Term
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Definition
- assessment
- diagnosis
- planning
- implementation
- evaluation |
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Term
| The two major goals of the Healthy People 2010 document |
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Definition
“increase quality and years of a healthy life,” and to “eliminate health
disparities.” |
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Term
| Functional assessment means |
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Definition
can they perform the activities of daily living
appropriate for their age, and if not, then what is their degree of limitation. |
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Term
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Definition
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Term
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Definition
| The two researchers involved in psychosocial devp |
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Term
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Definition
| The two researchers involved in adult psychosocial devp |
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Term
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Definition
| logical thinking and problem solving theorist |
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Term
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Definition
| theory of moral development |
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Term
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Definition
| stages of spiritual development |
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Term
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Definition
research on moral
development mostly involved women |
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Term
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Definition
Her work is very important
because she emphasized the concepts of caring and responsibility starting with caring for self. |
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Term
| a major goal of JCAHO and of Healthy People 2010 |
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Definition
| safety, with its focus on health promotion and health maintenance |
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Term
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Definition
| a process of change whereby cognitive processes mature sufficiently to allow the person to solve problems that were unsolvable before, probably because new knowledge has been assimilated |
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Term
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Definition
| coping behavior, the ability to handle the demands made by the environment |
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Term
| Adaptive Mechanisms - Frued |
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Definition
| learned behaviors that assist an individual to adjust to the environment. The result of the conflicts between the id's impulses and the anxiety that attends these conflicts due to environmental restrictions |
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Term
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Definition
| the process through which humans encounter and react to new situations by using the mechanisms they already possess. In this way, people acquire knowledge and skills as well as insight into the world around them |
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Term
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Definition
| refers to the mannber in which people learn to think, reason, and use language |
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Term
| Defense Mechanisms - Frued |
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Definition
| same as Adaptive Mechanisms |
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Term
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Definition
| an increase in the complexity of function and skill progression |
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Term
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Definition
| a task which arises at or about a certain period in the life of an individual, successful achievement of which leads to his happiness and to success with later tasks, while failure leads to unhappiness and difficulty with later tasks |
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Term
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Definition
| operates on the reality principle. It balances the gratification demands of the id with the limitations of social and physical circumstances. Includes consciousness and memory, which serves to mediate between primitive instinctual drives (id), internal social prohibitions (superego), and reality |
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Term
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Definition
| immobilization or the inability of the personality to proceed to the next stage because of anxiety |
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Term
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Definition
| physical change and increase in size is called_____ |
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Term
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Definition
| resides in the unconscious and, operating on the pleasure principle, seeks immediate pleasure and gratification |
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Term
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Definition
| urge or desire for sexual activity. Frued proposes that it's the underlying motivation to human devp |
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Term
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Definition
| relating to right and wrong |
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Term
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Definition
| the way a person perceives those requirements (necessary to live together) and responds to them |
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Term
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Definition
| the requirements necessary for people to live together in society |
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Term
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Definition
| a complete concept that is difficult to define. The outward extension of the inner self |
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Term
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Definition
| contains the conscience and the ego idea. The conscience of personality; the source of feelings of guilt, shame and inhibition |
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Term
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Definition
| the part of a person's mental life that the person is unaware of. Freud's greatest contribution |
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Term
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Definition
| the part of a person's mental life that the person is unaware of. Freud's greatest contribution |
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Term
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Definition
| the part of a person's mental life that the person is unaware of. Freud's greatest contribution |
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Term
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Definition
| growth occurs from the head down |
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Term
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Definition
| growth occurs from the center of the body out |
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Term
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Definition
| simple to complex, or from single acts to integrated acts |
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Term
| Devp becomes increasingly differentiated.... |
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Definition
| differentiated devp w/ a generalized response and progresses to a skilled specific response |
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Term
| The most critical period to G&D... |
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Definition
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Term
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Definition
| behavior is largely reflexive and devps to more purposeful behv. |
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Term
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Definition
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Term
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Definition
| motor devp permits inc physical autonomy. Psychosocial skills inc |
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Term
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Definition
| the world is expanding. New experiences and the preschooler's social role are tried during play. Physical growth is slower |
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Term
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Definition
| stage includes the preadolescent period (10-12yrs). Peer groups increasingly influences behv. Physical, cog, and social devp inc, and comm skills improve |
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Term
|
Definition
| Self-concept changes with biologic devp. Values are tested. Physical growth accelerates. Stress inc, especially in face of conflicts |
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Term
| Young adulthood: 20-40yrs |
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Definition
| a personal lifestyle devps. Person establishes a relationship with a sig other and a commitment to something |
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Term
| Middle adulthood: 40-65yrs |
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Definition
| lifestyle changes due to other changes; for example, empty nester, occupational goals change |
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Term
|
Definition
| adaptation to retirement and changing physical abilities is often necessary. Chronic illness may devp |
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Term
|
Definition
| adaptation to decline in speed movement, reaction time, and inc dep on others may be necessary |
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Term
|
Definition
| inc physical probs may devp |
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Term
| Five major components of G&D |
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Definition
- physiologic
- psychosocial
- cognitive
- moral
- spiritual |
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Term
| Robert Havighurst: Devp Task Theory |
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Definition
| G&D occurs in 6 stages, each with 6-10 tasks to be learned |
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Term
| Havighurst: Infancy and Early Childhood |
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Definition
learning to:
- walk
- take solid foods
- talk
- control elimination
- sex diff and sexual modesty
- achieving psychologic stability
- forming simple concepts of social and physical reality
- relate emotionally to parents, siblings, and to others
- distinguish right and wrong and devp a conscience |
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Term
| Havighurst: Middle Childhood |
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Definition
- learning physical skills necessary for ordinary games
- building wholesome attitudes toward oneself as a growing organism
-learning to get along with age-mates
- learning an approp masculine or feminine social role
- devp fund skills in reading, writing, and calculating
- devp concepts nec for everyday living
- devp conscience, morality, and a scale of values
- achieving personal indep
- devp attitudes towards social groups and institutions |
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Term
|
Definition
- achieving new and more mature relations with age-mates of both sexes
- achieving a masc or fem social role
- accepting one's physique and using the body effectively
- achieving emot indp from parents and other adults
- achieving assurance of eco indp
- selecting and preparing for an occupation
- preparing for marriage and family life
- devp intellectual skills and concepts nec for civic competence
- desiring and achieving socially responsible behv
- acquiring a set of values and an ethical system as a guide to behv |
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Term
| Havighurst: Early Adulthood |
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Definition
- selecting a mate
- learning to live with a partner
- starting a family
- rearing children
- managing a home
- getting started in an occupation
- taking on civic responsibility
- finding a congenial social group |
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Term
|
Definition
- achieving adult civic and social responsibility
- establishing and maint an economic standard of living
- assisting teenage children to become resp and happy adults
- devp adult and leisure-time activities
- relating one's self to a spouse as a person
- accepting and adjusting to the physiologic changes of middle age
- adjusting to aging parents |
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Term
| Havighurst: Later Maturity |
|
Definition
- adj to dec physical strength and health
- adj to retirement and reduced income
- adj to death of a spouse
- establishing an explicit affiliation with one's age group
- meeting social and civil obligations
- estab satisfactory physical living arrangements |
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Term
|
Definition
| refers to devp of personality |
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Term
| Personality encompasses.. |
|
Definition
- temperament
- feelings
- char traits
- independence
- self esteem
- self concept
- behv
- ability to interact with others
- ability to adapt to life changes |
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Term
| Freud's Theory of Psychosexual Devp |
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Definition
| The personality devps in 5 overlapping stages from birth to adulthood. The libido changes its location of emphasis within the body from one stage to another. |
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Term
| Oral stage: birth - 1.5yrs |
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Definition
- mouth is center of pleasure
- security is primary need
- major conflict is weaning |
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Term
|
Definition
- anus and bladder
- major conflict is toilet training |
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Term
|
Definition
- genitals
- major conflict is the Oedipus or Electra complex, which resolves when the child ID with parent of the same sex |
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Term
|
Definition
- energy is directed to physical and intellectual activities
- sexual impulses repressed
- develops same sex relationships |
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Term
| Genital: pubery and after |
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Definition
| - energy is directed toward full sexual maturity and function and devp of skills needed to cope with the environ |
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Term
|
Definition
| adapted and expanded Freud's theory of devp to include the entire lifespan |
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Term
| Erikson: Infancy birth-10mos |
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Definition
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Term
| Erikson: Early Childhood 18mos-3yrs |
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Definition
| Autonomy vs Shame and Doubt |
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Term
| Erikson: Late Childhood 3-5yrs |
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Definition
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Term
| Erikson: School Age 6-12yrs |
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Definition
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Term
| Erikson: Adolescence 12-20yrs |
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Definition
| Identity vs Role Confusion |
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Term
| Erikson: Young Adulthood 18-25yrs |
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Definition
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Term
| Erikson: Adulthood 25-65yrs |
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Definition
| Generativity vs Stagnation |
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Term
| Erikson: Maturity 65yrs-death |
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Definition
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Term
|
Definition
- mental and social capacities tend to inc in the latter part of life
- proposes 3 devp tasks during old age |
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Term
| Robert Peck: Ego differentiation vs work-role preoccupation |
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Definition
| - on retirement, people must derive their sense of identity from roles other than work |
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Term
| Robert Peck: Body transcendence vs body preoccupation |
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Definition
| - the individual must adjust to decreasing physical capacities and at the same time maintain feelings of well-being |
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Term
| Robert Peck: Ego transcendence vs ego preoccupation |
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Definition
- Ego transcendence is the acceptance, w/o fear of one's own eminent death
- ego preoccupation is holding on to life and a preoccupation with self-gratification |
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Term
|
Definition
- individuals consider themselves part of the family rather than indvs and want to separate from their parents
A Gould stage..... |
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Term
|
Definition
| - although the indv has established autonomy, he feels that it's in jeopardy; he feels he could be pulled back into his family |
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Term
|
Definition
- indvs feel established as adults and autonomous from their families
- they see themselves as well-defined, but still feel the need to prove themselves to their parents
- they see this as the time for growing and building for the future |
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Term
|
Definition
- neonatal
- infancy
- toddlerhood
- preschool
- school age
- adolescence
- young adulthood
- middle adulthood
- older adulthood
- young old
- middle old
- old old |
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Term
|
Definition
- infancy and early childhood
- middle childhood
- adolescence
- early adulthood
- middle age
- later maturity |
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Term
|
Definition
- oral
- anal
- phallic
- latency
- genital |
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Term
| Erikson's 8 stages of devp |
|
Definition
- infancy
- early childhood
- late childhood
- school age
- adolescence
- young adulthood
- adulthood
- maturity |
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Term
|
Definition
| marriage and careers are well established. individuals question what life is all about and wish to be accepted as they are, no longer finding it necessary to prove themselves |
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Term
|
Definition
period of self-reflection. individuals question values and life itself. they see time as finite, with little time to shape the lives of adolescent children
A Gould stage..... |
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Term
|
Definition
| personalities are seen as set. Time is accepted as finite. Individuals are interested in social activities with friends and spouse and desire both sympathy and affection from spouse |
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Term
|
Definition
| This is a period of transformation, with a realization of mortality and a concern for health. there is an increase of warmth and a decrease in negativism. The spouse is seen as a valuable companion |
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Term
| Piaget's 5 major phases of cognitive theory |
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Definition
- sensorimotor phase
- preconceptual phase
- intuitive thought phase
- concrete operations phase
- formal operations phase |
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Term
| A person uses three primary abilities to move from one of Piaget's phases to the next |
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Definition
- assimilation
- accommodation
- adaptation |
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Term
| Piaget: Sensorimotor phase birth-2yrs |
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Definition
| Piaget: Stage 1-6 is called? |
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Term
Piaget: Sensorimotor phase
Stage 1 birth-1mos |
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Definition
- use of reflexes
- most action is reflexive |
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Term
Piaget: Sensorimotor phase
Stage 2 1-4mos |
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Definition
- primary circular reaction
- perception of events is centered on the body
- objects are an extension of self |
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Term
| Piaget: Sensorimotor phase Stage 3 4-8mos |
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Definition
- secondary circular reaction - acknowledges the external env - actively makes changes in the env
Children become aware of things beyond their own body and become more object oriented. Can put ' secondary circular reactions' together to solve new problems; e.g. uncover, then grasp |
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Term
Piaget: Sensorimotor phase
Stage 4 8-12mos |
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Definition
- coordination of secondary schemata
- can distinguish a goal from a means of attaining it |
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Term
Piaget: Sensorimotor phase
Stage 5 12-18mos |
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Definition
- tertiary circular reaction
- tries and discovers new goals and ways to attain goals
- rituals are important |
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Term
Piaget: Sensorimotor phase
Stage 6 18-24mos |
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Definition
- inventions of new means
- interprets the envir by mental image
- uses make-believe and pretend play |
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Term
| Piaget: Preconceptual phase 2-4yrs |
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Definition
- uses an egocentric approach to accommodate the demands of an envir - everything is sig and relates to "me" - explores the envir - language devp is rapid - associates words with objects
A Piaget phase______ |
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Term
| Piaget: Intuitive Thought phase 4-7yrs |
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Definition
- egocentric thinking diminishes
- thinks of one idea at a time
- includes others in the enviro
- words express thoughts |
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Term
| Piaget: Concrete Operational phase 7-11yrs |
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Definition
- solves concrete problems
- begins to understand relationships such as size
- understands right and left
- cognizant of viewpoints |
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Term
| Piaget: Formal Operations phase 11-15yrs |
|
Definition
- uses rational thinking
- reasoning is deductive and futuristic |
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Term
| Kohlberg's Stages of Moral Devp |
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Definition
1 - preconventional
2 - conventional
3 - postconventional |
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Term
Kohlberg's Stages of Moral Devp
1. Preconventional toddler-7yrs |
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Definition
- person is responsive to cultural rules of labels of good and bad, right or wrong
- externally established rules determine right or wrong actions
- person reasons in terms of punishment, reward, or exchange of favors
Stage 1 - Punishment and Obedient Orientation: fear of punishment, not respect for authority, is the reason for decisions, behaviors, and conformity |
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Term
Kohlberg's Stages of Moral Devp
1. Preconventional toddler-7yrs
Egocentric Focus preschooler-school age |
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Definition
| Stage 2- Instrumental Relativist Orientation: conformity is based on egocentricity and narcissistic needs. There is no feeling of justice, loyalty, or gratitude |
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Term
Kohlberg's Stages of Moral Devp
2. Conventional school age-adulthood (most american women are in this stage) |
|
Definition
- person is concerned with maintaining expectations and rules of the family, group, nation, or society
- a sense of guilt has devp and affects behv
- the person values conformity, loyalty, and active maintenance of social order and control
- conformity means good behv or what pleases or helps another and is approved |
|
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Term
Kohlberg's Stages of Moral Devp
2. Conventional school age-adulthood |
|
Definition
Stage 3 - Interpersonal Concordance Orientation: decisions and behvs are based on concerns about other's reactions; the person wants other's approval or a reward
- an emphatic response, based on understanding of how another person feels, is a determinant for decisions and behv |
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Term
Kohlberg's Stages of Moral Devp
2. Conventional school age-adulthood
Societal Focus adolescence and adulthood (most men are in this stage) |
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Definition
| Stage 4 - Law and Order Orientation: the person wants established rules from authorities, and the reason for decisions and behv is that social and sexual rules and traditions demand the response |
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Term
Kohlberg's Stages of Moral Devp Middle age or older adult. Only 20% or less of americans achieve this stage
III. Postconventional |
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Definition
- The person lives autonomously and defines moral values and principles that are distinct from personal ID with group values
- She lives according to principles that are universally agreed on and that the person considers appropriate for life |
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Term
Kohlberg's Stages of Moral Devp
III. Postconventional |
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Definition
| Stage 5: Social Contract Legalistic Orientation - The social rules are not the sole basis for decisions and behv because the person believes a higher moral principle applies such as equality, justice, or due process |
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Term
Kohlberg's Stages of Moral Devp
III. Postconventional
Universal Focus Few people attain or maintain this stage. Examples are seen in extreme crisis |
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Definition
| Stage 6 - Universal Ethical Principle Orientation: Decisions and behv are based on internalized rules, on conscience rather than social laws, and on self-chosen ethical and abstract principles that are universal, comprehensive, and consistent |
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Term
| Gilligan's Stages of Moral Devp |
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Definition
1. caring for oneself
2. caring for others
3. caring for self and others |
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Term
| Gilligan's Two Transitions |
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Definition
| Transition 1 occurs in Stage 1 when the person begins to view the approach of caring for oneself only as selfish and starts to realize the need for others |
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Term
| Gilligan's Two Transitions |
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Definition
| Transition 2 occurs in Stage 2 when a move is made from goodness to truth, the person realizes that a balance is needed between caring for oneself and caring for others |
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Term
| Fowler's Stages of Spiritual Devp |
|
Definition
- undifferentiated
- intuitive-projective
- mythic-literal
- synthetic-conventional
- individuating-reflexive
- paradoxical- consolidative
- universalizing |
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|
Term
Fowler's Stages of Spiritual Devp
Undifferentiated 0-3yrs |
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Definition
| Infant unable to formulate concepts about self or the enviro |
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Term
Fowler's Stages of Spiritual Devp
Intuitive-projective 4-6yrs |
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Definition
| A combo of images and beliefs given by trusted others, mixed with the child's own experiences and imagination |
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Term
Fowler's Stages of Spiritual Devp
Mythic-literal 7-12yrs |
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Definition
| Private world of fantasy and wonder; symbols refer to something specific; dramatic stories and myths used to communicate spiritual meanings |
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Term
Fowler's Stages of Spiritual Devp
Synthetic-conventional adol or adult |
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Definition
| World and ultimate enviro structured by the expectations and judgements of others; interpersonal focus |
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Term
Fowler's Stages of Spiritual Devp
Individuating-reflexive after 18yrs |
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Definition
| Constructing one's own explicit system; high degree of self-consciousness |
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Term
Fowler's Stages of Spiritual Devp
Paradoxical-consolidative after 30 yrs |
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Definition
| Awareness of truth from a variety of viewpoints |
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Term
Fowler's Stages of Spiritual Devp
Universalizing maybe never |
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Definition
| Becoming an incarnation of the principles of love and justice |
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Term
| Westerhoff's Four Stages of Faith |
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Definition
- experienced faith
- affiliative faith
- searching faith
- owned faith |
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Term
Westerhoff's Four Stages of Faith
Experienced faith infancy/late adolesc |
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Definition
| experiences faith through interaction with others who are living a particular faith tradition |
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Term
Westerhoff's Four Stages of Faith
Affiliative faith late adoles |
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Definition
| actively participates in activities that characterize a particular faith tradition; experiences awe and wonderment; feels a sense of belonging |
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Term
Westerhoff's Four Stages of Faith
Searching faith Young adulthood |
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Definition
| through a process of questioning and doubting own faith, acquires a cognitive as well as an affective faith |
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Term
Westerhoff's Four Stages of Faith
Owned faith middle adulthood/old age |
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Definition
| puts faith into personal and social action and is willing to stand up for what the individual believes even against the nurturing community |
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Term
|
Definition
| the period during which the person becomes physically and psychologically mature and acquires a personal ID |
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Term
|
Definition
| During puberty, sudden and dramatic physical changes |
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Term
|
Definition
| reduce visual acuity in one eye, is usually the result of strabismus (toddler) |
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Term
|
Definition
| provides a numeric indicator of the baby's physiologic capacities to adapt to a extrauterine life |
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Term
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Definition
| develop in the axillae, anal and genital areas, external auditory canals, and around the umbilicus and the areola of the breasts. Apocrine sweat is released in response to emotional stimuli only |
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Term
| Denver Developmental Screening Test (DDST) |
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Definition
| used to screen children from birth to 6yrs. It measures: personal-social, fine-motor adaptive, language, and gross motor |
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Term
|
Definition
| found over most of the body, produce sweat |
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Term
|
Definition
outer layer of the embryo tissue formed in the second week
- forms the brain and spinal cord |
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Term
| Embryonic phase first 8wks of pregnancy |
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Definition
| the period during which the fertilized ovum develops into an organism with most of the features of a human |
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Term
|
Definition
| as the eye grows in length, it refracts light normally |
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Term
|
Definition
inner layer of the embryo tissue formed in the second week
- forms the bladder and the urethra |
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Term
|
Definition
| a unique syndrome in which an infant falls below the 5th percentile for W&H on a standard growth chart or is falling in percentiles on a growth chart |
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Term
|
Definition
| 2nd and 3rd trimester; characterized by a period of rapid growth in the size of the fetus. Both genetic and environmental factors affect its growth |
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Term
|
Definition
| unossified membraneous gaps in the bone structure of the skull |
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Term
|
Definition
| farsighted - preschool children |
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Term
|
Definition
| occurs when the child perceives the self as similar to another person and behaves like that person |
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Term
|
Definition
| important part of the preschooler's lives. Imagination and fantasy in play |
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Term
|
Definition
| similar to ID, it's the assimilation of the attributes of others |
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Term
|
Definition
| a fine downy hair that covers the body of the fetus at the end of the 2nd trimester |
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Term
|
Definition
middle layer of the embryo tissue formed in the third week
- forms the heart |
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Term
|
Definition
|
|
Term
|
Definition
| normal head circumference |
|
|
Term
|
Definition
| during adolescence they provide a sense of belonging, pride, social learning, and sexual roles |
|
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Term
|
Definition
- a flat, disc-shaped organ and is highly vascular
- normally forms in the upper segment of the endometrium of the uterus
- its functions are to exchange nutrients and gases between the embryo or fetus and the mother |
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Term
| Primary sexual characteristics |
|
Definition
| puberty - organs necessary for reproduction, such as the testes, penis, vagina and uterus |
|
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Term
|
Definition
| 1st stage of adolescence in which sexual organs begin to grow and mature |
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Term
|
Definition
| reverting to an earlier devp stage |
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Term
|
Definition
| removing experiences, thoughts, and impulses from awareness |
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|
Term
| Secondary sexual characteristics |
|
Definition
puberty - differentiates males from females but don't relate directly to reproduction
- examples are pubic hair growth, breast devp, and voice changes |
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Term
|
Definition
| made up of body image devp, feelings about self, adaptive and defensive mechanisms, reactions from others, and one's perceptions of these reactions, attitudes, values, and many of life's experiences |
|
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Term
|
Definition
| ability to ID an unseen object simply by touch |
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|
Term
|
Definition
|
|
Term
|
Definition
| anything that adversely affects normal cellular devp in the embryo or fetus |
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Term
|
Definition
| a white, cheeselike substance that adheres to the skin of the fetus and can become 1/8" thick by birth |
|
|
Term
| Health Promotion of the Fetus or embryo |
|
Definition
- oxygen
- nutrition and fluids
- rest and activity
- elimination
- temp maint
- safety |
|
|
Term
Neonates - 0-1mos Physical Devp
Infants - 1mos-1yr |
|
Definition
Weight
- born at 6-8.5lbs
- loses 5-10% of wt after birth
- after a few days they gain 6oz weekly for 6mos
- by 5mos they double wt
- by 1yr they triple wt |
|
|
Term
Neonates - 0-1mos Physical Devp
Infants - 1mos-1yr |
|
Definition
Length
- 20" at birth
- the crown-to-rump length usually the same as the head circumference
- by 6mos they gain 5.5"
- by 12mos they gain 3" |
|
|
Term
Neonates - 0-1mos Physical Devp
Infants - 1mos-1yr |
|
Definition
Head and Chest Circumference
- at birth, head circum is 14"
- chest circu is 1" smaller
- 9-10mos, head and chest the same |
|
|
Term
Neonates - 0-1mos Physical Devp
Infants - 1mos-1yr |
|
Definition
Head Molding
- the lg anterior fontanelle inc in size for several mos after birth
- closure occurs between 9-18mos
- the posterior fontanelle closes between 2-33mos after birth |
|
|
Term
Neonates - 0-1mos Physical Devp
Infants - 1mos-1yr |
|
Definition
Vision
- at birth the eyes can't focus on near objects
- at 4mos can recognize familiar objects and follow them moving
- 6mos, perceive color
- 9mos, can recognize faces
- 12mos, depth perception |
|
|
Term
Neonates - 0-1mos Physical Devp
Infants - 1mos-1yr |
|
Definition
Hearing
- moro reflex
- a few days, distinguish sounds
- 9mos, locate sounds and recognize familiar ones
- listens, distinguishes words, and responds to simple commands |
|
|
Term
Neonates - 0-1mos Physical Devp
Infants - 1mos-1yr |
|
Definition
Smell and Taste
- functional shortly after birth
- can recognize mother's milk |
|
|
Term
Neonates - 0-1mos Physical Devp
Infants - 1mos-1yr |
|
Definition
Touch
- well devp at birth
- can't isolate source of pain on skin |
|
|
Term
Neonates - 0-1mos Physical Devp
Infants - 1mos-1yr |
|
Definition
Reflexes
- unconscious, involuntary responses
- rooting, sucking, moro, palmar grasp, plantar, tonic neck, stepping, babinski |
|
|
Term
Neonates - 0-1mos Physical Devp
Infants - 1mos-1yr |
|
Definition
Motor Devp
- initially body movement is uncoordinated
- at 1mos, lifts and turns head when prone
- 6mos, sitting w/o support
- 9mos, reach, grab, xfer object from hand to hand
- 12mos, fime motor skills devp |
|
|
Term
Neonates - 0-1mos Phycosocial Devp
Infants - 1mos-1yr |
|
Definition
Erikson
- trust vs mistrust |
|
|
Term
Neonates - 0-1mos Motor Devp
Infants - 1mos-1yr |
|
Definition
| newborn - turns head from side to side when in a prone position. Grasps by reflex when object is placed in palm of hand |
|
|
Term
Neonates - 0-1mos Motor Devp
Infants - 1mos-1yr |
|
Definition
6 mos
- lifts chest and shoulders off table when prone, bearing wt on hands. Manipulates small objects |
|
|
Term
Neonates - 0-1mos Motor Devp
Infants - 1mos-1yr |
|
Definition
9 mos
- Creeps and crawls. Uses pincer grasp w/ thumb and forefinger |
|
|
Term
Neonates - 0-1mos Motor Devp
Infants - 1mos-1yr |
|
Definition
12 mos
- Walks alone w/ help. Uses spoon to feed self |
|
|
Term
Neonates - 0-1mos Social Devp
Infants - 1mos-1yr |
|
Definition
Newborn
- displays displeasure by crying and satisfaction by soft vocalizations. Attends to adult face and voice by eye contact and quieting |
|
|
Term
Neonates - 0-1mos Social Devp
Infants - 1mos-1yr |
|
Definition
6 mos
- starts to imitate sounds. Vocalizes one-syllable sounds |
|
|
Term
Neonates - 0-1mos Social Devp
Infants - 1mos-1yr |
|
Definition
9 mos
- complies with simple verbal commands
- displays fear of being left alone
- waves goodbye |
|
|
Term
Neonates - 0-1mos Social Devp
Infants - 1mos-1yr |
|
Definition
12 mos
- clings to mother in unfamiliar situations
- demonstrates emotions such as anger and affection |
|
|
Term
Neonates - 0-1mos Cog Devp
Infants - 1mos-1yr |
|
Definition
Piaget
- cog devp is a result of interaction between an indv and the enviro
- sensorimotor phase: the initial phase of cog devp. It has 6 stages, 3 take place during the 1st yr
- 4-8mos: infants begin to have perceptual recognition
- 6mos: responds to new stimuli and remember certain objects and look for them
- 12mos: concept of both space and time
- an infants cog devp proceeds from reflexive ability of the newborn to using one or two actions to attain a goal by the age of one |
|
|
Term
Neonates - 0-1mos Moral Devp
Infants - 1mos-1yr |
|
Definition
| - infants associate right and wrong with pleasure and pain by the way they are treated by their parents |
|
|
Term
Neonates - 0-1mos Health Probs
Infants - 1mos-1yr |
|
Definition
- failure to thrive
- colic
- crying
- abuse
- SIDS |
|
|
Term
Neonates - 0-1mos Health Assess and Promo
Infants - 1mos-1yr |
|
Definition
- apgar: HR, resp, muscle tone, reflex irritability, color
- devp screening tests: physical, motor, sensory, psychosocial, ADLs
- ongoing assess |
|
|
Term
| Toddlers 1-3yrs Physical Devp |
|
Definition
Weight
- 4x birth wt
- 3yrs wt is 30lbs |
|
|
Term
| Toddlers 1-3yrs Physical Devp |
|
Definition
Height
- 1-2yrs avg growth is 4-5"
- 2-3yrs avg growth is 2.5-3.5" |
|
|
Term
| Toddlers 1-3yrs Physical Devp |
|
Definition
Head circum
- inc by 1"
- 2yrs, head is 80% of adult and brain is 70% |
|
|
Term
| Toddlers 1-3yrs Physical Devp |
|
Definition
Sensory
- 18mos: accommodation to near and far objects
- 3yrs: can look away from a toy prior to reaching out and picking it up. Integration of visual and neuromuscular functions |
|
|
Term
| Toddlers 1-3yrs Physical Devp |
|
Definition
Motor
- fine muscle coord and gross motor skills improve
- 18mos, walk
- 24mos, run
- 3yrs, toilet |
|
|
Term
| Toddlers 1-3yrs Psychosocial Devp |
|
Definition
- anal phase
- autonomy vs shame and doubt
- abandonment is greatest fear |
|
|
Term
|
Definition
- Piaget: toddler completes 5th and 6th stages of the sensorimotor phase
- stage 5: problem solving b trial and error
- stage 6: problem solves mentally
- starts preconceptual phase: devp considerable cog and intellectual skills, concepts start to form |
|
|
Term
| Toddlers 1-3yrs Moral Devp |
|
Definition
Kohlberg
- 1st yr: preconventional, response to punishment and reward
- 2nd yr: they notice that certain actions and rituals garner praise |
|
|
Term
| Toddlers 1-3yrs Spiritual Devp |
|
Definition
Fowler
- undifferentiated: more interested in learning knowledge and emotional reactions |
|
|
Term
|
Definition
Health
- accidents
- visual probs
- cavities
- respiratory tract and ear infections |
|
|
Term
Preschoolers 4 & 5yrs
Physical Devp |
|
Definition
- taller and thinner than toddlers
- brain almost adult size
- limbs grow faster than trunk
- posture becomes more straightened |
|
|
Term
Preschoolers 4 & 5yrs
Physical Devp |
|
Definition
Weight
- slow, only added 10lbs to 3yr old wt making their wt 42lbs |
|
|
Term
Preschoolers 4 & 5yrs
Physical Devp |
|
Definition
Height
- grow 2"/yr to 40" |
|
|
Term
Preschoolers 4 & 5yrs
Physical Devp |
|
Definition
Vision
- hyperopic
- normal vision is 20/30 |
|
|
Term
Preschoolers 4 & 5yrs
Physical Devp |
|
Definition
Hearing and Taste
- reached optimum level |
|
|
Term
Preschoolers 4 & 5yrs
Physical Devp |
|
Definition
Motor abilities
- oral care
- modest with body
- can run and jump |
|
|
Term
Preschoolers 4 & 5yrs
Psychosocial Devp |
|
Definition
- initiative vs guilt
- gender ID
- phallic |
|
|
Term
Preschoolers 4 & 5yrs
Psychosocial Devp |
|
Definition
4 Adaptive Measures Learned
- ID
- Introjection
- Imagination
- Repression |
|
|
Term
Preschoolers 4 & 5yrs
Cognitive Devp |
|
Definition
- intuitive thought
- still egocentric
- reading skills start |
|
|
Term
Preschoolers 4 & 5yrs
Moral Devp |
|
Definition
- prosocial behv: any action that a person takes to benefit someone else
- moral behv largely learned by modeling
- they usually control their behv because they want love and approval from parents |
|
|
Term
Preschoolers 4 & 5yrs
Spiritual Devp |
|
Definition
- intuitive-projective stage
- their spiritual behv is based on imitation |
|
|
Term
Preschoolers 4 & 5yrs
Health Problems |
|
Definition
|
|
Term
School-Age 6-12yrs
Physical Devp |
|
Definition
Weight
- boys: 46lbs
- girls: 44lbs
- avg 7lbs/yr
- most wt gain 9-12yrs |
|
|
Term
School-Age 6-12yrs
Physical Devp |
|
Definition
Height
- 6yrs: 46"
- 12yrs: 60"
- lordosis disappears |
|
|
Term
School-Age 6-12yrs
Physical Devp |
|
Definition
Vision, hearing, touch
- 10yrs: all well established
- |
|
|
Term
School-Age 6-12yrs
Physical Devp |
|
Definition
Prepubertal changes
- 9-13yrs: endocrine functions slowly inc |
|
|
Term
School-Age 6-12yrs
Physical Devp |
|
Definition
Motor abilities
- 6-10yrs: muscular skills and coordination perfected |
|
|
Term
School-Age 6-12yrs
Psychosocial Devp |
|
Definition
- industry vs inferiority
- latency stage
- behv devp by school control
- self concept molded by comparison to other kids
- peer groups become important |
|
|
Term
School-Age 6-12yrs
Cog Devp |
|
Definition
- concrete operations
- changes from egocentric to cooperative
- logical reasoning developed from intuitive reasoning
- devp sense of time and currency |
|
|
Term
School-Age 6-12yrs
Spiritual Devp |
|
Definition
- stage 2: mythical-literal
- they learn to distinguish fact from fantasy |
|
|
Term
School-Age 6-12yrs
Health problems |
|
Definition
- same as preschoolers
- obesity |
|
|
Term
Adolescents 12-18yrs
Physical Devp |
|
Definition
Physical growth
- 10-18yrs: male gain 72lbs and 16"
- females gain 55lbs and 9"
- growth is noted in musculoskeletal system: head, hands, and feet are 1st to grow to adult size
- limbs grow faster than trunk
- after trunk devps, hips, chest, and shoulders do |
|
|
Term
Adolescents 12-18yrs
Physical Devp |
|
Definition
Glandular Changes
- eccrine and apocrine glands inc their secretion and become fully functional
- sebaceous glands become active under the influence of androgens |
|
|
Term
Adolescents 12-18yrs
Physical Devp |
|
Definition
Sexual characteristics
- primary and secondary sex characteristics devp |
|
|
Term
Adolescents 12-18yrs
Psychsocial Devp |
|
Definition
- ID vs role confusion
- in-groupers vs out-groupers
- the task of devp trust in self and others is again encountered when adols look for ideal persons whom they can trust and with whom they can prove trustworthy
- conflict arises between behaving in the eyes of the parents and behaving in such a way as to avoid ridicule from peers
- they need to establish a self-concept that accepts both personal strengths and weaknesses |
|
|
Term
Adolescents 12-18yrs
Physical Devp |
|
Definition
- strive to achieve sexual ID
- sexually active
- at 15yrs, try to balance the need for independence from family and the need for family support. It can create conflict and confusion within the adol and with family
- can cause hostility and depression
- adols still need guidance and love from their parents, although they appear to not want or need it
- they consistent guidance and fewer restrictions than before |
|
|
Term
Adolescents 12-18yrs
Cog Devp |
|
Definition
- formal operations
- they can think beyond the present and beyond the world of reality
- the capacity to absorb and use knowledge is great |
|
|
Term
Adolescents 12-18yrs
Moral Devp |
|
Definition
- conventional level
- still follows Golden Rule but doesn't automatically retain parent's values
- when they move into postconventional or principled level they start to question the laws and rules of society |
|
|
Term
Adolescents 12-18yrs
Spiritual Devp |
|
Definition
- synthetic-conventional stage
- they observe differences in faith |
|
|
Term
Adolescents 12-18yrs
Health probs |
|
Definition
- crashes
- homicides
- suicide
- other unintentional injuries |
|
|
Term
| The following factors contribute to failure to thrive: |
|
Definition
- lack of early mothering
- deficient sensory stimulation
- a serious illness such as cardiac disease |
|
|
Term
| When a toddler has a tantrum, the parent should... |
|
Definition
Make sure the child is safe and then leave
- set and enforce consistent and reasonable limits |
|
|
Term
| In assessing the psychosocial devp of a 4-5yr old, the nurse observes that the child... |
|
Definition
| the psychosocial devp of a _____yr old separates easily from parents and enjoys playing and cooperating with peers |
|
|
Term
|
Definition
A child is walking with assistance. What age is the kid and what skill is it demonstrating?
|
|
|
Term
Care Across the Lifespan - Highlights
Infants - birth-1yr |
|
Definition
- reacts to sound and voices
- gain 5-7oz/wk
- gain head control and begin to roll
- maintain safety
- follow a feeding schedule
- immunizations
- maintain a healthy sleep schedule |
|
|
Term
Care Across the Lifespan - Highlights
Toddler 1-3yrs |
|
Definition
- start to crawl then walk
- begin to explore and touch
- begin to eat solid food and use utensils
- begin to talk and learn
- maintain safety
- use gates for kitchens and stairs
- don't leave small objects on floor, they put everything in their mouth |
|
|
Term
Care Across the Lifespan - Highlights
Preschool 3-5yrs |
|
Definition
- begin to ride bikes and run
- love to use imaginations
- begin to learn the alphabet are able to form sentences
- start teaching safety measures such as wearing helmets |
|
|
Term
Care Across the Lifespan - Highlights
School age 6-10yrs |
|
Definition
- begin to gain independence, adventurous
- maintain a schedule and hygiene, and initiate rules
- minimize fears
- teach safety measures
- immunizations |
|
|
Term
Care Across the Lifespan - Highlights
Adolescents 11-17yrs |
|
Definition
- begin to have independence
- start driving and going out with friends
- initiate limits and rules
- teach to avoid smoking, drugs and alcohol
- teach about safe sex, and preg prev
- encourage pos behv
- monitor for bullying and depression |
|
|
Term
Care Across the Lifespan - Highlights
Young adults 18-30yrs |
|
Definition
- have reached full maturity
- begin to work regularly and start careers
- feel confident in making choices
- begin families |
|
|
Term
Care Across the Lifespan - Highlights
Adults 30-60yrs |
|
Definition
- health begins to decline
- begin to take care of parents
- family responsibilities inc
- stress inc |
|
|
Term
Care Across the Lifespan - Highlights
OLder adults 60+ |
|
Definition
- health declines
- retirement
- ALFs
- help with ADLs
- may struggle with aging
- safety may be improved |
|
|
Term
| Refers to the change of life in men, when sexual activity dec |
|
Definition
|
|
Term
|
Definition
| The concern for establishing and guiding the next generation |
|
|
Term
| Humpback in the upper spine |
|
Definition
|
|
Term
|
Definition
Spontaneous, serious bone fractures due to a dec in bone density
|
|
|
Term
| The loss of hearing ability due to aging |
|
Definition
|
|
Term
Young Adults 20-40yrs
Psychsocial |
|
Definition
- genital stage
- intimacy vs isolation (Erikson) |
|
|
Term
Young Adults 20-40yrs
Cognitive |
|
Definition
- formal operations
- postformal thought: problem finding stage |
|
|
Term
Young Adults 20-40yrs
Moral |
|
Definition
| - post-conventional level (Kohlberg): the person is able to separate self from the expectations and rules of others and to define morality in terms of personal principles |
|
|
Term
Young Adults 20-40yrs
Spiritual |
|
Definition
| - individuating-reflective period (Fowler): focused on reality |
|
|
Term
Young Adults 20-40yrs
Health issues |
|
Definition
- motor accidents
- suicide
- HTN
- substance abuse
- STDs
- violence
- abuse of women
- malignancies |
|
|
Term
Middle-aged 40-65yrs
Psychosocial |
|
Definition
- generativity vs stagnation (Erikson)
- Peck, 4 sets of dev tasks
- valuing wisdom vs physical power and attractiveness
- socializing vs sexualizing
- emotional flexibility vs emotional rigidity
- mental flexibility vs rigidity |
|
|
Term
Middle aged 40-65yrs
Moral Devp |
|
Definition
| - moves beyond the conventional level to the postconventional level |
|
|
Term
Middle aged 40-65yrs
Spiritual Devp |
|
Definition
| - paradoxical-consolidative stage: the indv can view truth from a number of viewpoints |
|
|
Term
Middle aged 40-65yrs
Health Problems |
|
Definition
- accidents
- cancer
- CVD
- obesity
- alcoholism
- mental health alterations |
|
|
Term
Older adults over 65yrs
Devp Tasks |
|
Definition
Adjusting to:
- dec physical strength and health
- retirement and lower and fixed income
- death of parents, spouses, and friends
- new relationships with adult children
- leisure time
- slower physical and cognitive responses
- keeping active and involved
- making satisfying living arrangements as aging progresses |
|
|
Term
Older adults over 75yrs
Devp Tasks |
|
Definition
- adapting to living alone
- safeguarding physical and mental health
- adjusting to the possibility of moving into a nursing home
- remaining in touch with other family members
- finding meaning in life
- adjusting to one's own death |
|
|
Term
Normal physical changes associated with aging
Integumentary |
|
Definition
- inc skin dryness
- inc skin pallor
- inc skin fragility |
|
|
Term
Normal physical changes associated with aging
Neuromuscular |
|
Definition
- dec speed and power of skeletal muscle contractions
- slowed reaction time |
|
|
Term
Normal physical changes associated with aging
Sensory/perceptual |
|
Definition
|
|
Term
Normal physical changes associated with aging
Pulmonary |
|
Definition
- dec ability to expel foreign or accumulated matter
- dec lung expansion, less effective exhalation, reduced vital capacity, and inc residual volume
- difficult, short, heavy, rapid breathing (dyspnea) following intense exercise |
|
|
Term
Normal physical changes associated with aging
Cardiovascular |
|
Definition
- reduced cardiac output and stroke volume, particularly during inc activity or unusual demands; may result in SOB on exertion and pooling of blood in the extremeties
- reduced elasticity and inc rigidity of arteries
- inc in BP
- orthostatic HTN |
|
|
Term
Normal physical changes associated with aging
GI |
|
Definition
- delayed swallowing time
- inc tendency for indigestion
- inc tendency for constipation |
|
|
Term
Normal physical changes associated with aging
Urinary |
|
Definition
- reduced filtering ability of the kidneys and impaired renal function
- less effective conc of urine
- urinary urgency and urinary freq
- tendency for a nocturnal freq and retention of residual urine |
|
|
Term
Normal physical changes associated with aging
Genitals |
|
Definition
- prostate enlargement in men (benign)
- multiple changes in women (shrinkage and atrophy of the vulva, cervix, uterus, fallopian tubes, and ovaries; reduction in secretions; and changes in vaginal flora) |
|
|
Term
Older adults over 65yrs
Health probs |
|
Definition
- accidents
- chronic disabling illness
- drug use and misuse
- alcoholism
- dementia
- elder abuse |
|
|
Term
Older adults over 65yrs
Health probs |
|
Definition
- accidents
- chronic disabling illness
- drug use and misuse
- alcoholism
- dementia
- elder abuse |
|
|
Term
Functional Assessment
Primary aging changes |
|
Definition
| - normal changes which everyone experiences, such as thinning hair, dec peristalsis and dec hormone prod |
|
|
Term
Functional Assessment
Secondary aging changes |
|
Definition
| - disease related changes that don't occur universally as a part of aging |
|
|
Term
|
Definition
- adult devp researcher
- the central theme of adulthood is transformation |
|
|
Term
| Two major goals of Healthy People 2010 |
|
Definition
- “increase quality and years of a healthy life,”
- “eliminate health
disparities.”
