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NURS 356 > Week 10/11 Health & Wellness/Stress & Adaptation, Loss & Grief, Dying & Death/legal and ethical and integrative > Flashcards

Week 10/11 Health & Wellness/Stress & Adaptation, Loss & Grief, Dying & Death/legal and ethical and integrative Flashcards

1
Q

what are the 4 models of health and illness

A

health belief, health promotion, mallows hierarchy of needs, holistic health

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2
Q

what is the health belief model?

A

Rosenstoch (1974) and Becker/maiman (1975)

based on relationship between individuals beliefs and behaviors.

examines and aids in understanding factors that influence patient perception/belief/behavior

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3
Q

what is the health promotion model?

A

proposed by pender 1982

designed to complement health protection, and defines health as a “positive, dynamic state, not merely the absence of disease”

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4
Q

what is maslows hierarchy of needs?

A

although each person has individual needs, humans all have the same basic needs, and some needs are more basic than others and need to be met first

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5
Q

what is the correct order of maslows needs? (love and belonging, safety/security, self actualization, physiologic needs, self esteem

A

most basic

physiological= breathing, food/water, shelter, sleep
safety/security= health, employment, property, family, social stability
love and belonging= friendship, family, intimacy, connection
self esteem= confidence, achievement, respect of others
self actualization=

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6
Q

what is true of holistic health models?

A

consider emotional and spiritual well being as important aspects of physical health and wellness

recognizes natural abilities of the body and incorporates alternative and complementary modes of healing

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7
Q

what internal variables can influence health, health beliefs, and health practices?

A

development stage, intellectual background, perception of functioning, emotional factors, spiritual factors

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8
Q

what external variablescan influence health, health beliefs, and health practices?

A

family practices, psychosocial and socioeconomic factors, cultural background

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9
Q

what is primordial prevention?

A

eliminating risk factors (discouraging development of habits such as smoking or other negative ones)

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10
Q

what are the 4 levels of prevention?

A

primordial, primary, secondary, tertiary

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11
Q

what is primary prevention?

A

health promotion.
stop it before it even occurs

education, providing resources, hygiene, immunizations, screenings

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12
Q

what is secondary prevention?

A

early diagnosis and treatment
Secondary prevention aims to reduce the impact of a disease or injury that has already occurred.

screening, selective exams to cure or prevent disease processes, treatments to prevent complications of diseases

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13
Q

what is tertiary prevention?

A

restoration and rehabilitation
Tertiary prevention aims to soften the impact of an ongoing illness or injury that has lasting effects. This is done by helping people manage long-term, often-complex health problems and injuries (e.g. chronic diseases, permanent impairments)

hospital and community facilities, selective placement

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14
Q

what are the 5 stages of behavioral change?

A

precontemplation, contemplation, preparation, action, maintenance

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15
Q

what is the precontemplation stage

A

not intending change in the next 6 months

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16
Q

what its he contemplation stage

A

considering a change in the next 6 months

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17
Q

what is the preparation stage?

A

making small changes in preparation for change in the next month

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18
Q

what is the action stage?

A

actively engaged in strategies to change behavior, lasts up to 6 months

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19
Q

what is the maintenance stage?

A

sustained change over time. begins 6 months after action has started and continues indefinitely.

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20
Q

what are the three developmental theories?

A

Frued, Erikson, Piaget

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21
Q

what is Freud’s developmental theory?

A

5 stages of psychosexual development, with each stage characterized by sexual pleasure in parts of the body depending on the age

resolving conflict between sources of pleasure and mandates of reality

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22
Q

what is the Infancy (birth to 18 mos) stage of freud’s development

A

oral stage
primary source of interaction is through the mouth, with pleasure through actions of the mouth

(feeding)

oral personality in adults is smoking/biting nails

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23
Q

Early Childhood/toddler (18 mos to 3 yrs)

stage of freud’s development

A

anal

child learns to control and manage elimination. (toilet training)

adults is orderliness and messiness

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24
Q

Preschool (3 to 5 years)

stage of freud’s development

A

phallic stage
Childs begin to see their mother/father as competition for their spouse (oedipus/Electra complex)

