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nur104 test 4 Flashcards

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1
Q

What is Loss

A

the undesired change or removal of a valued object, person, or situation

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2
Q

how is loss categorized

A 
actual vs. perceived
physical vs. psychological
external vs. internal
loss of aspects of self
enviromental loss
loss of significant relationship
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3
Q

what is actual loss

A

death of loved one, theft, deterioration, destruction, & natural disaster can be identified by others no just by person experience

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4
Q

what is perceived loss

A

internal only by person experiencing it

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5
Q

what is physical loss

A

injuries, removal of organ, loss of function

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6
Q

what is psychological loss

A

belief system sexuality, control, fairness, meaning & trust

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7
Q

what is external loss

A

actual loss of object that importantb/c of cost or sentimental value

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8
Q

what is internal loss

A

percieved or psychological loss

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9
Q

loss of aspects of self

A

could be physical loss, psych & perceived (personality, developmental change(aging) hopes, dreams, faith)

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10
Q

what is enviromental loss

A

change in familiar even positive changes (job, home) (perceived or actual)

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11
Q

what is loss of significant relationships

A

actual loss of spouse,family member, divorce, seperation

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12
Q

what is grief

A

physical, psychological & spiritual response to loss can interfer with health & delay healing

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13
Q

what is mourning

A

actions associated with grief

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14
Q

what is nereavement

A

mourning & adjustment time after loss

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15
Q

what are factors affecting grief

A

significance of loss, amount of support, conflict, circumstances of loss, previous loss, developmental stage, spiritual & cultural background, timeliness of death

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16
Q

what are types of grief

A

uncomplicated and complicated

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17
Q

what are uncomplicated grief

A

abbreviated-process faster & anticipatory grief- letting go before loss

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18
Q

what are complicated grief

A

chronic, masked,delayed, disenfranchised

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19
Q

what is chronic grief

A

complicated begins as normal continues long term

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20
Q

what is masked grief

A

complicated when grieving express through behavior

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21
Q

what is delayed

A

complicated put off until later time

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22
Q

what is disenfranchised grief

A

complicated not supported

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23
Q

how is death defined

A

historical, heart-lung, whole-brain, higher-brain, uniform determination of death act

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24
Q

what is historical

A

cessation of flow of bodily fluids

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25
Q

what is heart-lung death

A

spontaneous respiration & circulation

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26
Q

what is whole-brain death

A

all functions of brain including brain stem

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27
Q

what is higher-brain death

A

higher brain functions (brain stem & resp could still be working)

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28
Q

what is uniform determination of death act

A

loss of brainstem functions

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29
Q

what is the physiological stage 1-3 mo prior to death

A

begins withdraw from world & people sleep increase food intake decrease

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30
Q

what is physiological stage 1-2 wks prior death

A

host of physical changes begin lose ability maintain self cardio deterioration decrease BP, pulse change & skin color, resp rate increase or decrease apnea

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31
Q

what is physiological stage days -hrs prior to death

A

surge of energy desire eat &talk get dehydrated decrease blood vol

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32
Q

what is physiological stage moments prior to death

A

doesn’t respond to touch sound short series long spaced breath before stops

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33
Q

what is the end of life care

A

palliative and hospice care

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34
Q

what is the end of life palliative care

A

cure no longer possible or refuse tx (comfort care)

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35
Q

what is end of life hospice care

A

die within 6mo

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36
Q

what are the psychological stages of dying (five stages (kubler-ross)

A

denial, anger, bargaining, depression, acceptance

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37
Q

what are legal & ethical considerations

A

advance directives,DNR, assisted suicide, euthanasia, autopsy

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38
Q

what is advanced directives

A

group instructions stating persons wishes (durable power attorney)

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39
Q

what is DNR

A

do not resuscitate

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40
Q

what is assisted suicide

A

making available needs for pt end his own life

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41
Q

what is euthanasia

A

good death deliberate end of life one suffering terminal or incurable illness

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42
Q

what is autopsy

A

examination of body determine cause of death

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43
Q

what is assessment of terminally ill client & family

A

knowledge, history of loss, coping abilities & support, meaning of loss/illness, depression of grief, physical assessment, cultural & spiritual assessment