- Note that the first goal acknowledges the increasing number of aging adults in the population, whereas the second goal reflects the diversity of the population |
|
|
Term
|
Definition
| can they perform the activities of daily living appropriate for their age, and if not, then what is their degree of limitation |
|
|
Term
| Gilligan’s Theory of Moral Development |
|
Definition
Research based on women
• Includes the concepts of caring and responsibility
• Three levels and two transitions
• Each level representing a more complex understanding of the relationship
of self and others
• Each transition resulting in a crucial reevaluation of the conflict between
selfishness and responsibility |
|
|
Term
| Fowler’s Theory of Spiritual Development |
|
Definition
| Describes faith as a force that gives meaning to a person’s life |
|
|
Term
| Fowler 19s Theory of Spiritual Development |
|
Definition
| Describes faith as a force that gives meaning to a person 19s life |
|
|
Term
| Psychosocial Development (Erikson) |
|
Definition
Neonates and Infants
– Trust versus mistrust
• Toddlers
– Autonomy versus shame
• Preschoolers
– Initiative versus guilt
• School-age Children
– Industry versus inferiority
• Adolescents
– Identity versus role confusion |
|
|
Term
Cognitive Development
(Piaget): Neonates and Infants |
|
Definition
Sensorimotor Phase
– Perceptual recognition (4–8 mo.)
– Responds to new stimuli,
remembers objects, looks for them
(6 mo.)
– Concept of both space and time
develops (12 mo.) |
|
|
Term
Cognitive Development
(Piaget): Toddlers |
|
Definition
Completes Sensorimotor Phase
– Trial-and-error problem solving
– Solving problems mentally
• Preconceptual Phase (2 yr)
– Learn sequence of time
– Develop some symbolic thought |
|
|
Term
Cognitive Development
(Piaget): Preschoolers |
|
Definition
Intuitive Thought Phase
– Still egocentric, but subsiding
• Learn through trial and error
• Think of one idea at a time
• Do not understand relationships
• 5 yr – count pennies, reading skills develop |
|
|
Term
Cognitive Development
(Piaget): School-age Children |
|
Definition
Concrete Operations Phase
– Cooperative interactions
– Intuitive reasoning
– Cause-and-effect
– Concepts of money and time
learned
– Reading skills well developed |
|
|
Term
Cognitive Development
(Piaget): Adolescents |
|
Definition
Formal Operations Phase
– Thinking beyond the present
– Idealistic thinking
– Abstract thinking |
|
|
Term
Moral Devp Kohlberg
Toddlers |
|
Definition
preconventional level
stage 1: reward and punishment |
|
|
Term
Moral Devp Kohlberg
Preschoolers |
|
Definition
preschoolers
- prosocial behv
- modeling moral behv |
|
|
Term
Moral Devp Kohlberg
School age children |
|
Definition
preconventional level
stage 1 - punishment and reward
stage 2 - instrumental-relativist
conventional level
stage 3 - "good boy-nice girl"
stage 4 - law and order |
|
|
Term
Moral Devp Kohlberg
Adolescence |
|
Definition
conventional level (young adol)
postconventional level or principled level |
|
|
Term
| Three major concepts are related to health status in older adults |
|
Definition
- absence of disease
- ADLs:
- Instrumental ADLs (IADLs): performance of complex social activities of living (shopping, finances, managing meds, using the phone) |
|
|
Term
|
Definition
| it has been shown to correlate with physical illness, self-care ability, complications during hospitalization, rehab potential, and mortality |
|
|
Term
| The child merely watches as the other children pretend-play. |
|
Definition
| A 20-month-old child is a client on the pediatric unit of a hospital. The nurse notices that this child is lagging in stage 6 of Piaget's phases of cognitive development. Which activity would indicate that this child is struggling at this stage? |
|
|
Term
| stage 6 of Piaget's phases of cognitive development |
|
Definition
| In this stage of development, inventions of new means, children interpret the environment by mental image. They use make-believe and pretend-play. A child who is unable to do this would not be demonstrating the behavior that is significant at this stage. |
|
|
Term
tertiary circular. commonly referred to as discovery of new means through active experimentation."
|
|
Definition
| Ritual is important for the child of the ____ ____ reaction, age 12 to 18 months. Piaget |
|
|
Term
| inventions of new means: stage 6 |
|
Definition
| A parent tells the nurse that his child is quite creative and learning how to pretend with "almost anything in the house." According to Piaget, this child is descriptive of which stage/phase? |
|
|
Term
| infancy and early childhood |
|
Definition
| according to Havighurst, A toddler would be in the ____ ____ ____ ____ age period, of which learning to relate emotionally to parents, siblings, and other people is a developmental task. |
|
|
Term
| identity versus role confusion |
|
Definition
| A client is being seen in the mental health clinic for antisocial behavior. According to Erikson's stages of development, this client is dealing with which task of development? |
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Term
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Definition
| A young adult has never lived away from his parents. He has difficulty making decisions and feels unable to make decisions on his own. According to Freud's theory of development, this person would be fixated at which stage of development? |
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Term
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Definition
| Freud's ____ stage is characterized by energy that is directed toward full sexual maturity and function and development of skills needed to cope with the environment. It occurs during puberty and extends beyond. Implications of this stage include separation from parents, achievement of independence, and decision making. |
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Term
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Definition
| A school nurse is counseling adolescents about risks for STDs. Using recent statistics, the nurse presents information that the number of new cases of STDs in this age group, each year, will be approximately: |
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Term
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Definition
| He describes faith as a way of being and behaving that evolves from an experienced faith guided by parents and others during a person's infancy and childhood to an owned faith that is internalized in adulthood. For the client who is ill, faith provides strength and trust. |
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Term
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Definition
| His theory describes the development of faith as a force that gives meaning to a person's life. |
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Term
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Definition
| In the infancy years (birth to 18 months), the child's central task is to form ____ __ ____ with people. |
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Term
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Definition
| Willfulness and defiance are negative indicators of the ____ _____ stage. |
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Term
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Definition
| Playing with other children is a part of the self-esteem and self-expression of the ____ ____ years. |
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Term
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Definition
| According to Piaget, when young children encounter new situations, they use the mechanisms they already possess to acquire knowledge. This is an example of what? |
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Term
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Definition
| learning to trust others and having self-control w/o losing self-esteem, according to Erikson, are the indicators of pos resolution in the _____ and ______ devp stage |
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Term
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Definition
| according to Kohlberg, at this level of moral devp, indvs are concerned about conformity and loyalty to one's and society's expectations |
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Term
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Definition
| Havighurst's devp tasks for ____ _____ include finding a mate and starting an occupation |
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Term
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Definition
| according to Fowler, after age ___, an indv in the paradoxical-consolidative stage, would have an awareness of truth from a variety of viewpoints |
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Term
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Definition
| according to Fowler, after age ___, an indv in the paradoxical-consolidative stage, would have an awareness of truth from a variety of viewpoints |
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Term
| Factors influencing G&D, functional ability, and health promotion |
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Definition
- genetics
- sex
- age
- indv preferences and patterns
- physical condition
- cultural and spiritual/religious beliefs
- SEC factors
- enviormental
- psychological
- nutrition |
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Term
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Definition
| more complex social activities such as shopping, cooking, housekeeping, transportation, managing finances and meds, using the phone |
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Term
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Definition
| complex abilities that enable the individual to engage in voluntary social, occupational, or recreational abilities |
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Term
| components of a pt's history for functional assessment |
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Definition
- ADLs, IADLs
- family history
- sleep patterns
- dietary patterns
- exercise habits
- addictions
- immunizations
- anxiety and stress levels
- appropriate use of meds
- home safety
- mental faculty, cognitive level |
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Term
| Assessment of factors influencing the pt's health status |
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Definition
- risk behvs specific to pt's age
- health promotion activities the pt participates in
- physical activity level, including a description of any exercise program
- sexual behvs and attitudes; safe sex practices
- family type and support
- dental care habits
- air quality of pt's enviro
- tobacco and alcohol use or abuse
- drug use or abuse
- exposure to and screening for TB
- Tonometry: a procedure used to measure intraocular tension to detect glaucoma |
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Term
| Objective Data for Functional Health |
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Definition
- functional independence measure (FIM)
- Barthel Index Score
- JAREL Index Score
- Sexual Assessment
- Nutritional Assessment
- chewing or swallowing probs or gum disease
- Denver Devpl Screening Test (DDST)
- Apgar score
- immunization history
- parental supervision
- motor devp
- psychosocial devp
- the CAGE assessment
- the Elderly Alcohol Screening Test (EAST)
- cogn assess
- Geriatric Depression Scale (GPS) |
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Term
| Functional Independence Measure (FIM Score) |
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Definition
- measures 18 items in 5 categories
- self-care
- sphincter control
- mobility and locomotion
- communication and cognition
- helps to id the severity of a disability regardless of type |
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Term
|
Definition
measures a ct's level of independence in ADL's using a numeric scale of 0-5, 10, or 15 depending on the skill being assessed
- it does not rate cogn or commun |
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Term
| JAREL Spiritual Well-Being Scale |
|
Definition
it measures the ct's attitude towards spiritualism.
- does spiritualism provide comfort and help him cope? |
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Term
|
Definition
| measures sexual devp, knowledge and practices |
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Term
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Definition
| screening tool about drinking |
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Term
|
Definition
in older adults:
- Short Portable Mental Status Questionnaire (SPMSQ)
- Mini-Mental State Exam (MMSE) |
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Term
| Review Laboratory and Other Diagnostic Data. Infants |
|
Definition
- screening for PKU
- thyroid disease
- sickle cell
- TB
- hearing, ht, and wt |
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Term
| Review Laboratory and Other Diagnostic Data. Toddlers and Preschoolers |
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Definition
- lead levels
- TB
- vision and hearing
- ht and wt |
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Term
| Review Laboratory and Other Diagnostic Data. School-age children |
|
Definition
- periodic vision, speech, and hearing
- TB
- blood pressure
- risk for lead exposure
- cholesterol
- ht and wt |
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Term
| Review Laboratory and Other Diagnostic Data. Adolescents |
|
Definition
- ht and wt
- TB
- periodic vision and hearing |
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Term
| Review Laboratory and Other Diagnostic Data. Adults |
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Definition
- blood pressure
- breast exams/over 40
- cholesterol
- TB
- fecal occult blood
- colonoscopy
- ht, wt |
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Term
| Review Laboratory and Other Diagnostic Data. Older adults |
|
Definition
- blood pressure
- chol
- vision, hearing, ht, wt
- H & H
- TB
- cancer screenings |
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Term
| Review Laboratory and Other Diagnostic Data. Fe levels |
|
Definition
- infants
- toddlers, preschoolers
- pregnancy
- any other risk for anemia |
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Term
| Nursing Diagnoses related to functional assessment |
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Definition
- Health seeking behv r/t initiating a regular exercise program
- Risk for delayed devp r/t inadequate parental support
- Risk for falls r/t degenerative joint disease
- Self-care deficit (feeding) r/t stroke
- Nutrition less than body requirements r/t lack of parental knowledge |
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Term
| Priorities based on assess of pt needs |
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Definition
- basic physiologic needs: food, h2o, and o2
- life threatening issues
- med priority level things such as issues coping w/ illness
low priority such as normal devp needs
- I must also consider the cogn ability of my pt and things like his access to hc, transp, ins, and support systems |
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Term
Expected Outcomes r/t Health Promotion, Health Maintenance and Health Restoration
Nursing Diagnosis: Risk for falls r/t degenerative joint disease |
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Definition
| Expected Outcome: Pt will not fall...for what diagnosis? |
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Term
Expected Outcomes r/t Health Promotion, Health Maintenance and Health Restoration
Nursing Diagnosis: Self-care deficit (feeding) r/t stroke |
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Definition
| Expected Outcome: pt will feed self soft diet w/ adaptive utensils is for which diagnosis? |
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Term
Expected Outcomes r/t Health Promotion, Health Maintenance and Health Restoration
Nursing Diagnosis: Health seeking behv r/t initiating a regular exercise program |
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Definition
| Expected Outcome: ct will participate in a regular exercise program that includes wt-bearing for at least 30mins a min of 3X weekly is for which dx? |
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Term
Expected Outcomes r/t Health Promotion, Health Maintenance and Health Restoration
Nursing Diagnosis: nutrition less than body req r/t lack of parental knowledge |
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Definition
| Expected Outcome: child will eat 3 servings of veges each day is for which dx |
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Term
Rationale for NIs r/t Functional Assessment
Ethical and legal implication |
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Definition
- social and technical changes have made ethical decisions more complex
- the nurse must advocate for health svs for the uninsured, the underserved and the disenfranchised
- safety and health promotion must be priorities
- nurses must be aware of the states laws regarding child, adol, and adult abuse |
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Term
Rationale for NIs r/t Functional Assessment
Standards of care |
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Definition
The ANA revised Standards of Clinical Nursing Practice
- nurses must maintain pt confidentiality within legal and regulatory parameters
- must be a pt advocate
- must promote self-care
- must preserve ct's dignity, autonomy and rights
- Healthy People 2010 must be the nurse's gold standard |
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Term
Rationale for NIs r/t Functional Assessment
EBP - a study |
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Definition
Koenig, 834 pts, avg age: 64, hospitalized over a 4yr period, avg of 5 coexisting conditions
- strong spiritual or religious beliefs associated with: coping with illness better, greater social support, less depression, better cogn function, better physical health
- |
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Term
Rationale for NIs r/t Functional Assessment
EBP - a study |
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Definition
Masters: 107 older adults
- surveyed about their perception of moderate alcohol consumption and any possible health benefits
- 40% defined moderate consumption higher than the govt's guidelines |
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Term
Rationale for NIs r/t Functional Assessment
EBP - a study |
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Definition
researchers interviewed 375 people over the age of 65 about their attitudes r/t their meds, the dosages, the timing, and what to do if a dose was missed
- more than 50% showed excellent knowledge
- 7.5% had a limited understanding
- 7% were clueless |
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Term
Rationale for NIs r/t Functional Assessment
EBP - a study |
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Definition
| a study found that exercise sessions 2x weekly in community settings along with at-home exercise was found to sig improve balance and mobility |
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Term
Functional factors influencing the pt's plan of care.
Questions to ask |
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Definition
- does the ct have adequate finances to purchase food for her children?
- is the preschooler able to feed himself?
- does the ct have chewing or swallowing problems?
- how accessible are the essential items in the home enviro for the elderly ct who lives alone?
- does the older adult have any restrictions to his mobility?
- has the toddler achieved the age-appropriate gait pattern? |
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Term
|
Definition
| initiate and complete nursing care plans designed to move the pt and caregiver towards the expected outcomes r/t health promotion, health maintenance and health restoration |
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Term
| Nursing Measures to Establish a Collaborative Relationship with the Pt |
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Definition
| - the use of therapeutic communication skills to id cultural and indv differences and to establish expectations of care w/ the ct |
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Term
| Nursing Measures to Enhance Pt Compliance with the HC Team |
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Definition
| - all approaches that enlist the participation of the pt in decision making |
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Term
| Provide info and instruction re: health promotion, maintenance, and restoration |
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Definition
- nurse provides pt edu as it relate to Healthy People 2010
- nurse must be aware of health promotion guidelines for each age group
- health edu re safety |
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Term
| Use nursing measures to promote continuity of care |
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Definition
| - nurse provides info and referrals |
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Term
|
Definition
Nursing Measures to:
- establish a collaborative relationship with the pt
- enhance pt compliance w/ the HC team
- provide info and instruction re health promo, maint, and restoration
- promote continuity of care
- create an enviro conducive to health promo and risk reduc
- supervise pt care activities assigned to other members of the team |
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Term
| create an enviro conducive to health promo and risk reduc |
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Definition
- providing guidelines for childproofing
- provide home safety checks
- inform abused ct of Safe Haven
- address drug interactions and safe use of drugs |
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Term
| Supervise pt care activities assigned to other team members |
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Definition
| - nurse needs to line-up the proper team |
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Term
| Evaluation: reassess the pt to determine responses to NIs, including progress toward the expected outcomes (pt-centered goals) |
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Definition
- reassess, doc, and report the pt's responses to NIs
- revise the pt's plan of care based on the reassessment of the pt
- determine the pt's response to care provided by other team members |
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Term
| reassess, doc, and report the pt's responses to NIs |
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Definition
- pt was out of bed with assist and xfer belt q4hrs w/o injury
- pt is trying to use the new adaptive utensils
- CNA reports that the child tried the green beans and liked them, but hated the spinach
- family reports to the nurse that the children's immune are all current |
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Term
| revise the pt's POC based on the pt reassessment |
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Definition
- ins the pt's time out of bed by 30 min increments
- implement an OT referral for addl pt teaching re the use of assistive devices
- ask parent ot consistently encourage the child to eat veges |
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Term
| determine the pt's response to care provided by other team members |
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Definition
- pt tolerated an inc to 30 mins of activity in the chair today
- OT reports a slight mod in the padding of the adaptive utensil improved the pt's ability to use it
- the CNA's encouragement has resulted in the child gradually getting used to veges and eating more of them |
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Term
| NREM- Non-REM Sleep Stages |
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Definition
I - very light sleep (drowsy-relaxed)
II - body processes continue to slow
III - heart and respiratory rate are slower
IV - signals deep sleep |
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Term
|
Definition
- NREM (pass the four stages in 1 hr
- sleeper passes from stage I NREM through stages II and III to stage IV in about 20-30 mins |
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Term
|
Definition
- restores normal levels of acuity
- Sympathetic NS (while awake)
- Parasymph NS increases
- regular sleep pattern more important than actual hours slept |
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Term
| Normal Sleep Patterns and Requirements |
|
Definition
- newborns: sleep 16-18 hrs daily, usually seven sleep patterns
- infants: 22 hrs daily, 20-30% REM
- toddlers: 10-12 hrs daily, 20-30% REM
- preschoolers: 11-12 hrs
- school age: 8-12 hrs
- adoles: 8-10 hrs
- young adults: 7-8, may require less
- middle aged: 6-8 hrs
- older: 6 hrs |
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Term
|
Definition
- age: one of the most important factors affecting persons sleep and rest periods
- illness: causing pain or physical distress
- environment: noise, heat
- fatigue: more tired, shorter the first REM
- lifestyle: shift work
- emotional stress
- alcohol, stimulants, meds, smoking
- diet
- motivation |
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Term
|
Definition
- primary sleep disorder: those in which the person's sleep problem is the main disorder
- secondary: caused by another clinical disorder, such as thyroid dysfunction, depression, or alcoholism |
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Term
|
Definition
- insomnia: most common
- hypersomnia: opposite of insomnia, excessive sleep, especially daytime
- narcolepsy: also called "sleep attack"
- sleep apnea: periodic cessation of breathing during sleep
- parasomnias: behv that may interfere with sleep (somnambulism/sleep walking, sleep talking, nocturnal enuresis, nocturnal erections, bruxism).
- sleep deprivation: prolonged disturbances results in decreased amt , quality, and consistency of sleep |
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Term
|
Definition
| assessment relative to a ct's sleep includes a sleep history, sleep diary, a physical, and a review of dx studies |
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Term
|
Definition
- usual sleeping pattern, specifically sleeping and waking times, hours of undisturbed sleep, etc.
- bedtime rituals
- use of sleep meds
- sleep enviro
- changes in sleep pattern |
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Term
|
Definition
- observe ct's facial appearance, behv, and energy level
- darkened bags under eyes, puffy eyelids, reddened conjunctiva, glazed or dull appearing eyes
- irritability, yawning, slumped posture, hand tremor, rubbing of eyes, confusion, fatigued, lethargic, etc. |
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Term
|
Definition
- assessment
- diagnosis
- planning
- implementation
- evaluation |
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Term
| The two major goals of the Healthy People 2010 document |
|
Definition
“increase quality and years of a healthy life,” and to “eliminate health
disparities.” |
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Term
| Functional assessment means |
|
Definition
can they perform the activities of daily living
appropriate for their age, and if not, then what is their degree of limitation. |
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Term
|
Definition
|
|
Term
|
Definition
| The two researchers involved in psychosocial devp |
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Term
|
Definition
| The two researchers involved in adult psychosocial devp |
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Term
|
Definition
| logical thinking and problem solving theorist |
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Term
|
Definition
| theory of moral development |
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Term
|
Definition
| stages of spiritual development |
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Term
|
Definition
research on moral
development mostly involved women |
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Term
|
Definition
Her work is very important
because she emphasized the concepts of caring and responsibility starting with caring for self. |
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Term
| a major goal of JCAHO and of Healthy People 2010 |
|
Definition
| safety, with its focus on health promotion and health maintenance |
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Term
|
Definition
| a process of change whereby cognitive processes mature sufficiently to allow the person to solve problems that were unsolvable before, probably because new knowledge has been assimilated |
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Term
|
Definition
| coping behavior, the ability to handle the demands made by the environment |
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Term
| Adaptive Mechanisms - Frued |
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Definition
| learned behaviors that assist an individual to adjust to the environment. The result of the conflicts between the id's impulses and the anxiety that attends these conflicts due to environmental restrictions |
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Term
|
Definition
| the process through which humans encounter and react to new situations by using the mechanisms they already possess. In this way, people acquire knowledge and skills as well as insight into the world around them |
|
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Term
|
Definition
| refers to the mannber in which people learn to think, reason, and use language |
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Term
| Defense Mechanisms - Frued |
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Definition
| same as Adaptive Mechanisms |
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Term
|
Definition
| an increase in the complexity of function and skill progression |
|
|
Term
|
Definition
| a task which arises at or about a certain period in the life of an individual, successful achievement of which leads to his happiness and to success with later tasks, while failure leads to unhappiness and difficulty with later tasks |
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Term
|
Definition
| operates on the reality principle. It balances the gratification demands of the id with the limitations of social and physical circumstances. Includes consciousness and memory, which serves to mediate between primitive instinctual drives (id), internal social prohibitions (superego), and reality |
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Term
|
Definition
| immobilization or the inability of the personality to proceed to the next stage because of anxiety |
|
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Term
|
Definition
| physical change and increase in size is called_____ |
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Term
|
Definition
| resides in the unconscious and, operating on the pleasure principle, seeks immediate pleasure and gratification |
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Term
|
Definition
| urge or desire for sexual activity. Frued proposes that it's the underlying motivation to human devp |
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Term
|
Definition
| relating to right and wrong |
|
|
Term
|
Definition
| the way a person perceives those requirements (necessary to live together) and responds to them |
|
|
Term
|
Definition
| the requirements necessary for people to live together in society |
|
|
Term
|
Definition
| a complete concept that is difficult to define. The outward extension of the inner self |
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Term
|
Definition
| contains the conscience and the ego idea. The conscience of personality; the source of feelings of guilt, shame and inhibition |
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Term
|
Definition
| the part of a person's mental life that the person is unaware of. Freud's greatest contribution |
|
|
Term
|
Definition
| the part of a person's mental life that the person is unaware of. Freud's greatest contribution |
|
|
Term
|
Definition
| the part of a person's mental life that the person is unaware of. Freud's greatest contribution |
|
|
Term
|
Definition
| growth occurs from the head down |
|
|
Term
|
Definition
| growth occurs from the center of the body out |
|
|
Term
|
Definition
| simple to complex, or from single acts to integrated acts |
|
|
Term
| Devp becomes increasingly differentiated.... |
|
Definition
| differentiated devp w/ a generalized response and progresses to a skilled specific response |
|
|
Term
| The most critical period to G&D... |
|
Definition
|
|
Term
|
Definition
| behavior is largely reflexive and devps to more purposeful behv. |
|
|
Term
|
Definition
|
|
Term
|
Definition
| motor devp permits inc physical autonomy. Psychosocial skills inc |
|
|
Term
|
Definition
| the world is expanding. New experiences and the preschooler's social role are tried during play. Physical growth is slower |
|
|
Term
|
Definition
| stage includes the preadolescent period (10-12yrs). Peer groups increasingly influences behv. Physical, cog, and social devp inc, and comm skills improve |
|
|
Term
|
Definition
| Self-concept changes with biologic devp. Values are tested. Physical growth accelerates. Stress inc, especially in face of conflicts |
|
|
Term
| Young adulthood: 20-40yrs |
|
Definition
| a personal lifestyle devps. Person establishes a relationship with a sig other and a commitment to something |
|
|
Term
| Middle adulthood: 40-65yrs |
|
Definition
| lifestyle changes due to other changes; for example, empty nester, occupational goals change |
|
|
Term
|
Definition
| adaptation to retirement and changing physical abilities is often necessary. Chronic illness may devp |
|
|
Term
|
Definition
| adaptation to decline in speed movement, reaction time, and inc dep on others may be necessary |
|
|
Term
|
Definition
| inc physical probs may devp |
|
|
Term
| Five major components of G&D |
|
Definition
- physiologic
- psychosocial
- cognitive
- moral
- spiritual |
|
|
Term
| Robert Havighurst: Devp Task Theory |
|
Definition
| G&D occurs in 6 stages, each with 6-10 tasks to be learned |
|
|
Term
| Havighurst: Infancy and Early Childhood |
|
Definition
learning to:
- walk
- take solid foods
- talk
- control elimination
- sex diff and sexual modesty
- achieving psychologic stability
- forming simple concepts of social and physical reality
- relate emotionally to parents, siblings, and to others
- distinguish right and wrong and devp a conscience |
|
|
Term
| Havighurst: Middle Childhood |
|
Definition
- learning physical skills necessary for ordinary games
- building wholesome attitudes toward oneself as a growing organism
-learning to get along with age-mates
- learning an approp masculine or feminine social role
- devp fund skills in reading, writing, and calculating
- devp concepts nec for everyday living
- devp conscience, morality, and a scale of values
- achieving personal indep
- devp attitudes towards social groups and institutions |
|
|
Term
|
Definition
- achieving new and more mature relations with age-mates of both sexes
- achieving a masc or fem social role
- accepting one's physique and using the body effectively
- achieving emot indp from parents and other adults
- achieving assurance of eco indp
- selecting and preparing for an occupation
- preparing for marriage and family life
- devp intellectual skills and concepts nec for civic competence
- desiring and achieving socially responsible behv
- acquiring a set of values and an ethical system as a guide to behv |
|
|
Term
| Havighurst: Early Adulthood |
|
Definition
- selecting a mate
- learning to live with a partner
- starting a family
- rearing children
- managing a home
- getting started in an occupation
- taking on civic responsibility
- finding a congenial social group |
|
|
Term
|
Definition
- achieving adult civic and social responsibility
- establishing and maint an economic standard of living
- assisting teenage children to become resp and happy adults
- devp adult and leisure-time activities
- relating one's self to a spouse as a person
- accepting and adjusting to the physiologic changes of middle age
- adjusting to aging parents |
|
|
Term
| Havighurst: Later Maturity |
|
Definition
- adj to dec physical strength and health
- adj to retirement and reduced income
- adj to death of a spouse
- establishing an explicit affiliation with one's age group
- meeting social and civil obligations
- estab satisfactory physical living arrangements |
|
|
Term
|
Definition
| refers to devp of personality |
|
|
Term
| Personality encompasses.. |
|
Definition
- temperament
- feelings
- char traits
- independence
- self esteem
- self concept
- behv
- ability to interact with others
- ability to adapt to life changes |
|
|
Term
| Freud's Theory of Psychosexual Devp |
|
Definition
| The personality devps in 5 overlapping stages from birth to adulthood. The libido changes its location of emphasis within the body from one stage to another. |
|
|
Term
| Oral stage: birth - 1.5yrs |
|
Definition
- mouth is center of pleasure
- security is primary need
- major conflict is weaning |
|
|
Term
|
Definition
- anus and bladder
- major conflict is toilet training |
|
|
Term
|
Definition
- genitals
- major conflict is the Oedipus or Electra complex, which resolves when the child ID with parent of the same sex |
|
|
Term
|
Definition
- energy is directed to physical and intellectual activities
- sexual impulses repressed
- develops same sex relationships |
|
|
Term
| Genital: pubery and after |
|
Definition
| - energy is directed toward full sexual maturity and function and devp of skills needed to cope with the environ |
|
|
Term
|
Definition
| adapted and expanded Freud's theory of devp to include the entire lifespan |
|
|
Term
| Erikson: Infancy birth-10mos |
|
Definition
|
|
Term
| Erikson: Early Childhood 18mos-3yrs |
|
Definition
| Autonomy vs Shame and Doubt |
|
|
Term
| Erikson: Late Childhood 3-5yrs |
|
Definition
|
|
Term
| Erikson: School Age 6-12yrs |
|
Definition
|
|
Term
| Erikson: Adolescence 12-20yrs |
|
Definition
| Identity vs Role Confusion |
|
|
Term
| Erikson: Young Adulthood 18-25yrs |
|
Definition
|
|
Term
| Erikson: Adulthood 25-65yrs |
|
Definition
| Generativity vs Stagnation |
|
|
Term
| Erikson: Maturity 65yrs-death |
|
Definition
|
|
Term
|
Definition
- mental and social capacities tend to inc in the latter part of life
- proposes 3 devp tasks during old age |
|
|
Term
| Robert Peck: Ego differentiation vs work-role preoccupation |
|
Definition
| - on retirement, people must derive their sense of identity from roles other than work |
|
|
Term
| Robert Peck: Body transcendence vs body preoccupation |
|
Definition
| - the individual must adjust to decreasing physical capacities and at the same time maintain feelings of well-being |
|
|
Term
| Robert Peck: Ego transcendence vs ego preoccupation |
|
Definition
- Ego transcendence is the acceptance, w/o fear of one's own eminent death
- ego preoccupation is holding on to life and a preoccupation with self-gratification |
|
|
Term
|
Definition
- individuals consider themselves part of the family rather than indvs and want to separate from their parents
A Gould stage..... |
|
|
Term
|
Definition
| - although the indv has established autonomy, he feels that it's in jeopardy; he feels he could be pulled back into his family |
|
|
Term
|
Definition
- indvs feel established as adults and autonomous from their families
- they see themselves as well-defined, but still feel the need to prove themselves to their parents
- they see this as the time for growing and building for the future |
|
|
Term
|
Definition
- neonatal
- infancy
- toddlerhood
- preschool
- school age
- adolescence
- young adulthood
- middle adulthood
- older adulthood
- young old
- middle old
- old old |
|
|
Term
|
Definition
- infancy and early childhood
- middle childhood
- adolescence
- early adulthood
- middle age
- later maturity |
|
|
Term
|
Definition
- oral
- anal
- phallic
- latency
- genital |
|
|
Term
| Erikson's 8 stages of devp |
|
Definition
- infancy
- early childhood
- late childhood
- school age
- adolescence
- young adulthood
- adulthood
- maturity |
|
|
Term
|
Definition
| marriage and careers are well established. individuals question what life is all about and wish to be accepted as they are, no longer finding it necessary to prove themselves |
|
|
Term
|
Definition
period of self-reflection. individuals question values and life itself. they see time as finite, with little time to shape the lives of adolescent children
A Gould stage..... |
|
|
Term
|
Definition
| personalities are seen as set. Time is accepted as finite. Individuals are interested in social activities with friends and spouse and desire both sympathy and affection from spouse |
|
|
Term
|
Definition
| This is a period of transformation, with a realization of mortality and a concern for health. there is an increase of warmth and a decrease in negativism. The spouse is seen as a valuable companion |
|
|
Term
| Piaget's 5 major phases of cognitive theory |
|
Definition
- sensorimotor phase
- preconceptual phase
- intuitive thought phase
- concrete operations phase
- formal operations phase |
|
|
Term
| A person uses three primary abilities to move from one of Piaget's phases to the next |
|
Definition
- assimilation
- accommodation
- adaptation |
|
|
Term
| Piaget: Sensorimotor phase birth-2yrs |
|
Definition
| Piaget: Stage 1-6 is called? |
|
|
Term
Piaget: Sensorimotor phase
Stage 1 birth-1mos |
|
Definition
- use of reflexes
- most action is reflexive |
|
|
Term
Piaget: Sensorimotor phase
Stage 2 1-4mos |
|
Definition
- primary circular reaction
- perception of events is centered on the body
- objects are an extension of self |
|
|
Term
| Piaget: Sensorimotor phase Stage 3 4-8mos |
|
Definition
- secondary circular reaction - acknowledges the external env - actively makes changes in the env
Children become aware of things beyond their own body and become more object oriented. Can put ' secondary circular reactions' together to solve new problems; e.g. uncover, then grasp |
|
|
Term
Piaget: Sensorimotor phase
Stage 4 8-12mos |
|
Definition
- coordination of secondary schemata
- can distinguish a goal from a means of attaining it |
|
|
Term
Piaget: Sensorimotor phase
Stage 5 12-18mos |
|
Definition
- tertiary circular reaction
- tries and discovers new goals and ways to attain goals
- rituals are important |
|
|
Term
Piaget: Sensorimotor phase
Stage 6 18-24mos |
|
Definition
- inventions of new means
- interprets the envir by mental image
- uses make-believe and pretend play |
|
|
Term
| Piaget: Preconceptual phase 2-4yrs |
|
Definition
- uses an egocentric approach to accommodate the demands of an envir - everything is sig and relates to "me" - explores the envir - language devp is rapid - associates words with objects
A Piaget phase______ |
|
|
Term
| Piaget: Intuitive Thought phase 4-7yrs |
|
Definition
- egocentric thinking diminishes
- thinks of one idea at a time
- includes others in the enviro
- words express thoughts |
|
|
Term
| Piaget: Concrete Operational phase 7-11yrs |
|
Definition
- solves concrete problems
- begins to understand relationships such as size
- understands right and left
- cognizant of viewpoints |
|
|
Term
| Piaget: Formal Operations phase 11-15yrs |
|
Definition
- uses rational thinking
- reasoning is deductive and futuristic |
|
|
Term
| Kohlberg's Stages of Moral Devp |
|
Definition
1 - preconventional
2 - conventional
3 - postconventional |
|
|
Term
Kohlberg's Stages of Moral Devp
1. Preconventional toddler-7yrs |
|
Definition
- person is responsive to cultural rules of labels of good and bad, right or wrong
- externally established rules determine right or wrong actions
- person reasons in terms of punishment, reward, or exchange of favors
Stage 1 - Punishment and Obedient Orientation: fear of punishment, not respect for authority, is the reason for decisions, behaviors, and conformity |
|
|
Term
Kohlberg's Stages of Moral Devp
1. Preconventional toddler-7yrs
Egocentric Focus preschooler-school age |
|
Definition
| Stage 2- Instrumental Relativist Orientation: conformity is based on egocentricity and narcissistic needs. There is no feeling of justice, loyalty, or gratitude |
|
|
Term
Kohlberg's Stages of Moral Devp
2. Conventional school age-adulthood (most american women are in this stage) |
|
Definition
- person is concerned with maintaining expectations and rules of the family, group, nation, or society
- a sense of guilt has devp and affects behv
- the person values conformity, loyalty, and active maintenance of social order and control
- conformity means good behv or what pleases or helps another and is approved |
|
|
Term
Kohlberg's Stages of Moral Devp
2. Conventional school age-adulthood |
|
Definition
Stage 3 - Interpersonal Concordance Orientation: decisions and behvs are based on concerns about other's reactions; the person wants other's approval or a reward
- an emphatic response, based on understanding of how another person feels, is a determinant for decisions and behv |
|
|
Term
Kohlberg's Stages of Moral Devp
2. Conventional school age-adulthood
Societal Focus adolescence and adulthood (most men are in this stage) |
|
Definition
| Stage 4 - Law and Order Orientation: the person wants established rules from authorities, and the reason for decisions and behv is that social and sexual rules and traditions demand the response |
|
|
Term
Kohlberg's Stages of Moral Devp Middle age or older adult. Only 20% or less of americans achieve this stage
III. Postconventional |
|
Definition
- The person lives autonomously and defines moral values and principles that are distinct from personal ID with group values
- She lives according to principles that are universally agreed on and that the person considers appropriate for life |
|
|
Term
Kohlberg's Stages of Moral Devp
III. Postconventional |
|
Definition
| Stage 5: Social Contract Legalistic Orientation - The social rules are not the sole basis for decisions and behv because the person believes a higher moral principle applies such as equality, justice, or due process |
|
|
Term
Kohlberg's Stages of Moral Devp
III. Postconventional
Universal Focus Few people attain or maintain this stage. Examples are seen in extreme crisis |
|
Definition
| Stage 6 - Universal Ethical Principle Orientation: Decisions and behv are based on internalized rules, on conscience rather than social laws, and on self-chosen ethical and abstract principles that are universal, comprehensive, and consistent |
|
|
Term
| Gilligan's Stages of Moral Devp |
