x Nursing 104 Flashcards
1
Q
Health
A
condition of physical, mental and social well being, not merely absence of disease.
-constant change and adaptation, NOT STATIC
2
Q
Disease
A
dysfunction of body characterized by clinical SS’s.
3
Q
Diagnosis implies…
A
course, duration, communicability, prognosis and treatment
4
Q
Illness
A
when person feels unhealthy/ill, may or may not be related to disease.
-Only person can say they feel ill
5
Q
Acute Illness
A
- rapid onset
- short duration
- usually reversible
- can be life threatening
6
Q
Chronic Illness
A
- gradual
- long duration
- usually irreversible
- may have remission/exacerbations
7
Q
Wellness
A
active state of being health
-physical/mental/emotional
8
Q
Wellness per Anspaugh
A
- physical
- social
- emotional
- intellectual
- spiritual
- occupational
- environmental
9
Q
Etiology
A
causation of disease
10
Q
Etiology of Disease Stages
A
Stage 1: experience symptoms
2: assume sick role
3: assume dependent role
4: recovery/rehab
11
Q
Travis Illness/Wellness Continuum
A
premature death Hi level wellness
12
Q
Dunn on Wellness
A
Dunn (1980)
functioning to ones max potential while maintain balance and purposeful direction in envt.
-Good health is passive state when person is not ill (differentiated wellness from good health)
-encourage nurses to care for total person.
13
Q
Dunn Hi Lev Wellness: WELLNESS
A
a continuous interaction btwn health and envt.
14
Q
Dunn Hi Lev Wellness: HEALTH
A
peak wellness versus death
15
Q
Dunn Hi Lev Wellness: ENVIRONMENT
A
very favorable vs very UNfavorable
16
Q
Dunn Hi Lev Wellness: ENCOMPASSES
A
family, community, envt, societal issues that affect indiv health/wellness status
17
Q
Dunn: 4 Levels of Wellness
A
- Hi Level Wellness in FAVorable envt
- Emergent Hi level wellness in UNfavorable envt
- Protected poor health in FAVorable health envt
- Poor health in UNfavorable envt
18
Q
Rosenstock’s and Becker’s Health Belief Models
A
Assumed good health is goal of all people which could predict an individuals willingess to take advantage of preventive measures to maintain hi level of wellness
- Becker modified this to include: *Perceived susceptibility
- perceived seriousness
- perceived threat
19
Q
Leavell and Clark’s Model (1965)
A
Agent - Host - Envt
good for examining causes of disease in individual
- Agent must be present of absent of illness to occur
- Host is living organism capable of being infected
- ALL interact with each other
- predicts illness rather than promote wellness
20
Q
Pender, Murdaugh, Parsons (2006)
A
Health Promotion Model
-how people interact w environ as they pursue health
21
Q
Levels of Prevention
A
- Primary: action to prevent occurrence of health probs (vaccine, annual phys)
- Secondary: early id and tx of specific health probs, early dx, prompt tx
- Tertiary: return client to highest level of fx possible, rehab
22
Q
Defense Mechanisms
A
SEE
- N104 bk, pg 117-118
- levels of anxiety, pg 118
- health maintenance, Unit 4, study guide
23
Q
Stress and Adaptation: Stimulus based model
A
Circumstances in life that produce physiological or psychological reactions that influence indiv response to illness
24
Q
General Adaptation Syndrome (GAS)
A
Hans Selye
- biochemical model of stress
- physiological response to stress that results from physical and emotional stressors
- seen in severely injury or illness
- GAS is factor in mental illness, social isolation and loss of human relationship
25
GAS Stages
* Alarm: fight or flight
* Stage of resistance (physiological an psychological adaptation takes place)
* Stage of Exhaustion: body can't maintain homeostasis
26
Local Adaptation Syndrome (LAS)
- localized response
- involve specific body part (tissue/organ)
- homeostatic short term adaptive response
- reflex pain/inflammatory response
27
LAS (Local Adaptation Syndrome) Responses
REFLEX:
* response of CNS to pain
* rapid/automatic
* protective mechanism to prevent injury
* require intact neurologic reflex arc (sensory and motor neurons)
INFLAMMATION
*local response to injury/infection
*localize and prevent spread, promote wound healing
*symptoms: pain, swelling, redness, heat, loss of functoin
Rubor, tumor, calor, dolor, loss fx
28
Pysical Illness associated w Stress
```
AUTOIMMUNE:
*graves (hyper thyroid)
*myasthenia gravis
*psoriasis
*ulcerative colitis
*rheumatoid arthritis
CARDIOVASCULAR
*HTN
*coronary artery disease
RESPIRATORY
*ashtma
GASTRO
*esophageal reflux
*constipation
*diarrhea
*ulcerative colitis
```
29
Transaction Based Model of Stress
```
COGNITIVE
affective coping response arise from person/envt transaction
PHYSIOLOGICAL STRESSORS
*chemicals (drugs, poison, etoh)
PHYSICAL
*heat, cold, radiation, trauma, elec shock)
INFECTIOUS AGENTS
*Virus, bacteria, fungi)
IMMUNE
GENETIC
NUTRITIONAL
HYPOXIA
```
30
Increased Stress S&S
- dilated pupils
- diaphoresis
- UP heart rate, cardiac output
- pallid skin
- UP BP
- UP Respiration
- Urinary Output decrease
