Test 3 Flashcards
Mechanistic nursing
getting it done
holistic nursing
meet complete needs of the person
Nursing theory
an organized set of ideas that help us find meaning in our experiences, organize our thinking, and develop new insights into the work we do.
5 Components of a Theory
Phenomena, assumptions, concepts, definitions, and statements/propositions.
Logical reasoning
is to develop an argument or statement based on evidence that will result in a logical conclusion
Inductive reasoning
moves from specific to general
deductive reasoning
starts with general premise and moves to a specific deduction
4 essential concepts of a nursing theory
person, environment, health, and nursing
Important nurse theorists
Florence Nightingale, Virginia Henderson, Hildegard Peplau, Patricia Benner, Madeleine Leninger, and Jean Watson
Scientific Method or scientific inquiry
the process in which the researcher, through use of the senses, systemically collects observable, verifiable data to describe, explain, or predict events.
Quantitative research
generalized to populations
qualitative research
focuses on lived experiences of people
Steps of the research process
1.identify and state the problem you wish to study, 2 clarify the purpose of the study, 3 review the related literature, 4 develop a theoretical/conceptual framework, 5 form a hypothesis, 6 define study variables/terms, 6 select the population and sample, 7 conduct a pilot study and/or collect data, 8 analyze data, 9 interpret findings, 10 communicate findings
PICO questions
P: patient/population, I: intervention, C: comparison intervention, O: Outcome, T: time
The reason for conduction research is to establish ________-_______ practice
evidence-based
Sensory Systems
vision, hearing, taste, smell, and touch
Senses
provide info about internal and external environment and enable people to experience the world, allow responses to changes, help body maintain homeostasis, necessary for growth and development.
Components of the sensory experience
stimulus, reception, perception, arousal, response to sensations,
mechanoreceptors
in the skin and hair follicles detect touch, pressure, and vibration.
proprioceptors
detect stretch in muscles to create a mental picture of how the body is positioned
thermoreceptors
in the skin detect variations in temperature
chemoreceptors
taste are located in our taste buds.
sensory alterations
sensory deprivation and overload; impaired vision, hearing, taste, smell, tactile perception, and kinesthetic sense.
Interventions for sensory deprivation
focus is prevention, support senses (glasses or hearing aids), orientation (calendar, view of environment), and provide stimuli (regular contact, touch, TV, radio, pet therapy smells)
Interventions for sensory overload
minimize stimuli (less light, noise, less tv/radio, calm tone, reduce noxious odors), provide rest, and teach stress reduction
Interventions for impaired vision
attend to glasses, sufficient light, protect eyes in sunlight, magnifying lens/large-print books, evaluate (ability to perform ADL’s and remain safe in the environment) need for assistance seeing eye dog
Interventions for impaired hearing
care of hearing aid, closed-caption tv, regular inspection of ear canals, techniques to improve communication, promote safety, and assess for social isolation
Interventions for confused clients
reorient frequently (state you name; day, date, time; provide clocks, calendars, visual clues to time, and use personal belongings and maintain safe environment, communicate clearly, slowly respond to feelings use gestures) limit choices, promote feelings of security and use alternative therapies.
interventions for unconscious client
continue orientation to reality, safety measures (bed in low position side rails up (may be listening, hearing is last sense to go). attend to body systems (eye care, ROM, skin care/mouth care, urinary drainage, bowel management, and nutrition.
What is Pain?
unpleasant sensory/emotional experience, it can have destructive effects, can warn of potential injury, a multidimensional experience.
Classification of Pain by origin
superficial, visceral, somatic, radiating/referred, phantom, psychogenic.
classification of pain by cause
nociceptive or neuropathic
classification of pain by quality
quality
classification of pain by duration
acute, chronic, or intractable
Physiology of pain
transduction, transmission, pain perception, and pain modulation
factors that influence pain
past experience with pain, emotions, developmental stage, sociocultural factors, communication skills, cognitive impairments, other illnesses contributing to pain.
Assessing Pain
includes obtaining a complete pain history (onset, location, aggravating/alleviating factors), nonverbal signs of pain (elevated pulse/blood pressure, crying, moaning, grimacing).
Pain Scale
visual analogue scales (VAS), Numeric rating scale (NRS), simple descriptor scale, or Wong-Baker faces pain rating scale.