|
Definition
1. caring for oneself
2. caring for others
3. caring for self and others |
|
|
Term
| Gilligan's Two Transitions |
|
Definition
| Transition 1 occurs in Stage 1 when the person begins to view the approach of caring for oneself only as selfish and starts to realize the need for others |
|
|
Term
| Gilligan's Two Transitions |
|
Definition
| Transition 2 occurs in Stage 2 when a move is made from goodness to truth, the person realizes that a balance is needed between caring for oneself and caring for others |
|
|
Term
| Fowler's Stages of Spiritual Devp |
|
Definition
- undifferentiated
- intuitive-projective
- mythic-literal
- synthetic-conventional
- individuating-reflexive
- paradoxical- consolidative
- universalizing |
|
|
Term
Fowler's Stages of Spiritual Devp
Undifferentiated 0-3yrs |
|
Definition
| Infant unable to formulate concepts about self or the enviro |
|
|
Term
Fowler's Stages of Spiritual Devp
Intuitive-projective 4-6yrs |
|
Definition
| A combo of images and beliefs given by trusted others, mixed with the child's own experiences and imagination |
|
|
Term
Fowler's Stages of Spiritual Devp
Mythic-literal 7-12yrs |
|
Definition
| Private world of fantasy and wonder; symbols refer to something specific; dramatic stories and myths used to communicate spiritual meanings |
|
|
Term
Fowler's Stages of Spiritual Devp
Synthetic-conventional adol or adult |
|
Definition
| World and ultimate enviro structured by the expectations and judgements of others; interpersonal focus |
|
|
Term
Fowler's Stages of Spiritual Devp
Individuating-reflexive after 18yrs |
|
Definition
| Constructing one's own explicit system; high degree of self-consciousness |
|
|
Term
Fowler's Stages of Spiritual Devp
Paradoxical-consolidative after 30 yrs |
|
Definition
| Awareness of truth from a variety of viewpoints |
|
|
Term
Fowler's Stages of Spiritual Devp
Universalizing maybe never |
|
Definition
| Becoming an incarnation of the principles of love and justice |
|
|
Term
| Westerhoff's Four Stages of Faith |
|
Definition
- experienced faith
- affiliative faith
- searching faith
- owned faith |
|
|
Term
Westerhoff's Four Stages of Faith
Experienced faith infancy/late adolesc |
|
Definition
| experiences faith through interaction with others who are living a particular faith tradition |
|
|
Term
Westerhoff's Four Stages of Faith
Affiliative faith late adoles |
|
Definition
| actively participates in activities that characterize a particular faith tradition; experiences awe and wonderment; feels a sense of belonging |
|
|
Term
Westerhoff's Four Stages of Faith
Searching faith Young adulthood |
|
Definition
| through a process of questioning and doubting own faith, acquires a cognitive as well as an affective faith |
|
|
Term
Westerhoff's Four Stages of Faith
Owned faith middle adulthood/old age |
|
Definition
| puts faith into personal and social action and is willing to stand up for what the individual believes even against the nurturing community |
|
|
Term
|
Definition
| the period during which the person becomes physically and psychologically mature and acquires a personal ID |
|
|
Term
|
Definition
| During puberty, sudden and dramatic physical changes |
|
|
Term
|
Definition
| reduce visual acuity in one eye, is usually the result of strabismus (toddler) |
|
|
Term
|
Definition
| provides a numeric indicator of the baby's physiologic capacities to adapt to a extrauterine life |
|
|
Term
|
Definition
| develop in the axillae, anal and genital areas, external auditory canals, and around the umbilicus and the areola of the breasts. Apocrine sweat is released in response to emotional stimuli only |
|
|
Term
| Denver Developmental Screening Test (DDST) |
|
Definition
| used to screen children from birth to 6yrs. It measures: personal-social, fine-motor adaptive, language, and gross motor |
|
|
Term
|
Definition
| found over most of the body, produce sweat |
|
|
Term
|
Definition
outer layer of the embryo tissue formed in the second week
- forms the brain and spinal cord |
|
|
Term
| Embryonic phase first 8wks of pregnancy |
|
Definition
| the period during which the fertilized ovum develops into an organism with most of the features of a human |
|
|
Term
|
Definition
| as the eye grows in length, it refracts light normally |
|
|
Term
|
Definition
inner layer of the embryo tissue formed in the second week
- forms the bladder and the urethra |
|
|
Term
|
Definition
| a unique syndrome in which an infant falls below the 5th percentile for W&H on a standard growth chart or is falling in percentiles on a growth chart |
|
|
Term
|
Definition
| 2nd and 3rd trimester; characterized by a period of rapid growth in the size of the fetus. Both genetic and environmental factors affect its growth |
|
|
Term
|
Definition
| unossified membraneous gaps in the bone structure of the skull |
|
|
Term
|
Definition
| farsighted - preschool children |
|
|
Term
|
Definition
| occurs when the child perceives the self as similar to another person and behaves like that person |
|
|
Term
|
Definition
| important part of the preschooler's lives. Imagination and fantasy in play |
|
|
Term
|
Definition
| similar to ID, it's the assimilation of the attributes of others |
|
|
Term
|
Definition
| a fine downy hair that covers the body of the fetus at the end of the 2nd trimester |
|
|
Term
|
Definition
middle layer of the embryo tissue formed in the third week
- forms the heart |
|
|
Term
|
Definition
|
|
Term
|
Definition
| normal head circumference |
|
|
Term
|
Definition
| during adolescence they provide a sense of belonging, pride, social learning, and sexual roles |
|
|
Term
|
Definition
- a flat, disc-shaped organ and is highly vascular
- normally forms in the upper segment of the endometrium of the uterus
- its functions are to exchange nutrients and gases between the embryo or fetus and the mother |
|
|
Term
| Primary sexual characteristics |
|
Definition
| puberty - organs necessary for reproduction, such as the testes, penis, vagina and uterus |
|
|
Term
|
Definition
| 1st stage of adolescence in which sexual organs begin to grow and mature |
|
|
Term
|
Definition
| reverting to an earlier devp stage |
|
|
Term
|
Definition
| removing experiences, thoughts, and impulses from awareness |
|
|
Term
| Secondary sexual characteristics |
|
Definition
puberty - differentiates males from females but don't relate directly to reproduction
- examples are pubic hair growth, breast devp, and voice changes |
|
|
Term
|
Definition
| made up of body image devp, feelings about self, adaptive and defensive mechanisms, reactions from others, and one's perceptions of these reactions, attitudes, values, and many of life's experiences |
|
|
Term
|
Definition
| ability to ID an unseen object simply by touch |
|
|
Term
|
Definition
|
|
Term
|
Definition
| anything that adversely affects normal cellular devp in the embryo or fetus |
|
|
Term
|
Definition
| a white, cheeselike substance that adheres to the skin of the fetus and can become 1/8" thick by birth |
|
|
Term
| Health Promotion of the Fetus or embryo |
|
Definition
- oxygen
- nutrition and fluids
- rest and activity
- elimination
- temp maint
- safety |
|
|
Term
Neonates - 0-1mos Physical Devp
Infants - 1mos-1yr |
|
Definition
Weight
- born at 6-8.5lbs
- loses 5-10% of wt after birth
- after a few days they gain 6oz weekly for 6mos
- by 5mos they double wt
- by 1yr they triple wt |
|
|
Term
Neonates - 0-1mos Physical Devp
Infants - 1mos-1yr |
|
Definition
Length
- 20" at birth
- the crown-to-rump length usually the same as the head circumference
- by 6mos they gain 5.5"
- by 12mos they gain 3" |
|
|
Term
Neonates - 0-1mos Physical Devp
Infants - 1mos-1yr |
|
Definition
Head and Chest Circumference
- at birth, head circum is 14"
- chest circu is 1" smaller
- 9-10mos, head and chest the same |
|
|
Term
Neonates - 0-1mos Physical Devp
Infants - 1mos-1yr |
|
Definition
Head Molding
- the lg anterior fontanelle inc in size for several mos after birth
- closure occurs between 9-18mos
- the posterior fontanelle closes between 2-33mos after birth |
|
|
Term
Neonates - 0-1mos Physical Devp
Infants - 1mos-1yr |
|
Definition
Vision
- at birth the eyes can't focus on near objects
- at 4mos can recognize familiar objects and follow them moving
- 6mos, perceive color
- 9mos, can recognize faces
- 12mos, depth perception |
|
|
Term
Neonates - 0-1mos Physical Devp
Infants - 1mos-1yr |
|
Definition
Hearing
- moro reflex
- a few days, distinguish sounds
- 9mos, locate sounds and recognize familiar ones
- listens, distinguishes words, and responds to simple commands |
|
|
Term
Neonates - 0-1mos Physical Devp
Infants - 1mos-1yr |
|
Definition
Smell and Taste
- functional shortly after birth
- can recognize mother's milk |
|
|
Term
Neonates - 0-1mos Physical Devp
Infants - 1mos-1yr |
|
Definition
Touch
- well devp at birth
- can't isolate source of pain on skin |
|
|
Term
Neonates - 0-1mos Physical Devp
Infants - 1mos-1yr |
|
Definition
Reflexes
- unconscious, involuntary responses
- rooting, sucking, moro, palmar grasp, plantar, tonic neck, stepping, babinski |
|
|
Term
Neonates - 0-1mos Physical Devp
Infants - 1mos-1yr |
|
Definition
Motor Devp
- initially body movement is uncoordinated
- at 1mos, lifts and turns head when prone
- 6mos, sitting w/o support
- 9mos, reach, grab, xfer object from hand to hand
- 12mos, fime motor skills devp |
|
|
Term
Neonates - 0-1mos Phycosocial Devp
Infants - 1mos-1yr |
|
Definition
Erikson
- trust vs mistrust |
|
|
Term
Neonates - 0-1mos Motor Devp
Infants - 1mos-1yr |
|
Definition
| newborn - turns head from side to side when in a prone position. Grasps by reflex when object is placed in palm of hand |
|
|
Term
Neonates - 0-1mos Motor Devp
Infants - 1mos-1yr |
|
Definition
6 mos
- lifts chest and shoulders off table when prone, bearing wt on hands. Manipulates small objects |
|
|
Term
Neonates - 0-1mos Motor Devp
Infants - 1mos-1yr |
|
Definition
9 mos
- Creeps and crawls. Uses pincer grasp w/ thumb and forefinger |
|
|
Term
Neonates - 0-1mos Motor Devp
Infants - 1mos-1yr |
|
Definition
12 mos
- Walks alone w/ help. Uses spoon to feed self |
|
|
Term
Neonates - 0-1mos Social Devp
Infants - 1mos-1yr |
|
Definition
Newborn
- displays displeasure by crying and satisfaction by soft vocalizations. Attends to adult face and voice by eye contact and quieting |
|
|
Term
Neonates - 0-1mos Social Devp
Infants - 1mos-1yr |
|
Definition
6 mos
- starts to imitate sounds. Vocalizes one-syllable sounds |
|
|
Term
Neonates - 0-1mos Social Devp
Infants - 1mos-1yr |
|
Definition
9 mos
- complies with simple verbal commands
- displays fear of being left alone
- waves goodbye |
|
|
Term
Neonates - 0-1mos Social Devp
Infants - 1mos-1yr |
|
Definition
12 mos
- clings to mother in unfamiliar situations
- demonstrates emotions such as anger and affection |
|
|
Term
Neonates - 0-1mos Cog Devp
Infants - 1mos-1yr |
|
Definition
Piaget
- cog devp is a result of interaction between an indv and the enviro
- sensorimotor phase: the initial phase of cog devp. It has 6 stages, 3 take place during the 1st yr
- 4-8mos: infants begin to have perceptual recognition
- 6mos: responds to new stimuli and remember certain objects and look for them
- 12mos: concept of both space and time
- an infants cog devp proceeds from reflexive ability of the newborn to using one or two actions to attain a goal by the age of one |
|
|
Term
Neonates - 0-1mos Moral Devp
Infants - 1mos-1yr |
|
Definition
| - infants associate right and wrong with pleasure and pain by the way they are treated by their parents |
|
|
Term
Neonates - 0-1mos Health Probs
Infants - 1mos-1yr |
|
Definition
- failure to thrive
- colic
- crying
- abuse
- SIDS |
|
|
Term
Neonates - 0-1mos Health Assess and Promo
Infants - 1mos-1yr |
|
Definition
- apgar: HR, resp, muscle tone, reflex irritability, color
- devp screening tests: physical, motor, sensory, psychosocial, ADLs
- ongoing assess |
|
|
Term
| Toddlers 1-3yrs Physical Devp |
|
Definition
Weight
- 4x birth wt
- 3yrs wt is 30lbs |
|
|
Term
| Toddlers 1-3yrs Physical Devp |
|
Definition
Height
- 1-2yrs avg growth is 4-5"
- 2-3yrs avg growth is 2.5-3.5" |
|
|
Term
| Toddlers 1-3yrs Physical Devp |
|
Definition
Head circum
- inc by 1"
- 2yrs, head is 80% of adult and brain is 70% |
|
|
Term
| Toddlers 1-3yrs Physical Devp |
|
Definition
Sensory
- 18mos: accommodation to near and far objects
- 3yrs: can look away from a toy prior to reaching out and picking it up. Integration of visual and neuromuscular functions |
|
|
Term
| Toddlers 1-3yrs Physical Devp |
|
Definition
Motor
- fine muscle coord and gross motor skills improve
- 18mos, walk
- 24mos, run
- 3yrs, toilet |
|
|
Term
| Toddlers 1-3yrs Psychosocial Devp |
|
Definition
- anal phase
- autonomy vs shame and doubt
- abandonment is greatest fear |
|
|
Term
|
Definition
- Piaget: toddler completes 5th and 6th stages of the sensorimotor phase
- stage 5: problem solving b trial and error
- stage 6: problem solves mentally
- starts preconceptual phase: devp considerable cog and intellectual skills, concepts start to form |
|
|
Term
| Toddlers 1-3yrs Moral Devp |
|
Definition
Kohlberg
- 1st yr: preconventional, response to punishment and reward
- 2nd yr: they notice that certain actions and rituals garner praise |
|
|
Term
| Toddlers 1-3yrs Spiritual Devp |
|
Definition
Fowler
- undifferentiated: more interested in learning knowledge and emotional reactions |
|
|
Term
|
Definition
Health
- accidents
- visual probs
- cavities
- respiratory tract and ear infections |
|
|
Term
Preschoolers 4 & 5yrs
Physical Devp |
|
Definition
- taller and thinner than toddlers
- brain almost adult size
- limbs grow faster than trunk
- posture becomes more straightened |
|
|
Term
Preschoolers 4 & 5yrs
Physical Devp |
|
Definition
Weight
- slow, only added 10lbs to 3yr old wt making their wt 42lbs |
|
|
Term
Preschoolers 4 & 5yrs
Physical Devp |
|
Definition
Height
- grow 2"/yr to 40" |
|
|
Term
Preschoolers 4 & 5yrs
Physical Devp |
|
Definition
Vision
- hyperopic
- normal vision is 20/30 |
|
|
Term
Preschoolers 4 & 5yrs
Physical Devp |
|
Definition
Hearing and Taste
- reached optimum level |
|
|
Term
Preschoolers 4 & 5yrs
Physical Devp |
|
Definition
Motor abilities
- oral care
- modest with body
- can run and jump |
|
|
Term
Preschoolers 4 & 5yrs
Psychosocial Devp |
|
Definition
- initiative vs guilt
- gender ID
- phallic |
|
|
Term
Preschoolers 4 & 5yrs
Psychosocial Devp |
|
Definition
4 Adaptive Measures Learned
- ID
- Introjection
- Imagination
- Repression |
|
|
Term
Preschoolers 4 & 5yrs
Cognitive Devp |
|
Definition
- intuitive thought
- still egocentric
- reading skills start |
|
|
Term
Preschoolers 4 & 5yrs
Moral Devp |
|
Definition
- prosocial behv: any action that a person takes to benefit someone else
- moral behv largely learned by modeling
- they usually control their behv because they want love and approval from parents |
|
|
Term
Preschoolers 4 & 5yrs
Spiritual Devp |
|
Definition
- intuitive-projective stage
- their spiritual behv is based on imitation |
|
|
Term
Preschoolers 4 & 5yrs
Health Problems |
|
Definition
|
|
Term
School-Age 6-12yrs
Physical Devp |
|
Definition
Weight
- boys: 46lbs
- girls: 44lbs
- avg 7lbs/yr
- most wt gain 9-12yrs |
|
|
Term
School-Age 6-12yrs
Physical Devp |
|
Definition
Height
- 6yrs: 46"
- 12yrs: 60"
- lordosis disappears |
|
|
Term
School-Age 6-12yrs
Physical Devp |
|
Definition
Vision, hearing, touch
- 10yrs: all well established
- |
|
|
Term
School-Age 6-12yrs
Physical Devp |
|
Definition
Prepubertal changes
- 9-13yrs: endocrine functions slowly inc |
|
|
Term
School-Age 6-12yrs
Physical Devp |
|
Definition
Motor abilities
- 6-10yrs: muscular skills and coordination perfected |
|
|
Term
School-Age 6-12yrs
Psychosocial Devp |
|
Definition
- industry vs inferiority
- latency stage
- behv devp by school control
- self concept molded by comparison to other kids
- peer groups become important |
|
|
Term
School-Age 6-12yrs
Cog Devp |
|
Definition
- concrete operations
- changes from egocentric to cooperative
- logical reasoning developed from intuitive reasoning
- devp sense of time and currency |
|
|
Term
School-Age 6-12yrs
Spiritual Devp |
|
Definition
- stage 2: mythical-literal
- they learn to distinguish fact from fantasy |
|
|
Term
School-Age 6-12yrs
Health problems |
|
Definition
- same as preschoolers
- obesity |
|
|
Term
Adolescents 12-18yrs
Physical Devp |
|
Definition
Physical growth
- 10-18yrs: male gain 72lbs and 16"
- females gain 55lbs and 9"
- growth is noted in musculoskeletal system: head, hands, and feet are 1st to grow to adult size
- limbs grow faster than trunk
- after trunk devps, hips, chest, and shoulders do |
|
|
Term
Adolescents 12-18yrs
Physical Devp |
|
Definition
Glandular Changes
- eccrine and apocrine glands inc their secretion and become fully functional
- sebaceous glands become active under the influence of androgens |
|
|
Term
Adolescents 12-18yrs
Physical Devp |
|
Definition
Sexual characteristics
- primary and secondary sex characteristics devp |
|
|
Term
Adolescents 12-18yrs
Psychsocial Devp |
|
Definition
- ID vs role confusion
- in-groupers vs out-groupers
- the task of devp trust in self and others is again encountered when adols look for ideal persons whom they can trust and with whom they can prove trustworthy
- conflict arises between behaving in the eyes of the parents and behaving in such a way as to avoid ridicule from peers
- they need to establish a self-concept that accepts both personal strengths and weaknesses |
|
|
Term
Adolescents 12-18yrs
Physical Devp |
|
Definition
- strive to achieve sexual ID
- sexually active
- at 15yrs, try to balance the need for independence from family and the need for family support. It can create conflict and confusion within the adol and with family
- can cause hostility and depression
- adols still need guidance and love from their parents, although they appear to not want or need it
- they consistent guidance and fewer restrictions than before |
|
|
Term
Adolescents 12-18yrs
Cog Devp |
|
Definition
- formal operations
- they can think beyond the present and beyond the world of reality
- the capacity to absorb and use knowledge is great |
|
|
Term
Adolescents 12-18yrs
Moral Devp |
|
Definition
- conventional level
- still follows Golden Rule but doesn't automatically retain parent's values
- when they move into postconventional or principled level they start to question the laws and rules of society |
|
|
Term
Adolescents 12-18yrs
Spiritual Devp |
|
Definition
- synthetic-conventional stage
- they observe differences in faith |
|
|
Term
Adolescents 12-18yrs
Health probs |
|
Definition
- crashes
- homicides
- suicide
- other unintentional injuries |
|
|
Term
| The following factors contribute to failure to thrive: |
|
Definition
- lack of early mothering
- deficient sensory stimulation
- a serious illness such as cardiac disease |
|
|
Term
| When a toddler has a tantrum, the parent should... |
|
Definition
Make sure the child is safe and then leave
- set and enforce consistent and reasonable limits |
|
|
Term
| In assessing the psychosocial devp of a 4-5yr old, the nurse observes that the child... |
|
Definition
| the psychosocial devp of a _____yr old separates easily from parents and enjoys playing and cooperating with peers |
|
|
Term
|
Definition
A child is walking with assistance. What age is the kid and what skill is it demonstrating?
|
|
|
Term
Care Across the Lifespan - Highlights
Infants - birth-1yr |
|
Definition
- reacts to sound and voices
- gain 5-7oz/wk
- gain head control and begin to roll
- maintain safety
- follow a feeding schedule
- immunizations
- maintain a healthy sleep schedule |
|
|
Term
Care Across the Lifespan - Highlights
Toddler 1-3yrs |
|
Definition
- start to crawl then walk
- begin to explore and touch
- begin to eat solid food and use utensils
- begin to talk and learn
- maintain safety
- use gates for kitchens and stairs
- don't leave small objects on floor, they put everything in their mouth |
|
|
Term
Care Across the Lifespan - Highlights
Preschool 3-5yrs |
|
Definition
- begin to ride bikes and run
- love to use imaginations
- begin to learn the alphabet are able to form sentences
- start teaching safety measures such as wearing helmets |
|
|
Term
Care Across the Lifespan - Highlights
School age 6-10yrs |
|
Definition
- begin to gain independence, adventurous
- maintain a schedule and hygiene, and initiate rules
- minimize fears
- teach safety measures
- immunizations |
|
|
Term
Care Across the Lifespan - Highlights
Adolescents 11-17yrs |
|
Definition
- begin to have independence
- start driving and going out with friends
- initiate limits and rules
- teach to avoid smoking, drugs and alcohol
- teach about safe sex, and preg prev
- encourage pos behv
- monitor for bullying and depression |
|
|
Term
Care Across the Lifespan - Highlights
Young adults 18-30yrs |
|
Definition
- have reached full maturity
- begin to work regularly and start careers
- feel confident in making choices
- begin families |
|
|
Term
Care Across the Lifespan - Highlights
Adults 30-60yrs |
|
Definition
- health begins to decline
- begin to take care of parents
- family responsibilities inc
- stress inc |
|
|
Term
Care Across the Lifespan - Highlights
OLder adults 60+ |
|
Definition
- health declines
- retirement
- ALFs
- help with ADLs
- may struggle with aging
- safety may be improved |
|
|
Term
| Refers to the change of life in men, when sexual activity dec |
|
Definition
|
|
Term
|
Definition
| The concern for establishing and guiding the next generation |
|
|
Term
| Humpback in the upper spine |
|
Definition
|
|
Term
|
Definition
Spontaneous, serious bone fractures due to a dec in bone density
|
|
|
Term
| The loss of hearing ability due to aging |
|
Definition
|
|
Term
Young Adults 20-40yrs
Psychsocial |
|
Definition
- genital stage
- intimacy vs isolation (Erikson) |
|
|
Term
Young Adults 20-40yrs
Cognitive |
|
Definition
- formal operations
- postformal thought: problem finding stage |
|
|
Term
Young Adults 20-40yrs
Moral |
|
Definition
| - post-conventional level (Kohlberg): the person is able to separate self from the expectations and rules of others and to define morality in terms of personal principles |
|
|
Term
Young Adults 20-40yrs
Spiritual |
|
Definition
| - individuating-reflective period (Fowler): focused on reality |
|
|
Term
Young Adults 20-40yrs
Health issues |
|
Definition
- motor accidents
- suicide
- HTN
- substance abuse
- STDs
- violence
- abuse of women
- malignancies |
|
|
Term
Middle-aged 40-65yrs
Psychosocial |
|
Definition
- generativity vs stagnation (Erikson)
- Peck, 4 sets of dev tasks
- valuing wisdom vs physical power and attractiveness
- socializing vs sexualizing
- emotional flexibility vs emotional rigidity
- mental flexibility vs rigidity |
|
|
Term
Middle aged 40-65yrs
Moral Devp |
|
Definition
| - moves beyond the conventional level to the postconventional level |
|
|
Term
Middle aged 40-65yrs
Spiritual Devp |
|
Definition
| - paradoxical-consolidative stage: the indv can view truth from a number of viewpoints |
|
|
Term
Middle aged 40-65yrs
Health Problems |
|
Definition
- accidents
- cancer
- CVD
- obesity
- alcoholism
- mental health alterations |
|
|
Term
Older adults over 65yrs
Devp Tasks |
|
Definition
Adjusting to:
- dec physical strength and health
- retirement and lower and fixed income
- death of parents, spouses, and friends
- new relationships with adult children
- leisure time
- slower physical and cognitive responses
- keeping active and involved
- making satisfying living arrangements as aging progresses |
|
|
Term
Older adults over 75yrs
Devp Tasks |
|
Definition
- adapting to living alone
- safeguarding physical and mental health
- adjusting to the possibility of moving into a nursing home
- remaining in touch with other family members
- finding meaning in life
- adjusting to one's own death |
|
|
Term
Normal physical changes associated with aging
Integumentary |
|
Definition
- inc skin dryness
- inc skin pallor
- inc skin fragility |
|
|
Term
Normal physical changes associated with aging
Neuromuscular |
|
Definition
- dec speed and power of skeletal muscle contractions
- slowed reaction time |
|
|
Term
Normal physical changes associated with aging
Sensory/perceptual |
|
Definition
|
|
Term
Normal physical changes associated with aging
Pulmonary |
|
Definition
- dec ability to expel foreign or accumulated matter
- dec lung expansion, less effective exhalation, reduced vital capacity, and inc residual volume
- difficult, short, heavy, rapid breathing (dyspnea) following intense exercise |
|
|
Term
Normal physical changes associated with aging
Cardiovascular |
|
Definition
- reduced cardiac output and stroke volume, particularly during inc activity or unusual demands; may result in SOB on exertion and pooling of blood in the extremeties
- reduced elasticity and inc rigidity of arteries
- inc in BP
- orthostatic HTN |
|
|
Term
Normal physical changes associated with aging
GI |
|
Definition
- delayed swallowing time
- inc tendency for indigestion
- inc tendency for constipation |
|
|
Term
Normal physical changes associated with aging
Urinary |
|
Definition
- reduced filtering ability of the kidneys and impaired renal function
- less effective conc of urine
- urinary urgency and urinary freq
- tendency for a nocturnal freq and retention of residual urine |
|
|
Term
Normal physical changes associated with aging
Genitals |
|
Definition
- prostate enlargement in men (benign)
- multiple changes in women (shrinkage and atrophy of the vulva, cervix, uterus, fallopian tubes, and ovaries; reduction in secretions; and changes in vaginal flora) |
|
|
Term
Older adults over 65yrs
Health probs |
|
Definition
- accidents
- chronic disabling illness
- drug use and misuse
- alcoholism
- dementia
- elder abuse |
|
|
Term
Older adults over 65yrs
Health probs |
|
Definition
- accidents
- chronic disabling illness
- drug use and misuse
- alcoholism
- dementia
- elder abuse |
|
|
Term
Functional Assessment
Primary aging changes |
|
Definition
| - normal changes which everyone experiences, such as thinning hair, dec peristalsis and dec hormone prod |
|
|
Term
Functional Assessment
Secondary aging changes |
|
Definition
| - disease related changes that don't occur universally as a part of aging |
|
|
Term
|
Definition
- adult devp researcher
- the central theme of adulthood is transformation |
|
|
Term
| Two major goals of Healthy People 2010 |
|
Definition
- “increase quality and years of a healthy life,”
- “eliminate health
disparities.”
- Note that the first goal acknowledges the increasing number of aging adults in the population, whereas the second goal reflects the diversity of the population |
|
|
Term
|
Definition
| can they perform the activities of daily living appropriate for their age, and if not, then what is their degree of limitation |
|
|
Term
| Gilligan’s Theory of Moral Development |
|
Definition
Research based on women
• Includes the concepts of caring and responsibility
• Three levels and two transitions
• Each level representing a more complex understanding of the relationship
of self and others
• Each transition resulting in a crucial reevaluation of the conflict between
selfishness and responsibility |
|
|
Term
| Fowler’s Theory of Spiritual Development |
|
Definition
| Describes faith as a force that gives meaning to a person’s life |
|
|
Term
| Fowler 19s Theory of Spiritual Development |
|
Definition
| Describes faith as a force that gives meaning to a person 19s life |
|
|
Term
| Psychosocial Development (Erikson) |
|
Definition
Neonates and Infants
– Trust versus mistrust
• Toddlers
– Autonomy versus shame
• Preschoolers
– Initiative versus guilt
• School-age Children
– Industry versus inferiority
• Adolescents
– Identity versus role confusion |
|
|
Term
Cognitive Development
(Piaget): Neonates and Infants |
|
Definition
Sensorimotor Phase
– Perceptual recognition (4–8 mo.)
– Responds to new stimuli,
remembers objects, looks for them
(6 mo.)
– Concept of both space and time
develops (12 mo.) |
|
|
Term
Cognitive Development
(Piaget): Toddlers |
|
Definition
Completes Sensorimotor Phase
– Trial-and-error problem solving
– Solving problems mentally
• Preconceptual Phase (2 yr)
– Learn sequence of time
– Develop some symbolic thought |
|
|
Term
Cognitive Development
(Piaget): Preschoolers |
|
Definition
Intuitive Thought Phase
– Still egocentric, but subsiding
• Learn through trial and error
• Think of one idea at a time
• Do not understand relationships
• 5 yr – count pennies, reading skills develop |
|
|
Term
Cognitive Development
(Piaget): School-age Children |
|
Definition
Concrete Operations Phase
– Cooperative interactions
– Intuitive reasoning
– Cause-and-effect
– Concepts of money and time
learned
– Reading skills well developed |
|
|
Term
Cognitive Development
(Piaget): Adolescents |
|
Definition
Formal Operations Phase
– Thinking beyond the present
– Idealistic thinking
– Abstract thinking |
|
|
Term
Moral Devp Kohlberg
Toddlers |
|
Definition
preconventional level
stage 1: reward and punishment |
|
|
Term
Moral Devp Kohlberg
Preschoolers |
|
Definition
preschoolers
- prosocial behv
- modeling moral behv |
|
|
Term
Moral Devp Kohlberg
School age children |
|
Definition
preconventional level
stage 1 - punishment and reward
stage 2 - instrumental-relativist
conventional level
stage 3 - "good boy-nice girl"
stage 4 - law and order |
|
|
Term
Moral Devp Kohlberg
Adolescence |
|
Definition
conventional level (young adol)
postconventional level or principled level |
|
|
Term
| Three major concepts are related to health status in older adults |
|
Definition
- absence of disease
- ADLs:
- Instrumental ADLs (IADLs): performance of complex social activities of living (shopping, finances, managing meds, using the phone) |
|
|
Term
|
Definition
| it has been shown to correlate with physical illness, self-care ability, complications during hospitalization, rehab potential, and mortality |
|
|
Term
| The child merely watches as the other children pretend-play. |
|
Definition
| A 20-month-old child is a client on the pediatric unit of a hospital. The nurse notices that this child is lagging in stage 6 of Piaget's phases of cognitive development. Which activity would indicate that this child is struggling at this stage? |
|
|
Term
| stage 6 of Piaget's phases of cognitive development |
|
Definition
| In this stage of development, inventions of new means, children interpret the environment by mental image. They use make-believe and pretend-play. A child who is unable to do this would not be demonstrating the behavior that is significant at this stage. |
|
|
Term
tertiary circular. commonly referred to as discovery of new means through active experimentation."
|
|
Definition
| Ritual is important for the child of the ____ ____ reaction, age 12 to 18 months. Piaget |
|
|
Term
| inventions of new means: stage 6 |
|
Definition
| A parent tells the nurse that his child is quite creative and learning how to pretend with "almost anything in the house." According to Piaget, this child is descriptive of which stage/phase? |
|
|
Term
| infancy and early childhood |
|
Definition
| according to Havighurst, A toddler would be in the ____ ____ ____ ____ age period, of which learning to relate emotionally to parents, siblings, and other people is a developmental task. |
|
|
Term
| identity versus role confusion |
|
Definition
| A client is being seen in the mental health clinic for antisocial behavior. According to Erikson's stages of development, this client is dealing with which task of development? |
|
|
Term
|
Definition
| A young adult has never lived away from his parents. He has difficulty making decisions and feels unable to make decisions on his own. According to Freud's theory of development, this person would be fixated at which stage of development? |
|
|
Term
|
Definition
| Freud's ____ stage is characterized by energy that is directed toward full sexual maturity and function and development of skills needed to cope with the environment. It occurs during puberty and extends beyond. Implications of this stage include separation from parents, achievement of independence, and decision making. |
|
|
Term
|
Definition
| A school nurse is counseling adolescents about risks for STDs. Using recent statistics, the nurse presents information that the number of new cases of STDs in this age group, each year, will be approximately: |
|
|
Term
|
Definition
| He describes faith as a way of being and behaving that evolves from an experienced faith guided by parents and others during a person's infancy and childhood to an owned faith that is internalized in adulthood. For the client who is ill, faith provides strength and trust. |
|
|
Term
|
Definition
| His theory describes the development of faith as a force that gives meaning to a person's life. |
|
|
Term
|
Definition
| In the infancy years (birth to 18 months), the child's central task is to form ____ __ ____ with people. |
|
|
Term
|
Definition
| Willfulness and defiance are negative indicators of the ____ _____ stage. |
|
|
Term
|
Definition
| Playing with other children is a part of the self-esteem and self-expression of the ____ ____ years. |
|
|
Term
|
Definition
| According to Piaget, when young children encounter new situations, they use the mechanisms they already possess to acquire knowledge. This is an example of what? |
|
|
Term
|
Definition
| learning to trust others and having self-control w/o losing self-esteem, according to Erikson, are the indicators of pos resolution in the _____ and ______ devp stage |
|
|
Term
|
Definition
| according to Kohlberg, at this level of moral devp, indvs are concerned about conformity and loyalty to one's and society's expectations |
|
|
Term
|
Definition
| Havighurst's devp tasks for ____ _____ include finding a mate and starting an occupation |
|
|
Term
|
Definition
| according to Fowler, after age ___, an indv in the paradoxical-consolidative stage, would have an awareness of truth from a variety of viewpoints |
|
|
Term
|
Definition
| according to Fowler, after age ___, an indv in the paradoxical-consolidative stage, would have an awareness of truth from a variety of viewpoints |
|
|
Term
| Factors influencing G&D, functional ability, and health promotion |
|
Definition
- genetics
- sex
- age
- indv preferences and patterns
- physical condition
- cultural and spiritual/religious beliefs
- SEC factors
- enviormental
- psychological
- nutrition |
|
|
Term
|
Definition
| more complex social activities such as shopping, cooking, housekeeping, transportation, managing finances and meds, using the phone |
|
|
Term
|
Definition
| complex abilities that enable the individual to engage in voluntary social, occupational, or recreational abilities |
|
|
Term
| components of a pt's history for functional assessment |
|
Definition
- ADLs, IADLs
- family history
- sleep patterns
- dietary patterns
- exercise habits
- addictions
- immunizations
- anxiety and stress levels
- appropriate use of meds
- home safety
- mental faculty, cognitive level |
|
|
Term
| Assessment of factors influencing the pt's health status |
|
Definition
- risk behvs specific to pt's age
- health promotion activities the pt participates in
- physical activity level, including a description of any exercise program
- sexual behvs and attitudes; safe sex practices
- family type and support
- dental care habits
- air quality of pt's enviro
- tobacco and alcohol use or abuse
- drug use or abuse
- exposure to and screening for TB
- Tonometry: a procedure used to measure intraocular tension to detect glaucoma |
|
|
Term
| Objective Data for Functional Health |
|
Definition
- functional independence measure (FIM)
- Barthel Index Score
- JAREL Index Score
- Sexual Assessment
- Nutritional Assessment
- chewing or swallowing probs or gum disease
- Denver Devpl Screening Test (DDST)
- Apgar score
- immunization history
- parental supervision
- motor devp
- psychosocial devp
- the CAGE assessment
- the Elderly Alcohol Screening Test (EAST)
- cogn assess
- Geriatric Depression Scale (GPS) |
|
|
Term
| Functional Independence Measure (FIM Score) |
|
Definition
- measures 18 items in 5 categories
- self-care
- sphincter control
- mobility and locomotion
- communication and cognition
- helps to id the severity of a disability regardless of type |
|
|
Term
|
Definition
measures a ct's level of independence in ADL's using a numeric scale of 0-5, 10, or 15 depending on the skill being assessed
- it does not rate cogn or commun |
|
|
Term
| JAREL Spiritual Well-Being Scale |
|
Definition
it measures the ct's attitude towards spiritualism.
- does spiritualism provide comfort and help him cope? |
|
|
Term
|
Definition
| measures sexual devp, knowledge and practices |
|
|
Term
|
Definition
| screening tool about drinking |
|
|
Term
|
Definition
in older adults:
- Short Portable Mental Status Questionnaire (SPMSQ)
- Mini-Mental State Exam (MMSE) |
|
|
Term
| Review Laboratory and Other Diagnostic Data. Infants |
|
Definition
- screening for PKU
- thyroid disease
- sickle cell
- TB
- hearing, ht, and wt |
|
|
Term
| Review Laboratory and Other Diagnostic Data. Toddlers and Preschoolers |
|
Definition
- lead levels
- TB
- vision and hearing
- ht and wt |
|
|
Term
| Review Laboratory and Other Diagnostic Data. School-age children |
|
Definition
- periodic vision, speech, and hearing
- TB
- blood pressure
- risk for lead exposure
- cholesterol
- ht and wt |
|
|
Term
| Review Laboratory and Other Diagnostic Data. Adolescents |
|
Definition
- ht and wt
- TB
- periodic vision and hearing |
|
|
Term
| Review Laboratory and Other Diagnostic Data. Adults |
|
Definition
- blood pressure
- breast exams/over 40
- cholesterol
- TB
- fecal occult blood
- colonoscopy
- ht, wt |
|
|
Term
| Review Laboratory and Other Diagnostic Data. Older adults |
|
Definition
- blood pressure
- chol
- vision, hearing, ht, wt
- H & H
- TB
- cancer screenings |
|
|
Term
| Review Laboratory and Other Diagnostic Data. Fe levels |
|
Definition
- infants
- toddlers, preschoolers
- pregnancy
- any other risk for anemia |
|
|
Term
| Nursing Diagnoses related to functional assessment |
|
Definition
- Health seeking behv r/t initiating a regular exercise program
- Risk for delayed devp r/t inadequate parental support
- Risk for falls r/t degenerative joint disease
- Self-care deficit (feeding) r/t stroke
- Nutrition less than body requirements r/t lack of parental knowledge |
|
|
Term
| Priorities based on assess of pt needs |
|
Definition
- basic physiologic needs: food, h2o, and o2
- life threatening issues
- med priority level things such as issues coping w/ illness
low priority such as normal devp needs
- I must also consider the cogn ability of my pt and things like his access to hc, transp, ins, and support systems |
|
|
Term
Expected Outcomes r/t Health Promotion, Health Maintenance and Health Restoration
Nursing Diagnosis: Risk for falls r/t degenerative joint disease |
|
Definition
| Expected Outcome: Pt will not fall...for what diagnosis? |
|
|
Term
Expected Outcomes r/t Health Promotion, Health Maintenance and Health Restoration
Nursing Diagnosis: Self-care deficit (feeding) r/t stroke |
|
Definition
| Expected Outcome: pt will feed self soft diet w/ adaptive utensils is for which diagnosis? |
|
|
Term
Expected Outcomes r/t Health Promotion, Health Maintenance and Health Restoration
Nursing Diagnosis: Health seeking behv r/t initiating a regular exercise program |
|
Definition
| Expected Outcome: ct will participate in a regular exercise program that includes wt-bearing for at least 30mins a min of 3X weekly is for which dx? |
|
|
Term
Expected Outcomes r/t Health Promotion, Health Maintenance and Health Restoration
Nursing Diagnosis: nutrition less than body req r/t lack of parental knowledge |
|
Definition
| Expected Outcome: child will eat 3 servings of veges each day is for which dx |
|
|
Term
Rationale for NIs r/t Functional Assessment
Ethical and legal implication |
|
Definition
- social and technical changes have made ethical decisions more complex
- the nurse must advocate for health svs for the uninsured, the underserved and the disenfranchised
- safety and health promotion must be priorities
- nurses must be aware of the states laws regarding child, adol, and adult abuse |
|
|
Term
Rationale for NIs r/t Functional Assessment
Standards of care |
|
Definition
The ANA revised Standards of Clinical Nursing Practice
- nurses must maintain pt confidentiality within legal and regulatory parameters
- must be a pt advocate
- must promote self-care
- must preserve ct's dignity, autonomy and rights
- Healthy People 2010 must be the nurse's gold standard |
|
|
Term
Rationale for NIs r/t Functional Assessment
EBP - a study |
|
Definition
Koenig, 834 pts, avg age: 64, hospitalized over a 4yr period, avg of 5 coexisting conditions
- strong spiritual or religious beliefs associated with: coping with illness better, greater social support, less depression, better cogn function, better physical health
- |
|
|
Term
Rationale for NIs r/t Functional Assessment
EBP - a study |
|
Definition
Masters: 107 older adults
- surveyed about their perception of moderate alcohol consumption and any possible health benefits
- 40% defined moderate consumption higher than the govt's guidelines |
|
|
Term
Rationale for NIs r/t Functional Assessment
EBP - a study |
|
Definition
researchers interviewed 375 people over the age of 65 about their attitudes r/t their meds, the dosages, the timing, and what to do if a dose was missed
- more than 50% showed excellent knowledge
- 7.5% had a limited understanding
- 7% were clueless |
|
|
Term
Rationale for NIs r/t Functional Assessment
EBP - a study |
|
Definition
| a study found that exercise sessions 2x weekly in community settings along with at-home exercise was found to sig improve balance and mobility |
|
|
Term
Functional factors influencing the pt's plan of care.
Questions to ask |
|
Definition
- does the ct have adequate finances to purchase food for her children?
- is the preschooler able to feed himself?
- does the ct have chewing or swallowing problems?
- how accessible are the essential items in the home enviro for the elderly ct who lives alone?
- does the older adult have any restrictions to his mobility?
- has the toddler achieved the age-appropriate gait pattern? |
|
|
Term
|
Definition
| initiate and complete nursing care plans designed to move the pt and caregiver towards the expected outcomes r/t health promotion, health maintenance and health restoration |
|
|
Term
| Nursing Measures to Establish a Collaborative Relationship with the Pt |
|
Definition
| - the use of therapeutic communication skills to id cultural and indv differences and to establish expectations of care w/ the ct |
|
|
Term
| Nursing Measures to Enhance Pt Compliance with the HC Team |
|
Definition
| - all approaches that enlist the participation of the pt in decision making |
|
|
Term
| Provide info and instruction re: health promotion, maintenance, and restoration |
|
Definition
- nurse provides pt edu as it relate to Healthy People 2010
- nurse must be aware of health promotion guidelines for each age group
- health edu re safety |
|
|
Term
| Use nursing measures to promote continuity of care |
|
Definition
| - nurse provides info and referrals |
|
|
Term
|
Definition
Nursing Measures to:
- establish a collaborative relationship with the pt
- enhance pt compliance w/ the HC team
- provide info and instruction re health promo, maint, and restoration
- promote continuity of care
- create an enviro conducive to health promo and risk reduc
- supervise pt care activities assigned to other members of the team |
|
|
Term
| create an enviro conducive to health promo and risk reduc |
|
Definition
- providing guidelines for childproofing
- provide home safety checks
- inform abused ct of Safe Haven
- address drug interactions and safe use of drugs |
|
|
Term
| Supervise pt care activities assigned to other team members |
|
Definition
| - nurse needs to line-up the proper team |
|
|
Term
| Evaluation: reassess the pt to determine responses to NIs, including progress toward the expected outcomes (pt-centered goals) |
|
Definition
- reassess, doc, and report the pt's responses to NIs
- revise the pt's plan of care based on the reassessment of the pt
- determine the pt's response to care provided by other team members |
|
|
Term
| reassess, doc, and report the pt's responses to NIs |
|
Definition
- pt was out of bed with assist and xfer belt q4hrs w/o injury
- pt is trying to use the new adaptive utensils
- CNA reports that the child tried the green beans and liked them, but hated the spinach
- family reports to the nurse that the children's immune are all current |
|
|
Term
| revise the pt's POC based on the pt reassessment |
|
Definition
- ins the pt's time out of bed by 30 min increments
- implement an OT referral for addl pt teaching re the use of assistive devices
- ask parent ot consistently encourage the child to eat veges |
|
|
Term
| determine the pt's response to care provided by other team members |
|
Definition
- pt tolerated an inc to 30 mins of activity in the chair today
- OT reports a slight mod in the padding of the adaptive utensil improved the pt's ability to use it
- the CNA's encouragement has resulted in the child gradually getting used to veges and eating more of them |
|
|
Term
| NREM- Non-REM Sleep Stages |
|
Definition
I - very light sleep (drowsy-relaxed)
II - body processes continue to slow
III - heart and respiratory rate are slower
IV - signals deep sleep |
|
|
Term
|
Definition
- NREM (pass the four stages in 1 hr
- sleeper passes from stage I NREM through stages II and III to stage IV in about 20-30 mins |
|
|
Term
|
Definition
- restores normal levels of acuity
- Sympathetic NS (while awake)
- Parasymph NS increases
- regular sleep pattern more important than actual hours slept |
|
|
Term
| Normal Sleep Patterns and Requirements |
|
Definition
- newborns: sleep 16-18 hrs daily, usually seven sleep patterns
- infants: 22 hrs daily, 20-30% REM
- toddlers: 10-12 hrs daily, 20-30% REM
- preschoolers: 11-12 hrs
- school age: 8-12 hrs
- adoles: 8-10 hrs
- young adults: 7-8, may require less
- middle aged: 6-8 hrs
- older: 6 hrs |
|
|
Term
|
Definition
- age: one of the most important factors affecting persons sleep and rest periods
- illness: causing pain or physical distress
- environment: noise, heat
- fatigue: more tired, shorter the first REM
- lifestyle: shift work
- emotional stress
- alcohol, stimulants, meds, smoking
- diet
- motivation |
|
|
Term
|
Definition
- primary sleep disorder: those in which the person's sleep problem is the main disorder
- secondary: caused by another clinical disorder, such as thyroid dysfunction, depression, or alcoholism |
|
|
Term
|
Definition
- insomnia: most common
- hypersomnia: opposite of insomnia, excessive sleep, especially daytime
- narcolepsy: also called "sleep attack"
- sleep apnea: periodic cessation of breathing during sleep
- parasomnias: behv that may interfere with sleep (somnambulism/sleep walking, sleep talking, nocturnal enuresis, nocturnal erections, bruxism).