- Mouth becomes dry
- Peristalsis decreases
- UP mental alertness
- UP motor activity
- UP Blood sugar
31
F to C
deduct 32, x 5, / by 9
32
C to F
x 9, / 5, +32
33
WATCH
VIDS, 44/68
34
5 types of Percussion sounds
- Flatness (dull sound, very dense, (muscular or bone))
- Dullness
- Resonance
- Resonance
- Hyperresonance
- Tympany
35
Forms of Communications
-Verbal
-Nonverbal
-
36
Denotative Meaning
literal definition of work
37
Connotative Meaning
Implied
38
Nonverbal Comm
- body language
- facial expression
- posture
- gait
- eye contact (know culture)
- touch (not on angry patient)
39
Verbal Comm
- vocabulary
- denotative/connotatie
- pacing
- intonation
- clarity/brevity
- timing/relevance
- humor (never AT the patient or their disease process)
- credibility
40
Therapeutic Comm
client centered
- establish therap relationship
- use of empathy, respect, genuineness, concrete (nurse maintain power and confidence), confrontation (say what you mean)
41
Phases of Therapeutic Relationship
-PRE-INTERACTION
-orientation (when meet, establish trust, mutual introductions, exchange info ie. chief complaint)
-working relationship(nurse comm caring, pts express thoughts)
Termination: conclusion of relationship. Review plan of care, summarize (end of shift, discharge, end of appt etc)
42
Communication Techniques
- Active Listening (open posture, eye contact)
- Establishing Trust (acknoledge, address by name, reply honestly, consistent)
- Being Assertive ( confident, controlling conversation)
- Restating Message
- Clarifying Messages
- Validating messages (am I making a correct interpretation)
- Interpreting body language and sharing observatoins
- Exploring issues
- ask OPEN ENDED questions
- Using Silence (remain attentive, demonstrates acceptance)
- Summarizing Convo
43
Therapeutic Comm Barriers
-asking too many questions (feel interrogated, suggest insensitivity)
-Fire-hosing Info: presenting lots of info
-Asking why? (criticism, try "what concerns do you have, tell me more about ....")
-Changing subject inappropriately (try to redirect tangents smoothly)
-Failing to probe
-Express approval or disaproval
-Offering advice
-False Reassurance ( may feel dismissed, don't say everything will be ok, we can't promise that. do not mislead, instead say you are in good hands etc)
Stereotyping (don't, can distort your assessment)
-Patronizing language (imply superiority)
44
Types of Stressors
- external (death, heat, hurricane)
- Internal (disease, anxiety, neg self talk)
- Developmental (predictable, various stages)
- Situational (auto accid, illness, natural disaster)
- Physiological: affect body structure of fx (chem, physical, mechanical, nutritional, biological, genetic, lifestyle)
- Pshchosocial
45
Response to stressors
GAS: General Adaptation Syndrome
1. Alarm stage
2. Resistance stage (adaptation)
3. Exhaustion of Recovery
46
Alam Stage
1. Shock phase: brain to endocrine and sympathetic system
| 2. Countershock phase: person deals with threat.
47
Resistance (Adaptaions)
Coping
48
Exhaustion Stage
class 6, pg 23
49
Local adaptation syndrome
class 6, pg 24
50
Levels of Anxiety
- MILD- heightened perception, optimal fxing
- MODERATE-perceptual field narrows, focus on self, need to relieve discomfort, shorter atten span, rapid speach, up HR, UP perspiration, gastric discomfort
- SEVERE - narrow focus. totally on themselves. concenration severly limited, prevents problmen solving, confusion : SS, ha, palpit, d/n/v, urinay freq, diar
- PANIC: terror, impending doom, dilated pupils, labored breathing, palpitation, diaphoresis
51
Sress Mgmt
```
discharging tension
-exercise
-Relations (progressive/passive)
-Meditation
-Visualization/Imagery
-Biofeedback
-Acupuncture
etc
```
52
Progressive relaxation
-contract muscle then intentionally relax, can be done head to toe
53
Passive relaxation
-relaxing muscles without first contracting them
54
Types of Learning
- Cognitive
- Psycho motor (mental and physical activity. Include sensory awareness of cues. i.e. performing finger stick, admin injection
- Affective: changes in feeling, beliefs, attitudes, values. integrating new ideas in value system. i.e. chronic illness
55
Antidote for Aspirin
Dialysis
56
Antidote for Acetaminophen
N-Acetylcystine
57
Antidote for Digitalis
Lidocaine
58
CO
O2
59
Narcotic
Narcan
60
Cyanide
Sodium Nitrate
61
Iron
Deferoxamine
62
Ethylene Glycol
Ethanol
63
Sounds levels above ? is painful and cause hearing los
120 decibels
64
Disaster Level 1
local emergency response
65
Disaster Level 2
Regional efforts
66
Disaster Level 3
Local and regional AND statewide and federal aid
67
Malfeasance
Right Med, Wrong Route - cause death
68
5 rights
Right:
- Patient
- Medication
- Dose
- Route
- Time
69
5 rights
Right:
- Patient
- Medication
- Dose
- Route
- Time
70
Percutaneous
topical, effected through skin
71
Percutaneous
topical, effected through skin
72
USP NF
United States Pharmacopeia (USP) and the National Formulary (NF)