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44
Q

what is diagnosis for terminally ill pt & family

A

most norm loss grieving as problem, etiology, anticipatory grieving, dysfunctional grief AEB panic, hostility, regression, signs of deflated self-esteem

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45
Q

what are interventions for grief or loss

A

promote norm grieving , teach loss education through childhood help prepare in life, unse intervention based on stege person is in, encourage participation in support group, altered grief-professional help

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46
Q

what is therapeutic communication

A

perfect listening skills, encourage & accept expression of feelings, reassure not wrong feel anger, relief, or other unacceptable feeelings, respond nonverbal cues with touch, eye contact, increase self awareness, continue communicate even in case of coma

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47
Q

what is care of the dying patient

A

meeting physiological needs
meeting psychological needs
addressing spiritual needs
addressing cultural needs

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48
Q

what is providing postmortem care

A

care of body , norm for nurse feel grief when dies must also take care of yourself

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49
Q

what are types of stress

A

eustress, distress, external, internal, developmental, situational, physiological, & psychological

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50
Q

what is eustress

A

good stress

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51
Q

what is distress

A

can threaten health

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52
Q

what is external stress

A

RT family, enviroment

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53
Q

what is internal stress

A

anxiety

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54
Q

what is developmental stress

A

life stages

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55
Q

what is situational stress

A

random, unpredictable

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56
Q

what is physiological stress

A

affect body structure/function

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57
Q

what is psychological stress

A

arise from life events

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58
Q

what are maladaptive coping strategies

A

ineffective coping

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59
Q

what is adaptive coping strategies

A

effective coping

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60
Q

what are general approaches for coping

A

alter, adapt, & avoid stressors

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61
Q

what are personal factors influencing adaptation

A

personal perception of stressor(how handle), overall health status, support system, hardiness, & personal factors

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62
Q

what is stage 1 of adaptaion alarm fight or flight

A

endocrine system, sympathe nervouse system, CV, respiratory, metabolic, urinary, gastrointestinal, & musculoskeletal

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63
Q

how is the sympathe nervouse system affect in stage 1

A

epinphrine or norepinephrine

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64
Q

how is the CV system affected in stage 1

A

vasoconstriction elevated BP

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65
Q

how is the respiratory system affected

A

dilated bronchioles

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66
Q

how is the metabolic affected in stage 1

A

increased availability of glucose

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67
Q

how is urinary affected in stage 1

A

sodium & water retention

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68
Q

how is gastrointestinal affected in stage 1

A

decreased peristalis

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69
Q

how is musculoskeletal affected in stage 1

A

increased blood flow to muscles

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70
Q

what is the second stage of adaptation

A

resistance stage

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71
Q

what is the second phase resistance stage

A

use coping mechanisms failure to adapt to stress leads to third stage

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72
Q

what is the third stage of adaptation

A

exhaustion

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73
Q

what is the third stage exhaustion

A

adaptive mechanism become ineffective/ nonexistent decrease BP, elevated pulse, respiration usually ends in death

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74
Q

what is the third stage if adaptation is successful

A

recovery stage

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75
Q

what are response to stress

A

physical response local adaptation response involving specific body part, tissue, or organ

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76
Q

what is another response to stress

A

psychological feelings, thoughts, behavior (anxiety & fear, ego, anger, depression)

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77
Q

what are consequences of failed adaptation in stress induced organic responses

A

continual stress, repeated CNS sti,ulation, elevation of certain hormones, results in long term changes in body system

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78
Q

what are consequences of failed adaptation of somatoform disorders

A

hypochondriasis, somatization, somatoform pain disorder, & malingering

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79
Q

what are consequences of failed adaptation of stress induced psychological responses

A

crisis, burnout, post-traumatic stress disorder (PTSD)

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80
Q

what is crisis

A 
does not respond to adaptive activities
overwhelming
demands immediate response
produces change
brings unsolved problems 
increased affect & decrease communication
require intervention
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81
Q

what is focused assessment for ineffective coping to stress

A

lack of goal-directed behavior
inability to problem solve
unexplained fatigue
destructive behavior