- sleep deprivation: prolonged disturbances results in decreased amt , quality, and consistency of sleep |
|
|
Term
|
Definition
| assessment relative to a ct's sleep includes a sleep history, sleep diary, a physical, and a review of dx studies |
|
|
Term
|
Definition
- major goal for ct w/ sleep disturbances is to maintain a sleeping pattern that provides sufficient energy for daily activities
- interventions: guided imagery, therapeutic massage, progressive muscle relaxation, uninterrupted sleep periods |
|
|
Term
|
Definition
NIs to enhance the quality and quantity of sleep involve largely non-pharmacologic measures:
- ct teaching: indvs need to learn the importance of rest and sleep in maintaining active and productive lifestyles
- supporting bedtime rituals: many are accustomed to rituals or pre-sleep routines and if altered can affect sleep
- creating a restful enviro
- promoting comfort and relaxation: assist ct with hygienic routines, offer back massages, admin analgesics 30 min before sleep
- enhancing sleep w/ meds: nurse responsible for making decisions w/ the ct about when to admin sedative hypnotics
- reduce enviro distractions in the hospital |
|
|
Term
|
Definition
| people, relationships, and things matter |
|
|
Term
Meaning of Caring
Mayerhoff |
|
Definition
- growth and actualization
- a process
- benefits for the caregiver and the one receiving care |
|
|
Term
Meaning of Caring
Major ingredients of caring |
|
Definition
-knowing
- alternating rhythms
- patience
- honesty
- trust
- humility
- hope
- courage |
|
|
Term
Meaning of Caring
Summary of Definitions
Multidimensional concept |
|
Definition
Five viewpoints
- caring as a moral imperative
- caring as an affect
- as a human trait
- as an interpersonal relationship
- as a therapeutic intervention |
|
|
Term
Theories of Caring
Culture Care Diversity and Universality - Leininger |
|
Definition
| Theory that states that understanding culture is essential for nursing care |
|
|
Term
Theories of Caring
Theory of Bureaucratic Caring - Roy |
|
Definition
| Theory that states that caring is contextual, influenced by organizational structure |
|
|
Term
Theories of Caring
Caring, the Human Mode of Being (Roach) |
|
Definition
- Theory that states that the center of all attributes is used to describe nursing
- six "Cs" of caring |
|
|
Term
Theories of Caring
Nursing as Caring (Boykin and Schoenhofer) |
|
Definition
| Purpose of the discipline and profession of nursing |
|
|
Term
Theories of Caring
Theory of Human Caring (Watson) |
|
Definition
- basis for nursing's role in society
- essence and moral ideal of nursing |
|
|
Term
Theories of Caring
Theory of Caring (Swanson) |
|
Definition
- caring processes in NIs
- five caring processes |
|
|
Term
Theories of Caring
Primacy of Caring (Benner and Wrubel) |
|
Definition
- nursing as a relationship
- caring is primary
- possibility of giving and receiving help |
|
|
Term
| Types of knowledge in nursing |
|
Definition
- empirical knowing
- ethical knowing
- aesthetic knowing
- personal knowing |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| the therapeutic use of self |
|
|
Term
|
Definition
|
|
Term
Caring in Practice
Caring encounters are demonstrated by: |
|
Definition
- knowing the ct
- nursing presence
- empowering the ct
- compassion
- competence |
|
|
Term
The Value of Reflective Practice in Nursing
Reflective Practice |
|
Definition
- method of self-examination
- involves thinking over what happened in a nursing situation
- includes becoming aware of how one feels about oneself
- recognizing how one thinks and acts
- leads to new understandings and appreciations
- requires discipline, action, openness, and trust |
|
|
Term
The Value of Reflective Practice in Nursing
Reflective JOurnaling |
|
Definition
|
|
Term
|
Definition
- pace and intonation
- simplicity
- clarity and brevity
- timing and relevance
- adaptability
- credibility
- humor |
|
|
Term
|
Definition
- personal appearance
- posture and gait
- facial expression
- gestures |
|
|
Term
| Factors influencing the communication process |
|
Definition
- development
- gender
- values and perceptions
- personal space: intimate (touching to 1.5 ft)
personal (1.5-4 ft)
social (4-12 ft)
public (12-15 ft)
- territoriality
- roles and relationships
- environment
- congruence
- interpersonal attitudes |
|
|
Term
| Barriers to communication |
|
Definition
- need to recognize
- major barriers:
- failure to listen
- improperly decoding ct's intended msg
- placing nurse's needs above ct's needs
- stereotypes
- defensiveness
- judgment
- challenging
- giving common advice
- testing
- rejecting |
|
|
Term
|
Definition
referred to as:
- interpersonal relationship
- therapeutic relationship
- helping relationship |
|
|
Term
|
Definition
- growth facilitating process
- achieve two basic goals:
- help cts manage problems in living
- become better at helping themselves in their everyday lives |
|
|
Term
| Keys to Helping Relationships |
|
Definition
- devp of trust and acceptance between nurse and ct
- sincere interest in the ct's welfare |
|
|
Term
| Influences on Helping Relationships |
|
Definition
- personal and professional characteristics of nurse and ct
- age, sex
- appearance
- dx
- education
- values
- ethnic and cultural background
- personality
- expectations
- setting |
|
|
Term
| 4 phases of the helping relationship |
|
Definition
- preinteraction
- introductory
- working (maintaining)
- termination |
|
|
Term
4 phases of the helping relationship
Preinteraction phase |
|
Definition
- reviews pertinent data and knowledge
- considers potential areas of concern
- devps plans for interaction |
|
|
Term
4 phases of the helping relationship
Introductory phase |
|
Definition
1 - opening the relationship
2 - clarifying the prob
3 - structuring and formulating the contract |
|
|
Term
4 phases of the helping relationship
Working phase |
|
Definition
1 - exploring and understanding thoughts and feelings
2 - facilitating and taking action |
|
|
Term
4 phases of the helping relationship
Termination phase |
|
Definition
- nurse and ct accept feelings of loss
- ct accepts end of relationship w/o feelings of anxiety or dependence |
|
|
Term
| Features of Effective Groups |
|
Definition
- comfortable, relaxed atmosphere
- clearly defined purpose
- democratic leadership and member participation
- open communication
- group decision making
- cohesion
- tolerance of conflict
- shared power
- prob solving is a high priority
- creativity encouraged |
|
|
Term
| Groups Helpful in Promoting Health and Comfort |
|
Definition
- task
- teaching
- self help
- self awareness/growth
- therapy
- work related social support |
|
|
Term
Communication Skills and the Nursing Process
Assessing |
|
Definition
- determine communication impairments or barriers
- communication style
- cultural influence
- age and devp |
|
|
Term
Communication Skills and the Nursing Process
Diagnosing |
|
Definition
- impaired verbal communication
- fear or anxiety
- impaired verbal comm may be etiology |
|
|
Term
Communication Skills and the Nursing Process
PLanning |
|
Definition
- determine outcomes
- plan ways to promote effective comm
- overall outcome is to reduce or resolve the factors impairing the comm
- specific NIs planned for the stated etiology |
|
|
Term
Communication Skills and the Nursing Process
Implementing |
|
Definition
- manipulate the enviro
- providing support
- employing measures to enhance comm
- educating the ct and support person |
|
|
Term
Communication Skills and the Nursing Process
Evaluating |
|
Definition
Ct Comm
- listen actively
- observe nonverbal cues
- use therapeutic comm skills |
|
|
Term
|
Definition
Effective Comm is important for
- prevention of medical errors
- promotion of better ct outcomes
- preservation of nurse's pro integrity
- maint of ct's safety
- maint of a better working enviro |
|
|
Term
|
Definition
- promotes ct safety by minimizing miscommunication with colleagues
- honest, direct, and appropriate
- open to ideas
- respecting the rights of others
- use the "I" stmts vs the "you" stmts
- "I" stmts encourage discussion
- "You" stmts place blame and put the listener on the defensive |
|
|
Term
| Nonassertive Comm - Submissive Comm |
|
Definition
- allow rights to be violated by others
- meet the demands and requests of others w/o regard to own feelings and needs
- believe own feelings not important
- may be insecure and try to maintain self-esteem by avoiding conflict |
|
|
Term
| Nonassertive Comm - Aggressive Comm |
|
Definition
- strongly asserts the person's legitimate rights and opinions with little regard or respect for the rights and opinions of others
- often perceived as a personal attack by the other person
- humiliates, dominates, controls, or embarrasses the other person
- by lowering the other person's self-esteem, may feel superior
- several forms including:
- screaming, sarcasm
- rudeness, belittling jokes
- direct personal results |
|
|
Term
| Factors Affecting Ability To Protect Self from Injury |
|
Definition
- age and devp
- lifestyle
- mobility and health status
- sensory perceptual alterations
- cog awareness
- emotional state
- ability to communicate
- safety awareness
- enviro factors |
|
|
Term
| Nat'l Pt Safety Goals (NPSGs) |
|
Definition
1. improve the accuracy of pt id
2. improve the effectiveness of comm among caregivers
3. improve the safety of using meds
4. reduce the risk of hc associated infections
5. accurately and completely reconcile meds across the continuum of care
6. reduce the risk of pt harm resulting from falls
7. reduce the risk of influenza and pneumococcal disease in institutionalized older adults
8. reduce the risk of surgical fires
9. implement applicable NPSGs and associated requirements by components and practitioner sites
10. encourage the active involvement of pts and their families in the pt's care as a pt safety strategy
11. prevent hc associated pressure ulcers (decubitus) |
|
|
Term
| Common Potential Hazards: Devp Fetus |
|
Definition
- exposure to maternal smoking, alcohol consumption, addictive drugs
- x-rays (first trimester)
- certain pesticides |
|
|
Term
| Common Potential Hazards: Newborns and Infants |
|
Definition
- falling
- suffocation in cribs
- choking from aspirated milk or ingested objects
- burns from hot water or other spilled hot liquids
- car crashes
- cribs or playpen injuries
- electric shock
- poisoning |
|
|
Term
| Common Potential Hazards: Toddlers |
|
Definition
- physical trauma from falling, banging into objects, or by getting cut
- car crashes
- burns
- poisoning
- drowning
- electric shock |
|
|
Term
| Common Potential Hazards: Preschoolers |
|
Definition
- traffic, playgrounds, and other objects
- choking, suffocation, and obstruction of airway or ear canal by foreign objects; poisoning
- drowning
- fire and burns
- harm from other people or animals |
|
|
Term
| Common Potential Hazards: Adols |
|
Definition
- cars or cycle crashes
- recreational injuries
- firearms
- substance abuse |
|
|
Term
| Common Potential Hazards: Older adults |
|
Definition
- falling
- burns
- car crashes and pedestrian injuries |
|
|
Term
| Nursing Dx for Cts at Risk for Injury |
|
Definition
- Risk for Injury
- risk for:
- poisoning
- suffocation
- trauma
- latex allergy response
- aspiration
- disuse syndrome
- Deficient Knowledge (Injury Prevention) |
|
|
Term
| Desired Outcomes for Cts with Safety Risks |
|
Definition
- prevent injury
- often need to change health behv
- modify their environment
- desired outcomes depend on indv ct |
|
|
Term
| NIs for Cts at Risk for Injury |
|
Definition
- Helping the ct and family accomplish the following:
- id enviro hazards in home and community
- demonstrate safety practices appropriate to the home health care agency, community, and workplace
- experience a dec in the freq or severity of injury
- demon safe childrearing practices or lifestyle practices |
|
|
Term
| Preventing Thermal Injuries |
|
Definition
- pot handles should not protrude out
- electrical appliances should be out of reach of crawling infants and young children
- bath water not excessively hot
- monitor cts with impaired skin sensitivity
- use care when using therapeutic application of heat |
|
|
Term
|
Definition
- protect and evacuate cts
- report the fire
- contain it
- extinguish it |
|
|
Term
| Factors affecting ability to protect self from injury |
|
Definition
- age and devp
- lifestyle
- mobility and health status
- sensory perceptual alterations
- cog awareness
- emotional state
- ability to communicate
- safety awareness
- environ factors |
|
|
Term
| Assessing cts at risk for injury |
|
Definition
- H&P
- risk assessment tools
- assess of ct's home enviro |
|
|
Term
| Natl Pt Safety Goals (NPSGs) |
|
Definition
- improve the accuracy of pt id
- improve the effectiveness of comm among caregivers
- improve the safety of using meds
- reduce the risk of HC-associated infections
- accurately and completely reconcile meds across the continuum of care
- reduce the risk of pt harm resulting from falls
- reduce the risk of flu and pneumonia in institutionalized older adults
- reduce the risk of surgical fires
- implement applicable NPSGs and associated requirements by components and practitioner sites
- encourage the active involvement of pts and their families in the pt's care as a pt safety strategy
- prevent HC related pressure ulcers |
|
|
Term
|
Definition
- teaching parents to childproof the enviro
- provide info and counseling about insects, snake bites, and drugs used for rec purpose
- safeguarding the enviro and monitoring the underlying probs to prevent accidental ingestion of toxic subs
- teaching the phone #s of poison and control centers
- edu the public about what to do in the event of poisoning |
|
|
Term
| Planning for Bioterrorism |
|
Definition
- important HC personnel and facilities plan and prepare for the unknown
- HC orgs expected to address four specific phases of disaster planning
- mitigation
- preparedness
- response
- recovery
- should participate annually in at least one community-wide practice drill |
|
|
Term
| Measures to prevent falls |
|
Definition
- orient cts to surroundings and explain the call system
- carefully assess the ct's ability to ambulate and xfer
- provide walking aids and assist as required
- closely supervise the cts at risk for falls, especially at night |
|
|
Term
| Potential enviro causes of falls |
|
Definition
- inadequate lighting
- presence of electrical cords, loose rugs, clutter, and slippery floors
- absent or unsteady railings
- uneven step ht or surfaces
- unsteady base on furniture
- lack of armrests on chairs
- cabinets too hi or too lo
- wrong toilet ht
- slippery bathroom floor
- no grab bars |
|
|
Term
|
Definition
- pad the bed
- put oral suction eqpt in place
- kids with freq seizures should wear helmets |
|
|
Term
| Alternatives to restraints |
|
Definition
- assign nurses in pairs
- closely monitor unstable cts
- prepare cts before a move to limit relocation shock
- stay w/ a ct using a bedside commode or bathroom if confused, sedated, or has a gait disturbance or a high risk score for falling
- monitor all the ct's meds and if possible, lower or eliminate dosages of sedatives or psychotropics
- bed in lowest position
- replace full-length siderails with 1/2 or 3/4 length rails
- use rocking chairs to help confused cts expend some energy
- wedge pillows or pads against the sides of the wheelchairs
- place a removable lap tray on a wheelchair
- try a warm beverage, soft lights, a back rub, or a walk
- use enviro restraints
- place a pic or or other personal item on the door of ct's room
- try to determine the causes of the ct's sundowner syndrome
- establish ongoing assess |
|
|
Term
| Use and legal implications of restraints |
|
Definition
- they restrict the indv's freedom
- CMS standards
- behv mgmt. standard
- acute medical and surgical care standard |
|
|
Term
Use and legal implications of restraints
Behv mgmt. standard |
|
Definition
- nurse may apply restraints, but the dr or other licensed independent practitioner must see the ct within 1 hr for evaluation
- written restraint for an adult, following eval, valid for only 4 hrs
- there must be continual visual and audio monitoring if ct restrained and secluded |
|
|
Term
Use and legal implications of restraints
Med-Surg care standard |
|
Definition
- up to 12 hrs for obtaining the dr's written order
- orders renewed daily
- order must state the reason and time period
- PRN order prohibited
- in all cases, restraints used only after every possible means of ensuring safety unsuccessful and documented
- nurses must document need for the restraint made clear both to ct and family |
|
|
Term
| Desired outcomes for injury prevention |
|
Definition
- nurse's role largely educational
- desired outcomes reflect:
- acquisition of knowledge of hazards
- behvs that incorporate safety practices
- skills to perform in the event of certain emergencies |
|
|
Term
| Examples of Desired outcomes for injury prevention |
|
Definition
- describe methods to prevent specific hazards
- report use of home safety measures
- alter home physical enviro to reduce risk of injury
- describe emergency procedures for poisoning and fire
- describe age-specific risks or work safety risks or community safety risks
- demonstrate correct use of child safety seats
- demonstrate correct admin of CPR |
|
|
Term
Alternative/CAM therapies
Direct |
|
Definition
- massage
- acupressure
- acupuncture |
|
|
Term
Alternative/CAM therapies
Indirect |
|
Definition
- meditation
- imagery
- therapeutic touch/reiki
- music therapy
- biofeedback
- humor/laughter |
|
|
Term
|
Definition
1.
compassion
2.
competence
3.
confidence
4. conscience
5. commitment
6. comportment |
|
|
Term
Theories of Caring
Swanson |
|
Definition
- knowing
- being with
a theory of caring |
|
|
Term
|
Definition
a theory of caring
a. caring moment
b. rapport |
|
|
Term
| Factors influencing comfort and communication |
|
Definition
a.
gender
b.
age/developmental level
c. individual preference/patterns
d. physical condition
e. cultural/spiritual/religious
f. socioeconomic
g. support
h. time/temperature
i. psychological |
|
|
Term
|
Definition
| intentional action that conveys physical and emotional security and genuine connectedness w/ another person or people |
|
|
Term
| Mayeroff's 8 ingredients to caring |
|
Definition
Knowing - must have knowledge of the pt and her needs
Alternating Rhythms - there are times when I do not inject myself into the situation, I don’t take a stand one way or the other, I do “nothing”.
Patience
Honesty
Trust
Humility
Courage
Hope |
|
|
Term
|
Definition
- Leininger's cultural care diversity
- Watson's human caring theory
- Parse's human becoming theory
- Orem's self care theory
- Henderson's need theory
- Roger's unitary human beings
- Neuman's system model
- Peplau's interpersonal theory
- Benner's from novice to expert |
|
|
Term
| Benner's from novice to expert theory |
|
Definition
| describes five levels of nursing experience: novice, advanced beginner, competent, proficient and expert |
|
|
Term
|
Definition
| emphasized the importance of increasing a client's independence to promote their continued healing progress after hospitalization |
|
|
Term
| Roger's unitary human being theory |
|
Definition
| Nursing seeks to promote symphonic interaction between the environment and the person, to strengthen the coherence and integrity of the human beings, and to direct and redirect patterns of interaction between the person and the environment for the realization of maximum health potential |
|
|
Term
| Peplau's interpersonal theory |
|
Definition
| She defines the nurse/patient relationship evolving through orientation, identification, exploitation and resolution. She views nursing as a maturing force that is realized as the personality develops through educational, therapeutic, and interpersonal processes |
|
|
Term
| Leininger's transcultural theory |
|
Definition
| the goal of nursing is to provide care congruent with cultural values, beliefs, and practices. Leininger states that care is the essence of nursing and the dominant, distinctive and unifying feature. She says there can be no cure without caring, but that there may be caring with curing |
|
|
Term
Leininger's cultural care diversity and universality theory
3 intervention modes |
|
Definition
- culture care preservation and maint
- culture care accommodation, negotiating, or both
- culture care restructuring and repatterning |
|
|
Term
|
Definition
- compassion
- competence
- confidence
- conscience
- commitment
- comportment |
|
|
Term
The 6 Cs of caring
compassion |
|
Definition
| - awareness of one's relation to others, sharing their joys, sorrow, pain, and accomplishments. Participation in the experience of others |
|
|
Term
The 6 Cs of caring
Competence |
|
Definition
| - having the knowledge, judgement, skills, energy, experience, and motivation to respond adequately to others within the demands of professional responsibility |
|
|
Term
The 6 Cs of caring
Confidence |
|
Definition
| - the quality that fosters trusting relationships; comfort with self, ct, and family |
|
|
Term
The 6 Cs of caring
Conscience |
|
Definition
| - morals, ethics, and an informed sense of right and wrong; awareness of personal responsibility |
|
|
Term
The 6 Cs of caring
Commitment |
|
Definition
| - convergence between one's desires and obligations and the deliberate choice to act in accordance with them |
|
|
Term
The 6 Cs of caring
Comportment |
|
Definition
| - appropriate bearing, demeanor, dress, and language, that are in harmony with a caring presence; presenting oneself as someone who respects others and demands respect |
|
|
Term
| 5 caring Processes - Swanson's Theory of Caring |
|
Definition
- knowing
- being with
- doing for
- enabling
- maintaining belief |
|
|
Term
| 5 caring Processes - Swanson's Theory of Caring - knowing |
|
Definition
| - striving to understand an event as it has meaning in the life of others (avoiding assumptions; centering on the one cared for; assessing thoroughly; seeing cues; engaging the self of both) |
|
|
Term
| 5 caring Processes - Swanson's Theory of Caring - being with |
|
Definition
| - being emotionally present to the other (being there; conveying ability; shared feelings; not burdening) |
|
|
Term
| 5 caring Processes - Swanson's Theory of Caring - doing for |
|
Definition
| - doing for the other as he would do for himself if it were at all possible (comforting; anticipating; performing competently/skillfully; protecting; preserving dignity) |
|
|
Term
| 5 caring Processes - Swanson's Theory of Caring - enabling |
|
Definition
| - facilitating the other's passage through life transitions and unfamiliar events (informing/explaining; supporting/allowing; focusing; generating alternatives/thinking it through; validating/giving feedback) |
|
|
Term
| 5 caring Processes - Swanson's Theory of Caring - maintaining belief |
|
Definition
| - sustaining faith in the other's capacity to get through an event or transition and face a future with meaning (believing in/holding in esteem; maintaining a hope-filled attitude; offering realistic optimism; "going the distance") |
|
|
Term
| Carter's 4 ways of knowing |
|
Definition
- empirical
- personal
- ethical
- aesthetic |
|
|
Term
Carter's 4 ways of knowing
Emperical |
|
Definition
| - knowledge from research and objective facts. This knowledge is systematically organized into general laws and theories. One of the ways we employ this knowledge is through the use of evidenced-based practice (EBP). This way of knowing is often referred to as the “science” of nursing |
|
|
Term
Carter's 4 ways of knowing
Ethical |
|
Definition
| - helps one develop our own moral code; our sense of knowing what is right and wrong. For nurses, our personal ethics is based on our obligation to protect and respect human life. Our deliberate personal actions are guided by ethical knowing |
|
|
Term
Carter's 4 ways of knowing
Aesthetic |
|
Definition
| - makes nursing an “art.” It takes all of the other ways of knowing and through it creates new understanding of a phenomena. It is that “aha” moment that we have when we uncovered something new; and just as an artist creates a painting, you are afforded the opportunity of new perspective |
|
|
Term
Carter's 4 ways of knowing
Personal |
|
Definition
| - refers to the knowledge we have of ourselves and what we have seen and experienced. This type of knowledge comes to us through the process of observation, reflection, and self-actualization. It is through knowledge of ourselves that we are able to establish authentic, therapeutic relationships as it propels us towards wholeness and integrity |
|
|
Term
Caring communication
The helping relationship |
|
Definition
| - to care for someone is to help her grow and self-actualize. the process of caring engages the nurse and ct in a ________ relationship which is trusting and honest |
|
|
Term
|
Definition
- the helping relationship
- attentive listening
- physical attending |
|
|
Term
Caring Communication
Attentive listening |
|
Definition
- actively listening to the ct w/ all the senses reinforces the helping relationship.
- congruency between non-verbal and verbal communication is determined to accurately process the msg the ct is trying to convey |
|
|
Term
Caring Communication
physical attending |
|
Definition
- there are five actions of ____ _____ in communicating with the ct
1. face the ct squarely
2. adopt an open posture
3. lean towards the ct
4. maintain good eye contact
5. try to be relatively relaxed |
|
|
Term
| Barriers to communication |
|
Definition
- stereotyping
- agreeing and disagreeing: judgmental responses
- being defensive
- challenging
- probing: asking for info purely out of curiosity
- testing: asking questions that makes the ct admit to something
- rejecting: refusing to talk about certain topics
- changing the subject and/or topic
- unwarranted reassurances
- passing judgment
- giving common advice: telling the ct what to do |
|
|
Term
| Factors influencing the promotion of comfort and communication |
|
Definition
- gender
- indv preferences and patterns
- physical condition
- cultural and spiritual/religious beliefs |
|
|
Term
| The types of info and data a nurse would obtain to assess the pt's level of comfort and ease |
|
Definition
Relief – the state of having a specific comfort need met.
Ease – the state of calm or contentment.
Transcendence – the state in which one can rise above problems of pain |
|
|
Term
| Nursing dx r/t discomfort |
|
Definition
- activity intolerance r/t continued discomfort
- potential for injury r/t the side effects of pain meds
- readiness for enhanced comfort r/t pt's expressed desire to enhance comfort
- acute pain r/t physical therapy
- sleep pattern disturbance r/t nocturnal discomfort
- fatigue r/t sleep pattern disturbances |
|
|
Term
| Activity intolerance r/t continued discomforts |
|
Definition
| Expected outcomes: ct verbalizes decreased level of discomfort w/ inc activity....goes with which dx? |
|
|
Term
| At risk for injury r/t the side effects of pain meds |
|
Definition
| Expected outcome: ct remains free of injury....goes with which dx? |
|
|
Term
| Readiness for enhanced comfort r/t pt's expressed desire to enhance comfort |
|
Definition
| Expected outcome: ct expresses a desire to participate in techniques to enhance comfort and dec uneasiness....goes with which dx? |
|
|
Term
| Acute pain r/t physical injury |
|
Definition
| Expected outcome: ct reports discomfort level has dec to a 3/10....goes with which dx? |
|
|
Term
| Sleep pattern disturbance r/t nocturnal discomfort |
|
Definition
| Expected outcome: ct sleeps 6-8 hrs each night....goes with which dx? |
|
|
Term
| Fatigue r/t sleep pattern disturbance |
|
Definition
| Expected outcome: ct exhibits no evidence of fatigue....goes with which dx? |
|
|
Term
Dx: Fatigue r/t sleep pattern disturbance
Expected outcome: ct exhibits no evidence of fatigue |
|
Definition
| NI: reposition ct every 1-2 hrs.....is for which dx and expected outcome? |
|
|
Term
DX: potential for injury r/t the side effects of pain meds
Expected outcomes: ct remains free of injury |
|
Definition
| NI: use measures to promote safety such as: using side rails when ct is sedated, teaching ct not to operate machinery while on pain meds, positioning ct to maintain airway.....is for which dx and expected outcome? |
|
|
Term
Dx: readiness for enhanced comfort r/t pt's expressed desire to enhance comfort
Expected outcome: ct expresses a desire to participate in techniques to enhance comfort and dec uneasiness |
|
Definition
NI: - provide info and instruction to ct and sig others regarding comfort and relief
- instruct ct about relaxation techniques, meditation, guided imagery and ways to modify lifestyle to accommodate discomfort relief measures.....is for which dx and expected outcome? |
|
|
Term
Dx: acute pain r/t physical injury
EO: ct reports dec in discomfort to 3/10 |
|
Definition
NI: - admin pain meds before the discomfort becomes severe
- schedule pain meds before ambulation.....is for which dx and expected outcome? |
|
|
Term
Dx: sleep pattern disturbance r/t nocturnal discomfort
EO: ct sleeps 6-8 hrs each night |
|
Definition
| NI: use nursing measures to modift the envir such as: eliminate noise, provide music, dec lighting, eliminate odors, control temp, and provide the appropriate assistive devices.....is for which dx and expected outcome? |
|
|
Term
Dx: fatigue r/t sleep pattern disturbances
EO: ct exhibits no evidence of fatigue |
|
Definition
| NI: use the following nursing measures to provide time for uninterrupted sleep: dim lights, close doors, have visitors wait until ct awakes, minimize noises at nurse's desk and hallways.....is for which dx and expected outcome? |
|
|
Term
| Three views of health beliefs |
|
Definition
- magico-repigious
- scientific or biomedical
- holistic |
|
|
Term
| Physiologic effects of heat application |
|
Definition
- vasodilation
- skeletal muscle relaxation
- inc capillary permeability
- inc cellular metabolism
- inc inflammation
- sedative effect |
|
|
Term
| physiologic effect of cold application |
|
Definition
- vasoconstriction
- dec capillary permeability
- dec cellular metabolism
- slowing of bacterial growth which dec inflammation
- local anesthetic effect |
|
|
Term
|
Definition
- perceives comfort
- inc sensitivity to comfort
- older infant avoids comfort (pulls away)
NIs
- use glucose pacifier
- tactile stimulation
- play music or tapes of a heartbeat |
|
|
Term
|
Definition
- can describe comfort
- responds w/ crying and anger
- reasoning w/ child may not be successful
- may view comfort as a punishment
- has feelings of sadness
- begins to understand differences in gender response to comfort
- holds someone accountable for comfort
NIs
- distract w/ toys, books. Use bubbles to blow away the discomfort
- use magic blanket or glove to take away the discomfort
- hold for comfort
- explore misconceptions about discomfort |
|
|
Term
|
Definition
- tries to be brave when experiencing discomfort
- attempts to explain discomfort
- responds to explanations
- can ID location and describe discomfort
- may regress to earlier stage of devp in response to persistent discomfort
NIs
- use imagery to control discomfort
- educate prior tp procedure re: what to expect and how it looks and feels
- provide support and nurturing |
|
|
Term
|
Definition
- may be slow to acknowledge comfort
- thinks it may be a sign of weakness
- wants to appear brave and may play down uneasiness
NIs
- discuss comfort
- provide privacy
- discuss and encourage alternatives for pain control |
|
|
Term
|
Definition
- behvs may be gender based learned behv
- admitting discomfort may be a sign of weakness
- fear of cause of discomfort may prevent taking action
NIs
- address misconceptions re discomfort
- give ct control in comfort mgmt. techniques
- ease anxiety when possible |
|
|
Term
|
Definition
- may present with vague symptoms and multiple conditions
- sees discomfort as part of aging process
- dec sensation or perception of discomfort
- lethargy, anorexia, fatigue may be indicators of discomfort
- fear of txt may lead to withholding txt
- may withhold reporting due to fear of lifestyle changes or becoming dependent
- may use terms ache, hurt, or discomfort rather than pain
- may consider it unacceptable to admit or show discomfort
NIs
- assess and take full health history
- encourage conversation re ct's feelings about illness and comfort
- clarify misconceptions
- encourage independence when possible |
|
|
Term
|
Definition
| _______ are based on sociocultural considerations, optimal use of resources, devp level, indv preferences and Maslow's hierarchy |
|
|
Term
|
Definition
| amino acid messenger molecules produced at various sites throughout the body. When they attach to a receptor site, they either facilitate or block a cellular response |
|
|
Term
|
Definition
| the conversion or transformation of info or energy from one form to another |
|
|
Term
|
Definition
| the process by which the brain converts neural images (thoughts, attitudes, feelings, and emotions) into neuralhormonal messenger molecules and communicates them to all body systems that evoke states of health or illness |
|
|
Term
|
Definition
| focuses on the relationships among stress, the immune system, and health outcomes |
|
|
Term
|
Definition
| a renewal, an amplification of power or sense of control, an invigorating influence, a positive mind-set, and a readiness for action |
|
|
Term
|
Definition
| a group of NIs based on ct's cues of distress, with the goal of achieving ct comfort |
|
|
Term
|
Definition
| the verbal and nonverbal aspects of the msg match |
|
|
Term
|
Definition
| the verbatim account of a conversation |
|
|
Term
|
Definition
| the study of distance between people in their interactions |
|
|
Term
|
Definition
|
|
Term
|
Definition
| it acts to promote indv growth, preserve human dignity and worth, augment self-healing, and relieve distress |
|
|
Term
|
Definition
| a characteristic unique to nursing and an essential aspect of caring |
|
|
Term
|
Definition
| ----- ------ can be viewed in the framework of physical, psychospiritual, social, and enviro needs |
|
|
Term
|
Definition
| a two way interpersonal process. It also involves intrapersonal msgs, or self-talk, which can effect the msg, the interpretation of the msg, and the response |
|
|
Term
|
Definition
| it includes four elements: sender, message, receiver, feedback |
|
|
Term
|
Definition
| it is effective when the criteria of pace and intonation, simplicity, clarity and brevity, timing, relevance, adaptability and credibility are met |
|
|
Term
|
Definition
| when assessing verbal and nonverbal behvs, the nurse needs to consider _____ _______ |
|
|
Term
| Techniques that facilitate therapeutic comm |
|
Definition
- using silence
- providing gen'l leads
- being specific and tentative
- using open-ended questions
- using touch
- restating or paraphrasing
- seeking clarification
- perception checking or seeking consensual validation
- offering self
- reflecting |
|
|
Term
|
Definition
the nurse:
- manipulates the envir
- provides support
- employs measures to enhance comm
- educates the ct and support persons |
|
|
Term
|
Definition
- physical comfort needs
- psychospiritual comfort needs
- social comfort needs
- envir comfort needs |
|
|
Term
| 3 types of comfort described by Kolcaba |
|
Definition
- relief: from discomfort is the experience of having a specific need met
- ease: refers to a state of calm or peaceful contentment
- transcendence: the state in which the ct rises above probs or pain |
|
|
Term
| Communication strategies for providing comfort |
|
Definition
- empathy
- positive talk
- therapeutic touch
- competent physical and technical skills
- vigilance |
|
|
Term
| Verbal communication consists of |
|
Definition
- pace and intonation
- simplicity
- clarity and brevity
- timing and relevance
- adaptability
- credibility
- humor |
|
|
Term
Communication techniques for:
Infants |
|
Definition
- they communicate through their senses. Touch is important
- they respond best to a high-pitched, soft, or gentle tone of voice and eye contact |
|
|
Term
Communication techniques for:
Toddlers and Preschoolers |
|
Definition
- allow time for them to complete verbalizing their thoughts w/o interruption
- provide a simple response to questions because they have short attn. spans
- drawing a pic can provide another way for them to communicate |
|
|
Term
Communication techniques for:
School-Age children |
|
Definition
- talk to her at her eye level to help dec intimidation
- include her in the conversation when comm w/ the parents |
|
|
Term
Communication techniques for:
Adols |
|
Definition
- take time to build rapport with her
- use active listening skills
- project a nonjudgmental attitude and nonreactive behvs, even when she says disturbing remarks |
|
|
Term
| Phases of the helping relationship |
|
Definition
- preinteraction phase
- introductory phase
- working phase
- termination phase |
|
|
Term
Phases of the helping relationship:
Preinteraction phase |
|
Definition
| - similar to the planning stage before an interview. The nuse has info about the ct before he meets her |
|
|
Term
Phases of the helping relationship:
Intro phase |
|
Definition
- also referred to as the orientation or the prehelping phase
- consists of three phases:
- opening the relationship
- clarifying the prob
- structuring and formulating the contract
- it sets the tone for the rest of the relationship
- the ct and nurse observe each other and form judgments about the other's behv |
|
|
Term
| By the end of the introductory phase, cts should begin to: |
|
Definition
- devp trust in the nurse
- view the nurse as competent
- view the nurse as concerned
- believe the nurse will strive to understand him
- believe the nurse will respect them
- will respect confidentiality
- feel comfortable confiding in the nurse
- understand the purpose of the relationship and roles
- feel as though they are active participants in their own care |
|
|
Term
Phases of the helping relationship:
Working phase |
|
Definition
- the nurse and ct begin to view each other as unique indvs
- they begin to care about each other
- facilitating and taking action |
|
|
Term
Phases of the helping relationship:
Termination phase |
|
Definition
- nurse and ct accept feelings of loss
- the ct accepts the end of the relationship w/o feelings of anxiety or dependence |
|
|
Term
| Skills required of the nurse in the preinteraction phase |
|
Definition
| - organized data gathering; recognizing limitations and seeking assistance as required |
|
|
Term
| Skills required of the nurse in the introductory phase |
|
Definition
- relaxed, attending attitude to put the ct at ease
- attentive listening, paraphrasing, clarifying, and other effective comm techniques
- ability to overcome resistive behvs |
|
|
Term
| Skills required of the nurse in the working phase |
|
Definition
- listening and attending skills, empath, respect, genuineness, concreteness, self-disclosure, and confrontation
- decision making, goal setting, reinforcement skills |
|
|
Term
| Skills required of the nurse in the termination phase |
|
Definition
|
|
Term
| Features of Effective Groups |
|
Definition
- atmosphere: good
- purpose: clarified
- leadership and member participation: democratic
- communication: open
- decision making: by the group
- cohesion: respect
- conflict tolerance
- power: determined by ability and knowledge
- prob solving: high, constructive criticism
- creativity |
|
|
Term
|
Definition
- task groups: getting stuff done
- teaching groups: teaching other participants
- self help groups
- self awareness/growth groups
- therapy groups
- work related social support groups |
|
|
Term
Communication and the Nursing Process
Assessing |
|
Definition
- impairments to comm: language, sensory, structural, paralysis, cogn, style of comm, verbal and nonverbal comm
- the nurse must assess to determine their presence |
|
|
Term
Communication and the Nursing Process
Diagnosing |
|
Definition
- impaired verbal comm is a dx when a ct experiences a dec, delayed, or absent ability to receive , process, xmit, and use a system of symbols
- the dx may not be useful when the ct's probs are psychological or coping
- other dx used for cts experiencing comm probs:
- anxiety
- powerlessness
- situational low self-esteem
- social isolation
- impaired social interaction |
|
|
Term
Communication and the Nursing Process
Planning |
|
Definition
- the overall ct outcome with Impaired Verbal Comm is to reduce or resolve the impairing factors
- possible outcomes:
- comms that needs are being met
- begins to establish a method of comm
- perceives the msg accurately, aeb appropriate verbal and/or nonverbal responses
- comms effectively
- regains max comm abilities
- expresses min fear, anxiety, frust, and depression
- uses resources appropriately |
|
|
Term
Communication and the Nursing Process
Implementing |
|
Definition
- manipulating the envir
- providing support
- uses measures to enhance comm
- educating the ct and support person |
|
|
Term
Communication and the Nursing Process
Evaluating |
|
Definition
it is for both ct and nurse comm
- ct comm: nurse must listen actively, observe nonverbal cues, use therap comm to evaluate the ct
- nurse comm: process recordings frequently used |
|
|
Term
| Effects of prolonged exposure to heat application |
|
Definition
- increases capillary permeability which may result in edema
- burning |
|
|
Term
| Effects of prolonged exposure to cold application |
|
Definition
- impaired circulation
- cell deprivation
- subsequent damage to the tissues from lack of O2 and nourishment |
|
|
Term
| Systemic effects of heat and cold |
|
Definition
- heat may cause peripheral vasodilation, which produces a drop in BP...fainting
- a ct's BP can inc |
|
|
Term
| Variables affecting Physiologic Tolerance to Heat and Cold |
|
Definition
- body part
- size of exposed body part
- indv tolerance
- length of exposure
- skin integrity |
|
|
Term
| Specific conditions that necessitate precautions in the use of hot or cold application |
|
Definition
- neurosensory impairment
- impaired mental status
- impaired circulation
- immediately after injury or surgery
- open wounds |
|
|
Term
|
Definition
| it occurs at the time the max therapeutic effect of the hot or cold application is achieved and the opposite effect occurs |
|
|
Term
| Guidelines for applying heat or cold |
|
Definition
- determine ct's ability to tolerate therapy
- id conditions that might contraindicate txt
- explain txt to ct
- assess skin area beforehand
- ask ct to report any discomfort
- examine ct and skin area 15 mins after application
- remove at designated time
- examine area again and record ct's response |
|
|
Term
|
Definition
- muscle spasm: relaxes muscles and inc their contractility
- inflammation: increases blood flows, soften exudates
- pain: relieves
- contracture: reduces joint contracture and inc joint ROM
- joint stiffness: reduces |
|
|
Term
|
Definition
- muscle spasm: relaxes muscles and dec muscle contractility
- inflammation: dec blood flow, slows cellular metab
- pain: dec
- traumatic injury: dec bleeding and edema |
|
|
Term
|
Definition
- hot water bag or bottle
- aquathermia (K) pad
- hot and cold packs
- electric pads
- ice bags, ice gloves, and ice collars
- compresses
- soak
- sitz bath
- cooling sponge bath |
|
|
Term
|
Definition
a type of massage consisting of long, slow, gliding strokes
- used for:
- to relieve muscle tension
- to promote physical and mental relaxation
- to relieve insomnia |
|
|
Term
|
Definition
| excessive sensitivity to pain |
|
|
Term
|
Definition
| a medication that was developed for a use other than analgesia but has been found to reduce chronic pain and sometimes acute pain, in addition to its primary action |
|
|
Term
|
Definition
| means approximately equal angalgesia and is used when referring to the does of various opiod analgesics that provide approximately the same pain relief |
|
|
Term
|
Definition
| the physiologic processes related to pain perception, that involves four processes including, transduction, transmission, perception and modulation |
|
|
Term
|
Definition
| the result of current or past damage to the peripheral or central nervous system and may not have a stimulus, such as tissue or nerve damage, for the pain |
|
|
Term
|
Definition
| implies a renewal, an amplification of power or sense of control, and invigorating influence, a positive mind-set, and a readiness for action |
|
|
Term
| Swanson's theory of caring contains |
|
Definition
| process and definitions and subdimensions |
|
|
Term
|
Definition
| A client with degenerative joint disease comes to the clinic and states that he has been reading a lot about essential oils that are helpful for body aches, for pain relief, and as anti-inflammatories. The nurse may offer the client information about the use of which oil? |
|
|
Term
|
Definition
| The night nurse is assuming care of a cardiac client who wears antiembolic stockings. How should this nurse manage assessment of the skin on this client's legs? |
|
|
Term
|
Definition
| A client has requested that she have a special item present in her room and explains that it gives her a feeling of comfort and a sense of organization. This client is focusing on which component of heritage consistency? |
|
|
Term
| The components of heritage consistency |
|
Definition
- socialization
- religion
- ethnicity
- culture |
|
|
Term
The components of heritage consistency
Religion |
|
Definition
| It may be defined by a system of beliefs, practices, and ethical values about divine or superhuman power and is closely related to ethnicity. It gives a person a frame of reference and a perspective with which to organize information |
|
|
Term
The components of heritage consistency
Culture |
|
Definition
| is a learned behavior and depends on underlying societal traits including knowledge, beliefs, art, law, morals, and customs |
|
|
Term
The components of heritage consistency
Ethnicity |
|
Definition
| describes the traits and common religious customs and language of a group within the social system |
|
|
Term
The components of heritage consistency
Socialization |
|
Definition
| is the process of being raised within a culture and acquiring the characteristics of that group |
|
|
Term
|
Definition
| includes the use of commonly understood words, brevity, and completeness |
|
|
Term
|
Definition
| help indicate interest, anxiety, boredom, or fear-all of which modify the feeling and impact of the message |
|
|
Term
|
Definition
| imply that the message is direct and simple-saying precisely what is meant and using the fewest words necessary. |
|
|
Term
The
main purposes of the JCAHO pain management guidelines |
|
Definition
are to:
Establish measure
ment as the key for improvement
Dispel false beliefs a
bout pain and its treatment
Pro
vide objective data to gain support for establi
shing policies, procedures
educational programs to promote effective pain manag
ement |
|
|
Term
In
2001 JCAHO instituted policies that specifically mandate health car
e providers to: |
|
Definition
Recognize patients’ rights to:
pain assessment and management
Assess the intensity and nature of the pain
Record the results of patients’ pain a
ssessment to help in follow up
Ensure competency in pain a
ssessment and management
Appropriately prescribe pain medication
Address the need for pain management in discharge planning |
|
|
Term
|
Definition
One of the validated tools used for children 2 months to 7 years is the _____ scale which rates pain behaviors manifested in:
Facial expressions, Leg movement, Activity, Cry, and Consoling measures that yield a 0 to 10 score |
|
|
Term
|
Definition
he is often quoted definition of pain says that
“pain is whatever the experiencing
person says it is, existing whenever he says it does". |
|
|
Term
| The process by which painful stimulus is perceived involves four steps: |
|
Definition
| Transduction • Transmission • Modulation • Perception |
|
|
Term
| Pain receptors (nociceptors) |
|
Definition
- are found at the free nerve endings of unmyelinated or lightly myelinated afferent neurons
- are located extensively in skin and mucosa; less frequently are found in viscera, joints, arterial walls, and bile ducts
- contain molecular receptors, which enable nociceptor responses to a wide range of harmful or potentially harmful stimuli |
|
|
Term
The process by which painful stimulus is perceived involves four steps:
Transduction |
|
Definition
| receptor activation - converts noxious stimuli (eg, chemical, thermal, or mechanical) into electrochemical impulses carried to the CNS |
|
|
Term
| Transmission of pain impulses occurs via primary afferent nerve fibers entering the spinal cord |
|
Definition
- impulses synapse into second-order neurons
- modulated by substance P
- inpulses carried by secondary neurons synapse to cross the spinal cord
- impulses connect with ascending spinal pathways
- descending spinal pathways conduct nociceptive inhibitory impulses
- serotonin, norepinephrine, and endorphins are released by descending fibers and inhibit the release of neurotransmitters, thereby modulating (inhibiting) pain xmission by preventing stimuli from being xmitted to second-order neurons
- amino acids found in the spinal cord are also thought to inhibit neurotransmitter release through hyperpolarization of second-order neurons, thereby modulating pain xmission to the ascending spinal pathways |
|
|
Term
|
Definition
- four main regions of the cerebral cortex, with other areas of the forebrain, are activated by pain signals from the ascending pathways and interact to produce the sensory-discriminative, motivational-affective, and cogn aspects of pain
- an indvs perception of pain is influenced by culture, past pain experiences, the context of the pain, and the meaning of the situation in which the pain is occurring |
|
|
Term
| Theories of pain xmission |
|
Definition
- affect theory
- specific theory
- pattern theory
- gate control theory |
|
|
Term
Theories of pain xmission
Affect theory |
|
Definition
- pain is an emotion, and its intensity depends on the meaning of the part involved
- limitations: does not include physiologic aspects |
|
|
Term
Theories of pain xmission
Specific theory |
|
Definition
- specific pain receptors project impulses over neural pain pathways to the brain
- limitations: does not account for physiologic aspects of pain perception and variability of response |
|
|
Term
Theories of pain xmission
Pattern theory |
|
Definition
- pain results from combined effects of stimulus intensity and summations of impulse in the dorsal horn of the spinal cord
- limitations: does not account for psychologic pain |
|
|
Term
Theories of pain xmission
Gate control theory |
|
Definition
- pain impulses can be controlled by a gating mechanism in the substantia gelatinosa of the dorsal horn of the spinal cord to permit or inhibit xmission.
