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NURS362 - Practice of Nursing III > Week 2 - Self Concept, Stress, Adaptation & Crisis > Flashcards

Week 2 - Self Concept, Stress, Adaptation & Crisis Flashcards

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1
Q

Self Concept

A

A mental image or picture of yourself - it is what you understand and believe about yourself including your unique traits, skills, and personality

How one views self in relation to others and their environment

It is shaped and guided psychologically by our development

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2
Q

Self Concept can be __ or __

A

positive or negative

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3
Q

What are the 3 dimensions of self concept

A

self knowledge

self evaluation

self expectations

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4
Q

What do the 3 dimensions of self concept stem from?

A

Self Esteem

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5
Q

Self Knowledge

A

What is one’s emotional intelligence, knowledge of basic facts about themselves like sex, race, age, position in social groups, qualities or traits, and their own global self

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6
Q

Self Evaluation

A

How well one likes themselves at the current time

It boils down to a positive or negative self image from how we have experienced life thus far

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7
Q

Self Expectations

A

Who or what do I want to be?

This develops from role models

These are based on 3 factors

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8
Q

What are Self Expectations based on?

A

Self Respect

Self Approval

Self Worth

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9
Q

What are the 4 components that make up the 3 dimensions and self concept?

A

Self Esteem

Body Image

Role Performance

Personal Identity

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10
Q

What are the components of a Personal identity

A

Intellectual Self

Physical Self

Emotional Self

Moral/Ethical Self

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11
Q

What are some examples of things that shape personal identity

A

friends

family

interested

objects and possessions

creations

choices

values

beliefs

appearance

ethnicity

practices and habits

work and hobbies

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12
Q

Intellectual Self

A

Cognitive Ability - or - How one learns, their literacy level, and ability to think and push attention span

Includes: memory, learning, attention span, educational literacy, creative/artistic ability, understanding of illness they may have, how has our past shaped how we think and what we believe is true

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13
Q

Physical Self

A

View of physical body and an effect illness has on it including: appearance, function, control, mental and social aspects, and sexual function

Review of Systems gleans information on this aspect of the patient

The whole body is a part of personal identity

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14
Q

Moral/Ethical Self

A

Moral and ethical values/ what the person believes in including belief systems (personal beliefs, values, conscience, religious preferences) and cultural influences (traditions, food, role in the family)

An outsider like a nurse needs to be non-judgmental particularly for this aspect

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15
Q

Emotional Self

A

Mental health and psychological functioning

includes expressiveness (is it done in a healthy way?), needs and drives, mood and affect, support systems, psychological status, and beliefs

Must be intact to know how hard to work, get out of bed in the morning or deal with illness and loss

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16
Q

Personal Identity Assessment (Assessment of Self Concept)

A

list of labels that identify a person according to importance in order to see what is most important to a patient or person’s self concept

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17
Q

Why is assessment of self concept so important?

A

Understanding our patients will help us facilitate a change in their behavior and maximize coping

It also helps us understand why their priorities do not always match our own

By understanding, we can find sources of support and strengths that are meaningful to that individual to guide their care

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18
Q

How does Self Concept develop early on?

A

It begins as self awareness as an infant, which then grows to self recognition as a person and self definition, and eventually leads to a child’s self concept of themselves as a person

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19
Q

What are some characteristics of Self Concept

A

Dynamic and Complex

Holistic- all aspects of a person are important, not just one

Unique - to each person

Reflective of culture (influences values and beliefs)

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20
Q

Paplau’s Theory of Interpersonal relations

A

Appraisals made by significant others about the self are made –> these appraisals are repeated into a pattern and are incorporated into the self –> the person’s behavior morphs to match the appraisal

The self is then open to reappraisal from biophysical, maturational, and/or environmental changes

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21
Q

Developmental Cycle of Self Concept

A

Erikson’s Stages of Psychosocial Development

Mastery of each stage will support positive self concept and problems in one stage can delay mastery, stagnation, and lead to a negative self concept

We have to move up the ladder of trust –> autonomy –> etc to have a positive outcome

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22
Q

How does Maslow fit into the idea of self concept?

A

We need to meet the lower needs (physiological –> safety –> love and belonging –> self esteem –> self actualization) in order for a patient or person to move forward

Self esteem is near the top and a part of self concept, so inability to meet the first 3 stages can lead to negative self concept outcomes

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23
Q

Characteristics of a Health Self Concept

A

satisfaction with role performance

real self = ideal self to them

high self esteem

distinct sense of identity

emotionally stable

realistic life goals and aspirations

body image satisfaction

beliefs

understands faults and positive attributes

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24
Q

What are some events that can lead to altered self concept in a patient?