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82
Q

what is focused assessment for ineffective denial to stress

A

disavows knowledge meaning of event to decrease anxiety
delays in seeking care refuse tx
continues behavior that exacerbates condition

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83
Q

what is diagnoses to ineffective coping to stress

A

life even tends produce crisis
observable anxiety
behavior & language disorganized
diificult to understand

84
Q

what is diagnoses to ineffective denial to stress

A

inappropriate use of denial as a coping behavior

85
Q

what are planning expected outcome to stress tolererancce the pt will

A

be able identify stressors
demonstrate decreased stress
develop effective methods of coping with stress

86
Q

what is planning expected outcome for ineffective coping to stress the pt will

A

demonstrate effective coping behavior
effectively solve a problem
return to previous level of functioning

87
Q

what is planning expected outcome for ineffective denial to stress the pt will

A

demonstrate low to moderate anxiety receice facts of illness in positive manner

88
Q

what are stress reduction intervention health promotion activites

A

promote adequate nutrition, establish exercise routine, teach importance 7-8 hr sleep, specific intervention relieve anxiety, anger management, stress management tech(meditation, biofeedback, reiki, hmor), change perception of self

89
Q

what are interventions to improve coping skills

A

therapeutic relationships, enhancing social support, protecting vulnerable self, practice adaptive thinking (self suggestion, coping thoughts, inner dialogue), gaining control through knowledge

90
Q

what are interventions RT to crisis

A

prevent crisis by communicate clearly & anticipate situation

during crisis calm voice & slowly short phrases, avoid talking about future

91
Q

what are intervention help effectively manage stressors

A

focusing, reconstruction, compensating, stress managment skills (relaxing activities, meditation & prayer, creative activites, guided imagery, keeping a journal

92
Q

what is evaluation of stress

A

maintaining effectiveness of coping abilities assess outcomes
reassess if outcome not met
adjust the care plan

93
Q

what is gender

A

it is determined by chromosome structure XX female and XY male

94
Q

what are gender role

A

societal norms for behavior and old stereotypical males are breadwinners and females are nurses, teachers

95
Q

what are concepts related to sexuality

A

gender identity and sexual orientation

96
Q

what is gender identity

A

internal feeling of maleness or femaleness transgender, transsexual, intersexed, crossdresser

97
Q

what is sexual orientation

A

its based on the gender of the person one is sexually attracted to heterosexual, homosexual, or bisexual

98
Q

what is transgender

A

think of self as female even if have male genitles

99
Q

what is transsexual

A

feels like women even though male appearance

100
Q

what is intersexed

A

ambiguous sexual organs internal ovaries external penis

101
Q

what is a cross dresser

A

also known as transvestite wears clothing of opposite sex

102
Q

what is heterosexual

A

attracted to opposite sex

103
Q

what is homosexual

A

attracted to same sex

104
Q

what is bisexual

A

attracted to both sexes

105
Q

what are factors affecting sexuality

A

culture, religion, lifestyle, knowledge about sex, health status, & social context

106
Q

what other factors could affect sexuality

A

medication such as alcohol, antianxiety, anticonvulsants, antidepressants, antihistamines, antihypertensives, chemotherapy, opiods, & stimulants also decreased libido & sexual performance dysfunction

107
Q

what are concepts RT sexual health

A

state of physical, emotional, mental, & social well being RT sexuality

108
Q

what is required of sexual health

A

positive & respectful approach to sexual relationship, optimum expression of sexuality, & forms of sexual expression

109
Q

what are sexual health

A

sexual response cycle and sexual expression

110
Q

what is sexual response cycles

A

?desire, excitement, plateau, orgasm, resolution

111
Q

what is sexual expression

A

intimate relationships, fantasies & erotic dreams, touching, sexual intercourse, alternate sexual expression, celibacy

112
Q

what are problem affecting sexuality

A

medical & relationships

113
Q

what problems affecting sexuality does medical cause

A

STI’s sexually transmitted infections, dysmenorrhea, premenstrual syndrome (PMS), sexual response cycle disorder (low libido, arousal disorder, orgasmic disorders)