- gating factors include effect of impulses xmitted over fast or slow conducting nerve fibers and effects of descending impulses from the brainstem and cortex |
|
|
Term
Factors affecting pain xmission based on gate control theory
Fibers |
|
Definition
- close gate (block xmission): impulses xmitted by large, fast, myelinated A-beta and A-alpha fibers. Stimulation of unaffected skin areas (eg, massage)
- open gate (permit xmission): impulses xmitted by slow, small A-delta and C fibers. Stimulation of affected skin areas (eg, sunburned skin) |
|
|
Term
Factors affecting pain xmission based on gate control theory
Brainstem (descending pathway) |
|
Definition
- close gait (block xmission): endorphin effect, sufficient or maximal sensory input (eg, distraction)
- open gate (permit xmission): no endorphin effect, insufficient sensory input (eg, monotony) |
|
|
Term
Factors affecting pain xmission based on gate control theory
Cortex |
|
Definition
- close gate (block xmission): past experiences, feelings of pain control
- open gate (permit xmission): past experiences, anxiety |
|
|
Term
Comparison of acute and chronic pain
Acute |
|
Definition
- onset: usually sudden
- duration: transient (up to 3 mos)
- pain localization: pain vs nonpain areas generally well id
- clinical signs: signs of sympathetic overactivity (such as inc BP)
- purpose: warnings that something is wrong
- pattern: self-limited or readily corrected
- prognosis: likelihood of eventual complete relief |
|
|
Term
Comparison of acute and chronic pain
Chronic |
|
Definition
- onset: may be sudden or insidious
- duration: prolonged (months to years)
- pain localization: pain vs nonpain areas less well id; intensity more difficult to eval (change in sensation)
- clinical signs: usually no change in vitals (adaptation)
- purpose: meaningless; no purpose
- pattern: continuous or intermittent; intensity may vary or remain constant
- prognosis: complete relief usually not possible |
|
|
Term
Comparison of Superficial, Somatic, and Visceral Pain
Superficial |
|
Definition
- characteristic: skin and subcu tissue
- quality: sharp, pricking, burning
- localization: good
- referred pain: no
- provoking stimuli: cut, abrasion, excessive heat or cold, chemicals
- autonomic reactions: no
- reflex muscle contractions: no |
|
|
Term
Comparison of Superficial, Somatic, and Visceral Pain
Somatic |
|
Definition
- characteristic: deep muscles and bones
- quality: sharp or dull and aching
- localization: poor
- referred pain: no
- provoking stimuli: cut, pressure, heat, ischemia, displacement (bone)
- autonomic reactions: yes
- reflex muscle contractions: yes |
|
|
Term
Comparison of Superficial, Somatic, and Visceral Pain
Visceral |
|
Definition
- characteristic: internal organs
- quality: sharp or dull aching, cramping
- localization: poor
- referred pain: yes
- provoking stimuli: distention, ischemia, spasms, chemical irritants (no cutting)
- autonomic reactions: yes
- reflex muscle contractions: yes |
|
|
Term
|
Definition
- felt in areas other than those stimulated by injury or disease
- it can occur w/ damage or injury to visceral organs
- its mechanism of action is unknown, but it might be caused by the inability of higher brain centers receiving both somatic and visceral regions to the discriminate pain source |
|
|
Term
|
Definition
- it arises from injury to the nervous system
- it might be:
- sharp, spasm-like pain occurring along the course of one or more nerves
- severe burning pain associated with injury to a peripheral nerve
- phantom limb pain in an amputated extremity |
|
|
Term
| Factors that influence responses to pain |
|
Definition
- meaning of pain to the indv
- degree of pain perception
- past experience
- cultural values
- social expectations
- physical and mental health
- parental attitudes toward pain
- setting in which pain occurs
- fear, anxiety
- usual way of responding to stressors
- age
- preparation for pain context
- health professional's responses |
|
|
Term
| Pain intensity rating scales |
|
Definition
- categoric scale
- numeric scale
- visual analog scale |
|
|
Term
|
Definition
- most effective analgesic for moderate to severe pain
- must be given regularly to prevent recurrence of pain
- most common side effect is constipation
- reversible w/ naloxone
- oral admin is preferred, if tolerated
- may be admin via IV, SC, buccal, rectal, transdermal, subl, epidural, or intranasal route, or via respiratory tract |
|
|
Term
|
Definition
- NSAIDS
- used to control mild to moderate pain of dysmenorrhea, musculoskeletal disorders
- anti-inflammatory action w/ higher doses
- side effects include GI disturbances, dizziness, tinnitus, and headache
- COX-2 formulations provide selective inhibition action for pain, inflammation, and fever |
|
|
Term
Adjuvant meds that can be given to provide pain relief or as an adjunct to analgesics
These include: |
|
Definition
- phenothiazines
- tricyclic antidepressants
- anticonvulsants
- corticosteroids |
|
|
Term
| Nonpharmacologic strategies for pain mgmt. include and/or non-nursing interventions |
|
Definition
- transcutaneous electrical nerve stimulation (TENS)
- acupuncture
- neurosurgical procedures
- behv mod
- biofeedback
- psychoeducation
- hypnosis |
|
|
Term
| A 56-year-old female is admitted to your unit after discharge from PACU following knee replacement surgery. She has orders for morphine sulfate via intermittent PCA with a lockout of 1 mg every 6 minutes, maximum 10 mg/hr. You notice that she is not using the PCA pump, but that she reports her pain at 8/10 when using the CPM machine. When questioned about her reluctance to use the PCA, she states that she doesn't "want to become a drug addict." |
|
Definition
The pain following knee surgery can be characterized as which type of pain? (Hint: Superficial, somatic, or visceral) Somatic
• How should the nurse respond to the patient's fear of addiction? Tell the pt that the pump is set up below dosages for addiction
• The PCA is to be discontinued. What equianalgesic would the nurse expect to be initiated? Oral morphine 30mg
• What nursing actions should be implemented for this patient in pain?
- assist ct to explore methods for alleviation/control of pain
- promote wellness
- assess precipitating contributory factors
- evaluate ct's response to pain |
|
|
Term
| Sensory process: 4 aspects must be present |
|
Definition
- stimulus
- receptor
- impulse conduction
- perception: arousal mechanism |
|
|
Term
| Factors influencing sensory function |
|
Definition
- devp stage
- culture
- level of stress
- meds and illness
- lifestyle |
|
|
Term
| Clinical manifestations of sensory overload |
|
Definition
- complaints of fatigue, sleeplessness
- irritability, anxiety, and restlessness
- periodic or gen'l disorientation
- reduced prob-solving ability and task performance
- inc muscle tension
- scattered attn. and racing thoughts |
|
|
Term
| Clinical manifestations of sensory deprivation |
|
Definition
- excessive yawning, drowsiness, and sleeping
- dec attn. span, difficulty concentrating, and dec prob-solving
- impaired memory; periodic disorientation, gen'l confusion, or nocturnal confusion
- preoccupation with somatic complaints, such as palpitations
- hallucinations or delusions
- crying, annoyance over small matters and depression
- apathy and emotional liability |
|
|
Term
| Assessment of Sensory-Perceptual Function |
|
Definition
- nursing history
- mental status exam
- physical
- id of cts at risk
- enviro
- social support network |
|
|
Term
| Risk factors for sensory deprivation |
|
Definition
- nonstimulating or monotonous enviro
- impaired vision or hearing
- mobility restrictions
- inability to process stimuli
- emotional disorders
- limited social contact |
|
|
Term
| Risk for sensory overload |
|
Definition
- pain or discomfort
- admission to an acute care facility
- monitoring in ICU
- invasive tubes
- dec cogn ability |
|
|
Term
|
Definition
- disturbed sensory perception (specify: visual, auditory, kinesthetic, gustatory, tactile, olfactory)
- acute confusion
- chronic confusion
- impaired memory |
|
|
Term
| NANDA Nursing Dx: examples for which sensory-perceptual disturbances are the etiology |
|
Definition
- risk for injury
- impaired home maint
- risk for impaired skin integrity
- impaired verbal comm
- self care deficit: bathing/hygiene
- social isolation |
|
|
Term
NANDA Nursing Dx:
- risk for injury
- impaired home maint
- risk for impaired skin integrity
- impaired verbal comm
- self care deficit: bathing/hygiene
- social isolation
Outcome criteria: |
|
Definition
- prevent injury
- maintain the function of existing senses
- devp an effective comm mechanism
- prevent sensory overload or deprivation
- reduce social isolation
- perform ADLs independently and safely |
|
|
Term
| NIs to promote/maintain sensory function |
|
Definition
- Promote healthy sensory function
- appropriate sensory stimulation
- prevention of sensory disturbances
- Adjust enviro stimuli
- prevent sensory overload
- prevent sensory deprivation
- Manage acute sensory deficits
- use of sensory aids
- use of other senses
- effective comm |
|
|
Term
| Orientation strategies for ct w/ acute confusion/delirium |
|
Definition
- wear a legible name tag
- address the ct by name
- introduce myself freq
- id time and place as indicated
- ask the ct, "where are you?"
- orient the ct to place if indicated
- place a calendar and clock in the ct's room
- mark holidays w/ ribbons, pins, etc..
- speak clearly and calmly, allowing time for words to be processed and for a response
- encourage family to visit freq
- provide clear, concise explanations of ea txt, procedure, or task
- eliminate unnecessary noise
- provide adequate sleep
- keep glasses and hearing aids within reach
- ensure adequate pain mgmt.
- keep room well lit during waking hours |
|
|
Term
| Promoting structured sensory stim for unconscious ct |
|
Definition
- Auditory
- introduce myself to the ct
- orient the ct to time, month, year, location
- inform the ct beforehand the care to be provided
- read to ct
- play a recording of familiar voice
- convers directly to ct
- Visual
- sit ct upright in a chair or bed
- Olfactory
- provide aromatic stimuli that may include ct's favorites
- Gustatory
- provide mouth care
- place different tastes on tongue
- Tactile
- incorporate during bath activities
- Kinesthetic
- perform ROM exercises
- change ct's positioning |
|
|
Term
|
Definition
- experienced when an intact, properly functioning nervous system signals that tissues are damaged, requiring attn. and proper care
- transient
- persistent
- Subcategories
- somatic
- visceral |
|
|
Term
|
Definition
- experienced by people who have damaged or malfunctioning nerves
- Types
- peripheral
- central
- sympathetically maintained |
|
|
Term
| 4 processes involved in nociception |
|
Definition
- transduction
- transmission
- perception
- modulation |
|
|
Term
|
Definition
- pain at nociceptors (receptors)
- A-delta fibers: fast xmission of sharp localized pain
- C fibers: slow xmission of dull, burning chronic pain
- spinal ganglia
- dorsal horn: pain signal modified
- lateral spinothalamic tract
- pain perception point |
|
|
Term
|
Definition
- small dia (a-delta or C) peripheral nerve fibers carry signals of noxious stimuli to the dorsa horn
- signals are modified when they are exposed to the substantia gelatinosa
- ion channels on the pre- and postsynaptic membranes serve as gates
- when open, permit positively charged ions to rush into the second order neurons, sparking an electrical impulse and sending signals of pain to the thalamus
- large dia (A-delta) fibers have inhibitor effect
- may activate descending mechanism that can inhibit xmission of pain |
|
|
Term
| Clinical application of GCT |
|
Definition
- stop nociceptor firing
- apply topical therapies
- address ct's mood
- address ct's goals |
|
|
Term
| Factors affecting perception of pain |
|
Definition
- ethnic and cultural values
- devp stage
- enviro and support people
- past pain experiences
- meaning of pain
- spiritual
- social |
|
|
Term
| Pain assessment subjective data |
|
Definition
- comprehensive pain history includes COLDERR
- C: character
- O: onset
- L: location
- D: duration
- E: exacerbation
- R: relief
- R: radiation |
|
|
Term
Pain assessment
Addl data to obtain |
|
Definition
- associated symptoms
- effect on ADLs
- past pain experiences
- meaning of the pain to the person
- coping resources
- affective response |
|
|
Term
| Pain assessment: Objective data |
|
Definition
- nonverbal responses to pain
- facial expressions
- vocalizations like moaning and groaning or crying and screaming
- immobilization of the body or body part
- purposeless body movements
- behv changes such as confusion and restlessness
- rhythmic body mvmts or rubbing
- early physiologic responses
- inc BP, HR, RR
- pallor
- diaphoresis
- pupil dilation
- may be absent in people with chronic pain
- pain diary |
|
|
Term
| NANDA nursing dx for pain |
|
Definition
- acute and chronic pain
- specify the location
- related factors, when known, can include physiologic and psychologic factors
- pain may be etiology of other dxs
- pain as etiology of other nursing dxs
- ineffective airway clearance
- hopelessness
- anxiety
- ineffective coping
- ineffective health maintenance
- self care deficit (specify)
- deficient knowledge (pain control measures)
- disturbed sleep patterns |
|
|
Term
|
Definition
- goals vary according to the dx and its defining characteristics
- select pain relief measures appropriate for the ct, based on assessment data and input from the ct or support persons |
|
|
Term
| Practice guidelines for pain txt plan |
|
Definition
- establish a trusting relationship
- consider ct's ability and willingness to participate
- use a variety of pain relief measures
- provide pain relief before pain is severe
- use pain relief measures the ct believes are effective
- align pain relief measures with report of pain severity
- encourage ct to try ineffective measures again before abandoning
- maintain unbiased attitude about what may relieve pain
- keep trying
- prevent harm
- educate ct and caregiver about pain |
|
|
Term
|
Definition
- include a variety of pharmacologic and nonpharmacologic interventions
- plan w/ wide range of strategies
- document plan in ct records and for home care
- involve ct and support persons |
|
|
Term
| Barriers to effective pain mgmt |
|
Definition
- lack of knowledge of the adverse effects of pain
- misinformation regarding the use of analgesics
- misconceptions about pain
- may not report pain
- fear of addiction |
|
|
Term
|
Definition
- primary, chronic, neurobiologic disease
- genetic, psychosocial, and enviro are influential factors
- behvs can include:
- impaired control over drug use
- compulsive use
- craving
- continued use despite harm |
|
|
Term
|
Definition
- state of adaptation
- manifested by withdrawal syndrome
- produced by:
- abrupt cessation
- rapid dose reduction
- dec blood level of drug
- and/or admin of an antagonist |
|
|
Term
|
Definition
- state of adaptation
- exposure to a drug induces changes
- results in a diminution of one or more of the drug's effect over time |
|
|
Term
| Pharmacologic interventions for pain |
|
Definition
- opioids (narcotics)
- nsaids
- co-analgesics |
|
|
Term
|
Definition
- full agonists
- no ceiling on analgesia
- dosage can be steadily inc to relieve pain
- eg, morphine, oxycodone, hydromorphone
- Mixed agonist-antagonists
- act like opioids and relieve pain
- can block or inactivate other opioid analgesics
- eg, dezocine, petazocine HCL, butorphanol tartrate, nalbuphine HCL
- Partial agonist
- have a ceiling effect
- eg, buprenorphine |
|
|
Term
|
Definition
- vary little in analgesic potency, but do vary in anti-inflammatory effects, metabolism, excretions, and side effects
- have a ceiling effect
- narrow therapeutic index
- eg, acetaminophen, ibuprofen, aspirin |
|
|
Term
|
Definition
- antidepressants
- anticonvulsants
- local anesthetics
- others |
|
|
Term
| WHO Ladder Step approach for cancer pain control |
|
Definition
Step 1: for cts w/ mild pain (1-3/10), use of nonopioid analgesics (w/ or w/o a coanalgesic)
Step 2: ct has mild pain that persists or inc - pain is moderate (4-6/10). Use of a weak opioid (eg, codeine, tramadol, pentazocine) or a combo of opioid and nonopioid meds (oxycodone w/ acetaminophen, hydrocodone w/ ibuprofen)
Step 3: ct has moderate pain that persists or inc - pain is severe 7-10. Use strong opioids (eg, morphine, hydromorphine, fentanyl) |
|
|
Term
|
Definition
- evolved from WHO three step approach
- demands health pros be aware of all ingredients of pain meds
- use combos to reduce the need for high doses of any one med
- maximize pain control w/ a min of side effects or toxicity
- combined w/ multimodal therapy (eg, nondrug approaches) |
|
|
Term
|
Definition
Type of drug route
- preferred because of ease of admin
- duration of action is often only 4-8 hrs
- must awaken during night for medication
- long-acting preparations devp
- may need rescue dose of immediate-release med |
|
|
Term
|
Definition
Type of drug route
- enters blood immediately
- onset of action is rapid |
|
|
Term
|
Definition
Types of drug route
- useful for cts w/ dysphagia or nausea/vomiting |
|
|
Term
|
Definition
Type of drug route
- used for pain poorly controlled by oral meds |
|
|
Term
|
Definition
Type of drug route
- delivers relatively stable plasma drug level
- noninvasive |
|
|
Term
|
Definition
- supraclavicular
- abdomen |
|
|
Term
|
Definition
Type of drug route
- should be avoided
- variable absorption
- unpredictable onset of action and peak effect
- tissue damage |
|
|
Term
|
Definition
Type of drug route
- provides rapid and effective relief w/ few side effects |
|
|
Term
|
Definition
Type of drug route
- provides superior analgesia w/ less med used |
|
|
Term
| Benefits/Risks Routes and Tech |
|
Definition
- pt controlled analgesia (PCA) pump
- minimizes peaks of sedation and valleys of pain that occur w/ pm dosing
- safety mechanisms on pump |
|
|
Term
| Nonpharmacologic Pain control interventions |
|
Definition
- consists of a variety of pain mgmt. strategies
- physical
- cogn/behv
- lifestyle pain mgmt.
- targets body, mind, spirit, and social interactions |
|
|
Term
Nonpharmacologic Pain control interventions
Physical modalities |
|
Definition
- cutaneous stimulation
- immobilization or therapeutic exercises
- TENS |
|
|
Term
Nonpharmacologic Pain control interventions
Cogn/Behv (mind/body) |
|
Definition
- providing comfort
- eliciting relaxation response
- repatterning thinking
- facilitating coping w/ emotions |
|
|
Term
Nonpharmacologic Pain control interventions
Lifestyle Mgmt |
|
Definition
- stress mgmt.
- exercise, nutrition
- pacing activities
- disability mgmt |
|
|
Term
Nonpharmacologic Pain control interventions
Spiritual |
|
Definition
- feel part of a community
- bond w/ universe
- religious activities |
|
|
Term
| Nonpharmacologic Invasive Techniques |
|
Definition
- cordotomy
- rhizotomy
- neurotomy
- sympathectomy
- spinal cord stimulation |
|
|
Term
Nonpharmacologic Techniques
Body interventions |
|
Definition
- reducing pain triggers
- massage
- applying heat or ice
- TENS
- positioning and bracing (selective immobilization)
- acupressure
- diet and nutritional supplements
- exercise and pacing activities
- invasive interventions (eg, blocks)
- sleep hygiene
- |
|
|
Term
Nonpharmacologic Techniques
Mind Interventions |
|
Definition
- relaxation and imagery
- self hypnosis
- pain diary and journal writing
- distracting attn.
- repattern thinking
- attitude adj
- reducing fear, anxiety, stress, sadness, and helplessness
- providing info on pain |
|
|
Term
Nonpharmacologic Techniques
Spirit Interventions |
|
Definition
- prayer
- meditation
- self reflection
- meaningful rituals
- energy work (therapeutic touch, Reiki)
- spiritual healing |
|
|
Term
Nonpharmacologic Techniques
Social Interaction |
|
Definition
- functional restoration
- improved comm
- family therapy
- prob solving
- vocational training
- volunteering
- support groups |
|
|
Term
|
Definition
- an unpleasant sensory and emotional experience associated w/ actual or potential tissue damage
- whatever the ct says it is, existing whenever the ct says it does |
|
|
Term
|
Definition
- a major function of pain is to signal ongoing or potential tissue damage
- it can also be a protective mechanism against further injury |
|
|
Term
|
Definition
- categorized by origin
- categorized by nature |
|
|
Term
| Type of pain characterized by origin |
|
Definition
- cutaneous (caused by stimulation of the cutaneous nerve endings in the skin)
- somatic (nonlocalized and originates in support structures such as tendons, ligaments, and nerves
- visceral (discomfort in the internal organs)
- referred (originating from the abdominal organs) |
|
|
Term
|
Definition
|
|
Term
|
Definition
- the body can't sustain the extreme stress response of pain for more than short periods of time
- the body will conserve its resources by adapting even in the face of continuing pain of the same intensity |
|
|
Term
| Gate Control theory of Pain |
|
Definition
- theorizes that a person experiences pain w/ a combination of these processes:
- sensory
- motivationl/affective
- cogn |
|
|
Term
| Conduction of pain impulses |
|
Definition
- transduction: stimulus triggered
- transmission: impulses travel to spinal cord
- perception: a neural msg is converted into a subjective experience
- modulation: pain xmitters selectively inhibited |
|
|
Term
| Objective assessment of pain |
|
Definition
- Physiologic:
- acute pain involves elevated resp rate and BP, pallor, dilated pupils
- chronic pain shows adaptation
- Behavioral
- acute pain behaviors include:
- crying, moaning, clenching fists
- chronic pain behvs include depression, listlessness, loss of libido, and wt |
|
|
Term
| General Principles of pain relief |
|
Definition
- individualize the approach
- use a preventative approach
- use a multidisciplinary approach |
|
|
Term
| Nurse's role in admin analgesics |
|
Definition
- determine whether or not to admin the analgesic
- assess the ct's response to the analgesic
- report to the dr when a change is needed
- teach the ct and family re the use of analgesics |
|
|
Term
| Principles of admin analgesics |
|
Definition
- preventative approach
- titrate to effect |
|
|
Term
Principles of admin analgesics
Preventative approach |
|
Definition
- pain is much easier to control if treated when it's anticipated or at a mild intensity
- two methods of this approach are:
- ATC (around the clock)
- PRN |
|
|
Term
Principles of admin analgesics
Titrate to effect |
|
Definition
- the analgesic regimen needs to be titrated until the desired effect is achieved
- this choice involves adjusting the following: dosage, interval, route, choice of drug |
|
|
Term
|
Definition
| a process through which indvs learn to influence their physiological responses to stimuli |
|
|
Term
| The neuromodulators of pain |
|
Definition
- endogenous opioids
- serotonin
- norepinephrine
- they inhibit the ascending painful impulses in the dorsal horn by dec the number of pain impulses that are xmitted to the brain |
|
|
Term
| Procedural vs postop pain |
|
Definition
| a ct who doesn't understand the procedure being performed or doesn't know enough about the postop care decisions that need to be made may experience worse pain |
|
|
Term
| Emotional factors affecting pain |
|
Definition
- pain threshold
- pain tolerance
- pain reaction |
|
|
Term
Emotional factors affecting pain
Pain threshold |
|
Definition
| - the amt of pain stimulation that must occur for a ct to feel pain |
|
|
Term
|
Definition
| - excessive sensitivity to pain |
|
|
Term
Emotional factors affecting pain
Pain tolerance |
|
Definition
| - the max amt of pain a ct is willing to tolerate, influenced by psychologic and sociocultural factors |
|
|
Term
Emotional factors affecting pain
Pain reaction |
|
Definition
| - the behv response to pain as a response to the ANS, it's a learned response |
|
|
Term
| Examples of Intractable pain |
|
Definition
- pain from advanced stages of cancer
- pain from neuropathic abnormalities |
|
|
Term
| Anxiety and stress' effect on pain perception |
|
Definition
| - anxiety and stress increases it |
|
|
Term
|
Definition
| - an emotional response associated w/ inc pain |
|
|
Term
|
Definition
- it is a part of aging
- it's part of an hysterical personality
- people with chronic pain have hypochondriasis
- infants don't feel it
- lack of complaint means the ct is pain-free
- severe pain is only experienced when a ct has major surgery
- members of the hc team are the authorities re a ct's perception of and level of pain
- regular use of analgesics will lead to addiction
- pain is directly related to the amt of tissue damage
- pain can be verified by visible physiologic or behv signs |
|
|
Term
|
Definition
| ________, many of whom are older adults, may experience ________ _______ ________ when they have physical, emotional, social, and financial burdens that can seriously jeopardize their own health |
|
|
Term
|
Definition
| used for constipation, exhaustion, flatulance |
|
|
Term
|
Definition
| used for arthritis, bronchitis, cold sores, colds, coughing, fever, sinusitis |
|
|
Term
|
Definition
| used for mood modifier, anti-diarrheal agent |
|
|
Term
|
Definition
| used for headaches, insomnia, stress |
|
|
Term
|
Definition
| used for nausea, antipyretic, respiratory aid |
|
|
Term
|
Definition
| used for bronchitis, chapped skin, depression, dry skin, laryngitis, stress |
|
|
Term
|
Definition
| herbal preparation that is hepatotoxic and carcinogenic |
|
|
Term
|
Definition
herbal preparation that loses effectiveness after 2-3 weeks
- used as an immune stimulator
- may lead to hepatotoxicity
- if used more than 6 weeks, interferes w/immunosuppressants
Don't use with:
- progressive systemic disorders such as:
- TB
- leucosis
- collagenosis
- MS
- AIDS
- HIV and other autoimmune disorders |
|
|
Term
|
Definition
herbal preparation inc microcirculation
- used for dementia
- inc clotting time
- neurotoxic in seizure disorder
- my combine w/tricyclic antidepressants to lower seizure threshold
- caution with anticoags
- bleeding disorders
- surgery |
|
|
Term
|
Definition
used for mental clarity
adverse effects include:
- inc clotting time
- vomiting and headaches
- palpitations
- insomnia
- hyper/hypotension
- affects glucose
- may be addictive in combo w/estrogens or corticosteroids
- interferes w/digoxin effects and monitoring
- potentiates MAO inhibitors, phenelzine |
|
|
Term
|
Definition
| its use is associated with liver failure |
|
|
Term
|
Definition
| its use has a mild laxative effect that subsides after 2-3 days |
|
|
Term
|
Definition
| its use is contraindicated with MAO inhibitors, anticoags, and protease inhibitors |
|
|
Term
|
Definition
| nurse completes a nursing care summary at least once a week for cts requiring skilled care and every 2 weeks for those requiring intermediate care |
|
|
Term
| LTC nursing summaries should include: |
|
Definition
- specific probs noted in the care plan
- mental status
- ADLs
- hydration and nutrition status
- safety measures needed
- meds
- txts
- prev measures
- behv mod assess if taking psychtropics |
|
|
Term
| LTC Documentation - Practice Guidelines |
|
Definition
- complete the assess and screening forms (MDS) and POC within the specified time period
- record any visits or phone calls from family, etc...
- write nursing summaries and progress notes within specified time frame
- review and revise POC Q90 or whenever health status changes
- doc and report any change in ct's condition to the dr and family within 24 hrs
- document all measures implemented in response to change in condition
- make sure progress notes reflect goals in the POC |
|
|
Term
| Documentation practice guidelines - DOs |
|
Definition
- chart change in ct's condition and follow up actions taken
- read previous nurse's notes to check for change in ct
- be timely in charting
- use objective, specific, and factual descriptions
- correct charting errors
- chart all teaching
- record ct's words in quotes
- chart responses to interventions |
|
|
Term
| Documentation practice guidelines - DONT'S |
|
Definition
- leave blank spaces
- chart in advance
- use vague terms
- chart for someone else
- use "pt or ct", as it's their chart
- alter a record even if requested by supervisor or a dr
- record assumptions |
|
|
Term
| Common sites of referred pain from various body organs |
|
Definition
heart
- jaw both sides
- left pectoralis major
lungs/diaphragm
- (L)side neck near clavicle (post/ant)
liver
- (R) trapezius (post/ant)
- right side mid sternum
- right posterior under ribcage
Stomach
- mid base of sternum (ant/post)
Ovaries
- below abdominals
Appendix
- right side of groin
Ureters
- left side midway between groin and hip
gallbladder
- right shoulder (ant/post)
Kidneys
- right side gluteus medius
- both sides small of back posterior
Bladder
- gluteus maximus and vastus lateralis |
|
|
Term
|
Definition
- peripheral pain
- central pain
- pain w/ underlying pathology |
|
|
Term
| Common Pain Syndromes - peripheral |
|
Definition
- postherpetic neuralgia: encircles the body
- phantom limb |
|
|
Term
| Common Pain Syndromes - central |
|
Definition
|
|
Term
| Common Pain Syndromes - pain with underlying pathology |
|
Definition
- headache
- cancer pain syndrome
- myofascial pain syndrome: occurs in muscle and fascia |
|
|
Term
| A ct reporting a 3 or greater on the pain scale |
|
Definition
| it signals a need to revise the pain the pain txt plan |
|
|
Term
| A ct reporting a 6 or greater on the pain scale |
|
Definition
| a pain rating that demands immediate attn |
|
|
Term
Categories and examples of Analgesic
Opioids |
|
Definition
- butorphanol (Stadol)
- fentanyl citrate (Sublimaze)
- hydrocodone (Lortab, Vicoden)
- hydromorphone HCL (Dilaudid)
- meperidine HCL (Demerol)
- codeine (Tylenol 3, Empirin 3)
- morphine sulfate (morphine)
- propoxyphene napsylate (Darvon-N, Darvocet-N) |
|
|
Term
Categories and examples of Analgesic
NSAIDs |
|
Definition
- acetaminophen (Tylenol, Datril)
- acetylsalicylcic acid (aspirin)
- choline Mg trisalicylate (Trilisate)
- diclofenac Na (Voltaren)
- ibuprofen (Motrin, Advil)
- indomethacin Na trihydrate (Indocin)
- naproxen (Naprosyn)
- naproxen Na (Anaprox)
- piroxicam (Feldine)
- tolmetin Na (Tolectin) |
|
|
Term
Categories and examples of Analgesic
Adjuvant Analgesics |
|
Definition
- amitriptyline (Elavil)
- chlorpromazine (Thorazine)
- diazepam (Valium)
- hydroxyzine (Vistaril) |
|
|
Term
| Options to prevent constipation due to opioid use |
|
Definition
- inc fiber intake
- use a mild laxative (MOM) regularly
- taking oral laxatives at bedtime
- using rectal suppositories in the am
**** stool softeners are not useful in treating constipation unless used w/ stimulant laxatives |
|
|
Term
|
Definition
S = sleep, easy to arouse
1 = awake and alert
2 = slightly drowsy, easily aroused
3 = frequently drowsy, arousable, drifts off to sleep during conversation
4 = somnolent, minimal or no response to physical stim |
|
|
Term
| The opioid dosage is excessive |
|
Definition
| if ct experiences sig resp depression (eg, 18 to 12) or is overly sedated |
|
|
Term
|
Definition
| assessing for sedation and resp status is critical during the first -----to------ hours after starting opiod therapy |
|
|
Term
| Common Opioid side effects |
|
Definition
- constipation
- N+V
- sedation
- resp dep
- pruritis
- urinary retention |
|
|
Term
Common Opioid side effects prevention and txt
Constipation |
|
Definition
- inc fluid intake
- inc fiber and bulk forming agents to diet (fresh fruits and veges)
- inc exercise regimen
- admin stool softeners and if necessary provide a mild laxative |
|
|
Term
Common Opioid side effects prevention and txt
N+V |
|
Definition
- inform ct that tolerance to this emetic effect generally devps over several days of opioid therapy
- provide an antiemetic PRN
- change the analgesic as indicated |
|
|
Term
Common Opioid side effects prevention and txt
Sedation |
|
Definition
- inform ct that tolerance usually devps after 3-5 days
- admin a stimulant, such as Dexedrine or Ritalin each am |
|
|
Term
Common Opioid side effects prevention and txt
Resp Dep |
|
Definition
- admin an opioid antagonist such as Narcan until reps return to normal
- admin the med slowly via IV w/ 10 mg NS
- if ct is on PCA pump, stop or slow the infusion |
|
|
Term
Common Opioid side effects prevention and txt
Pruritis |
|
Definition
- apply cool packs, lotion, and diversional activity
- admin Benadryl
- inform the ct that tolerance devps to priritis |
|
|
Term
Common Opioid side effects prevention and txt
UR |
|
Definition
- may need to catheterize ct
- admin Narcan |
|
|
Term
| Misconceptions about NSAIDS |
|
Definition
- regular use is much safer than taking opioids
- it should not be given at the same time as an opioid
- admin antacids with it is an effective method of reducing gastric distress
- they are not useful for severe pain
- gastric distress (eg, abd pain) is indicative of NSAID-induced gastric ulceration |
|
|
Term
Regular use is much safer than taking opioids
Correction |
|
Definition
| side effects from regular NSAID use are more severe and life threatening than daily doses of oral opioids |
|
|
Term
NSAIDs should not be given at the same time as an opioid
Correction |
|
Definition
|
|
Term
Admin antacids with NSAIDs is an effective method of reducing gastric distress
Correction |
|
Definition
| it might be, but it is counterproductive because antacids reduce the absorption of NSAIDs |
|
|
Term
They are not useful for severe pain
Correction |
|
Definition
|
|
Term
Gastric distress (eg, abd pain) is indicative of NSAID-induced gastric ulceration
Correction |
|
Definition
| most cts w gastric lesions have no symptoms until bleeding or perforation occurs |
|
|
Term
| If a ct is going to be on a SubQ opioid pump at home, the caregiver needs to be able to: |
|
Definition
- describe the basic parts and symbols of the system
- id ways to determine if the pump is working
- change the battery
- change the med
- demonstrate starting and stopping the pump
- demon tubing care, site care, and changing of the injection site
- id signs that an injection site needs to be changed
- describe genl care of the pump when the ct is ambulatory, bathing, sleeping, or traveling
- id actions to take when the alarm signals |
|
|
Term
| 3 methods of intraspinal analgesia admin |
|
Definition
- bolus
- continuous infusion admin by pump
- pt controlled epidural analgesia (PCEA) is admin by the ct using the pump |
|
|
Term
| As a precaution for a ct receiving an opioid-containing epidural infusion |
|
Definition
| have on hand: naloxone, NaCl 0.9% diluent, and injection eqpt |
|
|
Term
| Contralateral stimulation |
|
Definition
| it can be accomplished by stimulating the skin in an area opposite to the painful area |
|
|
Term
|
Definition
| a chemical interruption of a nerve pathway, effected by injecting a local anesthetic into the nerve |
|
|
Term
| Intractable pain pathways can be interrupted surgically |
|
Definition
- cordotomy
- rhizotomy
- neurectomy
- sympathectomy |
|
|
Term
| Intractable pain pathways can be interrupted surgically - cordotomy |
|
Definition
| - it obliterates pain and temp sensation below the level of the spinothalamic portion of the anterolateral tract severed, and is usually done for pain in the legs and trunk |
|
|
Term
| Intractable pain pathways can be interrupted surgically - rhizotomy |
|
Definition
it interrupts the anterior or posterior nerve root between the ganglion and the cord
- interruption of anterior motor nerve roots stops spasmodic movements that accompany paraplegia
- interruption of posterior sensory nerve roots eliminates pain in areas innervated by that specific nerve root
- rhizotomies are generally performed on cervical nerve roots to alleviate pain of the head and neck from cancer or neuralgia |
|
|
Term
| Intractable pain pathways can be interrupted surgically - neurectomy |
|
Definition
| peripheral or cranial nerves are interrupted to alleviate localized pain, such as pain in the lower leg or foot arising from a vascular occlusion |
|
|
Term
| Intractable pain pathways can be interrupted surgically - sympathectomy |
|
Definition
pathways of the sympathetic division of the autonomic nervous system are severed
- it eliminates vasospasms, improves peripheral blood supply
- effective txt for painful vascular disorders such as angina and Raynaud's disaese |
|
|
Term
| Intractable pain pathways can be interrupted surgically - spinal cord stimulation (SCS) |
|
Definition
used with nonmalignant pain
- a cable is inserted with an electrode directly on the spinal cord that sends electrical impulses to it |
|
|
Term
| Major nursing strategies for all cts regarding pain |
|
Definition
- acknowledge and convey beliefs in the ct's pain
- assist support people
- reduce misconceptions about pain
- prevent pain
- reduce fear and anxiety associated w/ pain |
|
|
Term
|
Definition
- tissue injury triggers the release of biochemical mediators, such as prostaglandin.