Nonpharmacological measures
cutaneous stimulation (based on “gate control” theory, TENS, PENS, acupuncture, acupressure, massage, use of heat/cold, contralateral stimulation; immobilization/rest; cognitive-behavioral interventions (distraction, progressive muscle relaxation, guided imagery, hypnosis, therapeutic touch, humor or journaling)
Pharmacological measures
non-opioid analgesics (NSAIDs, acetaminophen), Opioid analgesics (includes IV, IM, Transdermal, and epidural forms, Client-controlled analgesia pumps)
It is most important for the nurse to understand the various ways in which pain is classified
so that he can develop an effective pain management plan
Physiology of Pain
transduction, transmission, pain perception, and pain modulation.
transduction
activation of nociceptors by stimuli
transmission
conduction of pain message to spinal cord
pain perception
recognizing and defining pain in cortex
pain modulation
changing pain perception
What is Growth?
physical changes that occur over time
What is Development?
process of adapting to one’s environment over time.
Principles of growth and development
they follow an orderly, predictable pattern. Growth cephalocaudal pattern, Development Proximodistal pattern.
Principles of development
simple skills develop separately and independently, each body system grows at its own rate, and body system functions become increasingly differentiated over time.
Developmental Task Theory
by Havighurst
Psychoanalytic Theory
by Freud
Cognitive Development Theory
by Piaget
Psychosocial Development Theory
By Erikson
The concepts of adaptation, assimilation, and accommodation are the 3 core competencies central to the theory developed by ____
Piaget
The Gestational period of Development
begins at conception and culminates in birth, lasts approximately 40 weeks, maternal health directly impacts fetal well being, embryonic phase, and fetus
The Neonatal period of development
birth to 28 days, critical adaptations (ex. establishment of respirations, independent circulation, thermoregulation, and production of urine), and Reflexes present at birth
The Infancy period of development
1 month - 1 year, period of rapid growth, learns by doing, central task–development of trust.
The Toddlerhood period of development
1 year - 3 years, growth rate is lower, rapid language development, explores environment and attempts to become autonomous
The preschool stage of development
proportions of head to trunk closer, able to control bodily functions, able to communicate needs through language, able to separate from parents, and develops conscience.
The school-age children of development
6-12 years, slimmer appearance with lower center of gravity, uses thought process to experience actions and events, and able to develop relationships outside of home.
The adolescence stage of development
12 -18 years, puberty, ability to think abstractly, establishes own identity, and begins to make decisions that affect the future.
The young adulthood stage of development
19 -40 years, healthiest stage of life, leaves home and explores options, and begins to function as an independent person.
The middle adulthood stage of development
40 - 64 years, menopause and andropause, balances aspirations with reality, and needs of children diminish; needs of aging parents increase
The older adulthood stage of development
begins at age 65, fastest-growing age group, most health problems are chronic, chronic disorders affect independent living and frail elderly
NANDA diagnoses for development
Risk for disproportionate growth; Adult failure to thrive; Delayed growth and development; Risk for delayed development; and Several diagnoses address age-specific problems.
Psychosocial theory
understanding people as a combination of psychological and social events; patient responses to illness are influenced by the relationship among physical pathology, psychosocial health, and overall wellness.
Self-Concept: Overall view of oneself
forms out of a person’s evaluation of her/his physical appearance, sexual performance, intellectual abilities, success in the workplace, friendships, problem-solving and coping abilities and unique talents.
Factors affecting self-concept
gender, developmental level, socioeconomic status, family, peer relationships, and internal locus of control.
Components of self-concept
body image-your mental image of your physical self, ideal, perceived, and actual can be different; role performance-actions and behaviors to full fill a role, mismatch results in strain or conflict; personal identity-view of self; self-esteem-how well a person likes himself.
Self-esteem
how well a person likes one’s self and the difference between ideal self and actual self.
psychosocial assessment
biological, psychological, and social details, functional abilities, self-efficacy, family relationships, and relationships with the wider social environment, interpersonal communication, social resources and networks, understanding current illness, usual coping mechanisms, and health priorities.
Psychosocial diagnoses
must determine cause and effect: interrupted family processes-significantly affecting health, family coping-compromised, parental role conflict-conflict or confusion r/t conflict, ineffective individual coping-poor judgement, and post-trauma syndrome-maladaptive learned response; risk for loneliness-separated from those attached to ; social isolation- significant aloneness; risk for violence: directed at others-threats, violence or aggression; impaired social interaction -significant difficulties in social exchange.
self-concept diagnoses
chronic low self-esteem-long term self-dissatisfaction; situational low self-esteem-self-dissatisfaction in the moment; disturbed personal identity-poor boundaries; ineffective role performance-mismatch in role expectations and performance; disturbed body image-confused or negative image.
