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NURS 212 > Psychosocial Function and Assessment > Flashcards

Psychosocial Function and Assessment Flashcards

1
Q

Psychosocial refers to

A
  • Mental health
  • Cognition involves thinking, reasoning, and impairments like
    delirium and dementia.
  • Affective function is intrapersonal (within ourselves) and
    interpersonal (relationship with others and the world), and
    impairments like depression, psychiatric illnesses and loss of
    touch with reality.
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2
Q

Mental health

A

a large umbrella encompassing both the cognitive and affective aspects of a person.

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3
Q

Psychological Aspects of Aging

A
  • Psychosocial changes associated with older adulthood are often
    challenging and require energy for coping.
  • Challenges are associated with compromised health and function
    and are also affected by role change, relationships, and living
    environments.
  • Nurses can promote psychosocial wellness through development
    of effective coping strategies.
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4
Q

Life Changing Events

A
  • Retirement
  • Relocation
  • Chronic illness and Functional impairment
  • Widowhood
  • Death of friends and family
  • Ageist Attitudes
  • Loss of autonomy (ie. Driving)
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5
Q

Risk Factors That Affect Psychosocial
Function

A
  • Factors contributing to high levels of stress
    • Poor physical health
      * Impaired functional abilities
      * Weak social supports
      * Lack of economic resources
      * Immature developmental level
      * Narrow range of coping skills
      * Occurrence of unanticipated events
      * Occurrence of several daily hassles at the same time
      * Occurrence of several major life events over short time
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6
Q

Stress

A

Defined as the sum of all effects of factors that act on the body

chronic stress increases risks for various conditions

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7
Q

Stressors

A

Normal activities and disease states, both pleasant and unpleasant

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8
Q

Three stages of stressors

A

Alarm

resistance

exhaustion

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9
Q

Coping styles categorized as problem focused or emotion focused

A
  • Seeking information
  • Reframing situation
  • Maintaining hopeful outlook
  • Using stress reduction techniques
  • Channeling energy into physical activity
  • Creating fantasies regarding outcomes
  • Finding reassurance and emotional support
  • Identifying limits and realistic goals
  • Getting involved in activities such as art, music
    and writing
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10
Q

Stress and Coping in Older adults: Relevance for Nurses

A
  • Identifying interventions for
    optimal functioning and quality
    of life
  • Psychosocial interventions to
    deal with chronic conditions to
    remain at home safely
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11
Q

Factors that
affect
psychosocial
function in
older adults

A
  • Spirituality
  • Culture
  • Support system
  • Resilience
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12
Q

Spirituality and Aging

A
  • Is much broader and more personal with age
  • Spirituality and religious practices of older people are linked to
    positive health outcomes
  • Health care professionals should be aware of patients’ religious and spiritual beliefs and seek to understand what function they serve
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13
Q

Health-enhancing or
health-protecting effects of
religiosity are due to the
unique qualities of social
support provided through
church networks.

True or false

A

True:

Religion and religiosity have a strong social component and are associated with a faith community. The health benefits of religiosity have been identified by research, and health-enhancing or health-protecting effects of religiosity are due to the unique qualities of social support provided through church networks.

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14
Q

Culture and Psychosocial Function

A
  • Culture influences the way a person perceives psychosocial function
  • Cultural bound syndrome
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15
Q

Support System

A

Social, spiritual, and emotional support

Informational Support:

  • Health Literacy: listening skills, the ability to
    speak and communicate health needs, and the
    ability to act on written health information
    and instruction from health care providers
  • Limited literacy skills influence understanding
    health-related information
  • 6/10 adult Canadian do not have proficient
    health literacy
  • Especially true for immigrants
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16
Q

Resilience

A
  • The ability to bounce back and recover physical
    and psychological health in the face of adversity
  • The ability to use coping mechanisms
  • Outcome of increasing wisdom
  • Closely linked to spirituality , a sense of
    hopefulness and finding meaning in life and losses
  • Nurses’ role is to support resilience
17
Q