adults is sexual dysfunction

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25
``` Middle childhood (6 to 12 years) stage of freud's development ```
latent libido is there, but not focused into any area. social and interactional skills
26
Adolescence (12 to 19 years) | stage of freud's development
genitals child focuses on sexual activity and maturing not really any adult fixation
27
what is the pnemonic for Freuds stages ?
old age parrots love grapes | oral, anal, parrots, phallic, latent (none), genital
28
what are the stages for eriksons development?
infancy, early childhood, preschool, middle child, adolescence, young adult, adult, old adult,
29
what is the infancy stage?
birth to 18 months trust vs. mistrust = ability to trust others learning trust by being given attention through parents
30
what is the early childhood stage?
18mos-3 years autonomy vs. shame and doubt= self control and independence vs shame because they can't do their own thing walking, making choices, etc
31
what is the preschool stage?
3-5yrs initiative vs guilt= highly imaginative feeling they have purpose in decisions vs. developing guilt and feeling as if they are not valued
32
what its the middle childhood stage?
6-12yo industry vs. inferiority= engaged in tasks and activity feeling industrious and confident, or feeling that they do not have competence and inferior
33
what is the adolescence stage?
12-19 years identity vs. role confusion= sexual maturity, who am I? learning identity and place through peers, or confusion when they dont find a place
34
what is the young adult stage?
intimacy vs isolation= affiliation vs. love exploring relationships and commitment, or avoiding it to create isolation/loneliness
35
what is the adult stage?
generativeity vs. stagnation/self absorption establish career and feeling as if they are part of a bigger picture, vs feeling as if they are stuck and not adding to the world
36
what is the old adult stage?
integrity vs. despair feeling as if your life was productive and accomplished, or feeling as if they didn't do enough and then are dissatisfied
37
what is Piagets theory?
moving from one stage to another specifically by creating frameworks (schemas) to create cognitive equilibrium
38
what are the stages of Piaget?
sensorimotor, pre operational, concrete operational, formal operational
39
what is sensorimotor stage
birth to 18mos | reflex activity to repetitive actions
40
what is preoperational stage
18mos to about 5years | thinking using symbols, egocentric
41
what is concrete operational stage
6-12 years | logical thinking, conservation, reversibility
42
what is formal operation stage
12-19 years | abstract thinking, hypothetical, etc
43
what is stress?
physiologically, it is a flight or fight response. high BP, high CO, high RR, ETC
44
what is selye general adapt syndrome (GAS)
alarm, resistance, exhaustion stages
45
what is the alarm stage
stress is introduced, fight or flight initial response
46
what is resistance stage of stress?
stress over time, trying to return to normal
47
what is exhaustion stage of stress
body can't take it anymore
48
what are the two assessments to determine stress
primary and secondary appraisal
49
what is primary GAS appraisal
evaluate event and what the meaning is to you or someone
50
what is secondary GAS appraisal
focuses on possible coping strategies
51
what are coping approaches
alter stressor, avoid stressor, adapt to stressor
52
what is adaptive coping
directly reduce negative effects i.e. change lifestyle, solve course of stress
53
what is maladaptive coping
unhealthy style, temp fix i.e. over eating or drinking
54
ability to adapt depends on ___?
intensity of stressor, effectiveness of coping, personal factors
55
what are ego defense mechanisms?
how you defensively react to a stressor i.e. denial, regression (progress but then new comes and you regress)
56
what are some resiliency skills? (healthy ways to cope)
relaxation ,eating well, fitness, social support, etc
57
what factors influence stress and coping?
situational (job change, illness, caregiver stress), maturational (vary with life stages) , sociocultural (environmental, social, cultural) perceived by patient
58
what is chronic stress
occurs in stable conditions resulting from stressful roles
59
what is acute stress
time limited events that threaten a person for brief period of time
60
what is developmental crises?
occur as a person moves through life stages (kids, adults, being old, etc)
61
what is a situational crises?
external sources such as job change, accident, death, severe illness.
62
what is adventitious crises?
natural or man made disaster (i.e. shooting or hurricane)
63
what are some nursing diagnoses for stress?
anxiety, ineffective coping, fear, multiple diagnoses
64
what is loss?
produced by an event perceived to be negative by those involved and results in changes to ones social, relationship, or cognition
65
what is bereavement?
state of being without or In absence of something valued
66
what is grief?
the response to loss
67
what is grieving and suffering
grieving is working through losses suffering is measure of gap between reality and what is desired
68
what is mourning?
outward expression of loss
69
what is normal/uncomplicated grief
includes, physical, psychological/emotional, cognitive, social, spiritual reactions
70
what are some normal physical grief reactions?
heart palpitation, breathlessness, headache, fatigue, nausea, tightness in throat, sleep disturbances
71
what are some normal psychological/emotional grief reactions?
irritability/anger, restlessness, sadness/depression, numbness/shock, helplessness, hopelessness
72
what are some normal cognitive grief reactions?
difficulty concentrating, difficulty expressing, forgetful, disorientation, hyperactivity, difficulty organizing tasks
73
what are some normal social/familial grief reactions?
closed communication, changed power structure, social stigma
74
what are some normal spiritual grief reactions?
questioning meaning of life, comfort in faith, doubt in or loss of faith, anger at God
75
what is complicated grief ?
can include normal grief, but reactions are intensified and prolonged
76
what are the types of complicated grief