- ibuprofen works by blocking the production of prostaglandin |
|
|
Term
| Tricyclic antidepressants |
|
Definition
| - affects the modulation phase because they inhibit the reuptake of norepinephrine and serotonin, which increases the modulation phase that helps inhibit painful ascending stimuli |
|
|
Term
|
Definition
| - blocks the release of neurotransmitters, particularly substance P, which stops the pain at the spinal level that occurs during the xmission phase |
|
|
Term
|
Definition
| - is best used during the perception phase when the ct becomes conscious of the pain |
|
|
Term
|
Definition
| ________ relieves pain by acting to stimulate the release of body toxins |
|
|
Term
|
Definition
| Narcotics achieve pain relief by working to_____ |
|
|
Term
| Standardize a list of abbreviations that are not to be used throughout the organization |
|
Definition
| How do the JCAHO 2006 National Patient Safety Goals improve the effectiveness of communication among caregivers? |
|
|
Term
|
Definition
| Based on the _____ theory of pain, effective pain management should include non-invasive interventions and a combination of pharmacological agents |
|
|
Term
| Activities should be scheduled at the same time each day. |
|
Definition
| The nurse is planning care for a client who is experiencing dementia. What essential concept should the nurse consider for this planning? |
|
|
Term
| "Attempts begin while the client is still in the ICU." |
|
Definition
| The client who had a traumatic brain injury last week is now persistently unconscious and is being cared for in the intensive care unit. The family asks when attempts to stimulate the client will begin. What is the nurse's best answer? |
|
|
Term
|
Definition
| they include early detection of illness through routine screening such as providing regular dental exams |
|
|
Term
|
Definition
they are directed towards preventing illnesses: eg,
- communicable diseases in infants
- immunizations to prevent diphtheria or poliomyelitis
- or among the elderly: influenza
- enviro programs to dec air pollution therby preventing resp dis |
|
|
Term
|
Definition
he is responsible for:
- ongoing assessment of the ct who is terminally ill and the family
- supervision of the care delivered by other team members
- provision of addl resources |
|
|
Term
|
Definition
| type of nursing care that focuses on the tasks or jobs to be performed |
|
|
Term
| the home setting is intimate and the behvs are more natural |
|
Definition
| the advantage of home care is that.... |
|
|
Term
| Monitor family interaction probs r/t ct care |
|
Definition
| which NI is appropriate for s risk of caregiver role strain? |
|
|
Term
| actions required to take care for a ct post-op in the recovery room |
|
Definition
| a situation that would be appropriate for a protocol |
|
|
Term
| Not considered a protocol |
|
Definition
- a checklist in a standardized care plan
- defined interventions for which nurses are held accountable (they are standards of care)
- standardized care plans are nursing oriented but are written from the perspective of what a ct can expect as care |
|
|
Term
| The following are independent NIs |
|
Definition
| - teaching, counseling, and ongoing assess |
|
|
Term
| an example of an observation nursing order |
|
Definition
an _______ nursing order includes assessments to be made of the ct's responses to interventions as well as to determine if complications are arising
- an example is inspection of an area of concern like inspect ct's dressing q2h |
|
|
Term
| Prevention nursing orders |
|
Definition
| toileting, turning, and repositioning are examples of _______ nursing orders |
|
|
Term
| Health promotion nursing orders |
|
Definition
| discussion of the importance of deep breathing is an example of ____ _____ nursing orders |
|
|
Term
| info included in the narrative nurse's notes |
|
Definition
- pertinent assess of the ct
- specific nursing care
- ct's complaints
- how the ct is coping |
|
|
Term
| info documented on graphic or daily care records |
|
Definition
- vitals
- ct's daily activities such as:
- bathing
- hygiene
- diet |
|
|
Term
| info documented in the medical history record |
|
Definition
- info about the family
- past ct history |
|
|
Term
| info documented in the consultation records |
|
Definition
| - reports from different specialists |
|
|
Term
|
Definition
includes a :
- nursing diagnosis
- an acute change in the ct's condition
- ct's behv |
|
|
Term
|
Definition
| nurses must provide this to verify the need for skilled service and reimbursement in the LTC setting |
|
|
Term
|
Definition
| pain threshold does not appear to change with this age group, but the effect of analgesics may inc |
|
|
Term
| Wagner and Associates Chronic Care Model has four internal components |
|
Definition
- self-management support, decision support, e.g., clinical practice guidelines
- delivery system redesign, e.g., case- management and primary care teams
- clinical information systems, i.e., registries, clinical feedback and reminders |
|
|
Term
| 2 external components of the Chronic care model |
|
Definition
- community resources
- HC organizations |
|
|
Term
|
Definition
| they have defined what they feel is the most critical thing needed to care for clients with chronic illness as “a therapeutic approach that emphasizes treating the patient with disease(s) rather than treating disease(s) in the patient |
|
|
Term
| 1995 an antifraud waste and abuse initiative began and became known as Operation Restore Trust (ORT) |
|
Definition
| created to stop Medicare fraud |
|
|
Term
| In Operation Restore Trust (ORT) Medicare fraud and abuse and fraudulent practices were found across the board that related to |
|
Definition
- Illegal billing to the Medicare program
- Billing for services for people who did not meet the criteria
- Illegally referring patients for home care services in exchange for funds or kickbacks |
|
|
Term
| Balanced Budget Act of 1997 |
|
Definition
| Responding to these ORT findings and also needing to curtail the growth and cost of the home health care benefit, the government passed a cost-containing legislation as part of the......? |
|
|
Term
| Prospective Pmt System (PPS) |
|
Definition
| The effect of the Balanced Budget Act of 1997 which had the greatest impact was the legislation that moved home health care from a cost-based reimbursement system to a |
|
|
Term
Outcome Assessment System and
Information Set (OASIS) |
|
Definition
| Actual reimbursement amounts to home health agencies are determined by clinical assessment of the patient’s needs using a mandated assessment tool called......? |
|
|
Term
Outcome Assessment System and
Information Set (OASIS). |
|
Definition
This 79 question tool was designed to
establish a national standard for collecting home health data that can be used to evaluate these services |
|
|
Term
| Common probs associated with chronic illness |
|
Definition
- Improvements in neonatal medicine, pharmacology and technology, have reduced the mortality rate of low birth weight and very low birth weight babies
- There has also been an increase in the incidence of cerebral palsy |
|
|
Term
|
Definition
| refers to a condition that a health care provider thinks of in terms of pathophysiology |
|
|
Term
|
Definition
| the human experience of pain, suffering and symptoms, and reflects how the individual perceives the disease and adjust to it |
|
|
Term
| Adjustment Patterns in Chronic Illness |
|
Definition
| Chronic conditions lasting 3 months or more may be due to illness, genetic factors or injury |
|
|
Term
| Chronic conditions lasting 3 months or more will usually cause..... |
|
Definition
- changes in lifestyle
- learning to live with symptoms and/or disabilities
- coming to terms with identity changes
- complications which may frequently recur |
|
|
Term
| RATIONALE FOR NURSING INTERVENTIONS RELATED TO CHRONIC ILLNESS |
|
Definition
- managed care has caused shorter hosp stays and ofc visits, causing the ct to shoulder more resp w/ less supervision
- ct resp more crucial w/ inc HC costs
- treatment regimens have become increasingly more complex and
resources to assist individuals are often limited
- the nurse must be able to assess the degree to which a client or caregivers can, in fact, comply with the plans they develop |
|
|
Term
|
Definition
| an all inclusive term for all behavior consistent with prescribed health care practices |
|
|
Term
| models and theories of compliance |
|
Definition
- Health Belief Model (HBM)
- Health Promotion Model (HPM)
- Common Sense Model (CSM)
- Self regulation Theory
- The Theory of Reasoned Action and the Theory of Planned Behavior
- Cognitive Social Learning Theory |
|
|
Term
models and theories of compliance
Health Belief Model |
|
Definition
- Predictor of Preventive Health Behavior developed by Hochman et al.
- The major premise of this model is that the probability of a person taking
recommended health actions is based on:
- perceived severity of the illness
- the patient’s perception of the likelihood that certain behaviors will reduce the threat
- perceived barriers to recommendations. |
|
|
Term
Models and Theories of Compliance
Health Promotion Model |
|
Definition
- Pender’s nursing model that evolved from the HBM in 1996.
- She postulates that health is a goal and believes that one will only engage in health promotion activities if one has a desire to be healthy. |
|
|
Term
Models and Theories of Compliance
Common Sense Model |
|
Definition
| This model proposes that how a person processes illness-related events determines how that person will cope and comply with a treatment plan |
|
|
Term
Models and Theories of Compliance
The Self-Regulation Theory of
Leventhal and associates |
|
Definition
it has the client participating actively in managing health behaviors. Beliefs about illness focus around five elements:
- identity, time-line, cause,
consequences, and cure or control.
This theory is unique because it has this feedback loop. |
|
|
Term
Models and Theories of Compliance
The Theory of Reasoned Action and the Theory of Planned Behavior |
|
Definition
- they have intention as their essential concept.
- Clients will engage in health behaviors intentionally based on their attitudes or on the extent to which the client has control over any specific behavior |
|
|
Term
Models and Theories of Compliance
Cognitive Social Learning Theory |
|
Definition
- it tries to predict behavior based on outcome and efficacy.
- It states that changes in health behavior will occur if:
- a lifestyle pattern is recognized as being harmful
- that a change would be beneficial
- and that clients have the awareness that they are capable of adopting a new behavior. |
|
|
Term
NURSING PROCESS:
DETERMINING THE INDIVIDUAL’S CAPACITY FOR SELF-EFFICACY |
|
Definition
| There is general agreement that clients with chronic illness will have to assume a great part of the ongoing responsibility for their health care |
|
|
Term
|
Definition
refers to the “performance of preventive or therapeutic health care activities, often in collaboration with health care professionals and involves learning new skills and behaviors
- it has been recognized as a
fundamental basis for the tasks associated with chronic diseases or conditions |
|
|
Term
| Three Steps Involved in Self Management |
|
Definition
- self-monitoring: which involves scrupulous attention to one’s behavior.
- self-evaluation: when the new behavior and the expected behavior are compared.
- self-reinforcement: which motivates the
client to make any changes and continue to improve. |
|
|
Term
| FACTORS INFLUENCING THE PATIENT’S ADJUSTMENT TO CHRONIC Illness |
|
Definition
- role changes
- stigma
- HC professional's attitudes |
|
|
Term
FACTORS INFLUENCING THE PATIENT’S ADJUSTMENT TO CHRONIC Illness
Role Changes |
|
Definition
- role insufficiency
- role ambiguity
- role conflict
- intra role
- inter role
- role strain |
|
|
Term
|
Definition
there is a disparity in carrying out the expectations, obligations or goals of a role as these are perceived by the client or significant others.
- may be either voluntary, i.e., the patient may deliberate over the rewards and costs of a certain role and deduce that the costs are greater than
the rewards, or involuntary |
|
|
Term
|
Definition
| If clients have little information about the behaviors expected in a specific role, or if these are not adequately communicated to them, then there is a lack of clarity and _____ ______ occurs |
|
|
Term
|
Definition
When an individual has to deal with
conflicting role demands |
|
|
Term
| Two types of role conflict |
|
Definition
|
|
Term
|
Definition
a new mother who is trying to adjust
to her new role of motherhood and is
constantly bombarded with conflicting
information from her mother and her
mother-in-law about how she should care
for her new baby |
|
|
Term
|
Definition
occurs when a person does not take on
appropriate role behaviors because they are in two roles that have incompatible expectations. |
|
|
Term
|
Definition
| when a person feels that the expectations are too difficult or impossible to fulfill, and will exhibit psychological and physiological signs, such as anxiety, irritation, hostility, depression, etc |
|
|
Term
FACTORS INFLUENCING THE PATIENT’S ADJUSTMENT TO CHRONIC ILLNESS
Stigma |
|
Definition
- “something that disqualifies an individual from full social acceptance
- we are socialized to put people into categories, sometimes by
characteristics, sometimes by specific attributes or sometimes by occupations, etc
- Anything that changes one of these, such as a disability, changes the person’s identity and can become a _______. |
|
|
Term
| Requirements necessary for a stigma to effect a person |
|
Definition
- individuals must first be aware of and accept the negative self-perceptions
- accept that this relates to them
- apply these negative perceptions to
themselves |
|
|
Term
| Reasons We may stigmatize the chronically ill |
|
Definition
- they force us to let go of our dream that life is fair.
- They remind us of our mortality and vulnerability.
- So these individuals live each day having to deal not only with their illness and symptoms, but with those who perceive them as less worthy and valuable |
|
|
Term
| Different types of stigma |
|
Definition
- physical deformity
- character blemishes
- prejudice |
|
|
Term
| Secondary benefits or gains to remain in a stigmatized category |
|
Definition
- people may get special favors or txt
- may help to decrease the negative stereotypes associated with certain conditions |
|
|
Term
|
Definition
| Another potential response to being in a stigmatized category is referred to as _______, i.e., pretending to have a less stigmatic problem |
|
|
Term
| Regarding being in a stigmatized category |
|
Definition
Acceptance and self-respect
mitigate to hide the condition, but voluntary disclosure is a sign of a well
adjusted phase, a state of grace.
(Goffman, 1963
). |
|
|
Term
|
Definition
| Due to the anxiety-provoking nature of disclosure of a stigmatizing difference, individuals tend to make the difference seem smaller or less significant than it really is |
|
|
Term
FACTORS INFLUENCING THE PATIENT’S ADJUSTMENT TO CHRONIC ILLNESS
The attitude of the HC pro |
|
Definition
Possible responses:
- devaluing
- stereotyping
- labeling |
|
|
Term
ASSESSMENT:
DETERMINE THE INDIVIDUAL’S SENSE OF POWER OR POWERLESSNESS |
|
Definition
- loss of control
- the power resources that may be diminished or lost in chronic illness:
- physical strength, energy, hope,
motivation, knowledge, positive self-esteem, psychological stamina and social support
- a chronic illness may result in frustration and inability to overcome obstacles in accessing or being
able to pay for health care services and this will contribute to feelings of powerlessness |
|
|
Term
Seeman and Lewis evaluated the relationship of powerlessness, health status and mortality.
Some of their findings revealed that: |
|
Definition
- Powerlessness was associated with limitations in activity and with psychosocial symptoms.
- Initial powerlessness was predictive of health problems 5 and 10 years later.
- Increasing powerlessness was linked with declining health
- High powerlessness scores at the beginning of the study were associated with mortality in men |
|
|
Term
| In 1967, Dorothy Johnson, described powerlessness as |
|
Definition
- variation of alienation
- a “perceived lack of personal or internal control of certain events or in certain situations.”
- She went on to say that this was particularly significant when establishing priorities of care, especially regarding education, because if a patient feels powerless then education will not be
effective |
|
|
Term
|
Definition
USE NURSING MEASURES TO ESTABLISH A
COLLABORATIVE RELATIONSHIP WITH THE chronic PATIENT |
|
|
Term
The Personal Control Model of White and Roberts
(1993) |
|
Definition
a model which can be used to identify the strengths of clients and plan appropriate interventions.
Their concept links personal control with powerlessness |
|
|
Term
The Personal Control Model of White and Roberts
(1993) |
|
Definition
They believe that 4 types of loss of con-
trol are associated with powerlessness:
Physiological— the biological changes of chronic illness.
Cognitive— can be a sensory loss of control as in the misinterpretation of sensations OR can be an appraisal loss of control which is present when clients
cannot focus on threatening
situations or recognize potential harm.
Environmental— clients cannot control where they are or what they are experiencing.
Decisional— clients are unable to make decisions for themselves or about their care. |
|
|
Term
| Nurse's goal in dealing w/ the chronic ct |
|
Definition
Our goal is to empower individuals and their families to find ways of coping.
They really do need to believe that their ability to cope is far greater than any of their problems |
|
|
Term
| Younger (1991) describes mastery as |
|
Definition
“a human response to difficult or stressful circumstances in which competency, control, and dominion are gained over the experience of stress
- It means having developed new capabilities, having changed the environment, and/or reorganized the self
so that there is meaning and purpose in living that transcends the difficulty of the experience.” |
|
|
Term
| EBP of chronic illness research studies generally falls into two categories: |
|
Definition
- descriptive research
- intervention research |
|
|
Term
EBP of chronic illness research studies generally falls into two categories:
Descriptive research |
|
Definition
- provides data on risk factors
- the course of an illness and the client’s response to it
- factors that would influence
health promotion behaviors
- factors that could impact the incidence of chronic illness and the consequences on clients, their families and on communities |
|
|
Term
EBP of chronic illness research studies generally falls into two categories:
Intervention research |
|
Definition
| focuses on evaluating the specific approaches aimed at individuals, groups or communities |
|
|
Term
There is now a growing body of knowledge about chronic illness because of much theoretically based research that has been done.
Nursing theorists have engaged in |
|
Definition
- prevention research
- mgmt. of chronic illness
- Stress and Coping theories
- Self Help theories
- Self Care theories |
|
|
Term
|
Definition
• Is based on the philosophy of individualized, patient-centered, goal-oriented care
• Focuses on abilities, not disabilities
• Uses an interdisciplinary approach
• Supports and develops functional ability through training, retraining, and the use of adaptive devices |
|
|
Term
| Rehabilitation process involves: |
|
Definition
• Assessment of the patient's ability to benefit
• Selection of an appropriate facility
The rehabilitation nurse must develop a therapeutic trusting relationship with the patient and family. The nurse must build and maintain a partnership so the patient can be an active participant in goal setting and in planning to achieve those goals.
• Goals should be both short and long term, specific, and measurable. Goal achievement is dependent on the patient's motivation to learn and confidence in his or her ability to achieve the goal.
• Functional assessment: Physical, psychological, emotional, and social |
|
|
Term
| The nurse regularly encounters the following patient problems in the rehabilitation setting: |
|
Definition
• Self-care deficits
• Impaired mobility
• Altered bowel and bladder function
• Impaired skin integrity |
|
|
Term
| The success of a rehabilitation program depends on a number of factors, including a supportive learning environment: |
|
Definition
• Patients must be comfortable with taking the time needed to perform a self-care activity.
• Patients must know what is safe to attempt alone and feel comfortable asking for assistance.
• Instructions and guidance must be consistent and tailored to the patient's abilities.
- When a patient is incapable of resuming self-care, the nursing focus is on enabling the patient to direct their care. |
|
|
Term
|
Definition
| a major influence on the quality of life of a chronic ct |
|
|
Term
| A primary goal of nursing care is to maximize the patient's mobility. The plan might include interventions to enable the patient to: |
|
Definition
• Sit or stand up
• Transfer from bed to chair, toilet, and/or tub
• Walk, with the use of adaptive devices if necessary
- Care is designed to prevent musculoskeletal complications of immobility |
|
|
Term
| Alterations in bladder and bowel elimination include: |
|
Definition
• Urinary incontinence
• Fecal incontinence
• Urinary retention
• Constipation and impaction
- Establishing bladder and bowel training routines is an important goal of care |
|
|
Term
|
Definition
| Impaired mobility, bowel and bladder incontinence, and inability to perform selfcare contribute to making _____ _____ _____ a major nursing challenge in the rehabilitation setting. |
|
|
Term
|
Definition
refers to any impairment or deviation from normal that has one or more of the following characteristics:
• It is permanent.
• It leaves residual disability.
• It is caused by nonreversible pathologic alteration.
• It requires a long period of supervision, observation, or care.
- An estimated 99 million Americans have one or more chronic conditions |
|
|
Term
| The number of people with chronic illness in 2010 and 2020 respectively |
|
Definition
|
|
Term
|
Definition
| - evolves over time. Many of these are preventable through the adoption of healthy lifestyles and compliance with recommended screening protocols |
|
|
Term
| The National Center for Chronic Disease Prevention and Health Promotion |
|
Definition
| it conducts studies on the causes of chronic diseases, supports health promotion programs, and monitors the health of the nation |
|
|
Term
| Factors influencing the occurrence and management of chronic illness include: |
|
Definition
• Age
• Race, ethnicity, and culture
• Personal cost of disability
- Chronic illness and disability might date from birth (e.g., spina bifida) or might originate in childhood, adolescence, or early adult life (e.g., multiple sclerosis, rheumatoid arthritis). The major chronic illnesses among those 65 years and older are arthritis, diabetes, heart disease, and hypertension.
• Chronic illness often accompanies aging.
• The reduction in death rates in younger age groups has allowed a higher percentage of the population to reach the age of greatest risk for chronic diseases. |
|
|
Term
|
Definition
| Prevalence among Native Americans and Alaskan Natives twice that in the total population |
|
|
Term
|
Definition
| Occurs more often in AfricanAmericans and Hispanic-Americans than Caucasians |
|
|
Term
|
Definition
Response to illness also varies among people of different race, ethnicity, and culture.
• Nursing care should be tailored to the population served |
|
|
Term
|
Definition
- deal with great personal and emotional losses, including self-esteem, role status, and independence.
- Frequent or extended hospitalization and medical expenses can be ruinous |
|
|
Term
|
Definition
| provides hospital and medical insurance protection for those older than 65 years and those younger than 65 who are disabled and are eligible for Social Security benefits |
|
|
Term
|
Definition
| is available for those who meet medical and financial eligibility requirements |
|
|
Term
|
Definition
| The nurse caring for patients and families affected by chronic illness must understand family characteristics and function. An understanding of family and family systems theory provides the basis for planning nursing care. This framework suggests several key assessment areas for the nurse. |
|
|
Term
| Conceptual Frameworks for Chronic Illness |
|
Definition
- Chronic illness trajectory framework
- Shifting perspective model |
|
|
Term
Conceptual Frameworks for Chronic Illness
Chronic illness trajectory framework |
|
Definition
Nine phases reflect the dynamic and changing character of chronic illnesses―
- pretrajectory
- trajectory onset
- stable
- unstable
- acute
- crisis
- comeback
- downward
- dying |
|
|
Term
Conceptual Frameworks for Chronic Illness
Shifting Perspective Model |
|
Definition
| Acknowledges duality in the life of the chronically ill; sometimes illness is in the foreground, other times wellness is in the foreground |
|
|
Term
| Assessment of the Person with Chronic Illness |
|
Definition
- Physical status: Includes systems review; upper and lower extremity structure and function; speech, vision, and hearing; bowel and bladder function; and ADLs/IADLs
• Psychologic status: Includes attitudes, adaptation to illness, perception of impact of illness on the family, presence of chronic grief, and depression
• Social and financial status: Includes financial and supportive resources available to meet goals
• Compliance: Includes readiness to learn, capability of participating in a learning experience, and perception of relevance of goal |
|
|
Term
| Role of the Nurse in Chronic Illness |
|
Definition
• Clarifies nurse-patient values
• Promotes self care
• Promotes self-esteem
• Supports the person with progressive disability
• Provides community resources
• Acts as advocate |
|
|
Term
| Biophysical Considerations for Chronic Illness |
|
Definition
- Maturation and aging
• Gender
• Race and ethnicity
• Genetic inheritance
• Physiologic function |
|
|
Term
| Physical Environmental Considerations of Chronic Illness |
|
Definition
- Environmental pollutants
• Global climate changes
• Seasonal variations
• Distance to treatment
• Environmental hazards |
|
|
Term
| Sociocultural Considerations of Chronic Illness |
|
Definition
- Social norms
• Role modeling
• Media messaging
• Cultural factors
• Social participation
• Socioenvironmental factors |
|
|
Term
| Behavioral Considerations in Chronic Illness |
|
Definition
- Consumption patterns
• Exercise
• Other behaviors
– Self-assessment behaviors
– Use of safety devices and precautions |
|
|
Term
| Health System Considerations in Chronic Illness |
|
Definition
• Lack of access to care
• Failure of providers to educate about risk behaviors
• Availability of screening services
• Availability and quality of treatment |
|
|
Term
| Primary Prevention: Health Promotion |
|
Definition
• Promoting healthy lifestyles
• Political activity
• Immunization |
|
|
Term
|
Definition
• Screening
– Existing chronic conditions
– Programs for targeted populations
– Programs for underserved groups
• Early diagnosis
– Case finding
– Case referral
– Surveillance |
|
|
Term
| Secondary Prevention: Treatment |
|
Definition
• Prompt treatment
– Stabilizing client’s condition
– Establishing treatment regimen
– Motivating compliance
– Promoting self-management |
|
|
Term
| Tertiary Prevention/Chronic Illness |
|
Definition
• Preventing loss of function in affected and unaffected systems
• Restoring function
• Monitoring health status |
|
|
Term
|
Definition
| a coping mechanism, involves ways indvs describe, monitor, and interpret their symptoms, take remedial actions, and use the HC system |
|
|
Term
| Parson's - 4 aspects of the sick role |
|
Definition
1. cts are not held responsible for their condition
2. cts are excused from certain social roles and tasks
3. cts are obliged to try to get well ASAP
4. cts or their families are obliged to seek competent help |
|
|
Term
| Suchman's 5 stages of illness |
|
Definition
1. symptom experiences
2. assumption of the sick role
3. medical care contact
4. dependent ct role
5. recovery or rehab |
|
|
Term
Suchman's 5 stages of illness
symptom experiences |
|
Definition
at this stage a person comes to believe something is wrong. During this stage, the unwell person usually consults others about the symptoms or feelings, validating with a spouse or support person that the symptoms are real. It has three aspects:
- the physical experience of symptoms
- the cogn aspect (the interpretation of the symptoms in terms that have some meaning to the person)
- the emotional response (eg., fear or anxiety) |
|
|
Term
Suchman's 5 stages of illness
Assumption of the sick role |
|
Definition
| The indv now accepts the sick role and seeks confirmation from family or friends |
|
|
Term
Suchman's 5 stages of illness
Medical care contact |
|
Definition
The indv seeks professional advice for:
- validation of real illness
- explanation of the symptoms in understandable terms
- reassurance that they will be alright or prediction of what the outcome will be |
|
|
Term
Suchman's 5 stages of illness
Dependent ct role |
|
Definition
| The ct becomes dependent on the professional for help |
|
|
Term
Suchman's 5 stages of illness
Recovery or rehab |
|
Definition
| The ct is expected to relinquish the dependent role and resume former roles and responsibilities |
|
|
Term
| Indicators of stress - physiologic |
|
Definition
- pupils dilate
- inc sweat production
- HR inc
- skin is pallid
- Na and H2O retained
- Resp inc
- urinary output dec
- dry mouth
- peristalsis dec
- mental alertness improves for serious threats
- muscle tension inc
- blood sugar inc |
|
|
Term
| Indicators of stress - psychologic |
|
Definition
- anxiety
- fear
- anger
- depression
- unconscious ego defense mechanisms |
|
|
Term
| Trajectory model of chronic illness |
|
Definition
it ids the different phases that the ct will pass through and helps to anticipate potential probs that will need specific interventions
- not all cts pass through each phase and the course might be uncertain |
|
|
Term
Trajectory model of chronic illness
Pretrajectory |
|
Definition
| the indv/community at risk for chronic illness due to genetic factors or lifestyle |
|
|
Term
Trajectory model of chronic illness
Trajectory onset |
|
Definition
| symptoms appear: diagnostic workup; coping with diagnosis, and symptoms begin |
|
|
Term
Trajectory model of chronic illness
Stable |
|
Definition
| symptoms controlled, adapts life to illness limitations, maintained in the home |
|
|
Term
Trajectory model of chronic illness
Unstable |
|
Definition
| symptoms disrupt life w/ necessity of adaptation in life activities, usually maintained at home |
|
|
Term
Trajectory model of chronic illness
Acute |
|
Definition
| severe/unrelieved symptoms w/ illness complication. Hospitalization may be necessary; life activities disrupted |
|
|
Term
Trajectory model of chronic illness
Crisis |
|
Definition
| critical/life threatening occurrence requires emergency txt or care; life activities suspended |
|
|
Term
Trajectory model of chronic illness
Comeback |
|
Definition
| following crisis; physical recovery; limitations stretching and psychosocial reintegration |
|
|
Term
Trajectory model of chronic illness
Downward |
|
Definition
| progressive body degeneration. May degenerate to death or remission of symptoms for a period of time |
|
|
Term
Trajectory model of chronic illness
Dying |
|
Definition
| Profound physical and psychosocial changes |
|
|
Term
| Shifting Perspectives Model of Chronic Illness |
|
Definition
| proposes that living with a chronic condition is a long term, continually shifting process in which the illness focus alternately recedes and intrudes. When illness is in the foreground, illness becomes the focus, when illness recedes to the background, the family’s focus shifts to the health of the chronically ill individual and the family |
|
|
Term
| Difference between trajectory and shifting perspectives model |
|
Definition
| the traj model has phases, whereas the shifting persp model has either sickness in the forefront or the background, either/or |
|
|
Term
|
Definition
| one in which symptoms occur soon after exposure to a cause and runs a relatively short course. It may or may not end in death or chronic |
|
|
Term
|
Definition
- illness or impairment is permanent
- leaves residual disability
- is caused by nonreversible or pathologic alteration
- requires a long period of supervision, observation or care
- usually have a slow onset and often periods of remission when symptoms disappear and periods of exacerbation when symptoms reappear |
|
|
Term
| Adjustment patterns in chronic illness |
|
Definition
- acceptance of a chronic condition is important so txt will not be delayed
- coping skills and resources available to assist the ct will affect adjustments in lifestyle, body image, and role changes |
|
|
Term
| Issues of disability for the chronically ill client |
|
Definition
- access to health care
- transportation
- time orientation
- enviro barriers
- drscrimination |
|
|
Term
| Issues of disability for the chronically ill client - access to health care |
|
Definition
- demand is great
- poor people |
|
|
Term
| Decreased self-care capacity |
|
Definition
- physical immobility
- fatigue
- disfigurement
- deformities
- limited indep |
|
|
Term
| Strategies to promote self care |
|
Definition
- find out what is meaningful to the ct
- encourage indep as much as is possible
- educate ct about disease and process
- assess the ct's response to the course of the disease |
|
|
Term
| Strategies to promote self-esteem |
|
Definition
- help stimulate ct in all sensory areas
- involve them in activities
- encourage family to engage ct in activities outside their illness |
|
|
Term
| Deterioration and decline of health |
|
Definition
- the ongoing facet of chronic illness is difficult
- it can't always be cured or respond to therapeutic interventions
- physical deterioration can occur
- care must focus on retarding the downhill progression of the disease
-helping the ct and family cope is paramount
- |
|
|
Term
| Physical limitations of ct w/ hemiplegia or fatigue |
|
Definition
- physiological
- psychological
- sensorimotor
- strength
- endurance
- ADLs
- dec cardio and resp |
|
|
Term
| Areas of importance to the quality of life for indvs w/ a chronic illness |
|
Definition
- sex
- changes in body appearance
- SOB
- musculoskeletal or neurological impairments |
|
|
Term
| Family/caregiver dimensions of chronic illness |
|
Definition
- they may experience isolation because of lack of time for activities outside the house
- high levels of stress, strain, and fatigue
- they need:
- info on support groups and respite care
- alternative levels of care to home care
- realistic prognosis info
- they provide emotional, financial and HC support |
|
|
Term
| Factors influencing the ct's adjustment to chronic illness |
|
Definition
- gender differences in the caregiver role
- age/devp level
- indv/family preferences and patterns
- personal cost of disability
- physical condition |
|
|
Term
| Factors influencing the ct's adjustment to chronic illness - gender differences in the caregiver role |
|
Definition
- women are traditionally the main caregivers
- daughters and daughters-in-law
- husbands more likely than sons |
|
|
Term
| Factors influencing the ct's adjustment to chronic illness - age/devp level |
|
Definition
| - children w/disabilities adapt better than adults |
|
|
Term
| Factors influencing the ct's adjustment to chronic illness - indv/family preferences and patterns |
|
Definition
- nurse must know the family's perspective on chronic illness
- some can handle it, some can't |
|
|
Term
| Factors influencing the ct's adjustment to chronic illness - personal cost of disability |
|
Definition
- economic cost can be devastating
- great personal and emotional loss
- loss of self-esteem
- loss of status within the family
- loss of indep
- feelings of helplessness |
|
|
Term
| Factors influencing the ct's adjustment to chronic illness - physical condition |
|
Definition
- dec self-care ability r/t pain and/or fatigue
- powerlessness leads to depression |
|
|
Term
| How cultural values and religious beliefs influence HC of the chronically ill |
|
Definition
- social and cultural norms may promote or condone behvs which contribute to the devp of chronic probs
- some cultural groups think that a HC provider should be able to solve their probs immediately and won't understand the concept of long term or lifelong txts
- religion may affect a pt's health practices and acceptance of txt |
|
|
Term
| Family adaptability and cohesion |
|
Definition
- the characteristics of a family unit has an impact on the willingness of pts to seek HC as well as their compliance to prescribed txt
- how well the family adapts to changes
- how well does members accept changing roles within the family
- how committed are they |
|
|
Term
|
Definition
- the financial status of the ct and family has big impact on the pt's adjustment to chronic illness
- the nurse's social assessment should include:
- living arrangements
- family roles
- support of sig others
- cult and social group membership
- education and vocational activities |
|
|
Term
|
Definition
- assessment of the ct's needs and capabilities should focus on feelings about the illness and impact on family members, goals on living with an illness, coping skills
- pt may express feelings of anxiety. frustration, irritability, bitterness, guilt
- depression, suicidal
- strategies pt's use to normalize their lives: hide symptoms, engaging in pre-illness activities, maintaining social relationships |
|
|
Term
| Strategies for working with a person who exhibits aggressive behv and depressed behv |
|
Definition
- cts and caregiver should be encouraged and given the opportunity to verbalize these feelings and find more appropriate ways to express their feelings
- respite care, socialization, counseling and medication if indicated are measures for depression |
|
|
Term
| NIs to help cts and families adjust to the psychological impact of chronic illness |
|
Definition
- they both need outlets for feelings of anxiety, frustration, guilt, and anger
- the nurse should explore feelings and existing coping skills of both and help support both |
|
|
Term
|
Definition
treat the person, not the disease
- a holistic healing philosophy that sees health as a balance of the physical, mental, and spiritual whole |
|
|
Term
|
Definition
- promotes comfort and provides pain relief
- its use has risen in the US from 33% to 42% between 1992 and 1997 |
|
|
Term
| The 5 major domains of CATs |
|
Definition
- alternative medical systems: naturopathic medicine or Chinese medicine
- mind-body interventions: meditation, dance, or prayer
- biologically based txts: herbal products or macrobiotic diets
- manipulative and body based methods: chiropractic and massage
- energy therapies: Qi Gong, Reiki, or therapeutic touch |
|
|
Term
| How the culturally competent nurse assists the ct |
|
Definition
| - establishing therapeutic approaches that the ct and family consider acceptable |
|
|
Term
| Alternative medical systems |
|
Definition
- non-traditional methods of coping with and txting illnesses
- acupuncture
- acupressure
- auricular therapy
- moxibustion
- martial arts |
|
|
Term
| Mind-body and spiritual therapies |
|
Definition
- art therapy
- biofeedback
- hypnosis: depends on susceptibility
- imagery: uses cogn techniques
- prayer and techniques which encourage spiritual healing and relaxation |
|
|
Term
| Biologically based therapies |
|
Definition
- the use of natural products
- nutritional supplements
- herbal products |
|
|
Term
| Manipulative and body based therapies |
|
Definition
- focus on the body's structural and functional integrity: massage, chiropractic
- craniosacral- used in the mgmt. of chronic fatigue, chronic headaches, joint probs, and stroke rehab
- Trager and Alexander techs |
|
|
Term
|
Definition
- therapeutic touch
- Reiki
- vibration medicine
- physioacoustics
- bioelectromagnetics |
|
|
Term
| Costs of chronic illness- |
|
Definition
- Eighty-six percent of the nation's $2.7 trillion annual health care expenditures are for people with chronic and mental health conditions
- Total annual cardiovascular disease costs to the nation averaged $316.1 billion in 2012–2013.
- Of this amount, $189.7 billion was for direct medical expenses and $126.4 billion was for lost productivity costs (from premature death).18
- Cancer care cost $157 billion in 2010 dollars.19
- The total estimated cost of diagnosed diabetes in 2012 was $245 billion, including $176 billion in direct medical costs and $69 billion in decreased productivity. Decreased productivity includes costs associated with people being absent from work, being less productive while at work, or not being able to work at all because of diabetes.20
- The total cost of arthritis and related conditions was about $128 billion in 2003. Of this amount, nearly $81 billion was for direct medical costs and $47 billion was for indirect costs associated with lost earnings.21
- Medical costs linked to obesity were estimated to be $147 billion in 2008. Annual medical costs for people who were obese were $1,429 higher than those for people of normal weight in 2006.22
- For the years 2009–2012, economic cost due to smoking is estimated to be at least $300 billion a year. This cost includes nearly $170 billion in direct medical care for adults and more than $156 billion for lost productivity from premature death estimated from 2005 through 2009.12
- The economic costs of drinking too much alcohol were estimated to be $249 billion, or $2.05 a drink, in 2010. Most of these costs were due to binge drinking and resulted from losses in workplace productivity, health care expenses, and crimes related to excessive drinking.23 |
|
|
Term
|
Definition
- provides protection to Americans with disabilities
- addresses employment
- public services
- public accommodation
- services operated by private entities
- telecommunication services |
|
|
Term
| 2005 Surgeon General's Call to Action to Improve the Health and Wellness of Persons with Disabilities |
|
Definition
- emphasizes the centrality of health to the quality of our lives
- it describes the particular challenges to health and wellbeing faced by persons of all ages with disabilities. It places their health squarely among the public health issues at the forefront of research, service delivery, financing, training and education and health care policy today. It also builds upon the Nation's efforts to promote wellness and disease prevention in all persons, including those with disabilities, as called for in the President's HealthierUS Initiative. |
|
|
Term
| 2005 Surgeon General's Call to Action to Improve the Health and Wellness of Persons with Disabilities - 4 Goals |
|
Definition
GOAL 1: People nationwide understand that persons with disabilities can lead long, healthy, productive lives.
GOAL 2: Health care providers have the knowledge and tools to screen, diagnose and treat the whole person with a disability with dignity.
GOAL 3: Persons with disabilities can promote their own good health by developing and maintaining healthy lifestyles.
GOAL 4: Accessible health care and support services promote independence for persons with disabilities |
|
|
Term
|
Definition
| - they allow indvs to indicate their preferences for txt if unable to make independent HC decisions |
|
|
Term
|
Definition
| - the ct can direct decisions for withholding or withdrawing life sustaining txts when he is in a terminal condition or death is imminent |
|
|
Term
|
Definition
| - a type of advanced directive that authorizes a designated party to make HC decisions in the event that the ct becomes unresponsive or unable to make his own decisions |
|
|
Term
| Nurse's role in caring for a ct who is chronically ill |
|
Definition
- provider of care
- mgr of care
- teacher
- ct advocate |
|
|
Term
| Assessment of the pt's chronic illness |
|
Definition
| determine the presence of functional ability in ADLs, IADLs and cogn ability |
|
|
Term
| Areas that should be included in assessment of physical status |
|
Definition
- IADLs
- mental status exam in 6 categories |
|
|
Term
| Physical status should include: |
|
Definition
- physical condition (cardio, pulm, GI, GU, endocrine, cerebrovascular)
- upper extremities (structure and function) including the shoulder girdle and cervical and upper dorsal spine
- lower extremities (structure and function) including the pelvis and lower dorsal and lumbar sacral spine
- sensory components relating to speech, vision and hearing
- excretory function, including the bowels and bladder
- mental and emotional status |
|
|
Term
| Cts at risk for physical injury |
|
Definition
those cts with:
- a confused mental state
- sensory deficits
- weakened physical state |
|
|
Term
| Areas of assessment for a chronically ill ct |
|
Definition
- physical status
- physical environ of the home
- the ct's position on the chronic illness trajectory
- environ factors that influence the ct's chronic illness |
|
|
Term
| The physical environ of the home |
|
Definition
- assess safety issues
- the ct's condition and therapeutic regimes
- assess for basic factors that affect the ct's health and adjustment to HC |
|
|
Term
| Determine the ct's position on the chronic illness trajectory |
|
Definition
- a ct will experience ups and downs of the illness that lead to a sense of uncertainty about the future
- strategies for the nurse to have the cts employ:
- become more informed about the illness
- search for addl txts
- undertake stress reduction techniques
- seek support from others including friends, family, people with the same illness, and HC pros |
|
|
Term
| Environ factors that influence the ct's chronic illness |
|
Definition
- info about the home within the community
- location of necessary home care services
- durable med eqpt companies
- emergency care sites
- availability of transportation |
|
|
Term
|
Definition
| in conjunction with the ct and members of the HC team, synthesize data to ID the ct's actual or potential health probs |
|
|
Term
|
Definition
- nursing dx
- set priorities
- caregiver role strain and ways to reduce it
- guidelines that could improve the pt's willingness or motivation to learn the necessary home care regimen |
|
|
Term
| Nursing Dx specific to the ct w/ a chronic illness include: |
|
Definition
- chronic pain r/t cancer progression
- caregiver role strain r/t 24-hr care responsibility
- feeding self-care deficit r/t confusion
- ineffective health maint r/t dec mobility
- impaired home maint mgmt. r/t lack of motivation
- potential for missed meds due to cogn loss |
|
|
Term
|
Definition
they are set based on the ct's self-care capacity, quality of life, access to HC, and use of resources
- maslow
- rank ordering
the nurse should:
- id nursing measures that encourage participation by the ct to the best of his/her ability to promote the best quality of life for the person
- suggest resources
- make referrals
- assess the ability of the ct to access the HC system (money, transpo) |
|
|
Term
| Guidelines that could improve the pt's willingness or motivation to learn the necessary home care regimen |
|
Definition
- understand the pt's lifestyle
- include plans which would cause the least disruption
- use the pt's available resources
- use praise or reinforcement when teaching
- encourage cts to schedule therapies at easily remembered times
- provide materials and info to reinforce teaching
- assess pt's understanding of the language being used during teaching
- include cultural beliefs into teaching and therapies
- encourage family members to participate in teaching and therapies
- present material and info at the pt's educational level |
|
|
Term
| Nursing Dx: Chronic pain r/t cancer progression |
|
Definition
Expected outcome for which dx?
