacraments

Draw the bed curtains if the patient can’t be moved to a private setting

131
Q

Evaluating Expected Outcomes

A

Identify some spiritual belief that gives meaning and purpose of life

Move toward healthy acceptance of the current situation

…..

132
Q

Growth

A

Increase in body size or changes in body cell structure, function, and complexity

133
Q

Development

A

Orderly patter and changes in structure, thoughts, feelings, or behaviors resulting from maturation, experiences and learning.

134
Q

Growth and Development

A

Orderly and Sequential

135
Q

Genetics

A

Determines the person’s cellular differentiation, growth, and function

136
Q

Heredity

A

Refers to transmission of genetics

what is passed down and inherited from one generation to another

137
Q

Genomics

A

Study of the structure and interactions of all genes in the human body.

138
Q

HGP

A

Human Genome Project

Determine the order of sequence of all bases in human DNA

Making maps that show the locations of genes on chromosomes

139
Q

Different Theories

A

Freud: theory of psychoanalytic development
* id, ego, superego; oral, anal, phallic, latency, genital a/w age
* Piaget: theory of cognitive development
* Sensorimotor, preoperational, concrete, formal operational stages
* Erickson: theory of psychosocial development
* Expanded on Freud to include cultural & social influences (__ vs. __)
* Havighurst: theory based on developmental tasks
* Gould: theory based on specific beliefs and developmental phases
* 16 – 60 years old; transformation-focused
* Levinson: based on the organizing concepts of individual life structure
* Novice, settling down, midlife transition, entering middle adulthood
* Kohlberg: theory of moral development
* Build on Piaget’s theory, preconventional, conventional, postconventional level
* Gilligan: conception of morality from the female viewpoint
* Kohlberg + female perspective
* Fowler: theory of faith developme

140
Q

Freud

A

theory of psychoanalytic development
* id, ego, superego; oral, anal, phallic, latency, genital a/w age

141
Q

Piaget

A

theory of cognitive development
* Sensorimotor, preoperational, concrete, formal operational stages

142
Q

Erikson

A

theory of psychosocial development
* Expanded on Freud to include cultural & social influences (__ vs. __)

143
Q

Havighurst

A

theory based on developmental tasks

144
Q

Gould

A

theory based on specific beliefs and developmental phases
* 16 – 60 years old; transformation-focused

145
Q

Levinson

A

based on the organizing concepts of individual life structure
* Novice, settling down, midlife transition, entering middle adulthood

146
Q

Kohlberg

A

theory of moral development
* Build on Piaget’s theory, preconventional, conventional, postconventional level

147
Q

Gilligan

A

conception of morality from the female viewpoint
* Kohlberg + female perspective

148
Q

Fowler

A

Theory of faith development

149
Q

Incorporating Principles of Growth and Development

A

Know the various stages of cognitive, psychosocial, moral, and spiritual development.

Remember that patients are members of families and that the family unit can have both positive and negative influences on the development of individual members

Maintain flexibility in assessing PTs and respect their uniqueness

Anticipate possible regression during crisis

Understand the environment and cultural influences have strong effect on development

150
Q

Common Health Problems in Middle Adulthood

A

Malignant Neoplasms
CV Diseases
Injury
Depression
DM
Chronic Lower Respiratory Disease
Liver and kidney disease
Alcoholism

151
Q

Role of the nurse to health of middle adult

A

Health related screenings, examinations, and immunizations

Teach dangers of substance use, smoking, alcohol consumption

Teach adults to eat a diet low in fat and cholesterol
Teach importance of regular exercise

152
Q

Variation in Life Expectancy Older Adulthood

A

Socioeconomic and race ethnicity factors

Behavioral and metabolic risk factors
Health Care factors

153
Q

Common Myths of Older Adults

Ageism

A

Older Adults

Old Age begins at 65
Most older adults are in LTC
Do not care how they look
Bladder problems
Can’t learn new things
Not interested in sex.

154
Q

Physiologic Changes of Older Adults

A

General Status
Every Single system is affected

Senses are the ones that are hit hard the most

155
Q

Cognitive Development in Older Adults

A

Intelligence increases into the 60s and cognition does not change appreciably with aging

Response and reaction times increase

Mild short term memory loss

156
Q

Dementia, Alzheimer’s disease, depression and delirium may occur and cause what?