114
Q

how do relationship problem affect sexuality

A

negative intimate relationships, sexual harassment, rape, dysfunctional intimate relationship

115
Q

what are concepts of rest

A

rest-physically/ mentally relaxed; refreshing

116
Q

what are concepts of sleep

A

physiology of sleep cyclical states, decreased skeletal muscle activities, decreased metabolism, reduced consciousness

117
Q

what are functions of sleep

A

restores energy, improves ability to cope, strengthens the immune system

118
Q

what are the stages of non-rapid eye movement NREM sleep

A

stage 1 lightest sleep transition (5-10 min)5%
stage 2 eye movement stops 50%/sleep
stage 3 deep sleep diffulcult to arouse 8%/sleep
stage 4 no eye movement or muscle activity deepest sleep difficult arrouse 11%

119
Q

stage V rapid eye movement REM sleep

A

dreaming high brain activity 20-30min 25%/sleep last cycle may last up to 60min

120
Q

What is the sleep cycle

A

norm adult sleep 4-6 cycles nightly each last 100 min average 7-8hr range 5-10hr

121
Q

what is the function of the sleep cycle

A

energy conservation & restoration

122
Q

what are factors that affect sleep & rest

A

lifespan, lifestyle, sleep disorder

123
Q

how long should newborns sleep

A

16-20hrs

124
Q

how long should infants sleep

A

min of 14hr/day

125
Q

how much sleep should school age & adolescents

A

they increase the need with growth spurts

126
Q

how much sleep should elderly get

A

they need less sleep but more rest

127
Q

what in lifestyle affect sleep & rest

A

enviroment, nutrition, exercise, sleep patterns

128
Q

what are sleep disorders

A

insomnia, circadian disorder, restless leg syndrome, sleep deprivation, hypersomnia, sleep apnea, & narcolepsy

129
Q

what is insomnia

A

inability fall asleep, remain sleep, or go back sleep

130
Q

what is circadian disorder

A

sleep wake schedule, time zone (jet leg), shift work

131
Q

what is restless leg syndrom

A

disorder of CNS uncontrolled movement of leg low levels of iron & some antidepressants can cause

132
Q

what is sleep deprivation

A

not actually a sleep disorder its a result of prolonged sleep distrubance result from NREM & REM

133
Q

what is hypersomnia

A

excessive sleep especially in daytime

134
Q

what is sleep apnea

A

periodic interruption in breathing during sleep

135
Q

what is narcolepsy

A

chronic disorder caused by brains inability to regulate sleep-wake cycles normally

136
Q

what is parasomnias

A

sleepwalking/talking, night terrors, substance-induced, nocturnal enuresis, bruxism, REM sleep behavior disturbance

137
Q

What is pain

A

unpleasant sensory/emotional experience

can have destructive effects, warn of potential injusry, its a multidimensional experience

138
Q

what are classifications of pain

A

origin, cause, quality, intensity, & duration

139
Q

what is the classification of pain origin mean

A

superficial, visceral, radiating,or referred, phantom

140
Q

what is the classification of pain cause mean

A

nociceptive

neuropathic

141
Q

what is the classification of pain quality mean

A

how the pain feels to the patient

142
Q

what is the classification of pain intensity mean

A

subjective; use rating scale 0-10

143
Q

what is the classification of pain duration mean

A

acute, chronic, intractable

144
Q

what is physiology of pain

A

transduction, transmission, pain perception, & pain modulation

145
Q

what is physiology of pain transduction mean

A

a process where nociceptors become activated by perception of potentially damaging mechanical, thermal, & chemical stimuli

146
Q

what is physiology of pain transmission mean

A

its the peripheral nerves that carry the pain message to the dorsal horn of the spinal cord

147
Q

what is physiology of pain perception mean

A

its the recognition in the frontal cortex and the brain recognizes and defines a stimulus as pain

148
Q

what is physiology of pain modulation mean

A

it changes the perception of pain by either facilitating or inhibiting pain signal

149
Q

what are factors the influence pain

A

past experience w/ pain
emotions, developmental, sociocultural factors, communication skills, cognitive impairments, other illness that contribute to pain