A

Altered appearance

Altered function

Altered control

Altered relationships

Altered beliefs

A combination of events

(But beliefs can influence the impact of these events)

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25
Q

Risk Factors for Self concept Disturbance

A

Major developmental change

not meeting developmental milestones

new trauma or multiple traumas

loss of a body part

loss of a valued role (ex: like if a stay at home mom loses her husband and now needs a job but cannot juggle both roles and “take care of everything” like she though she could before.)

inability to meet role expectations

gender and cultural issues

relationship and social concerns

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26
Q

Characteristics of Low Self Concept

A

refusal to look at or touch a body part (ex: ostomy)

unwillingness to talk about a problem

denial of the existence of a problem

increasing/abnormal dependence on others

self destructive behavior

withdrawal from social contracts

change in patterns of normal responsibilities

change in usual behavior patterns

self sabotage

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27
Q

Examples of Nursing Process and Self Concept Diagnoses

A

Disturbed body image

low self esteem

ineffective role performance

disturbed personal identity

ineffective coping

(note most are psychological)

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28
Q

Examples of Nursing Diagnoses that are NOT related to Self concept

A

Impaired physical mobility

ineffective breathing

risk for infection

risk for falls

pain

(all more physiological)

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29
Q

What is key to getting a patient to open up and be truthful about self concept

A

establishing a therapeutic relationship with them

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30
Q

The first step to being able to help a patient with self concept issues is…

A

understanding your own self concept first and being able to be nonjudgmental, caring, and available

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31
Q

Stress

A

Condition in which the human system RESPONDS TO CHANGES from its normal balanced state

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32
Q

What are the 3 main factors about stress?

A
  1. changes come from MANY SOURCES
  2. it can be positive or negative
  3. PERCEPTION greatly influences stress
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33
Q

How does perception influence stress

A

how you experience stress depends on beliefs, identity, environment, and pas events that shape your perception

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34
Q

Examples of Types of Stressors

A
  1. Physiological (chemicals, physical agents, infectious agents, nutritional imbalances, hypoxia, immune issues, pandemics)
  2. Psychological (accidents, traumatic experiences, horrors of history, fear of aggression or mutilation, rapid changes in the world, pandemics)
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35
Q

What is a key interaction between two systems when stress occurs?

A

The Mind-Body Interaction

When the mind experiences stress, the body will respond

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36
Q

What are some physiologic (body) stress indicators?

A 
Anxiety
Backache
Constipation or diarrhea
Dry mouth
HA
Increased urination
Increased pulse, BP, respirations
Nausea
Sleep Disturbances
Stiff neck
Increased perspiration
Chest pain
Weight gain or less
Decreased sex drive
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37
Q

Coping Mechanisms

A

behaviors that are SHAPED and LEARNED in order to deal with stress

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38
Q

What 3 things shape and teach a person coping mechanisms?

A
  1. Family
  2. Past Experiences
  3. Sociocultural Influences and Expectations
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39
Q

What are some important aspects about coping mechanisms?

A

They can be positive or negative

If they are effective they will be used again regardless of what they are

Additional methods can create a sense of emotional strength and endurance - so the more the better

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40
Q

Defense Mechanisms

A

Unconscious and AUTOMATIC reactions to stressors

Something in the past experiences we have had has taught us to do this automatically in response

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41
Q

Examples of Defense Mechanisms

A

compensation

denial

displacement

introjection

projection

rationalization

regression

sublimation

undoing

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42
Q

What aspects of a person can be impacted by stress?

A

Physiologic Functions

Safety and Security Feelings

Love and Belonging Feelings

Self Esteem

Self Actualization

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43
Q

Stress effects…

A

all parts of a person not just compartments.

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44
Q

Crisis

A

What occurs when coping mechanisms no longer resolve a situation of stress

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45
Q

What can cause a crisis

A

Threat

-or-

Perceived Threat to Self

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46
Q

Threat

A

something that is, or expected to, lead to an unexpected or dangerous situation affecting an individual, group, community, or whole society

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47
Q

Perceived Threat to Self

A

Disturbance caused by a PRECIPITATING EVENT: Perceived loss, a threat of loss, or a challenge

48
Q

What are the characteristics of a person in crisis

A

time limited to 4-6 weeks

self concept assaulted

personalized experience

inability to cope due to a lack of frame of reference for the situation

change in normal behavior patterns - become uncharacteristic of self

49
Q

Crisis is a ___ to self concept

A

assault

50
Q

Types of Crisis

A

Situational Crisis

Maturational and Developmental Crises

Adventitious and Social Crises

51
Q

Situational Crises

A

unanticipated, sudden in onset

life events disrupts persons psychological equilibrium

52
Q

Maturational/Developmental Crises

A

growth and development

events that require a role change

predictable

53
Q

Adventitious/Social Crises

A

major event affecting many people

accidental and unexpected (ex: Pandemic)

54
Q

What is more important than what type of crisis someone is having?