- ct or caregiver will state methods to control chronic pain |
|
|
Term
| DX: Caregiver role strain r/t 24-hr care responsibility |
|
Definition
Expected outcome for which dx?
- caregiver will state plan for respite |
|
|
Term
| DX: Feeding self-care deficit r/t confusion |
|
Definition
Expected outcome for which dx?
- caregiver will monitor ct for maintenance of adequate nutrition |
|
|
Term
| DX: Ineffective health maint r/t dec mobility |
|
Definition
Expected outcome for which dx?
- ct will id environmental mods that will allow for home maint behvs |
|
|
Term
| DX: Impaired home maint mgmt. r/t lack of motivation |
|
Definition
Expected outcome for which dx?
- ct and caregiver will id needed skill or knowledge to effectively manage the pt's home care regime |
|
|
Term
| DX: Potential for missed med due to cogn loss |
|
Definition
Expected outcome for which dx?
- caregiver will id the need to assist w/ med admin |
|
|
Term
|
Definition
| detailed guidelines that describe nursing care for groups of cts rather than indvs, and they describe achievable rather than ideal nursing care |
|
|
Term
| Interventions to help the ct w/ a chronic illness meet the expected outcomes |
|
Definition
- monitoring the ct's rest and activity pattern
- referring cts w/ cogn impairments to day care
- helping cts develop a realistic plan for daily activities |
|
|
Term
| The factors with the greatest predictive power in regard to chronically ill pts med compliance were |
|
Definition
(1) patients' ability to state the names of or accurately describe their medicines, (2) patients' ability to state the functions of their drugs
(3) the complexity of the medication regimen as measured by the number of drugs prescribed for the patient |
|
|
Term
| Factors to be included in a home safety assessment |
|
Definition
- location of the home in relation to med eqpt, emergency assistance and home care services
- physical environ of the home such as wheel chair access, if needed, and adequacy of utilities
- infestations and plumbing in relation to safety hazard to the ct
- family/ct knowledge of emergency procedures |
|
|
Term
| Measures to improve home safety |
|
Definition
- floors: presence of rugs which could cause tripping or falling; texture of flooring (skid proof?)
- stairs: nonskid, uniform ht, adequate side rails, adequate lighting, uniform riser hts
- bathroom: hand rails by tub, shower and toilet; nonskid in tub/shower
- smoke alarms
- fire extinguishers
- accommodation for meds or other toxic elements if children are in the house |
|
|
Term
| Incorporating factors influencing the pt's environ safety and nursing measures to assist the family to structure a safe environ, avoid hazards |
|
Definition
- the pt's abilities and needs are considered when assessing for environ safety in the home
- check for hazards
- assisting family members in organizing care routines, obtaining eqpt, and helping the ct to prioritize self-care needs
- monitor the ct's cogn level as the disease progresses
- focus should be on the observation or prediction of potentially harmful situations |
|
|
Term
|
Definition
- establish expected outcomes w/ the ct
- environmental safety
- assigning ct care activities to other members of the HC team as appropriate |
|
|
Term
| assigning ct care activities to other members of the HC team as appropriate |
|
Definition
- the home health aide provides physical care to the ct only after the RN visit
- ongoing supervision of the aide is the responsibility of the RN
- RN instructs the aide to report how the family is coping, and any changes that will affect their coping abilities |
|
|
Term
| Nursing measures to establish a collaborative relationship w/ the ct |
|
Definition
- family members become experts in their family member's care
- they want to be acknowledged and respected by HC pros
- nurses need to:
- listen to what the ct and family say
- respecting and valuing what they say
- supporting them in making choices based on their own experience and expertise |
|
|
Term
| Principles of Therapeutic Comm to determine pt's goals |
|
Definition
- be aware of verbal and nonverbal messages from the ct
- use attentive listening
- active listening
- physical attending:
- squarely face the person
- using an open position with legs or arms not crossed
- lean towards the ct
- maintain eye contact
- speak in relaxed manner |
|
|
Term
|
Definition
- poor vision
- cogn dysfunction
- impaired gait or balance and difficulty walking because of lower extremity dysfunction
- difficulty getting in and out of bed or chair
- orthostatic hypotension
- urinary freq or receiving diuretics
- weakness from disease process or therapy
- current meds: sedatives, hypnotics, tranqs, narcs, diurtics |
|
|
Term
Preventive measures for fall risk factors:
Poor vision |
|
Definition
- ensure glasses are functional
- ensure appropriate lighting
- mark doorways and edges of steps as needed
- keep environ tidy |
|
|
Term
Preventive measures for fall risk factors:
Cogn Dysfunction |
|
Definition
- set safe limits to activities
- remove unsafe objects |
|
|
Term
Preventive measures for fall risk factors:
impaired gait or balance and difficulty walking because of lower extremity dysfunction |
|
Definition
- wear nonskid shoes, slippers or socks
- use ambulatory devices PRN
- provide assistance w/ ambulation PRN
- monitor gait and balance
- adapt living arrangements to one floor if necessary
- encourage exercise and activity as tolerated to maintain muscle strength, joint flexibility, and balance
- ensure uncluttered environ w/ securely fastened rugs |
|
|
Term
Preventive measures for fall risk factors:
difficulty getting in and out of bed or chair |
|
Definition
- encourage ct to request assistance
- keep bed in low position
- install grab bars in bathroom
- provide raised toilet seat |
|
|
Term
Preventive measures for fall risk factors:
orthostatic hypotension |
|
Definition
| - instruct ct to raise slowly from lying to sitting to standing position, and to stand in place for several seconds before walking |
|
|
Term
Preventive measures for fall risk factors:
urinary freq or receiving diuretics |
|
Definition
- bedside commode
- assist w/ voiding on a freq and scheduled basis |
|
|
Term
Preventive measures for fall risk factors:
weakness from disease process or therapy |
|
Definition
- encourage ct to summon help
- monitor activity tolerance |
|
|
Term
Preventive measures for fall risk factors:
current meds: sedatives, hypnotics, tranqs, narcs, diuretics |
|
Definition
- attach side rails to bed
- keep rails in place when bed is in lowest position
- monitor orientation and alertness status
- discuss how alcohol causes falls
- don't mix booze and meds
- encourage freq review of meds prescribed |
|
|
Term
| Nursing measures to promote the resolution of the pt's chronic illness |
|
Definition
- help families
- motivate families
- provide resources/referrals
- community resources
- help groups |
|
|
Term
|
Definition
- emotional support
- possible respite care, therapy assistance
- |
|
|
Term
| Self-help groups as a social support for caregivers |
|
Definition
- create a caring community
- inc member's coping skills with forums |
|
|
Term
| Nursing measures appropriate to particular safety needs |
|
Definition
- safety knowledge and skills are directly r/t the pt's unique dx and txt plan
- nurse should monitor ct for depression and potential for self-harm |
|
|
Term
| Proper use of safety devices |
|
Definition
| - ensure that family knows how to use, maintain, and repair eqpt |
|
|
Term
| Use of safety measures to admin meds |
|
Definition
- nurse should assess the knowledge and caregiver w/ regard to each med
- provide written ct education materials about all meds
- help ct/caregiver establish a weekly med admin schedule system |
|
|
Term
| Teaching caregiver to give g-tube meds correctly |
|
Definition
- check w/ pharm for liquid forms of med
- make sure meds can be crushed
- crush a tablet into 30ml warm water
- read meds label before opening a capsule
- don't attempt to admin whole or undissolved meds through g-tube
- assess tube placement
- before giving meds, aspirate all the stomach contents and measure the residual. Check agency policy if residual is greater than 100mls
- remove plunger from syringe barrel and connect to pinched tube
- put 15-30ml of water into syringe barrel to flush tube before first med admin
- pinch tube before all water is instilled to prevent air from entering the stomach
- poor med sol'n into barrel and allow to flow by gravity into the enteral tube
- when finished admin meds, flush tube w/ 15-30mls
- if the tube is connected to suction, disconnect suction and keep the tube clamped for 20-30mins after giving the med to enhance absorption |
|
|
Term
| The nurse as a pt care advocate |
|
Definition
- resource mgr
- make key policymakers aware of need for a more equitable distribution of resources for cts w/ chronic illness
- advocate for rights of cts |
|
|
Term
| The role of the nurse in continuing HC |
|
Definition
- the nurse's role is to assist the ct in devp the highest level of self-care
- nurse should be aware of his values and goals and how they complement the ct's
- the ct should control the devp and progress of any therapies, w/o the nurse imposing his own agenda upon the txt plan |
|
|
Term
|
Definition
| appraise the effectiveness of the NIs relative to the nursing dx and the expected outcomes |
|
|
Term
|
Definition
| are developed by state law and allow individuals to indicate their preferences for treatment if unable to make independent health are decisions |
|
|
Term
|
Definition
| provide clients with the opportunity to direct decisions for withholding or withdrawing life sustaining treatments when the client is in a terminal condition or death is imminent |
|
|
Term
|
Definition
| statements that describe the patient's acceptance or refusal of specific life-sustaining treatments |
|
|
Term
|
Definition
| A patient is receiving digoxin for a heart condition. Cardiac monitoring should be implemented if serum lab values show K < or = to: ______ |
|
|
Term
|
Definition
| Evidence-based practice shows that opioid addiction occurs in less than ___% of hospitalized pts |
|
|
Term
|
Definition
| During the ______ stage of chronic illness anatomic changes can produce physical signs of the illness. |
|
|
Term
|
Definition
| A woman is experiencing _______ loss as a result of losing her mother so soon before her upcoming wedding. |
|
|
Term
A landmark “Study to Understand Prognoses and Preferences for Outcomes and Risks
of Treatments (SUPPORT) |
|
Definition
in 1995 it documented the following troubling deficiencies in the care of the dying in the hospital setting:
- Many patients received unwanted care at the end of life.
- Clinicians were NOT aware of patient preferences for life-sustaining treatments, even when preferences were documented in the clinical record.
- Pain was often poorly controlled at the end of life.
- Efforts to enhance communication were ineffective. |
|
|
Term
|
Definition
manages the care of anyone with a life-
threatening illness with the goal of improving the quality of life through prevention, assessment and management
of pain and other coexisting problems.
It also allows for the continuation of life
-sustaining treatments which usually hospice does not |
|
|
Term
According to Byock (1997), an expert in palliative care, there are 5 aspects of
relationship completion that allow for healing |
|
Definition
the statements:
“I forgive you;”
“Please forgive me;”
“Thank you;”
‘I love you;”
“Goodbye.” |
|
|
Term
Suggesting that patients put together an oral or written narrative history, i.e
., a life review, |
|
Definition
| helps patients find meaning and comfort at the end of life. |
|
|
Term
| the most significant conclusion about loss |
|
Definition
reaction to losses is very personal, and individuals confronted with the same loss don’t follow the same course of grieving or don’t follow the stages or phases in the exact sequence the theorists have presented
them. |
|
|
Term
|
Definition
| How a person perceives oneself will affect one's placement in the _______-______ _____ |
|
|
Term
|
Definition
| Don't _____ when admin heparin SubQ |
|
|
Term
| How would a nurse establish the landmark prior to injecting into the vastus lateralis site in an adult? |
|
Definition
| Divide the area between the greater trochanter of the femur and lateral femoral condyle into thirds and select the middle third |
|
|
Term
|
Definition
- they occur at predictable times throughout an indv's life and there are tasks that need to be achieved
- young adults tasks = leaving home, marriage, job |
|
|
Term
|
Definition
| an example of an external stressor |
|
|
Term
|
Definition
| they are unpredictable and can be positive or negative |
|
|
Term
|
Definition
- a person's lymphatic structures atrophy or shrink, including the lymph nodes, spleen and thymus
- adrenal glands enlarge
- stomach lining devps ulcers |
|
|
Term
|
Definition
- difficulty concentrating
- headache
- fearful facial expression
- easily distracted |
|
|
Term
|
Definition
| a stress level where indvs are alert |
|
|
Term
|
Definition
- a narrowed focus of attn. and selective inattention is present
- mild gastric symptoms may be present |
|
|
Term
|
Definition
- perception is distorted
- the indv is unable to function
- he experiences feelings of impending doom |
|
|
Term
|
Definition
| a type of formation that causes the indv to act exactly the opposite of how they feel |
|
|
Term
|
Definition
| the displacement of energy associated with primitive drives into more acceptable outlets |
|
|
Term
|
Definition
| acting in a way to relieve the guilt or unacceptable thoughts by reparation |
|
|
Term
|
Definition
| the attempt to manage anxiety by imitating the behvs of someone feared or respected |
|
|
Term
|
Definition
| consciously putting a thought or feeling out of the consciousness |
|
|
Term
|
Definition
| it entails assuming a manner and facial expression that conveys being in control |
|
|
Term
|
Definition
| the arranging of a situation so that threatening events don't occur |
|
|
Term
|
Definition
| ______ is the result of emotional conflict; ______ is the result of a discrete physical or psychologic entity |
|
|
Term
| Release of adrenal glands |
|
Definition
| This physiological response describes the ability of a person to perform a far more strenuous physical activity than normal when faced with a stressor |
|
|
Term
|
Definition
| Inc blood clotting is a physiological response to ______ |
|
|
Term
|
Definition
| the inability to form a valid appraisal of stressors, inadequate choices of responses and inability to use available resources |
|
|
Term
|
Definition
| uncertainty about the course of action among competing actions that involves loss or challenge to life values |
|
|
Term
|
Definition
| a sustained maladaptive response to a traumatic event |
|
|
Term
|
Definition
| repeated projection of falsely positive self-evaluation to defend against a perceived threat to self-esteem |
|
|
Term
|
Definition
actual
- recognized by others
perceived
- experienced by one person but can't be verified by others
- it can also be anticipatory (psychological losses, leaving a job to care for aging parents could create feelings of loss of independence and freedom
anticipatory
- experienced before loss occurs
- can be actual or perceived
situational
- i.e., loss of job, death of child
developmental
- i.e., departure of children from home |
|
|
Term
|
Definition
- an aspect of self: changes in body image, scars from burns, amputation as a result from injury
- an object external to oneself: theft of a car or pet
- separation from an accustomed environment: a child going to school for the first time, a student going away to college, an elderly going to an ALF
- loss of a loved one or valued person: death or divorce |
|
|
Term
| Kubler Ross stages of grieving |
|
Definition
- denial
- anger
- bargaining
- depression
- acceptance |
|
|
Term
|
Definition
- shock and disbelief
- devp awareness
- restitution
- resolving the loss
- idealization
- outcome |
|
|
Term
| Sanders phases of bereavement |
|
Definition
- shock
- awareness of loss
- conservation/withdrawal
- healing: the turning point
- renewal |
|
|
Term
| Martocchio clusters of grief |
|
Definition
- shock and disbelief
- yearning and protest
- anguish, disorganization and despair
- id in bereavement
- reorganization and restitution |
|
|
Term
| Rando categories of response |
|
Definition
- avoidance
- confrontation
- accommodation |
|
|
Term
| Clinical symptoms of grief |
|
Definition
- S&S of stress reaction
- normal manifestations
- verbalization of the loss
- crying
- sleep disturbance
- loss of appetite
- difficulty concentrating
- complicated grieving
- extended time of denial
- depression
- severe physiologic symptoms
- suicidal thoughts |
|
|
Term
| Factors affecting grief response |
|
Definition
- age
- sig of the loss
- culture
- spiritual beliefs
- gender
- SEC status
- support systems
- cause of death |
|
|
Term
| Measures that facilitate the grieving process |
|
Definition
- explore and respect ethnic, cultural, religious, and personal values
- teach what to expect in the grief process
- encourage the ct to express and share grief with support people
- teach family members to encourage the ct's expression of grief
- encourage the ct to resume activities on a schedule that promotes physical and psychologic health |
|
|
Term
| Manifestations of impending death |
|
Definition
- loss of muscle tone
- slowing of the circulation
- changes in respiration
- sensory impairment |
|
|
Term
| Traditional signs of death |
|
Definition
cessation of:
- apical pulse
- respiration
- blood pressure |
|
|
Term
| World Medical Assembly guidelines for death |
|
Definition
- total lack of response to external stimuli
- no muscular movement, especially during breathing
- no reflexes
- flat EEG
- in instances of artificial support, absence of brain waves for at least 24 hours |
|
|
Term
|
Definition
- occurs when cerebral cortex is irreversibly destroyed
- permanent loss of cerebral and brainstem function
- absence of responsiveness to external stimuli
- absence of cephalic reflexes
- apnea
- isoelectric EEG for at least 30 mins in the absence of hypothermia and poisoning by CNS depressants |
|
|
Term
| Helping cts die with dignity |
|
Definition
- introduce options available to the ct and sig others to restore and support feelings of control
- assist cts to manage the events preceding death so they can die peacefully
- help cts to determine their own physical, psychologic, and social priorities
- support the ct's will and hope
- location of care
- times of appts with HC pros
- activity schedule
- use of health resources
- times of visits from relatives and friends |
|
|
Term
| Strategies to facilitate discussions about death |
|
Definition
- id personal feelings about death
- focus on ct's needs
- determine ct's usual way of coping
- establish communication relationship
- determine what ct knows about illness
- respond with honesty and directness
- make time to be available |
|
|
Term
| Assisting families or caregivers of dying cts |
|
Definition
- use therapeutic comm
- provide an empathetic and caring response
- explain what's happening and what to expect
- have a calm and patient demeanor
- encourage to participate in the physical care as they are able:
- assist w/ bathing
- speak or read to the ct
- hold hands
- support those who feel unable to care for or be with the dying
- show an appropriate waiting if they wish to remain nearby
- may be therapeutic for the family to verbally give permission to the ct to "let go" when ready |
|
|
Term
|
Definition
- encourage the family to view the body
- may wish to clip a lock of hair as remembrance
- children should be included in the events surrounding the death if they wish |
|
|
Term
| Care of the body after death |
|
Definition
- follow corporate policy
- check the ct's religion rituals and make every attempt to comply
- id family or friends wish to view the body:
- make the environ as clean and as pleasant as possible
- make the body appear natural and comfortable
- all equip, soiled linen, and supplies should be removed fro the bedside
- follow agency policy when caring for tubes
- place the body in supine position
- place arms at sides, palm down, or across the abdomen
- place one pillow under the head and shoulders
- close the eyelids for a few seconds
- insert dentures
- close mouth
- wash soiled areas of the body
- place absorbent pads under the buttocks
- place a clean gown on the ct
- brush and comb the hair
- remove all jewelry except a wedding band which is taped to the finger
- adjust the top bed linen to cover the ct to the shoulders
- provide soft lighting and chairs for the family |
|
|
Term
| After the body is viewed by the family |
|
Definition
- leave wrist id tag on
- apply add'l id tags
- wrap body in shroud
- apply id to the outside of the shroud
- take the body to the morgue
- or arrange for pickup
- handle the deceased with dignity |
|
|
Term
| Palliative Care Delivery Models |
|
Definition
- consultation svs team consisting of drs, NPs, nurse, and MSWs
- dedicated inpatient unit in an acute or LTC setting or combined w/ a freestanding inpatient hospice
- combined consultative team within an inpatient unit
- combined hospice program and palliative care program
- hospital or private practice-based outpatient palliative care clinic
- hospice-based palliative care at home
- hospice-based consultation in outpatient settings
- community network w/ home visits |
|
|
Term
| Populations commonly served by palliative care specialists |
|
Definition
- persons of any age w/ acute, serious, and life-threatening illnesses where the condition is potentially reversible
- individuals dependent on life-sustaining txts or LTC by others for support in daily activities
- persons living w/ progressive chronic conditions
- seriously and terminally ill pts requiring care in a hospital, home, or LTC facility |
|
|
Term
|
Definition
- symp mgmt. is the cornerstone of quality of life and death w/ dignity. Routine symptom assessment using validated instruments helps the nurse id and treat symptom distress, manage side effects of med txt, and monitor condition changes
- indvs living w/ chronic, serious, and terminal illness require monitoring of symptoms such as pain, dyspnea, n+v, anorexia, constipation, and changes in LOC |
|
|
Term
|
Definition
it's highly subjective and involves both the perception of breathlessness and the pt's reaction to it
- the pt's report is the gold standard for assessment |
|
|
Term
|
Definition
- selection of the most effective antiemetic txt involves id the suspected causes of n+v
- routine admin of the antiemetic, symptom reassessment, and med titration are important for optimal txt |
|
|
Term
|
Definition
- they are common in many advanced illnesses
- when planning care, it's important to consider and address conditions that might exacerbate loss of appetite and wt loss |
|
|
Term
|
Definition
- an uncomfortable symptom that often accompanies abdominal tumors, chronic illness, malnutrition, dehydration, hypokalemia, hypercalcemia, and use of opioids for pain mgmt.
- mgmt. of the pt w/ partial or complete bowel obstruction might include a NG tube; mouth care; control of n+v, gi secretions, and abdominal cramping; hydration; and surgical intervention |
|
|
Term
|
Definition
- impaired mental status (IMS), is the term used to describe cogn changes that frequently occur in those with advanced disease
- txt involves nonpharmacologic interventions when possible, such as providing a quiet, safe, and supportive environ |
|
|
Term
| Causes of impaired mental status |
|
Definition
- drug side effects: r/t build up of drug metabolites in the blood as a result of impaired renal function
- drug-drug interactions (eg., ranitidine and hydroxyzine)
- drug withdrawal
- underlying pathologic condition
- terminal multiorgan failure
- fluid imbalance
- electrolyte imbalance
- blood gas imbalance
- hematologic disturbance
- glucose disturbance
- infection
- emotional and physical pain
- |
|
|
Term
|
Definition
1. assess level of alertness
- normal 0
- hypo or hyperactive 1
II. test of attn: a timed recitation of months of the yr in reverse order beginning w/ dec
- delay > 30 sec add 1
- 1 omission add 1
- 2 omissions add 2
- >/= 3 omissions, add 3
reversal of task or termination of task
- inability to perform add 4
A score of 2-5 is abnormal and diagnostic of confusion |
|
|
Term
| The last hours of life are conceptualized as the perideath period |
|
Definition
Phase 1:Preparation for death - clinical manifestations include:
- coolness
- inc sleepiness
- dec thirst and appetite
- incontinence
- congestion
- change in breathing pattern
- disorientation
- restlessness
- withdrawal
- visions
- letting go and saying goodbye
Phase 2: Death - cessation of vitals
Phase 3: After death - decision making regarding post-death rituals |
|
|
Term
| Gerontologic palliative care |
|
Definition
includes the palliation of symptoms r/t chronic illness:
- symptomatic CHF
- chronic lung disease
- dementia
- stroke
- cancer
- recurrent infection
- degenerative joint disease
All causing functional impairment and chronic pain are disease-specific reasons to initiate ______ _______ |
|
|
Term
|
Definition
| a temp and emotional response to a loss, or the perception of a loss, which often impacts one's ability to function |
|
|
Term
| Characteristics of normal grieving |
|
Definition
- stress reaction
- verbalization of the loss
- crying
- sleep disturbance
- loss of appetite
- difficulty concentrating |
|
|
Term
| Difference between bereavement and mourning |
|
Definition
- bereavement is each indv's overall reaction to having suffered a loss. The emotional state of feeling left alone after a death
- mourning is a process, influenced by cultural and spiritual beliefs, by customs and rituals, which enable a person to resolve the grief |
|
|
Term
| S+S which may accompany grief |
|
Definition
- anxiety - wt loss - loss of appetite
- vomiting - headache - skin rashes
- palpitations - depression - crying
- dyspnea - excessive sweating
- dizziness - chest pain
- menstrual disturbances
- difficulty concentrating
- sleep disturbances - blurred vision
- fatigue - fainting
- alterations in libido |
|
|
Term
| Variations in normal grieving |
|
Definition
- Abbreviated grief: it's brief, but genuinely felt, e.g., losing an object that one cared a lot about, but which can be quickly replaced
- Anticipatory grief
- Disenfranchised grief: present when an indv can't freely open up about a specific loss to others, eg., suicide, abortion |
|
|
Term
| Risk factors that would indicate possible difficulties w/ bereavement |
|
Definition
- poor social support
- limited coping strategies
- sudden death
- financial difficulties
- previous poor physical or mental health
- learning disabilities
- multiple losses w/ unresolved grief
- stigmatized death
- personality variables
- younger age |
|
|
Term
|
Definition
- unresolved grief: reaction is unusual in length
- inhibited grief: an indv denies or doesn't acknowledge a loss and suppresses many of the normal symptoms |
|
|
Term
| S+S of dysfunctional grieving |
|
Definition
- ct fails to grieve - doesn't go to funeral
- ct avoids visiting the grave; refuses to participate in funeral svcs
- even after a period of normal grieving the ct can't discuss the loss w/o intense emotion
- ct experiences depression, severe physiologic symptoms, suicidal thoughts, and an extended time of denial
- ct experiences physical symptoms at each anniversary date of the death
- ct develops persistent guilt and lowered self-esteem
- insignificant events trigger symptoms of grief
- after a normal period of grieving, the ct experiences symptoms similar to the loved one who died
- ct distances himself from his friends and acquaintences |
|
|
Term
|
Definition
Initial
- shock and disbelief
Acute
- acute mourning
Recovery
- resolution |
|
|
Term
|
Definition
Initial
- shock and denial
Acute
- anger
- bargaining
- depression
Recovery
- acceptance |
|
|
Term
|
Definition
Initial
- numbing
Acute
- yearning and longing
- disorganization and despair
Recovery
- reorganization |
|
|
Term
|
Definition
Initial
- accepting reality
Acute
- experiencing the pain
- withdrawing
Recovery
- reinvesting
- reacting to separation
- recollecting and re-experiencing |
|
|
Term
|
Definition
Initial
- recognizing loss
Acute
- confrontation
Recovery
- relinquish old bonds
- readjusting
- reinvesting |
|
|
Term
|
Definition
Initial
- shock and disbelief
Acute
- yearning and protest
- anguish
- disorganization and despair
- id in bereavement
Recovery
- reorganization and restitution |
|
|
Term
|
Definition
Initial
- shock and disbelief
Acute
- developing awareness
- restitution
- resolving the loss
- idealization
Recovery
- awareness of loss |
|
|
Term
|
Definition
Initial
- shock
Acute
- awareness of loss
Recovery
- healing: the turning point renewal |
|
|
Term
Factors which influence the grief response
Age - children |
|
Definition
| it's critical to help children work through their grief because loss can impact a child's devp and sometimes cause regression |
|
|
Term
Factors which influence the grief response
Age - adults |
|
Definition
- they begin to experience loss as a part of normal devp
- how they respond is influenced by previous experience with loss, their self-esteem, and availability of support |
|
|
Term
Factors which influence the grief response
Age - elderly |
|
Definition
- loss of a spouse can be profound
- many become ill after spouse dies |
|
|
Term
| Factors which influence the grief response Significance of the loss |
|
Definition
it's dependent on the perceptions of the indv experiencing the loss, though several factors may influence the sig of the loss
- the importance of the lost person, object or function
- the degree of change required because of the loss, eg., the elderly may fear becoming a burden
- the person's beliefs and values |
|
|
Term
| Factors which influence the grief response Culture |
|
Definition
- a family's response to illness, medical interventions, death, and bereavement is defined by the shared teachings, beliefs, language and customs of indv cultures
- grief is usually handled by the nuclear family |
|
|
Term
Factors which influence the grief response
Spiritual beliefs |
|
Definition
- they may specific practices r/t death and dying that may be very important to the pt and family
- some may experience peace and resignation
- some may look forward to eternity |
|
|
Term
Factors which influence the grief response
Gender |
|
Definition
- men don't cry
- women do |
|
|
Term
Factors which influence the grief response
SEC status |
|
Definition
| - having the financial ability to take the hit of losing a loved one |
|
|
Term
Factors which influence the grief response
Support system |
|
Definition
| - it's important to have support when grieving |
|
|
Term
Factors which influence the grief response
Cause of the loss |
|
Definition
| a person's view on the cause of the loss, as well as society's views, can influence the grief response |
|
|
Term
Common beliefs and attitudes about death
1-5 yrs |
|
Definition
- no intellectual understanding of death
- death is a reversible event
- death is temp |
|
|
Term
Common beliefs and attitudes about death
5-9 yrs |
|
Definition
- know that death is final
- relate death to violent situations
- think they can prevent their own death
- think they can wish for someone to die |
|
|
Term
Common beliefs and attitudes about death
9-12 yrs |
|
Definition
- know that death is the inevitable end
- begin to ponder their own mortality
- start thinking about an afterlife |
|
|
Term
Common beliefs and attitudes about death
12-18 yrs |
|
Definition
- fear a lingering and painful death
- feel they are invincible, can defy death
- seldom think about death, and if they do, it's only in a philosophical or religious sense
- may still hold on to concepts from earlier devp stages
- may be emotionally unable to accept an adult perception of death, even if they seem to be there |
|
|
Term
Common beliefs and attitudes about death
18-45 yrs |
|
Definition
- culture and religious background influence one's attitude toward death
- death is perceived as a future event |
|
|
Term
Common beliefs and attitudes about death
45-65 yrs |
|
Definition
- accept their own mortality
- may have several experiences with loss
- actively deal with death anxiety
- death is accepted as real but also as frightening |
|
|
Term
Common beliefs and attitudes about death
65+ |
|
Definition
- fear prolonged illness
- experienced many losses
- view death as having many meanings (freedom from pain, reunion w/spouse)
- death may be viewed as more desirable than living w/ a poor quality of life |
|
|
Term
| 9 Phases of Dying Trajectory |
|
Definition
1. pretrajectory
2. trajectory onset
3. stable
4. unstable
5. acute
6. crisis
7. comeback
8. downward
9. dying |
|
|
Term
9 Phases of Dying Trajectory
Pretrajectory |
|
Definition
| - genetic factors or certain lifestyle behvs place an indv or community at risk for devp chronic conditions |
|
|
Term
9 Phases of Dying Trajectory
Trajectory Onset |
|
Definition
- symptoms appear
- pts have dx workup
- pts begin to cope w/ possible implications of dx |
|
|
Term
9 Phases of Dying Trajectory
Stable |
|
Definition
- course of illness is under control
- sometimes referred to remission
- pt needs to continue health promoting behvs in order to avoid complications |
|
|
Term
9 Phases of Dying Trajectory
Unstable |
|
Definition
- challenge is to keep symptoms under control
- illness may be reactivated
- probs w/ ADL
- home care often, pt still needs continual medical intervention to keep stabilized
- pt experiences feelings of uncertainty and may question dx and/or txt options |
|
|
Term
9 Phases of Dying Trajectory
Acute |
|
Definition
- a time of severe or unrelieved symptoms
- pt may have compls requiring hosp
- everyday life activities on hold |
|
|
Term
9 Phases of Dying Trajectory
Comeback |
|
Definition
- pt deals w/ limitations, but slowly returns to an acceptable way of life
- rehab
- mgmt. involves an understanding of the social context of the pt's life as well as the psy issues |
|
|
Term
9 Phases of Dying Trajectory
Downward |
|
Definition
- quick or gradual decline w/ severe symptoms being increasingly difficult to control
- challenge is adaptation to all these events |
|
|
Term
9 Phases of Dying Trajectory
Dying |
|
Definition
- final days or weeks before death
- all body processes begin to shut down
- pt gives up daily activities and interests and begins process of closure |
|
|
Term
Interventions which may alleviate physiological needs of dying
Airway clearance |
|
Definition
- if pt is conscious, Fowler's position
- suction prn
- if pt is unconscious, keep in lateral position
- nasal O2 prn for hypoxia |
|
|
Term
Interventions which may alleviate physiological needs of dying
Bathing/hygiene |
|
Definition
- bathe and change linen freq especially if pt is diaphoretic
- oral care
- lotions and moisturizing creams for dry skin
- moisture-barrier skin preps if incontinent |
|
|
Term
Interventions which may alleviate physiological needs of dying
Physical Mobility |
|
Definition
- assist out of bed when able
- change position freq
- support position in bed
- elevate legs when pt can sit up
- pressure ulcer protocols |
|
|
Term
Interventions which may alleviate physiological needs of dying
Nutrition |
|
Definition
- stimulate appetite; may need antiemetics or a small amt of alcohol
- encourage liquid foods |
|
|
Term
Interventions which may alleviate physiological needs of dying
Constipation |
|
Definition
- inc fiber as tolerated
- laxatives or stool softeners prn |
|
|
Term
Interventions which may alleviate physiological needs of dying
Urinary Function |
|
Definition
- skin care, especially if incontinent
- bedpan, urinal or commode within easy reach
- call light
- absorbent pads under pt
- linens changed freq
- cath if necessary
- keep room odor free |
|
|
Term
Interventions which may alleviate physiological needs of dying
Sensory/Perceptual changes |
|
Definition
- ask pt's preference about room lighting
- hearing is not diminished; don't whisper but speak clearly
- touch is diminished, but pt will feel pressure of touch
- implement pain mgmt. protocol prn |
|
|
Term
| Characteristics of imminent death |
|
Definition
- coolness
- altered mentation, disorientation due to changes in metabolism or meds
- restless and repetitive motions due to dec O2 circ
- incontinence
- dyspnea, altered breathing pattern
- Cheyne-Stokes respirations: irregular respirations, with shallow breaths followed by periods of no breathing for 5-30 secs or 1 min
- as pt gets closer to death:
- periods of rapid, shallow panting
- gurgling sounds, "death rattle" |
|
|
Term
|
Definition
- body is rigid
- 2-4 hrs after death
- starts in the involuntary muscles
- progresses to extremities last
- the result of ATP which causes the muscles to contract and consequently immobilize the joints |
|
|
Term
|
Definition
- dec in body temp after death
- circ of blood ceases, hypothalamus stops, body comes to room temp |
|
|
Term
|
Definition
- discoloration of tissue which appears in the lowermost, dependent areas of the body
- due to the release of the hemoglobin accumulating from the breakdown of the RBCs |
|
|
Term
| Circumstances in which the law requires an autopsy |
|
Definition
- sudden death
- occurs within 48 hrs of admittance to a hospital |
|
|
Term
| Current medicare hospice benefit criteria |
|
Definition
- a terminal dx
- 6 mos prognosis
- cts must discontinue curative or life-prolonging therapies |
|
|
Term
| Medicare hospice benefits provide- |
|
Definition
- nursing care for symptom assess
- skilled svcs, txts, and case mgmt.
- routine nursing visits w/ 24/7 emergency contact
- medical social work for counseling and planning
- counseling svcs for spiritual or bereavement care
- durable med eqpt
- meds and supplies pertaining to the terminal illness
- home health aide and homemaker svcs
- speech, nutrition, physical and occupational therapies when medically necessary
- bereavement support to families after the death
- short-term inpatient care for probs that can't be managed at home
- short-term respite care up to 5 days to give family or caregivers a break
- continuous care at home for short episodes of acute need
- |
|
|
Term
|
Definition
- it encompasses the entire continuum of care from dx to death
- it's not restricted to dying or terminally ill hospice pts |
|
|
Term
| Major components of palliative care |
|
Definition
- symptom mgmt. w/ emphasis on pain control
- sharing of info
- engaging the pt and family in conversations about advance care planning
- coord of care encompassing psychological and spiritual care for pts and their families |
|
|
Term
|
Definition
- case mgmt. skills
- expertise in symptom assessment and mgmt.
- being a strong pt advocate
- avoiding inappropriate prolongation of dying
- providing evidence based physical, emotional, psychological and spiritual care to pts and their families
- coord care across all disciplines |
|
|
Term
| Two major landmark reports that have been responsible for promoting the growth of hospice and palliative care in the US |
|
Definition
- The SUPPORT study (1995) by the Robert Wood Johnson Foundation
- Approaching Death: Improving Care at the End of Life by the IOM |
|
|
Term
Two major landmark reports that have been responsible for promoting the growth of hospice and palliative care in the US:
The SUPPORT Study |
|
Definition
- studied the dying process
- it showed that more than half of the pts studied had pain during the last few days of living
- there were major gaps in comm between pt and drs re goals of care, which led to emotional distress for the pt, family, and HC pros
- 31% of the families lost most of their life savings providing care
- as a result, the medical and research communities were driven to change the culture of death and dying in the US |
|
|
Term
Two major landmark reports that have been responsible for promoting the growth of hospice and palliative care in the US:
Approaching Death: Improving Care at the End of Life by the IOM |
|
Definition
- impacted the future of palliative care
- it found 4 broad deficiencies in the care of the dying:
1. there is much needless suffering at the end of life. Failure by the caregiver
2. there are economic, legal, and organizational barriers that hinder or prevent the implementation of excellent care
3. drs, nurses, and other HC pros don't get the foundational edu and training to prepare them with the knowledge, skills, and attitudes to effectively care for pts at the end
4. there is still opportunity for much more research in the care of the dying. info is still inadequate which would provide the basis for the consistent practice of EB medicine and nursing care at the end |
|
|
Term
| Common barriers which impact the use of hospice and palliative care in the US |
|
Definition
- a mind-set in medicine that emphasizes cure and prolongation of life at any cost
- Medicare only reimburses for txts which have a cure as their outcome, which only leaves Medicare Hospice
- for pts with debilitating, life-threatening, chronic conditions, prognostication is difficult and becomes a barrier to accessing adequate palliative care
- ins cos often dictate that the pt choose between comfort or cure
- drs have very little edu in the skill of sharing bad news and a poor prognosis, effectively managing pain and other EOL issues
- nursing curricula deficient in teaching about caring for the dying pt
access to hospice and palliative care svcs is often delayed due to lack of pt's knowledge of what's available
- denial of death and poor comm about pt preferences hinder timely referrals to palliative care |
|
|
Term
|
Definition
| gather and organize data in relationship to the pt's health status |
|
|
Term
| Assessments for a pt who has experienced a loss or who is dying |
|
Definition
- health history
- physical
- personal coping resources
- symptom assessment
- Edmonton Symptom Assessment Scale
- the Brief Pain Inventory
- the Bedside Confusion Scale (BSCS)
- types of Impaired Mental Status (IMS)
- off-label drug
- Breath Air
- state of awareness
- closed awareness
- mutual pretense
- open awareness
- signs of impending death |
|
|
Term
Assessments for a pt who has experienced a loss or who is dying
Health History |
|
Definition
- perception of losses; past experiences w/ illness, loss, or crisis
- usual coping mechanisms found useful
- awareness of med dx and prognosis
- fears
- comments about suicide
- comments about life not being fair
- cultural preferences or religious practices, presence of support system
- any recent changes in eating or sleeping
- quality of life assessment, should be done 4 times:
- at time of dx
- during txt
- post txt during the terminal phase
- during active dying phase
- |
|
|
Term
Assessments for a pt who has experienced a loss or who is dying
Physical |
|
Definition
| - observe for changes in all body systems, especially for signs common at the EOL, including changes in mental status |
|
|
Term
Assessments for a pt who has experienced a loss or who is dying
Personal coping resources |
|
Definition
- pt may not relate physical symptoms to emotional responses such as grief
- loss and grieving assessment interview
- question pt about previous or recent losses. explore the nature of and sig of these losses to the pt
- ask about other personal stressors and if pt is physically able to do everything she used to
- ask if pt anticipates any other losses in the near future and what they might mean to her
- ask how they handled loss in the past
- Symptom Assessment |
|
|
Term
Assessments for a pt who has experienced a loss or who is dying
Symptom Assessment - Edmonton Symptom Assessment Scale |
|
Definition
| - a tool used for assessing and tracking the level of symptoms pts are experiencing |
|
|
Term
Assessments for a pt who has experienced a loss or who is dying
Symptom Assessment - Brief Pain Inventory |
|
Definition
| - a form completed by the pt which includes personal info and questions to describe the location, duration, intensity, and freq of pain, and meds or methods to treat it |
|
|
Term
Assessments for a pt who has experienced a loss or who is dying
Symptom Assessment - Bedside Confusion Scale (BSCS) |
|
Definition
- assess delirium and confusion
- the detection of inattention is the basic criteria for a positive dx
- cogn changes that occur due to advanced disease or at EOL are described as Impaired Mental Status (IMS) |
|
|
Term
|
Definition
- hypoactive, social withdrawal and somnolence
- hyperactive, severe agitation
- possibly combative behv
- restlessness- myoclonus, delirium, or motor restlessness w/o mental disturbance
- delirium associated w/ hallucinations, paranoia, agitation, or hyperactiveness or hypo |
|
|
Term
Assessments for a pt who has experienced a loss or who is dying
Off-label drug |
|
Definition
| - a drug is approved for one prob but in this case it's being used because of some beneficial side effects rather than for its intended use |
|
|
Term
Assessments for a pt who has experienced a loss or who is dying
BREATH AIR |
|
Definition
The assessment of pts with breathing difficulties:
Bronchospasm
Rales
Effusions
Airway obstruction
Thick secretions
Hgb (low)
Anxiety
Interpersonal issues
Religious concerns |
|
|
Term
Assessments for a pt who has experienced a loss or who is dying
State of awareness- closed |
|
Definition
| - the ct isn't aware of impending death |
|
|
Term
Assessments for a pt who has experienced a loss or who is dying
State of Awareness - Mutual |
|
Definition
| - the pt, family, and HC team know of the terminal prognosis but don't comm about it at all |
|
|
Term
Assessments for a pt who has experienced a loss or who is dying
State of Awareness - Open |
|
Definition
| - everybody knows death is imminent and all feel comfortable discussing it |
|
|
Term
|
Definition
- loss of muscle tone
- slowing of circulation
- changes in respirations
- sensory impairment |
|
|
Term
S&S of Impending Death
Loss of muscle tone |
|
Definition
- difficulty speaking
- relaxation of the facial muscles
- probs swallowing w/ gradual loss of gag reflex
- dec activity of GI tract resulting in nausea, flatus, abdom distention and retention of feces, especially if the pt is receiving narcs or tranqs
- dec sphincter control which may result in incontinence
- dec body movement |
|
|
Term
S&S of Impending Death
Slowing of circulation |
|
Definition
- diminished sensation
- mottling and cyanosis of extremities
- cold skin, first in feet, then in hands, ears, nose
- weak, slow pulse and dec BP |
|
|
Term
S&S of Impending Death
Changes in respiration |
|
Definition
- rapid, shallow, irregular or abnormally slow resps
- noisy breathing (death rattle) due to the accumulation of mucus in the throat
- dry oral mucosa due to mouth breathing |
|
|
Term
S&S of Impending Death
Sensory impairment |
|
Definition
- blurred vision
- impaired sense of taste and smell |
|
|
Term
|
Definition
| In collaboration with the pt, family and the members of the HC team, synthesize data to ID actual or potential health probs (nursing dx) |
|
|
Term
| Nursing Dx related to the pt and family who are grieving |
|
Definition
- Anticipatory grieving r/t the recognition of impending loss
- Hopelessness r/t failing health and inevitable death
- Caregiver role strain r/t ongoing responsibility for providing physical, psychological and economic care to the dying person
- Interrupted family processes
- Impaired adjustment
- At risk for loneliness r/t the loss of relationships to others |
|
|
Term
|
Definition
| In collaboration w/ the pt and members of the HC team, determine expected outcomes (pt-centered goals), and formulate specific strategies to achieve the expected outcomes |
|
|
Term
| Nursing Dx: anticipatory grieving r/t the recognition of impending loss |
|
Definition
Grief resolution; adjustment to impending loss AEB seeking social support and progressing through the stages of grief. Pt's spouse will express satisfaction w/ care received and acknowledge grief.