150
Q

what are pain assessments

A

complete pain history, nonverbal signs of pain, & pain scale

151
Q

what are nonpharmacological measures of pain management

A

cutaneous stimulation, immobilization & rest, cognitive behavioral interventions

152
Q

what are pharmacological measures of pain management

A

nonopioid analgesics

Opioid analgesics

153
Q

what are pharmacological measures of pain management that is nonopioid analgesics

A

NSAIDS & Acetaminophen

154
Q

what are pharmacological measures of pain management that is Opioid analgesics

A

IV, IM, transdermal, & epidural form

patient controlled analgesia pumps-only pt push PCA button

155
Q

what are special nursing consideration

A

managing pain in elderly, pts with addictions, & use of placebos

156
Q

what are classifications of surgeries

A

purpose, degree of urgency, & degree of risk

156
Q

what are increased surgical risk factors

A

age, personal habits, allergies, type of wound, preexisting conditions, mental status, & medication

157
Q

what are perioperative nursing responsibilities

A

nursing history, assessment, preop screening tests, surgical consent, preop teaching, discussion, printed materials, prepare pt physically

158
Q

how do you prepare pt physically for preop

A

assess NPO status, prepare skin: surgical scrub, bowel prep, facilitate empty bladder, administer preop medication, apply antiembolism stockings, & remove prostheses

159
Q

what are intraoperative nursing responsibilites

A

sterile & clean team, anesthesia, skin prep, positioning, final verification, sterile field, moitor I&O, sponge, sharps, & instrument count, & documentaion

160
Q

what are postanesthesia recovery unit (PACU)

A

recovery from anesthesia, airway management, vital sign/level consciousness, dressing assessment/drainage, fluid therapy, & pain control

161
Q

what are postop nursing care

A

intial physical assessment, frequent vitals, dressing management, pain control, DVT prevention-SCDs, incentive spirometry/cough & deep breathing, early ambulation, & pt teaching

162
Q

how are pt response to illness influenced by relationship

A

physical pathology
psychosocial health
overall wellness

163
Q

what is psychosocial health theory

A

understanding people as a combination of psychological & social events

164
Q

what is the self concept of psychosocial health mean

A

overall view of self

165
Q

what are factors affecting self concets

A

gender, developmental, family & peers, internal/external influence

166
Q

what are the components of self concept

A

body image, role performance, personal identity, & self-esteem

167
Q

what are psychosocial illness

A

anxiety & depression

168
Q

what is psychosocial illness anxiety

A

vague uneasy feeling of discomfort, threat, norm & abnormal, various levels, signs & symptoms

169
Q

what is psychosocial illness depression

A

feeling of sadness diagnosed if depressed a day of two weeks, causes, S&S, & Tx

170
Q

what is assessment of psychosocial

A 
biological, psychological, & social details
functional abilities
self efficacy
family relationships
relationships with the wider social enviroment
interpersonal communication
social resources & networks
understanding current illness
usual coping mechanisms
health priorities
171
Q

what is diagnosis of psychosocial

A

interrupted family processes, parental role conflict, risk loneliness, isolation, risk viollence to others, impaired social interaction

172
Q

what is diagnosis of self concept

A

chronic low self-esteem, situational low self-esteem, disturbed personal identity, ineffective role performance, disturbed body image

173
Q

what is outcomes for low self-esteem

A

identify stressors, positives, encourage own behavior, action needed to influence outcome, returns baseline or improves

174
Q

what is outcomes for disturbed body image

A

physically adapt changed image mentally adapt to changed image

175
Q

what are some interventions for preventing depersonalization

A

introduce self, pt preferred name, listen, eye contact, & touch, dont talk about pt in other rooms, move gently, explain all procedure

176
Q

what are nursing interventions for promoting self esteem and self concept

A

feeling of acceptance, sense of competence, control, moral worth

177
Q

what are nursing interventions for promoting positive body image

A

allow grieving process active listening help express anger, frustration, resentment

178
Q

what are nursing interventions for facilitating role enhancement

A

communication between pt & significant other RT role responsibilities
describe realistic roles & responsibilities RT health changes