A

How the crisis impacts that person, self, or family

as a nurse we need to focus on that personalized impact aspect

EX: do not focus on the loss of a job but the financial instability that is causing the stress

55
Q

Crisis Impact

A

may be a mixture of crises depending on the situation

most important to measure the crisis impact on the client/family rather than the specific type of crisis

56
Q

8 Phases of Emotional Reactions`

A

8 emotions that can occur in order, out of order, only some, none, or all depending on the person reacting to crisis and stress

they are: High anxiety, denial, anger, shame, guilt, remorse, grief, and reconciliation

57
Q

What are some risk factors for a Crisis

A

crisis prone lifestyle - frequent exposure to losses, threats, role changes, poor life choices

failure to achieve developmental tasks

lack of supportive relationships, social problems

lack of coping skills

lack of resources

negative perception of the event

58
Q

What are some examples of Nursing Diagnoses used for Crises

A

fatigue

sleep pattern disturbance

anxiety

coping, defensive

coping, individual, ineffective

decisional conflict

denial, ineffective

fear

grieving, dysfunctional

hopelessness

powerlessness

59
Q

Crisis Intervention

A

as a nurse you should bring the person in emotional crisis back to homeostasis (breathe)

problem solving techniques to promote adaptive outcomes, including improved ability to cope with future crises should eb explored

60
Q

5 Steps for Crisis Intervention

A
  1. ID the problem
  2. List alternatives, all possible solutions
  3. Choose best alternative for that specific individual
  4. Implement the plan
  5. Evaluate the outcome
61
Q

How should a nurse identify the problem during crisis intervention?

A
  1. Define the problem from the CLIENT’S perspective (focus on the immediate problem) - validate how they feel and let them no there is no right or wrong way to feel
  2. Assess the situation of the client and the family
  3. Provide the opportunity for the client to express feelings.
62
Q

When implementing a plan for crisis intervention the nurse may have to…

A

provide support/encouragement and promote coping behaviors

63
Q

A crisis situation that has been intervened on can…

A

promote growth potentially if intervention works

64
Q

A nurse should always do what when doing crisis intervention for a patient?

A

Approach from the clients perspective to get alternatives and possibilities they may not have thought of that best suit the patient

65
Q

What are Coombs 2 major reasons for helping professions to concern themselves with self concept? (Reading)

A
  1. Facilitating client change is seriously impaired if the self concept is ignored
  2. Clients judge the value of their experience with helpers from the frame of reference of self concept
66
Q

The fundamental purpose of self theory is? (Reading)

A

to optimize the pleasure-pain balance of the individual over the course of a lifetime

67
Q

What is the difference between self concept and self report? (Reading)

A

Self concept is what the person perceives himself to be

Self report is what the person believes about himself

68
Q

The function of self concept is to… (Reading)

A

direct behavior

69
Q

4 Components of Self Concept (Reading)

A

Body Image

Self Esteem

Role

Personal Identity

70
Q

Body Image (Reading)

A

that picture of schema of our own body which we form in our minds as a tridimensional unity involving interpersonal, environmental, and temporal factors

Also includes perceptions, attitudes, emotions, and personality reactions of the individual in relation to their own body

71
Q

Self Esteem (Reading)

A

The ability of individuals to use themselves functionally to achieve a precise goal

The individuals perception of their worth

72
Q

Personal Identity (Reading)

A

Part of the self concept through which we recognize ourselves as unique beings separate from the rest of the world

73
Q

Bonham-Cheney Model of Self Concept (Reading)

A

Initial attempt to define a nursing focus for self concept

Utilizes a system approach to present self concept as a 2 dimensional process that includes the real self and the perceived self

74
Q

Systems Theory of Self Concept (Reading)

A

Demands we treat systems as wholes, composites of related parts between which interaction occurs to a major degree

In the case of self concept we look as the two interrelated subsystems of personal identity! and self perspective! which then divide further

75
Q

What are the 2 main systems of the System Theory of Self Concept (Reading)

A

Self Perspective

Personal Identity

*These two make up the Concept of Self

76
Q

Concept of Self (Reading)

A

a 2 dimensional process that evolves from the interaction between personal identity and the self perspective

77
Q

Personal Identity (Reading)

A

the fundamental construct of the concept of self comprised of 4 elements: Intellectual self, Physical self, Moral and Ethical Self, Emotional Self

78
Q

Intellectual Self (Reading)