Psychological Assessment

A
  • Mental Status Assessment (ie. MMSE)
  • Physical Appearance
  • Decision-Making and Executive Function
  • Affective Function
  • Contact with Reality
  • Social Support
  • Religion & Spirituality
18
Q

Mental Status Assessment

A
  • Mental status screening tools (MMSE)
  • Physical appearance
  • Motor function, body language,
    psychomotor behaviours
  • Social skills
  • Response to the interview
  • Orientation
  • Alertness and attention
  • Memory
  • Speech and language characteristics
  • Calculation and higher language skills
19
Q

Mini-Mental Status
Exam (MMSE)
medworksmedia.com

A

Assesses 5 areas of
cognitive function:

  • Orientation
  • Attention
  • Memory
  • Language
  • Spatial-visual skills
20
Q

Psychosocial Assessment continued

A
  • Affective Function
  • Contact with Reality
  • Social Support
  • Religion & Spirituality
21
Q

Psychosocial Assessment: Contact with Reality

A
  • Delusion: Fixed false beliefs
  • Hallucination: Sensory experience that have no basis in an
    external stimulus.
  • Illusion: Misperceptions of an external stimuli, have some basis in
    reality
22
Q

Psychosocial Assessment: Interview questions

A
  • “Do you have any thought that you can’t seem to get rid of?”
  • “Do you sometimes hear voices when you’re alone?”
  • “Do you sometimes think you see things that other people
    don’t see?”
23
Q

Psychosocial Assessment: Nonverbal Clues to Hallucination

A
  • Extreme withdrawal and isolation
  • Contentment with social isolation
  • Gestures and other actions that normally occur in response
    to perceive stimuli
24
Q

Examples of Nursing
Diagnoses

A
  • Situational low self-esteem (or risk for)
  • Powerlessness (or risk for)
  • Social isolation
  • Ineffective coping
  • Readiness for enhanced spiritual
    well-being
  • Readiness for enhanced coping
  • Readiness for enhanced resilience
25
Q

Examples of Nursing Outcomes and Planning

A
  • Psychosocial adjustment: life change
  • Self-esteem
  • Adaptation to physical disability
  • Body image
  • Grief resolution
26
Q

Nursing Interventions

A
  • Incorporate communication techniques
  • Promote sense of control
  • Address spiritual needs
  • Life review and reminiscence
  • Healthy aging classes
  • Improve functional abilities
27
Q

Examples of
Nursing
Interventions
to Promote
Psychosocial
Wellness

A
  • Enhancing self-esteem: using verbal and non- verbal communication, avoiding infantilization
    and elderspeak
  • Promoting a sense of control: providing
    information, rephrasing, addressing threats such
    as lack of privacy and loss of individuality
  • Involving older adults in decision-making:
    challenging attitudes
  • Addressing role loss: identify meaningful roles
  • Encouraging reminiscence
  • Fostering social supports
  • Addressing spiritual needs: communicating
    caring and compassion, referring for spiritual
    care, encouraging participation in religious
    activities
  • Teaching health aging
28
Q

Evaluating Effectiveness of Nursing Interventions

A
  • Positive self-perceptions
  • Express feeling of control
  • Involvement in decisions
  • Effective coping strategies
29
Q

An older woman returns to her hospital room after abdominal surgery. As the nurse completes her assessment, the client asks the nurse to pin her “prayer cloth” to her pillow. Which intervention is priority?

Question 1Select one:

a.
Say, “I will pin it on your pillow in a couple of hours after you are stable.”

b.
Ask, “What is the purpose of a prayer cloth? Did you make it?”

c.
Ask, “What religion do you practice? Did your minister give the prayer cloth to you?”

d.
Pin the prayer cloth to her pillow since it is an essential part of her spiritual health.