179
Q

what are nursing interventions for anxiety

A

identify coping strategies(defense mech( calm & safe envirometn, identify triggers, use clear factual info

180
Q

what are nursing interventions for depression

A

therapeutic communication, promote activity, good nutrition & hydration, provide support self care & decision making suicide prevention

181
Q

what are types of sensory systems

A

vision, hearing, taste, smell, touch, kinesthetic

182
Q

what are the purposes of sensory systems

A 
provide info about internal & external enviroment
enable people experience world
allows response to changes
help maintain homeostasis
necessary for human growth & development
183
Q

what are components of sensory experience

A

stimulus, reception, perception, arousal mechanisms, & response to sensation

184
Q

what does the stimulus do

A

stimulate receptors (loud noise, bright light, sour fruit)

185
Q

what is perception

A

ability interpret sensory impulse give meaning to impulse

186
Q

how is perception affected

A

location, number of receptors activated, frequency of action & changes

187
Q

what is the arousal mechanism

A

composed of consciousness & alretness mediated by RAS (reticular activating system)

188
Q

how is the arousal mechanism affected

A

enviroment & medication

189
Q

what is the response to sensation

A

it requires people to be alert & receptive to stimulation

190
Q

what are factors that affect the response to sensation

A

intensity of stimulus. contrasting stimuli, adaptation to stimuli, & previous experience

191
Q

what are factors that affect the sensory function

A 
age/stage of life
culture
illness
medication
stress
personality
lifestyle
192
Q

what are sensory alterations

A

sensory deprivation & overload

impaired vision, hearing , taste, smell, tactile perception, & kinesthetic sense, & seizures

193
Q

what is a general assessment of sensory system to health history & physical to gather data RT

A 
factors affecting sensory perception (visual, auditory, & dental exam)
mental status
level consciousness
recent changes in sensory stimulation
use of sensory aids
clients enviroment
support network
focused examination of affected sense
194
Q

what is diagnosis for sensory deficits

A 
disturbed sensory perception-actual sense & cause
risk for disturbed sensory perception
acute confusion
chronic confusion
impaired memory
195
Q

what is diagnosis for related sensory diagnosis

A 
risk for injury
imbalanced nutrition less than body requirements
impaired verbal communication
social isolation
self care deficit
disturbed thought processes
196
Q

what are planning outcomes for sensory deficit

A

pt does not experience injury

outcome specific to deficit

197
Q

what are planning outcomes for sensory deprivation

A

pt remains oriented to person, place, & time

short term may include using adaptive equipment

198
Q

what are planning outcomes for sensory overload

A

pt remains oriented to person, place, & time
short term planning may include decreased anxiety, lucid communication, reports excessive stimuli, establish routine sleep-wake cycle, positive coping behavior

199
Q

what are nursing interventions for sensory deprivation

A

focus prevention, support senses(sensory stimulation(glasses, hearing aids), orientation-calendar; view of enviroment, provide stimuli-reg contact;touch, television/radio, pet therapy, smells

200
Q

what are nursing interventions for sensory overload

A

minimize stimuli-less light, noise, less tv/radio, calm tone, reduce noxious odors
provide rest & teach stress reduction

201
Q

what are nursing interventions for impaired vision

A

attend to glasses, sufficient light, protect eyes in sunlight, magnifying lens/lg-print books, evaluate-ability perform ADLS, remain safe in enviroment, & need for assistance(seeing eye dog)

202
Q

what are nursing interventions for impaired hearing

A

care for hearing aid, closed cation tv, reg inspection of ear canal, techniques to improve communication, promote safety, assess for social isolation

203
Q

what are nursing interventions for the confused patient

A

reorient frequently(state name,day,time,provide clocks,calenders,visual clues to time, use personal belongings,maintain safe enviroment, communicate clearly slowly(respond to feeling & use gestures), limit choices, promote feelings of security, use alternative therapies

204
Q

what are nursing interventions for the unconscious patient

A

continue orientation to reality, safety measures(bed low position, side rails up), attend to body systems(eye care, ROM, skin care/mouth care, urinary drainage, bowel management, nutrition

Nursing 104 (3 decks)

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