A

Cognitive Impairment

157
Q

Psychosocial Development of Older Adult

A

Self concept is relatively stable

Disengagement theory: An older adult may substitute activities but does not disengage from society

Erikson- Ego integrity vs Despair and disgust

158
Q

Havighurst

A

Major tasks are maintenance of social contacts and relationships

159
Q

Adjusting Changes of Older Adulthood

A

Physical Strength and Health
Retirement and income
Spouse or Partner Health
Relating to one’s age group
Social roles
Living arrangements
Family and role reversal

160
Q

Moral and Spiritual Development of Older Adults

A

Kohlberg
Completed their moral development and most at conventional level

Spiritually- may be at earlier level often at the individualize - reflective level

Self- Transcendence is characteristic of life

161
Q

Gerotranscedence

A

Describes the transformation of a person’s view of reality from a rational, social, individually focused, materialistic perspective to a more transcendent vision

162
Q

Health of the Older Adult

A

Most older people are not impaired
More vulnerable to physical, emotional, or socioeconomic problems
Probability of becoming ill
Chronic health problems or disability may develop
Polypharmacy
Accidentally Injuries
Elder Abuse

163
Q

Delirium

A

Temporary state of confusion that can last from hours to weeks and resolves with treatment.

Hypoactive

Hyperactive

164
Q

Causes of Accidental Injuries in Older Adults

A

Changes in vision and hearing

Loss of mass and strength of muscles
Slower reflexes

Decreases sensory ability
Economic factors

165
Q

Elder Abuse

A

Experienced in 1 in 10 communities

Social, financial, environmental, educational inequities increase the risk

166
Q

SPICES assessment tools

A

S Sleep Disorders
P Problems with eating or feeding
I Incontinence
C Confusion
E Evidence of falls
S Skin Breakdown

167
Q

Nursing Actions to Promote Health in Older Adults

A

Physiologic function
Cognitive function
Psychosocial needs
Nutrition
Sleep and Rest
Elimination
Activity and Exercise
Sexuality
Meeting Developmentally Tasks

168
Q

Senses Involved in Sensory Reception

A

Visual
Auditory
Olfactory
Gustatory
Tactile
Stereognosis- perception of solidity of objects
Kinesthetic and Visceral - Basic internal orienting systems
Proprioception

169
Q

RAS

A

Reticular Activating System

Monitors and regulates incoming stimuli, maintaining, enhancing,

170
Q

Conscious

A

Delirium, dementia, confusion, normal consciousness, somnolence, minimally conscious states, locked in syndrome

171
Q

Unconscious

A

Asleep, stupor, coma
Vegetative state

172
Q

Sensory Overload

A

Pt experiences so much sensory stimuli that the brain is unable to stimuli meaningful or ignores it

PT feels out of control

Nursing care focuses on reducing stimuli and help patient regain control of the environment

173
Q

Sensory Deprivation

A

Occurs when a person experiences decreased sensory input

174
Q

PTs at high risk

A

Environment with decreased or monotonous stimuli
* Impaired ability to receive environmental stimuli
* Inability to process environmental stimuli
* Effects of sensory deprivation: Perceptual, cognitive, & emotional
disturbances

175
Q
A
176
Q

Sensory Deficits

A

Impaired sight or hearing
Altered Taste
Numbness or paralysis

177
Q

Sensory Poverty

A

Becoming Poorer as we lose the ability to be sensually present in the moment

178
Q

Factors Affecting Sensory Stimulation

A

Developmental Considerations
Culture
Personality and Lifestyle
Stress and Illness
Medications

179
Q

Assessment of the Sensory Experience

A

Stimulation
Reception
Transmission - perception- reaction
Signs and symptoms of sensory deprivation and overload

Physical Assessment
Assessment of the ability to perform self care
Vision and hearing assessments

180
Q

Interventions to improve Sensory Functioning

A

Prevent disturbed sensory perception and stimulate the senses

181
Q

Patient Outcomes for Sensory Alterations

A

Live in a developmentally stimulating and safe environment

Exhibit a level of arousal that allows for meaningful stimuli organization

Schedule health screenings

Maintain orientation of time place and person

Respond appropriately to sensory stimuli while executing self care activities

182
Q

Nursing Care for Visually Impaired Patients

A

Acknowledge your presence in the PT room

Speak in normal voice

Explain the reason of touching before doing it

Keep the call light in reach

Clear Pathways

Assist with ambulation Indicate when leaving

183
Q

Nursing Care for Hearing Impaired

A

Orient the Patient to your presence …

184
Q

Nursing care for a Patient who is confused

A

Frequent face to face contact
Speak calmly, simply, and directly to PT ….

185
Q

Nursing Care for Unconscious Patient

A

Be careful what is said in PTs presence, haring is last sense lost.

