midterm 2.0 Flashcards
Prejudice
A hostile attitude toward others simply because their apart of a certain group with objectionable characteristics
Stigma
Negative attitude, discrimination, rejecting attitudes and behaviours towards people
Stereotype
Over-generalized beliefs about a particular category of people
Dorthy Dix
Advocated for humane treatment, helped make mental health hospitals and humane prisons (social reform)
What was the first antimanic drug?
Lithium
What was the first anti-psychotic drug?
Chlorpromazine
What was the first anti-depressant?
Maoi & Tricyclic
discrimination
negative differential treatment of others becayse they are members of a certain group or identified as being negatively different
discrimination can include and arises from
ignoring, derogatory name-calling, denying services, and threatening
lack of understanding and appreciation of differences among people
3 levels of stigma
self, public, structural
What was the first mental health treatments?
- Lobotomy
2.Malaria Fever
3.Hydrotherapy
4.Insulin coma therapy
5.Electro shock therapy
What is projection?
falsely attributes own unacceptable feelings, impulses, or thoughts to another individual or object (ex. it’s your fault that I failed)
What is transference?
When the client unconsciously transfers assets of a past relationship to someone else onto you as a nurse (ex. abandonment issues - get’s mad when you leave the room)
What are the 4 main concepts (meta-paradigms)
- The Person
- The Environment
- Nursing Role
4.Health
what is self-awareness
process of understanding one’s own beliefs, thoughts, motivations, biases and limitations and recognizing how they affect self and others
What was Jean Watson’s theory?
Theory of Human Caring: transpersonal model: care valued over cure, patients need for dignity comes b4 tasks
What was Dorothea Orem’s Theory & descirbe
Self-Care Theory: promotes active engagement in care
florence nightingale theory and describe
environmental theory: made clear difference in roles b/w medicine & nursing, healing rather than disease & disease prevention
virginia henderson theory & describe
needs theory: promote client’s independence by understanding needs & assisting needs until they can themselves
Hildegard Peplau
Theory of Interpersonal Relations - to form therapeutic relationships
What was Sister Roach’s theory?
The human act of caring - The 6 C’s
betty neuman theory & explain
neuman’s system model - client system - holistic focused on prevention
sister callista roy
adaptation theory & how ppl cope & respond to stressors, patient adaptive being constantly interacting w/ environment
What were the 6 C’s in Sister Roach’s theory?
- Compassion
- Confidence
- Commitment
- Conscious
- Comportment
- Competence
What is compassion?
caring/spending/gather info/listening time with patients, EMPATHY (understanding situation), trust their nurse
What is competence?
having knowledge/skills/energy/experience required to respond adequately to demands/responsibilities
specific knowledge to interact w/ clients
What is confidence?
quality which fosters trusting relationships, trusting in own ability to provide care, knowing you can make differences
Physical appearance, the way you walk, talk, behave
What is conscience?
State of moral awareness, ethical practice, accountability and responsibility, moralðical decisionmaking
What is commitment?
Having good intentions and devoting yourself to your patients
What is comportment?
Having the appropriate attitude and dressing appropriately (how you present yourself)
philip bakers model of recovery
tidal model: assisting patients w/ reclaiming lives after setback, emphasises own personal story
What is the definition of a nursing process?
The nursing process is a problem solving approach to identifying, diagnosing and treating the health issues of the clients.
What are the 5 steps to the nursing process and explain
- Assess: gather info about pt condition
- Diagnose: identify the pt problems
- Plan: set goals of care and desired
outcomes and identify nursing actions - Implement: perform the nursing actions identified in planning
- Evaluation: determine if goals and expected outcomes are achieved
What is the purpose of STEP 1: ASSESSMENT?
Collection of data to determine the clients health and functional status & coping patterns
To establish a database about the clients health problems
-Identify priorities
-Recognize significant data/patterns
-Identify strength & problems
What does the DC conceptual framework consist of?
- Physiological variable (physical)
- Psychological variable (mental state)
- Developmental variable (age & stage)
- Sociocultural variable (relationships)
- Spiritual variable (beliefs/purpose in life)
What are some sources of assessment data?