A

that element of personal identity which includes all the COGNITIVE AND CREATIVE FUNCTIONS`

79
Q

Physical Self (Reading)

A

that element of personal identity which encompasses the STRUCTURE, FUNCTION, and APPEARANCE of the body

80
Q

Moral and Ethical Self (Reading)

A

That element of personal identity which determines the PERSONAL BELIEF AND VALUE SYSTEMS

81
Q

Emotional Self (Reading)

A

that element of the personal identity which encompasses the entire spectrum of FEELINGS AND ATTITUDES

82
Q

Self Perspective (Reading)

A

That aspect of the concept of self which views personal identity from 3 different foci

Located as an outer ring containing personal identity with 3 sections: Self Esteem, Self Image, Self in Action

83
Q

Self Perspective: Self Esteem Foci (Reading)

A

That perspective of personal identity which is concerned with HOW I VALUE myself

84
Q

Self Perspective: Self Image Foci (Reading)

A

That perspective of personal identity which is concerned with HOW I SEE myself

85
Q

Self Perspective: Self In Action Foci (Reading)

A

That perspective of personal identity which is concerned with HOW I USE MYSELF TO INTERACT WITH THE ENVIRONMENT

86
Q

Data of self concept should include what 2 things? (Reading)

A

Nurse observations AND Client perspective on things

87
Q

Body Image

A

How a person experiences ones body

88
Q

Depersonalization

A

Subjective experience of the partial or total disruption of ones ego and the disintegration and disorganization of ones self concept

89
Q

False Self

A

a sense of self that might develop in individuals who have the emotional need to respond to the needs and ambitions that significant people, such as parents, have for them

90
Q

Global Self

A

term used to describe the composite of all the basic facts, qualities, traits, images, and feelings one holds about oneself

91
Q

Ideal Self

A

self a person would like to be or thinks one should be, includes aspirations, moral ideas, and values

92
Q

Identity Diffusion

A

failure to integrate various childhood identifications into a harmonious adult psychosocial identity

93
Q

Personal Identity

A

an individuals conscious sense of who he or she is

94
Q

Role Performance

A

ability to successfully execute societal expectations regarding role specific behaviors

95
Q

Self Actualization

A

Reaching of ones potential through full development of ones unique capabilities

96
Q

Self Compassion

A

being kind and understanding when confronted with personal failings

97
Q

Self Concept

A

mental image or picture of self; includes body image, subjective self, ideal self, and societal self

98
Q

Self Esteem

A

persons perception of ones total being, including self worth and body image

99
Q

Adaptation

A

adjustment of living with other living things and environmental conditions

100
Q

Allostasis

A

the process of achieving stability or homeostasis through physiologic or behavioral change

101
Q

Anxiety

A

vague sense of impending doom or apprehension precipitated by new and unknown experiences

102
Q

Burnout

A
  1. Cumulative state of frustration with the work environment that develops over a long time
  2. Behaviors exhibited as the result of prolonged occupational stress
103
Q

Caregiver Burden

A

stress responses experienced during prolonged periods of home care by family caregivers

104
Q

Coping Mechanisms

A

patterns of behaviors used to neutralize, deny, or counteract anxiety

105
Q

Crisis

A
  1. Point at which body temperature drops rapidly to normal
  2. Occurs when coping and defense mechanisms are no longer effective, resulting in high levels of anxiety, disorganized behavior, and the inability to function normally
106
Q

Crisis Intervention

A

five step problem solving technique to promote adaptation and improve future coping

107
Q

Defense Mechanisms

A

forms of self deception; unconscious process the self uses to protect itself from anxiety or threats to self esteem

108
Q

Fear

A

a feeling of dread; a cognitive response to a known threat

109
Q

Fight or Flight Response

A

the body preparing itself against threat, to either resist (fight) or evade (flight) the danger

110
Q

General Adaptation Syndrome (GAS)

A

biochemical model of stress describing the bodys general response to stress

111
Q

Homeostasis

A

various physiologic and psychological mechanisms respond to changes in the internal and external environment to maintain a balanced state

112
Q

Inflammatory Response

A

localized response of the body to injury or infection; protective mechanism that eliminates invading pathogens and allows for tissue repair to occur

113
Q

Local Adaptation Syndrome (LAS)

A

localized response of the body to stress, precipitated by trauma or pathology

114
Q

Psychosomatic Disorder

A

physiologic alterations and illness believed to be due to psychological influences

115
Q

Reflex Pain Response

A

automatic response of the CNS to the stimulus of pain

116
Q

Stress

A

condition in which the human system responds to change in its normal balanced state

117
Q

Stressor

A

anything causing a person to experience stress; change in the balanced state

NURS362 - Practice of Nursing III (13 decks)

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