Assume that the PT can hear you and talk in a normal tone

Speak to patient before touching
Keep noises low in the environment

186
Q

Actual Loss

A

Can be recognized by others

187
Q

Perceived Loss

A

Felt by person, but is intangible to others

188
Q

Maturational Loss

A

Experienced as a result of an unpredictable event

189
Q

Anticipatory Loss

A

Loss has not yet taken place

190
Q

Grief

A

Internal emotional reaction to loss

191
Q

Bereavement

A

State of grieving from loss of a loved one

192
Q

Mourning

A

Actions and expressions of grief, including symbols and ceremonies that make up outward expression of grief.

193
Q

Dysfunctional Grief

A

Abnormal or distorted. May be either unresolved or inhibited.

194
Q

Stages of Grief for Engels

A

Shock and Disbelief
Developing Awareness
Restitution
Resolving the Loss
Idealization Outcome

195
Q

Kubler Ross 5 Stages of Grief

A

Denial
Anger
Bargaining
Depression
Acceptance

196
Q

Uniform Definition of Death Act

A

Individual who has sustained
1. Irreversible cessation of circulatory and respiratory functions

  1. Irreversible cessation of all functions of the entire brain, including the brainstem, is dead.
197
Q

Medical Criteria used to Certify Death

A

Cessation of breathing
No response to deep painful stimuli
Lack of reflexes
Flat encephalogram

198
Q

Clinical Signs of Impending Death

A

Difficulty talking or swallowing
Nausea, flatus, and abdominal distention
Urinary or BM incontinence or constipation
Loss of movement, sensation, and reflexes
Decreasing body temperature with cold and clammy skin
Weak slow and irregular pulse
Decreasing blood pressure
Noisy, irregular, or Cheyne Stokes respirations
Restlessness and agitation
Cooling, mottling, cyanosis of areas and extremities

199
Q

Providing Care to Facilitate a Good Death

A

Guided by values and preferences of the individual patient
Independence and dignity are central issues
Providing control
Focus on relief symptoms

200
Q

Palliative vs Hospice

A

Meant to enhance a person’s current care by focusing on quality of life for them and family

201
Q

Palliative Care

A

Give Patients with life threatening illnesses best qualify of life they can have by aggressive managements of symptoms

202
Q

Hospice Care

A

Limited Life expectancy, in home or hospice house, inpatient

Poor performance status, declining status, advanced…

203
Q

Advance Directives

A

Include living wills and durable power of attorney indicate:

who will make decisions for PT when unable to

Kind of medical treatment the PT wants
How the PT wants to be treated
What the PT wants loved ones to know

204
Q

Mourning

A

Actions and expression of grief, including the symbols and ceremonies that make up outward expression of grief

205
Q

Dysfunctional Grief

A

Abnormal or distorted, may be either unsolved or resolved

206
Q

Terminal Illness

A

Illness in which death is expected within a limited period of time

effect on the PT
effect on the Family
The Dying Person’s Bill of Rights

207
Q

POLST

A

Medical order indicating a patient’s wishes regarding treatments commonly used in a medical crisis

Must be completed and signed by a healthcare professional, not the PT
Inpatient: Need inpatient order

208
Q

Special Orders

A

Allow natural death DNR or no code
Comfort Measures
Terminal Weaning
VSED

Voluntarily stopping of eating and drinking

209
Q

Active and Passive Euthanasia

A

Not in California ….

210
Q

Palliative Sedation

A

Not in California ….

211
Q

Factors Affecting Grief and Dying

A

Developmental Considerations
Family
Socioeconomic factors
Cultural, sex, assigned at birth, and religious influences
Cause of Death

212
Q

Needs of Dying Patients

A

Physiologic Needs
Pain control and nutrition and hygiene

Psychological Needs
Fear of unknown, pain, separation, leaving loved one s

Needs for Intimacy

Physical needs ways to be physically intimate that meets needs of both partners

Spiritual Needs

Patient needs meaning and purpose, love and relatedness, forgiveness and hope

213
Q

Developing a trusting Nurse Patient Relationship

A

Explain the PT condition and treatment
Teach self care and promoting self esteem
Teach family members to assist in care
Meet the needs of the dying patient
Meet the family needs

214
Q

Interventions Providing Postmortem Care

A

Care of the body
Care of the family
Care of other patients
Caring for oneself
Prepare body for discharge
Place ID tags
Follow local law of communicable disease
Place in anatomical position, replace dressings and remove tubes unless autopsy scheduled

215
Q

Interventions Postmortem Care of Family

A

Listen to family’s expressions of grief, loss, and helplessness

Offer solace and support by being an attentive listener

Arrange for family to view the body

Provide private place for family to begin grieving

It is appropriate for the nurse to attend the funeral and make a follow up visit to the family

216
Q

Dimensions of Self Concept

A

Self Knowledge: Who am I?
Self Expectation: Who I want to be?
Self Evaluation: How well do I like myself?