- Client during interview
- Family/friends
- Charts
- Direct observation
- Measurements/ test results
What is the difference between objective data & subjective data?
Objective: observations or measurements of clients health status
Ex: BP of 120/70 or temp of 36.5
Subjective: clients reports ONLY
Ex: i feel dizzy right now
What is the purpose of STEP 2: NURSING DIAGNOSIS?
You prioritize what is most important which is done in colab with pt
Purpose: conclusion about the ways in which the illness is most impacting your pt and how you as the nurse will intervene to reduce this impact
holistic & patient centered
What are the characteristics of a nursing diagnosis using PNUR taxonomy?
Variance in __________ ( specific behaviour from assessment data) related to stressor
What is NANDA?
North American Nursing Diagnosis Association
Professional organization of nurses who standardized nursing terminology for the purpose of nursing diagnosis
What is the purpose of STEP 3: PLANNING?
Purpose: to set priorities and goals
what is SMART
specific, measurable, achievable, realistic, time frame
What is a nursing care plan
Legal document that is individualized and client centered which documents each stage of the nursing process
What is the purpose of STEP 4: IMPLEMENTATION?
Purpose: performance of nursing actions and documenting activities/responses
Assess & reassess through out implementation
Prevent, reduce or resolve health problems
What are the steps to intervention as prevention?
Primary:
Health promo & disease prevention
Before stress impacts baseline health
Maintain & promote health
Secondary:
Symptoms are present
Stressor has impacted baseline
Regain health
Tertiary:
Rehab & recovery
Prevent reoccurrence
What is the purpose of STEP 5: EVALUATION?
Purpose: measure the degree to which goals and desired outcomes have been achieved
Determine whether to continue, modify or terminate the plan of care
PHILOSOPHY
Considered as a science
Study of the fundamental nature of knowledge reality and existence
Nursing philosophy
Pertains to what we believe in correlation to our job
Who are we? What do we believe in? Nature of nursing? Morality?
Theory
System of ideas intended to explain something
Based on expert opinion/experience
Conceptual framework
Visual representation/organization of concepts and explains their relations
Concepts
abstract ideas or general notions that occur in the mind, in speech, or in thought
Metaparadigm concepts of nursing
Person
Health
Environment
Nursing
Ethics
The study of good conduct, character & motives.
In nursing, involves accountability
College of Registered Psych Nurses of BC
Primary purpose: protect the public
Defines/provides RPNs with practice standards
Defines/provides RPNs with a Code of Ethics
Is governed by the Health Processions Act
BCCNM Professional standards
Therapeutic Relationships
Theory/knowledge base
Professional Accountability
Ethical Practice
Health care ethical principles
Autonomy
Beneficence
Non-maleficence
Dignity
Justice
Truthfulness, informed consent & confidentiality
HC ETHICAL PRINCIPLES: Autonomy
Relates to someones independents & being able to make decisions without others influences
HC ETHICAL PRINCIPLES: Beneficence
Promoting good choice for others
HC ETHICAL PRINCIPLES: Non-maleficence
Avoidance of harm
HC ETHICAL PRINCIPLES: Dignity
Maintaining someones integrity & privacy
Protecting them from experiences where they feel less than.