A

Pin the prayer cloth to her pillow since it is an essential part of her spiritual health.

30
Q

A nurse assists adults to prepare for the changes that often occur in late adulthood. All of the following psychosocial consequences occur because of life events during this period except for which one.

Question 2Select one:

a.
Adjustment to a lower income

b.
A broadening of social networks

c.
Adjusting to relocation from home

d.
Coming to terms with one’s mortality

e.
Adaptation to chronic illnesses

A

b.
A broadening of social networks

31
Q

An older adult has impaired psychosocial functioning. Which consequence should the nurse monitor?

Question 3Select one:

a.
Anxiety

b.
Elevated blood glucose level

c.
Resilience

d.
Increased independence

A

Anxiety

32
Q

A nurse in a long-term care facility organizes a “healthy aging” class for residents. Which activity should be prioritized during these classes?

Question 4Select one:

a.
Discuss coping strategies helpful in adjusting to challenges of aging.

b.
Role-play responses to life events that may occur in their near future.

c.
Assess group members’ strategies used to deal with life events.

d.
Present tools that residents can use to develop better psychosocial health.

A

Discuss coping strategies helpful in adjusting to challenges of aging.

33
Q

A nurse admits an 81-year-old to the hospital for congestive heart failure. The client is widowed and has recently moved to an assisted living facility. Which event contributed the most to this admission?

Question 5Select one:

a.
The stress of widowhood and relocation stressed her body.

b.
Her age-related changes and risk factors increased.

c.
The assisted living facility serves food high in saturated fats.

d.
Moving changed her daily habits.

A

Her age-related changes and risk factors increased.

34
Q

A nurse performs a psychosocial assessment of an older adult living in the community. Which statement best captures the nature of psychosocial assessment?

Question 6Select one:

a.
It is a component of holistic nursing care of older adults.

b.
It is a formalized psychological test of the individual’s condition and needs.

c.
It aids in identifying and analyzing personality traits of the individual.

d.
It helps to identify the individual’s need for psychiatric care.

A

It is a component of holistic nursing care of older adults.

35
Q

A nurse addresses the social supports available for an older adult client. Which nursing action should be included in the planning?

Question 7Select one:

a.
Ask the client direct questions about the barriers to the use of social supports.

b.
Decide which of the programs is the highest quality.

c.
Provide the client information about services that are available.

d.
Determine if family or friends could do the work.

A

Ask the client direct questions about the barriers to the use of social supports.

36
Q

Even in a high-acuity situation, a nurse can assess the spiritual needs of a client. Which question is appropriate for the older adult admitted to the intensive care unit for sepsis?

Question 8Select one:

a.
“What are your beliefs about death?”

b.
“What religion are you?”

c.
“Is there a spiritual leader we can call for you?”

d.
“Do you attend church services?”

A

“Is there a spiritual leader we can call for you?”

37
Q

A nurse is conducting a comprehensive psychosocial assessment of an older adult who has recently moved to the long-term care facility. How should the nurse best assess the client’s motor function?

Question 9Select one:

a.
Assess the client’s deep tendon reflexes using a hammer.

b.
Observe the client walking into or out of the room.

c.
Perform passive range of motion exercises on the client’s arms and legs.

d.
Position the client supine and ask the client to perform a leg lift with each leg separately.

A

Observe the client walking into or out of the room.

38
Q

A nurse performs a psychosocial assessment on an older adult in the hospital. Which statement may suggest low self-esteem?

Question 10Select one:

a.
“I don’t know who’s going to take care of my spouse while I’m in the hospital.”

b.
“I’m worried about what’s going to happen once I get out of here.”

c.
“I know I have to rely on others for some help to get along in life.”

d.
“When I was younger, I worked around the clock and now I can’t even make it to the toilet.”

A

“When I was younger, I worked around the clock and now I can’t even make it to the toilet.”

NURS 212 (6 decks)

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