217
Q

Three Major Self evaluations

A

Pride Positive self examination

Guilt Based on behaviors incongruent with the ideal safe

Shame Low global self worth

218
Q

Formation of Self Concept

A

Infant learns physical self different from environment

Basic needs met, infant has positive feelings of self

Child internalizes other peoples attitude toward self

219
Q

Factors Affecting Self

A

Factors Affecting Self-Concept
* Developmental considerations
* Culture
* Internal and external resources
* History of success and failure
* Crisis or life stressors
* Aging, illness, disability, or trauma

220
Q

Nursing Strategies to Identify Personal Strengths

A

Encourage PT to identify strengths
Replace self- negation with positive thinking
Notice and reinforce patient strengths
Encourage patients to will for themselves
Help patients cope with necessary dependency

221
Q

Helping Patients Maintain Sense of Self

A

Communicate worth with looks, speech, and judicious touch

Acknowledge patient status, role, and individuality

Speak to PT respectfully

Converse with the patient about their life experiences
Offer simple explanations for procedures
Respect privacy
Acknowledge and allow of expression of negative feelings

222
Q

Examples of Physiologic Stressors

A

Chemical Agents
Physical Agents
Infectious Agents
Nutritional Imbalances
Hypoxia
Genetic or immune disorders

223
Q

Local Adaptation Syndrome

A

Involves one specific body part

Reflex pain response
Inflammatory response

224
Q

General Adaptation Syndrome

A

Biomedical model of stress

Alarm Reaction
Stage of resistance
Stage of Exhaustion

225
Q

Local Adaptation Syndrome

A

Localized response of the body to stress

Involves only a specific body part such as tissue or organ

Stress precipitating LAS may be traumatic or pathologic

226
Q

Primarily Homeostatic

A

Short term adaptive response

227
Q

Alarm Reaction

A

Person perceives stressor
Defense mechanisms activated
Fight or Flight
Hormone levels rise
Shock and counter shock phases

228
Q

Stage Resistance

A

Body attempts to adapt to stressor
Vital signs, hormone levels, and energy production return to normal

Body regains homeostasis or adaptive mechanisms fail

229
Q

Stage of Exhaustion

A

Results when adaptive mechanisms are exhausted
Body either rests and mobilizes its defenses to return to normal or dies

230
Q

Examples pf Psychosocial Stressors

A

Accidents
Stressful or traumatic experiences of family members
Horrors of history
Fear of aggression
Rapid changes in the world
Inherent stressors

231
Q

Psychological Homeostasis

A

Mind body interaction
Anxiety
Coping Mechanisms
Defense Mechanisms

232
Q

Coping Mechanisms

A

Crying, Laughing, sleeping, and cursing
Physical activity, exercise
Taking a deep breath mindfulness
Smoking, drinking
Lack of eye contact and withdrawal
Limiting relationships to those with similar values and interests

233
Q

Task Oriented Reactions to Stress

A

Attack Behavior
Attempts to overcome obstacles to satisfy need
Constructive: Assertive
Destructive: Aggression, hostility

Withdrawal Behavior
Physical Withdrawal from threat
Admitting Defeat, feeling guilty, isolated

Compromise Behavior
Substitution of goals or negotiation to partially fulfill needs

234
Q

Effects of Stress

A

Stress and basic human needs
Stress in health and illness
Long term stress
Family stress
Crisis

235
Q

Developmental Stress

A

Occurs when person progresses through stages of growth and development

236
Q

Situational Stress

A

Does not occur in predicable patterns

illness, divorce, marriage

237
Q

Stressful Activities in Nursing

A

Assuming responsibilities for one is not prepared for
Working with unqualified personnel
Working in unsupportive environment
Caring for dying patient
Conflict with peers
Being unable to take right action

238
Q

Teaching Activities of Healthy Daily Living

A

Exercise
Rest and Sleep
Nutrition
Support Systems
Use of stress management

239
Q

Stress Management Techniques

A

Relaxation
Mindfulness
Guided Imagery
Crisis Intervention

240
Q

Crisis Intervention

A

Disturbance caused by a precipitating event, coping ineffective

Stabilization
Acknowledgement
Facilitation of understanding
Encourage effective coping
Recovery
Referral

241
Q

Evaluating the Care Plan

A

PT verbalizes the causes and effects of stress and anxiety

Uses support systems
Uses problem solving to find a solution to stressors
Practices healthy habits and anxiety reducing techniques
PT verbalizes decrease in anxiety and increase in comfort

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