HC ETHICAL PRINCIPLES: Justice
Refers to fairness
HC ETHICAL PRINCIPLES: Truthfulness, informed consent & confidentiality
Obligation to be 100% truthful
Respecting confidentiality
Mental health care ethical issues
Behaviour control & restraint
Relational engagement & boundaries
Confidentially
Ethical practice environment
Social justice
Behaviour control & restraint
Ex:
Physical restraining a patient in a safe position which could look like restraint
Chemical restraint to slow their behaviour down
Relational engagement & boundaries
Ex:
Receiving & giving gifts
When patient only wants you to help them
Confidentiality
Sharing all what is needed to know
Sharing only what is relevant
Critical thinking
The art of analyzing and evaluating thinking with a view to improving it
Encompasses both cognitive processes and attitudes
Consciously examining our own thought process
problematic thinking
egocentric & sociocentric
Egocentric thinking
Results from out tendency to be self centered and to view situations/info from our own point of view with the assumption it is right
Sociocentric thinking
Looking into the lens that the group norms opinion is right without questioning it
How do our personal traits impact our thinking
Autonomy
Fair mindedness
Humility
Courage
Integrity
Perseverance
Confidence
Empathy
Autonomy CHECK
think for yourself based on rational thinking aware of your biases
Fairmindedness CHECK
Open to opposing views, treat all viewpoints fairly
Humility CHECK
admitting mistakes
Courage CHECK
Courage to look at issues or sides that we have strong feelings against
Integrity
Be true to ones thinking
Sticking to it
Perseverance
finding solutions
We dont give up
Confidence
We trust our decision
Empathy
Genuinely trying to understand and put yourself in someone elses shoes
Critical thinking standard: Clarity
Can you elaborate on that?
Could you express that in another way?
Making sure we clearly understand what is going on
Critical thinking standard: Accuracy
Is the info true
Does it represent the truth?
Is the info accurate
Critical thinking standard: Precision
Could you be more specific?
Give me more details
Specific
Critical thinking standard: Relevance
How is the info relevant to the question?
Critical thinking standard: Depth CHECK
Does the answer to the question address all the complexity of the situation
Critical thinking standard: Breadth
Have we taken all points of views?
Have we considered alternate decisions
Critical thinking standard: Logic
Does it make sense?
elements of critical thinking
purpose of thinking (goal), question at issue (what qts am i raising), information, concepts (what theory guide thinking), assumptions (what biases impact thinking), inferences (reasoning to explain conclusion), points of view (sensitivity to other perspectives), implications (consequences of thinking)
Problem solving process
Clarify the nature of a problem & suggest possible solutions
Evaluate solutions & choose the best one to implement
What are the 3 types of problem solving questions
- There is a correct answer- requires knowledge
- No “right” answer -calls for subjective opinion/preference
- Multi “right” answers- clinical judgement must be made
Open ended questions vs closed ended questions
Open ended questions:
Allows us opportunity to hear the clients perspective and will provide more detailed info
Example: What has it been like for you since your husband left?
Closed ended questions:
Used when only a yes or no answer is required. They give us factual info but limited detail.
Example: Do you have a history of high blood pressure?
Summary of Neuro Assessment: Health history
Asking about past seizures, substance use, head injuries, behavioural changes, numbness, dizziness, medications
Summary of Neuro Assessment: Glasgow Coma scale
Eye response 1-4
Verbal response 1-5
Motor response 1-6
summary of neuro assessment: neurological assessment form/neurovitals
PERRLA, GSC, MOTOR STRENGTHS (bilateral equality) & SENSATION, VITAL SIGNS
Summary of Neuro Assessment: LOC vs orientation
Level of consciousness = alert/ drowsy
orientation = Date, place, time, name, situation
Summary of Neuro Assessment: eyes
glasses, cataracts, PERRLA
Summary of Neuro Assessment: ears
hearing aids, cerumen
Summary of Neuro Assessment: swallowing reflex
impaired, delay, pocketing, coughing with food bolus
Summary of Neuro Assessment: pain
LOTTAARP, scale out of 10 (0 = none, 10 = worst)
Summary of Neuro Assessment: analgesics and alternate pain treatments
hot blankets, ice packs, guided meditation
Summary of Neuro Assessment: seizure activity
grand mal
What does the INITIAL neuro assessment include? (7)
- Substance abuse?
- History of headaches, numbness, change in speech or senses
- Recent behavioral changes
- Past trauma to head
- History of seizures or lost of consciousness
- Vital signs
- Allergies & medication history
What is PERRLA?
Pupils: presense of pupils in both eyes
Equal: observe size of BOTH pupils
Round: BOTH pupils should be round
Reactive to
Light and pupils constrict immediately to light
Accomodation: look at eye movement and pupil size as eyes accommodate to object moved from far to close
balance and coordination can indicate
damage to cerebellum, disease process (parkinsons, huntingtons), deconditioning
gait
person’s walking pattern