chronic, masked, delayed
77
what is chronic grief
reactions that do not subside, but continue for long time
78
what is masked grief?
survivor is unaware that behaviors are interfering with normal functioning as result of a loss
79
what is delayed grief?
reactions are suppressed or postponed survivor consciously or unconsciously avoids the pain of the loss
80
what is disenfranchised grief?
when loss cannot be openly acknowledged
81
what is anticipatory grief?
grieving before a loss or fear of a potential loss | experienced by patients, family, and professionals
82
what is the kubler ross model of grief?
aligned w continuing bonds includes denial, anger, depression, bargaining and then acceptance
83
what is the wordens model of grief?
aligned with breaking ties model tasks of grief (TEAR) to accept reality of loss, experience pain of loss, adjust to new environment, reinvest in new reality
84
nursing has been voted the most ___ profession in 17 of the last 18 years
ethical
85
what is the standard of care
minimum acceptable level of care
86
what makes sources for standard of care?
boards of nursing, specialty organizations, certifying body, federal statue, research, experts, facilities, accrediting organizations.
87
what is standards of practice?
same as standard of care, it is the level of competence
88
what is standards of nursing practice
competent level of nursing care, specific to nursing and nursing processes
89
what is standards of professional performance
professional behavior as a nurse
90
what is scope of practice
what someone in profession is legally allowed to do
91
what is the code of ethics
social contract w society formal statement of a groups morals, ideals and values set of ethical principles
92
what are the divisions of statutory law
civil and criminal
93
what is the flow for malpractice (unintentional)
law>statutory>civil>tort law>unintentional>negligence>malpractice
94
what is administrative and regulatory law?
group appointed to pass rules, regulations, and render opinions.
95
what groups are part of administrative and regulatory law?
FDA and state nursing boards
96
possible outcomes for BON investigation
dismissed charge, formal or informal letter of warning, license probation with stipulations, license suspension with stipulations, license revocation, diversion program for drug or alcohol related charged
97
what is license probation with stipulations
you have to do some form of remediation but are still able to practice.
98
what is tort law
legal wrongs committed against one person or a persons property
99
what is intentional tort law breach
civil and criminal, i.e. invasion of privacy, defamation, assault, battery
100
what is quasi intentional tort
some parts were intentional, but not the consequences of intentional acts
101
what is unintentional tort?
negligence (Example: dont change grandmas brief and she gets breakdown because you forgot)
102
What is malpractice?
professional negligence. (ex. nurse forgetting to change briefs and now grandma has pressure ulcer)
103
malpractice is the most ___ unintentional tort brought against nurses
common
104
what are the four elements of liability that must be present for someone to be liable
duty, a breach in duty, causation, and damages incurred.
105
what are ethics
rules or principles that determine what human actions are right or wrong
106
what is an ethical dilemma
having to chose between two or more equally undesirable alternatives
107
what are the 6 moral and ethical principles?
autonomy, beneficence, non maleficence, fidelity, justice, veracity
108
what is autonomy in morals/ethics?
patients right to self determination
109
what is beneficence in morals/ethics?
duty to actively do good for patients
110
what is non-maleficence in morals/ethics?
duty to prevent or avoid doing harm
111
what is fidelity in morals/ethics?
duty to be faithful to commitments
112
what is justice in morals/ethics?
duty to treat all patients fairly
113
what is veracity in morals/ethics?
duty to tell the truth
114
what moral principles are the most important
autonomy and maleficence seen as the frontrunner because it emphasizes respect and harm reduction
115
what is a deontological ethical framework
right or wrong based on duty doesn't look at consequences of action, individual has clear direction in how to act
116
what is a teleological ethical framework
humanistic origins, outcome focused
117
what is a principalism ethical framework
based on principles
118
what is a utilitarianism ethical framework
what is best for the most people
119
what is a feminist ethics/ethics of care ethical framework
what is right for one group is not necessarily for another
120
what is a situational ethical framework
each situation creates its own rules and principles. emphasizes uniqueness.
121
what is a casuistry ethical framework
case based reasoning, not focused on rules or theories but practical decision making. can compare to previous cases.
122
what is a whistleblower
person who identifies an incompetent unethical or illegal situation
123
what should be part of documentation ?
factual and objective, accurate, what and why you did something, care plans are pertinent and updated
124
simple documentation rules
date and time all entries, timely documentation, entries are legible/grammatically correct/spelled correct who performed it, enable reader to know what occurred, authenticated, quotes/descriptions,
125
Principle 1 of integrative nursing
human beings are whole systems inseparable from their environment
126
Principle 2 of integrative nursing
human beings have innate capacity for health and wellbeing
127
Principle 3 of integrative nursing
nature has healing and restorative properties that contribute to wellbeing (outdoors, plants, sunshine, nature)
128
Principle 4 of integrative nursing
it is person centered and relationship based
129
Principle 5 of integrative nursing
informed by evidence and uses the full range of therapeutic modalities to support and augment healing process. moving from least to more invasive
130
Principle 6 of integrative nursing
integrative nursing focuses on health and wellbeing of caregivers as well as those they serve

NURS 356 (6 decks)

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