This is the expected outcome for which Dx? |
|
|
Term
| Nursing Dx: Hopelessness r/t failing health and inevitable death |
|
Definition
Ct will verbalize feelings AEB sharing suffering openly and constructively w/ others and by reminiscing and reviewing life positively. Pt will verbalize acceptance of impending death
This is the expected outcome for which Dx? |
|
|
Term
| Nursing Dx: Caregiver role strain r/t ongoing resp for providing physical, psychological and economic care to the dying person |
|
Definition
Caregiver will ID resources available to help in giving care
This is the expected outcome for which Dx? |
|
|
Term
| Nursing Dx: At risk for loneliness r/t the loss of relationships to others |
|
Definition
Ct will participate in ongoing positive and relevant social activities and interactions that are personally meaningful
This is the expected outcome for which Dx? |
|
|
Term
|
Definition
| The nurse must integrate compliance with the Dying Pt's Bill of Rights and the Clinical Practice Guidelines for Palliative Care; advance directives like HC proxy (surrogate) and living will; DNRs; laws and protocols re the withholding and withdrawing of life-sustaining therapies; death certification; and inquest |
|
|
Term
| Grief resolution; adjustment to impending loss AEB seeking social support and progressing through the stages of grief. Pt's spouse will express satisfaction w/ care received and acknowledge grief. |
|
Definition
Encourage the person to share concerns, fears, effects on lifestyle
This is a NI for which EO? |
|
|
Term
| Ct will verbalize feelings AEB sharing suffering openly and constructively w/ others and by reminiscing and reviewing life positively. Pt will verbalize acceptance of impending death |
|
Definition
Convey empathy to promote verbalization of doubts, fears, and concerns
This is a NI for which EO? |
|
|
Term
| Caregiver will ID resources available to help in giving care |
|
Definition
Discuss the need for respite and short-term relief
This is a NI for which EO? |
|
|
Term
| Ct will participate in ongoing positive and relevant social activities and interactions that are personally meaningful |
|
Definition
Discuss the importance of quality socialization rather than a great number of interactions
This is a NI for which EO? |
|
|
Term
| 13 expectations ID on the Dying Pt's Bill of Rights |
|
Definition
I have the right to:
- be treated as a living human being until I die
- maintain a sense of hopefulness however changing its focus may be
- express my feelings and emotions about my approaching death in my own way
- participate in decisions concerning my care
- expect continuing medical and nursing attn. even though cure goals must be changed to comfort goals
- not to die alone
- be free from pain
- have my questions answered honestly
- not be deceived
- have help from and for my family in accepting my death
- die in peace and w/ dignity
- retain my individuality and not be judged for my decisions which may be contrary to the beliefs of others
- be cared for by caring, sensitive, knowledgeable people who will attempt to understand my needs and will be able to gain some satisfaction in helping me face my death |
|
|
Term
| Ethical issues facing nurses caring for pts at the end |
|
Definition
- are we prolonging life or are we actually prolonging death?
- quality of life, the right to die, and dying w/ dignity
- informed consent, living wills, advance directives
- should pain meds be used even if they may shorten the life span?
- when should life support be discontinued? |
|
|
Term
|
Definition
to determine an acceptable quality of life and goals of care, which are decisions unique to each indv and family
- it's critical for the nurse to promote family discussions about EOL concerns and decisions |
|
|
Term
| The nurse's role in advance care planning |
|
Definition
- devp a values history of the pt
- ensure that the pt has a clear and thorough understanding of the disease process, the implications r/t prognosis and any possible txt modalities
- help pt decide who her HC surrogate will be
- make sure HC surrogate is comfortable w/ the responsibility |
|
|
Term
|
Definition
it is something only a court can decide.
drs use this term to distinguish from the legal term |
|
|
Term
|
Definition
| it's relative, not absolute, and is also task specific |
|
|
Term
|
Definition
| being unable to exercise autonomy, a right which drs and nurses must respect |
|
|
Term
| To determine a pt's capacity for decision-making, drs should assess for: |
|
Definition
- the intellectual ability to receive and understand the info given
- the ability to process the info and understand the possible consequences and other options before making a choice
- the ability to communicate a decision clearly, at least by paraphrasing what they have been told, and to discuss how her own values and desires factor into the dr's recommendations about txt options |
|
|
Term
|
Definition
| it's implemented ONLY when indvs have reached the end stage of an illness, are no longer able to speak for themselves, and when txt would only prolong natural dying |
|
|
Term
| The Pt Self-Deter Act of 1991 mandates that all HC facilities receiving Medicare and Medicaid reimbursements |
|
Definition
- recognize advanced directives
- ask all pts if they have such a document, and if they don't, then
- provide edu materials and assistance they may need to complete one, assuring that pts are aware that it's their right to state their personal wishes re txt decisions, including the right to refuse med txt |
|
|
Term
| the ANAs 6 recommendations re DNR orders |
|
Definition
1. priority should always be given to the competent ct's wishes and choices, even if there is a conflict w/ those of the family or HC provider
2. when the pt no longer has capacity for decision making, txt decisions should be made based on the pt's advance directive or by the indv appointed as HC proxy
3. a DNR decision should always be made following extensive comm between the pt, family, the HC team and the pt's HC proxy
4. to meet the standards of JHACO, all DNR orders are to be clearly written, reviewed and updated based on changes in the pt's condition
5. a DNR order is separate from any other medical or nursing order and doesn't ever imply that other interventions should be withdrawn
6. if a nurse feels that a DNR order is in conflict with his personal values or beliefs, he should consult w/ a nurse mgr and request a change of assignment |
|
|
Term
| Criteria for withholding or withdrawing txt |
|
Definition
- the therapy is no longer medically effective
- if it offers no reasonable chance of helping the pt regain any human awareness
- if the pt and/or surrogate agree that the burden of this therapy is greater than the benefit |
|
|
Term
| Ethical issues re artificial nutrition and hydration at the EOL |
|
Definition
- sometimes the pt, family and friends will view the withholding of ______ and _____ as abuse, neglect, or as a purposeful way to hurry the dying process
- many also believe that withholding _____ may cause more pain and suffering at the EOL |
|
|
Term
|
Definition
- active
- passive
- voluntary
- involuntary |
|
|
Term
|
Definition
doing something which directly and intentionally leads to a person's death
- this is an act of commission with a specific end in mind |
|
|
Term
|
Definition
- usually an act of omission
- death is allowed to occur by either withdrawing or withholding txt that might prolong life
- directly killing is wrong
- not implementing extraordinary measures or discontinuing extraordinary txts and allowing someone to die naturally is morally permissible |
|
|
Term
|
Definition
| 1994, right to die law, dr assisted suicide |
|
|
Term
| Suicide and nursing implications |
|
Definition
- nurses are committed to providing care and not abandoning it
- they assure that dying pts are not alone and that they are comfortable and free of anxiety
- nurses have the legal and ethical obligation to assess pts for depression and suicide risk and to make consults to offer counseling
- nurses can advocate for suicidal pts by giving them opportunities for some control over issues such as pain mgmt., bowel and bladder control and depression
- they provide valuable support by making referrals to other HC members |
|
|
Term
|
Definition
| a legal inquiry that's conducted by a coroner or medical examiner, to investigate the cause or manner of death, as in an accident or sudden death |
|
|
Term
| Nurse's role in legalities r/t death |
|
Definition
| - defined by the laws of the state and by the policies of each HC facility |
|
|
Term
| Planning pt's care for the dying experience |
|
Definition
- an assessment interview focused on loss and grieving:
- impact of previous losses
- coping mechanisms
- physical symptoms r/t loss
- what brought comfort?
- what does the pt know about her dying process?
- understand the influence of the pt's culture |
|
|
Term
| Providing culturally sensitive care |
|
Definition
- be knowledgeable about cultural values and attitudes
- attend to diverse comm styles
- ask the pt for her preferences for decision-making early in the care process
- recognize cultural differences and varying comfort levels w/ regard to personal space, eye contact, touch, time orientation, learning styles and conversation styles
- use a cultural guide from the palliative care pt's ethnic or religious background
- get to know the community , its people, and its resources available for social support
- create a culturally friendly physical environ
- determine the acceptability of pts being physically examined by a practitioner of a different gender
- advocate for availability of svcs, accessibility in terme of cost and location, and acceptability of svcs that are compatible w/ cultural values and practices of the pt
- conduct a self-assessment of the HC provider's own beliefs about illness and death |
|
|
Term
| Delegation of EOL care activities by the RN |
|
Definition
- it's important to keep the number of staff assigned to the pt at a minimum
- UAP may care for the basic needs of the pt
- UAP must be sensitive to the pt's situation |
|
|
Term
|
Definition
| Initiate and complete nursing-care plans designed to move the pt toward the expected outcomes (pt-centered goals) r/t self-determined life closure, safe and comfortable death, and effective grieving |
|
|
Term
| The major nursing responsibility to the pt who is dying |
|
Definition
- assist the pt to a peaceful death by:
- provide physical comfort
- help pt to maintain a sense of security, dignity, self-confidence, and self-worth
- help the pt through the grieving necessary to accept losses
- provide relief from loneliness, fear, and depression |
|
|
Term
| Ineffective verbal responses |
|
Definition
- "you're doing so well", offering false assurance
- "God will take you when he wants you, or, "everyone dies sooner or later", being fatalistic
- "you don't really mean that, or, "you're going to live another 10 years", denying what's happening; not acknowledging the pt's feelings
- "you shouldn't say things like that", or, "let's talk about something more positive", changing the subject
- "I don't think things are really all that bad", conveying an attitude that stops further discussion
- "Let me do that for you", making the pt feel helpless and powerless when she is still able to have some degree of independence |
|
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Term
|
Definition
- somatic
- visceral gut
- neuropathic |
|
|
Term
Pain Syndromes
somatic pain |
|
Definition
- involves direct stimulation of intact nociceptors and electrical signals which are xmitted along normally functioning nerves
- tissue damage
- bone metastasis
- skin lesions
- fractures
- usually requires NSAIDS, steroids, or radiotherapy
- dull, aching, gnawing or throbbing pain
- localized |
|
|
Term
Pain Syndromes
visceral gut pain syndrome |
|
Definition
- results from stimulation of the ANS which provides the nervous system connection to all the organs
- sharp, aching, squeezing, cramping or pulling pain
- opioids |
|
|
Term
Pain Syndromes
Neuropathic pain |
|
Definition
- comes from probs w/ the peripheral and CNS and may be the result of shingles, diabetic neuropathy, HIV or postherpetic neuropathy
- burning, shooting, stabbing, tingling, numbness, radiating, or electric-like
- opioids, tricyclic depressants, or anticonvulsants |
|
|
Term
| WHO analgesic ladder for txt of non-cancer pain |
|
Definition
Mild pain:
- low-dose ibuprofen or nonacetylated salicylates
- non-pharmacologic modalities and/or acetaminophen
Moderate pain:
- full dose NSAIDS, with or w/o weak opioids
Severe pain:
- strong opioids, after all other analgesics have been uncuccessful
- |
|
|
Term
| Breakthrough Dose (BTD) for pain mgmt |
|
Definition
- should be available Q24hrs PRN for oral meds
- Q20mins PRN for SubQ meds
- BT or rescue drugs should be immediate release |
|
|
Term
|
Definition
- low dose immediate release opioids are often effective
- morphine is drug of choice for breathlessness at EOL
- expectorant: if cough reflex is present
- diuretics: used occasionally, but specifically for pts w/ pulmonary congestion or a concurrent heart condition
- corticosteroids, bronchodilators or anesthetics |
|
|
Term
|
Definition
- corticosteroids to reduce swelling and inflammation
- stool softeners or laxatives are started simultaneously w/ opioids
- docusate 100mg bid po, reduces cramping more than stimulant laxatives
- senna, 1-2 tabs at bedtime
- fleet enema or bisacodyl suppository if pt doesn't have a BM in 3 days |
|
|
Term
|
Definition
- benzodiazepine for simple anxiety
- tranqs for severe anxiety w/ hallucinations |
|
|
Term
|
Definition
- situational
- drug related
- organic
- psychologic |
|
|
Term
| Types of anxiety - situational |
|
Definition
| - pt worries about his physical condition, finances, abandonment or an uncertain future |
|
|
Term
| Types of anxiety - drug related |
|
Definition
| worries about therapies used in palliative care or has drug-induced effects or withdrawal from meds being used |
|
|
Term
| Types of anxiety - organic |
|
Definition
| results from uncontrolled symptoms, such as pain, dyspnea, insomnia, or hypoglycemia |
|
|
Term
| Types of anxiety - psychologic |
|
Definition
| may come from the pt's hopelessness, fears, or thoughts about death |
|
|
Term
|
Definition
- first ID the major cause, attempt to reverse it and then choose the appropriate antiemetic
- decadron works well as an adjuvant and also gives the pt a sense of well-being
- the following combo is effective in txt the symptoms as well as being cost-effective:
- lorazepam (Ativan) 1mg
- diphenhydramine (Benadryl) 25mg
- metoclopramide 10mg and haloperidol 1mg per suppository
- octreotide for persistent vomiting |
|
|
Term
|
Definition
| - the electrodes should not be placed over sutures, irritated skin, over hair, over the carotid sinus, over the laryngeal or pharyngeal muscles, or over the uterus of a preg woman |
|
|
Term
| Psychological and spiritual support for the dying pt and family: discussing death and dying |
|
Definition
- explore my own feelings about death and acknowledge my personal fears. Consider how these might influence my communication w/pts
- establish a trusting relationship w/ the pt and family which facilitates open comm and reflects my commitment to the pt |
|
|
Term
| Psychological and spiritual support for the dying pt and family: specific measures that let the pt know that I'm willing to talk about death |
|
Definition
- making my concern for the pt clear, e.g., "I'd like to know what you are feeling so that I can better help you".
- recognizing the pt's struggle, e.g., "It must so hard to be so uncomfortable. I'd like to see what I can do to help take away some of the distress".
- describing what I see, e.g., "You seem sad today. Would you like to talk about what's happening to you?"
- being present to the pt w/ a gentle caring touch. Hold the pt's hand, offer a therapeutic massage, encourage verbalization of her feelings
- having a discussion w/ the pt and family about how the pt usually deals w/ stress, the pt will probably deal w/ death in the same way
- keep the emphasis on the pt's needs
- finding out what the pt knows about his dx and prognosis
- answer the pt's questions about death w/ honesty and openness
- always make time to be w/ the pt, to listen, to provide support and to respond |
|
|
Term
| Revise the pt's care plan based on reassessment of the pt: questions the nurse will ponder |
|
Definition
- are there any behvs that might suggest dysfunctional grieving or another nursing dx?
- was the time unrealistic for the expected outcomes? Are there other stressors influencing the pt's grief response that were not known or not present at the time the plan was proposed?
- were all nursing orders consistently carried out w/ care and compassion?
- |
|
|
Term
|
Definition
| the subjective response experienced by the surviving loved ones after the death of a person with whom they have shared a significant relationship |
|
|
Term
|
Definition
| the behavioral process through which grief is eventually resolved or altered; it is often influenced by culture, spiritual beliefs, and custom |
|
|
Term
|
Definition
| the total response to the emotional experience related to loss that is manifested in thoughts, feelings, and behaviors associated with overwhelming distress or sorrow |
|
|
Term
|
Definition
| The patient, family and health care team know of the terminal prognosis but do not communicate about this at all |
|
|
Term
| The Genetic Information Nondiscrimination Act (GINA) |
|
Definition
| is a law that defines discrimination against a person or against that person’s family only because of real or perceived differences from the normal genome of that individual, contrary to altered genes because of an inherited condition. |
|
|
Term
|
Definition
| Legislation prior to the ADA included the ____ ______ of 1973, but its main concern was access to businesses, organizations and institutions that received federal financial assistance. This ruling did not impact the private sector at all. |
|
|
Term
| The ADA defines 3 categories of individuals with disabilities that are protected: |
|
Definition
| a) those having mental impairments such as learning disabilities, psychiatric disorders, retardation, etc., or physical impairments, such as cerebral palsy, cancer, HIV, orthopedic, visual, speech or hearing problems, etc, that limit one or more of life’s activities, b) those having a record of such an impairment, and c) those regarded as having an impairment. Certain conditions do not constitute a disability under the ADA, for example, pregnancy, lifting disabilities, depression and anxiety, migraine headaches, etc |
|
|
Term
| Coping with sensory impairment involves at least three types of adaptation: physical, emotional, and social |
|
Definition
| The emotional adjustment to these alterations, which implies acceptance of the losses, often determines the physical and social adjustments of the clients. |
|
|
Term
| Clinical manifestations of sensory deprivation |
|
Definition
- excessive yawning, drowsiness, and sleeping
- dec attn. span, difficulty concentrating, and dec prob-solving
- impaired memory; periodic disorientation, genl confusion, or nocturnal confusion
- preoccupation w/ somatic complaints, such as palpitations
- hallucinations or delusions
- crying, annoyance over small matters and depression
- apathy and emotional liability |
|
|
Term
| Risk factors for sensory deprivation |
|
Definition
- nonstimulating or monotonous enviro
- impaired vision or hearing
- mobility restrictions
- inability to process stimuli
- emotional disorders
- limited social contact |
|
|
Term
| Risk factors for sensory overload |
|
Definition
- pain or discomfort
- admission to an acute care facility
- monitoring in ICUs
- invasive tubes
- dec cog ability |
|
|
Term
|
Definition
- disturbed sensory perception (specify: visual, auditory, kinesthetic, gustatory, tactile, olfactory)
- acute confusion
- chronic confusion
- impaired memory |
|
|
Term
| Examples for which sensory-perceptual disturbances are the etiology and then outcome criteria |
|
Definition
- risk for injury - prevent injury
- impaired home maint - maintain the function of existing senses
- risk for impaired skin integrity
- impaired verbal comm - develop an effective comm mechanism
- self care deficit: bathing, hygiene - perform ADLs independently and safely
- social isolation - reduce social isolation
- prevent sensory overload or deprivation |
|
|
Term
| NIs to promote/maintain sensory function |
|
Definition
Promote healthy sensory function
- appropriate sensory stimulation
- prevention of sensory disturbances
Adjust enviro stimuli
- prevent sensory overload
- prevent sensory deprivation
Manage acute sensory deficits
- use of sensory aids
- use of other senses
- effective comm |
|
|
Term
| NIs to promote/maintain sensory function |
|
Definition
J.H. - 89 y.o. female, widow
Assessment:
- lived indep in own home for 15 yrs
- recent removal of cataracts
- experiencing more difficulty hearing
- children concerned about her safety and lack of socialization, and urged her to enter a NH
- confused
- disoriented to place and time
- restless
- withdrawn
- stated, "I'm afraid of all these strange creatures in this orphanage"
- VS: WNL
- CXR, CBC, U/A; negative
Generate Nursing DX
- disturbed sensory perception (sensory overload) r/t change in enviro and hearing loss
Outcome
- cog orientation aeb not compromised:
- identifies others, current place, correct season
Evaluation
- outcome met:
- able to id her nurse by name
- aware that Christmas is 3 wks away
- anxious to go shopping with the group
- wears hearing aid
Outcome
- hearing compensation behv aeb often demonstrated:
- positions self to advantage hearing
- reminds others to use techniques that advantage hearing
- eliminates background noise
- uses hearing aid
Outcome met:
- wears hearing aid during the day |
|
|
Term
| Orientation strategies for ct w/ acute confusion/delerium |
|
Definition
- wear a readable name tag
- address the person by name
- introduce myself freq
- id time and place prn
- ask the ct, "where are you?"
- orient the ct to place if indicated
- place a calender and clock in the ct's room
- mark holiday w/ ribbons, pins, or other means
- speak clearly and calmly, allowing time for words to be processed and for a response
- encourage family to visit freq
- provide clear, concise explanations of each txt, procedure or task
- eliminate unnecessary noise
- provide adequate sleep
- keep hearing aids and glasses in reach
- ensure adequate pain mgmt.
- keep room well lit during waking hours |
|
|
Term
|
Definition
- spherical organ made up of 3 layers
- sclera
- choroid
- retina
- cornea
- lens
- ciliary body muscles and suspensory ligaments
- iris
- pupil
- aqueous humor
- vitreous humor
- rods
- cones
- optic nerve
- eyelids
- conjunctiva
- lacrimal glands
- lacrimal canals |
|
|
Term
|
Definition
| outer most, fibrous, protective layer; whit of eye |
|
|
Term
|
Definition
| middle, vascular layer; provides blood supply, has pigmented cells to stop light penetration |
|
|
Term
|
Definition
- innermost, nerve receptors xmit light impulses
- highly vascular
- rods and cones |
|
|
Term
|
Definition
| transparent, no capillaries |
|
|
Term
|
Definition
| clear pliable, muscles changes shape to focus on retina |
|
|
Term
| Ciliary body muscles and suspensory ligaments |
|
Definition
|
|
Term
|
Definition
| pigmented membrane w/ sphincter-like function |
|
|
Term
|
Definition
|
|
Term
|
Definition
- fluid in the anterior cavity between the cornea and lens
- provides nourishment
- production is continuous
- excess fluid is drained through the canal of Schlemm |
|
|
Term
|
Definition
- clear jelly-like fluid
- fills interior of eyeball to keep inflated |
|
|
Term
|
Definition
- black and white
- dim light |
|
|
Term
|
Definition
|
|
Term
|
Definition
| carries image impulses to brain |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| drains tears to nasal cavity |
|
|
Term
|
Definition
3 major sections of ear and associated components
- external ear
- middle ear (tympanic cavity)
- inner ear |
|
|
Term
|
Definition
- auricle (pinna)
- cerumen (earwax)
- tympanic membrane (eardrum) |
|
|
Term
|
Definition
Air-filled cavity
Contains:
- ossicles
- oval window
- opening of Eustachian tube
- Eustachian tubes |
|
|
Term
|
Definition
- also called the pinna
- external ear
- collects sound waves deflected into canal (external auditory meatus) |
|
|
Term
|
Definition
- also called earwax
- external ear
- defense against foreign particles |
|
|
Term
|
Definition
Protects the middle ear and conducts sound vibrations
- composed of:
- outer skin layer
- fibrous middle layer
- inner mucosal layer
- also called eardrum
- middle ear
- thin membrane separating external and middle ear
- vibrates with sound waves |
|
|
Term
|
Definition
- in middle ear
- malleus, stapes, incus
- relays sound waves from outer to inner ear |
|
|
Term
|
Definition
|
|
Term
|
Definition
- inner ear
- snail shapes, fluid filled
- sound waves travel through fluid to hairs of Cordi where nerve endings carry impulses along auditory nerve to brain for interpretation |
|
|
Term
|
Definition
- inner ear
- part of cochlea that staples attaches |
|
|
Term
|
Definition
- inner ear
- connect middle ear and pharynx to keep pressure equal on eardrum surfaces |
|
|
Term
|
Definition
- semicircular canals (and vestibules)
- part of the inner ear responsible for maintaining equil
- static equil: orients body in relation to gravity while at rest
- dynamic equil: maintains body position during movement |
|
|
Term
|
Definition
- errors of refraction (ametropia): faiure of light to focus on retina
- myopia (nearsightedness): focus falls short of retina; eyeball too long
- presbyopia (farsightedness)
- astigmatism
- cataracts
- glaucoma
- strabismus
- macular degeneration |
|
|
Term
|
Definition
- difficulty seeing distant objects
- lack of classroom participation in kids
- DX and Txt
- comp eye exam
- corrective lenses, refractive surgery |
|
|
Term
|
Definition
- farsightedness
- focus falls behind retina
- eyeball to short |
|
|
Term
|
Definition
- holding reading material at a distance
- blurred vision
- eye fatigue
- headaches when working with close objects or reading
- DX and Txt
- corrective lenses or surgery |
|
|
Term
|
Definition
| - focus distorted due to abnormal curvature of lens or cornea |
|
|
Term
|
Definition
- blurred vision
- headaches
- eye strain
- fatigue
- DX and Txt
- corrective lenses or surgery |
|
|
Term
|
Definition
- opacities or cloudy film forms on lens between lens and cornea
- Causes:
- exact cause unknown
- UV light?
- diabetes?
- certain drug use? (steroids, diuretics, tranqs)
- high salt diet |
|
|
Term
|
Definition
- blurred vision
- cloudy vision
- inc glare
- cloudy white iris/pupil |
|
|
Term
|
Definition
- intracapsular extraction
- extracapsular "
- phocoemulsification |
|
|
Term
|
Definition
| - cold, metal probe (cryoprobe) used to remove the entire lens and its surrounding capsule. Rarely used |
|
|
Term
|
Definition
| - the anterior portion of the lens capsule and the capsule contents are removed, but posterior lens capsule left intact |
|
|
Term
|
Definition
- uses ultrasound to disintegrate cataract for extraction
- one or no stitch required |
|
|
Term
|
Definition
- increased intraocular pressure in eyeball
- Types:
- open angle (chronic): most common; narrowing of Canal of Schlemm
- closed angle (acute): restricted flow due to narrow anterior chamber
- if left untreated, either type will cause blindness |
|
|
Term
| Risk factors (chronic) for glaucoma |
|
Definition
- over 40
- family hx
- diabetes
- myopia |
|
|
Term
| Risk factors (acute) for glaucoma |
|
Definition
- old age
- family hx
- presbyopia
- use of systemic anticholinergic meds (atropine) in high risk indv |
|
|
Term
|
Definition
- severe eye/facial pain
- vision loss
- cloudy vision w/ halos
- red eye
- fixed, non-reactive pupil
- N&V |
|
|
Term
|
Definition
- gradual peripheral vision loss
- blurred or foggy vision
- mild, chronic headaches
- rainbow colored halos |
|
|
Term
|
Definition
- gradual peripheral vision loss
- blurred or foggy vision
- mild, chronic headaches
- rainbow colored halos |
|
|
Term
|
Definition
- tonometry: intraocular pressure
- retinal exam
- slit lamp exam
- visual acuity
- visual field |
|
|
Term
|
Definition
Meds to relieve IO pressure:
- drops: Timolol, Betagan and OptiPranolol
- oral: Daranide, Diamox, and Neptazane
- topical: Xalatan
Surgery: iridotomy (with laser) |
|
|
Term
| Strabismus - eye misalignment |
|
Definition
Causes:
- brain "malfunction" ignoring one eye
- trauma
- any condition altering brain function |
|
|
Term
|
Definition
- eye misalignment
- exotropia
- esotropia |
|
|
Term
|
Definition
- eyes turning outward
TXT:
- vision therapy
- patching
- glasses
- surgery |
|
|
Term
|
Definition
- eyes turning inward
TXT:
- vision therapy
- patching
- glasses
- surgery |
|
|
Term
|
Definition
- deterioration of the macula of the retina
- risk factors
- smoking
- age
- gender (women appear to be at slightly higher risk)
- family hx
- high cholesterol
- Caucasians are much more likely to have MD than nigs
- UV light?
- low consumption of fruits and veges
- light skinned, blue eyes? |
|
|
Term
|
Definition
- wet (neovascular): leaky blood vessels
- dry: drusden (yellow deposits) form |
|
|
Term
|
Definition
- loss of central vision
- difficulty reading or performing tasks that require the ability to see detail
- distorted vision (straight lines such as a doorway or the edge of a window may appear wavy or bent) |
|
|
Term
|
Definition
- Dx: retinal exam
- Txt: wet - no proven txt
dry - laser photocoagulation, vitrectomy. Doesn't improve vision but may spare central vision |
|
|
Term
|
Definition
- inflammation of middle ear; common in young children
- causes
- blocked Eustachian tube
- middle ear infection
- S&S
- earache
- purulent drainage
- hearing loss |
|
|
Term
|
Definition
- DX
- red, bulging tympanic membrane
- culture of drainage
- TXT
- antibiotics
- adenoidectomy
- myringotomy
- tube placement |
|
|
Term
|
Definition
- abnormal "spongy" bone growth in m. ear
- Risk factors
- heredity
- pregnancy
- Caucasian
- S&S
- hearing loss
- tinnitus |
|
|
Term
|
Definition
- DX
- audiometry
- head CT or xray
- TXT
- hearing aid
- stapedectomy (prosthesis placement)
- laser stapedectomy " |
|
|
Term
|
Definition
- Also called idiopathic endolymphatic hydrops
- sensorineural hearing loss
- A collection of S&S that may include:
- fluctuating hearing loss
- fluctuating rotational vertigo
- fluctuating tinnitus
- fluctuating aural fullness
- Cause:
- excess endolymphatic fluid (one of two inner ear fluids) |
|
|
Term
|
Definition
DX: r/o other causes
- CT scan/MRI
- caloric stimulation (eye reflexes)
- electronystagmography
- audiometry
- TXT
- no cure
- treat symptoms |
|
|
Term
| Sensory changes not caused by aging |
|
Definition
- functional impairment
- injury
- social isolation
- depression |
|
|
Term
| Normal age-related changes of the eye: External |
|
Definition
- graying and thinning of the eyebrows and eyelashes
- subQ tissue atrophy, which leads to wrinkling of skin surrounding the eyes
- dec orbital fat, which leads to sunken appearance of eye and sagging of eyelids |
|
|
Term
| Age-related changes of the eye: Internal |
|
Definition
- Cornea and lens
- changes in lens transparency
- dec visual field
- adaptability to dim light and darkness
- dec aqueous humor
- corneal changes
- less endothelial cells on the cornea > reduced ocular sensitivity > dec pain response
- lipid deposits around peripheral cornea > arcus senilis
- lenses thicken and harden
- yellowish appearance and opacity
- light to scatter > interference with color discrimination
- reduced space for drainage of aqueous humor > glaucoma
- impedes accommodation > presbyopia |
|
|
Term
| Age-related changes of the eye: Internal |
|
Definition
Pupil
- dec dilation and constriction
- delayed response > difficulty responding to changes in light
- diameter is dec > dec light reaching dia
Iris
- loses color > eyes appear gray or light blue |
|
|
Term
| Age-related changes of the eye: Internal |
|
Definition
Visual acuity
- diminishes gradually after age 50
- dec rapidly after age 70
Light sensitivity declines w/ age
- brightness contrast
- dark adaptation
- recovery from glare |
|
|
Term
| Age-related changes of the ear: External ear |
|
Definition
- auricle wrinkles and sags
- inc cerumen production
- dry > pruritis
- hard
- dec apocrine gland activity > accumulation |
|
|
Term
| Age-related changes of the ear: Inner ear |
|
Definition
- atrophy of organ of Corti and cochlear neurons
- loss of sensory hair cells
- degeneration of the stria vascularis |
|
|
Term
| Age-related changes: Taste |
|
Definition
Diminished sense of taste
- thresholds are ~ 2.5-5x higher in older adults
- protein
- salt
- sweet |
|
|
Term
| Age-related changes: Smell |
|
Definition
- thresholds for common odors ~ 11x higher for older people
- structural alterations contribute to loss of sense of smell
- upper airway
- olfactory tract and bulb
- hippocampus
- amygdaloid complex
- hypothalamus |
|
|
Term
| Age-related changes: Tactile sensation |
|
Definition
- diminishes w/ age
- dec ability to detect temp extremes |
|
|
Term
| Common nursing DX of older persons r/t sensory probs: Visual impairment |
|
Definition
- Linked w/ four causes
- cataracts
- glaucoma
- diabetic retinopathy
- Visual impairment = visual acuity 20/20 by Snellen chart at 20'
- inc w/ age
- Legal blindness = visual acuity 20/200 by Snellen chart at 20'
- inc w/ age
- peaks at 85 years |
|
|
Term
| Signs of difficulty w/ vision |
|
Definition
- squinting or tilting head to see
- changes in ability to drive, read, watch TV, or write
- holding objects closer to the face
- difficulty w/ color discrimination and walking up or down stairs
- hesitation in reaching for objects
- not being able to find something |
|
|
Term
| Age-Related Mac Deg (ARMD): Dry (atrophic form) |
|
Definition
- atrophy
- retinal pigment deg
- Drusen accumulations
- other symptoms
- slow progression of visual loss |
|
|
Term
| Age-Related Mac Deg (ARMD): Wet (Neovascular exudates) |
|
Definition
- blood or serum lead from newly formed blood vessels beneath retina > scar formation and visual probs
- other symptoms
- more light required for reading
- burred vision
- central scotomas
- metamorphopsia |
|
|
Term
| Age-Related Mac Deg (ARMD): Risk factors |
|
Definition
- > age 55
- smoker
- family hx
- inc exposure to UV light
- Caucasian race and light colored eyes
- HTN or CVD
- lack of dietary intake of antioxidants and zinc |
|
|
Term
|
Definition
- lens clouding > dec light to retina > limited vision
- devp is slow and painless
- leading cause of blindness in the world
- > 50% of adults > 65 have cataracts |
|
|
Term
|
Definition
- inc age
- smoking and alcohol
- diabetes, hyperlipidemia
- eye trauma
- sun exposure and UVB rays
- corticosteroid meds |
|
|
Term
|
Definition
- blurred vision
- glare
- halos around objects
- double vision
- lack of color contrast or faded colors
- poor night vision |
|
|
Term
|
Definition
- inc in IOP > optic nerve damage > vision loss
- primary open-angle (chronic, simple)
- secondary open-angle
- primary angle-closure (narrow angle, acute)
- secondary angle-closure
- congenital |
|
|
Term
|
Definition
- slowed flow of aqueous humor through trabecular meshwork > build up > inc IOP > damage to renal nerve fiber > vision loss
- painless vision loss
- midperopheral visual field loss
- "normal tension"
- normal IOP but still damaged optic nerve > visual changes
- symptoms
- enlargement of the optic cup
- nicking of the neuroretinal rim
- small hemorrhages near the optic disc |
|
|
Term
|
Definition
- angle of the iris obstructs drainage of aqueous humor through trabecular meshwork > inc IOP > visual changes
- symptoms
- unilateral headache
- visual blurring
- N&V
- photophobia |
|
|
Term
|
Definition
- inc IOP
- > 60 yrs old
- family ht
- personal ht of myopia, diabetes, HTN, or migraines
- jig ancestry |
|
|
Term
|
Definition
- microvascular disease of the eye > damage to the ocular microvascular system > impairing transpo of o2 and nutrients to the eye
- two forms: proliferative and nonproliferative |
|
|
Term
| Diabetic Retinopathy: Nonproliferative |
|
Definition
| - endothelial layers of blood vessels in eye are damaged + devp of microaneurysms > leakage > edema near macula > impaired vision |
|
|
Term
| Diabetic Retinopathy: Proliferative |
|
Definition
- damaged blood vessels > retinal ischemia > dec blood supply + nutrient supply to retina > neovascularization > fragile blood vessels + RBC leakage > hemorrhage + vision obscured
- tension exertion on retinal surface + vitreous body > retinal detachment + further damage to surrounding blood vessels > hemorrhage
- neovascularization of the iris > impaired drainage of the aqueous humor > neovascular glaucoma |
|
|
Term
| Diabetic Retinopathy: Symptoms |
|
Definition
- gradual vision loss
- generalized blurring
- areas of focal vision loss |
|
|
Term
| Nursing DX for vision-impaired older pts |
|
Definition
- evaluate functional ability
- perform ADLs, including the ability to read med labels
- drive or take public xportation
- ambulate safely in familiar and strange environs
- shop and pay for food and personal items
- prepare food while maintaining a safe and hygienic environ
- engage in recreational and leisure activities
- Sensory/perceptual alterations: visual
- encompasses a variety of nursing goals and interventions comm
- safety
- mobility
- self-care activities
- mood assessment |
|
|
Term
|
Definition
- > 30% aged 65-76 yrs
- 50% > 75 yrs
- older men and women
- whites and blacks |
|
|
Term
| Hearing loss Risk factors |
|
Definition
- LT exposure to excessive noise
- impacted cerumen
- ototoxic meds
- tumors
- diseases that affect sensorineural hearing
- smoking
- history of middle ear infection
- chemical exposure (eg, long duration of exposure to trichloroethylene) |
|
|
Term
|
Definition
Temporary threshold shift (TTS)
- sounds < 75 dB(A) > temp hearing loss
- sounds > 85 dB(A) for 8 hrs/day + many yrs > perm loss |
|
|
Term
|
Definition
- Sound unable to be xmitted > poor reception + amplification
- site of problem
- external or middle ear
- Cause
- otitis externa
- impacted cerumen
- most common and reversible
- otitis media
- benign tumors
- tympanic membrane perforation
- foreign bodies
- otosclerosis |
|
|
Term
| Sensorineural Hearing loss |
|
Definition
- Problems w/ cochlea + auditory nerve > sound distortion
- Causes
- presbycusis
- hearing impairment as a result of aging
- bilateral
- impaired ability to hear high pitches
- rare, severe hearing loss or deafness
- damage as a result of excessive noise exposure
- Meniere's disease
- tumors
- infection |
|
|
Term
|
Definition
- Assessment
- H+P
- inspection
- examination of ear canal
- childhood ear infections > ruptured eardrum > jagged white scars on tympanic membrane in elderly
- Hearing Handicap Inventory for the Elderly (HHIE-S)
- Talk w/ family members |
|
|
Term
| Common Hearing Probs in the Elderly |
|
Definition
- lobe enlargement
- Cerumen accumulation
- tympanic membrane atrophy
- conductive and sensorineural hearing loss
- "hairy" entrance
- Tinnitus
- objective - pulsatile sounds w/ turbulent blood flow through the ear
- HTN
- anemia
- hyperthyroidism
- subjective - perception of sound w/o sound stimulus
- meds
- infections
- neurological conditions
- disorders r/t hearing loss |
|
|
Term
| Nursing DX Associated with Hearing Impairment |
|
Definition
- Assessment
- ability to perform ADLs
- communication
- driving or taking public transpo
- safety awareness including the ability to hear alarms, doorbells
- engaging in leisure and recreational activities |
|
|
Term
| Nursing DX Associated with Hearing Impairment |
|
Definition
- DX
- sensory/perceptual alterations: hearing w/ a variety of nursing goals and interventions
- communication
- safety
- self-care activities
- mood
- recreation and leisure activities |
|
|
Term
|
Definition
- Contributing factors to _____ alterations:
- oral condition
- olfactory function
- meds
- diseases
- surgical interventions
- enviro exposure
- medical conditions |
|
|
Term
|
Definition
it can affect gustatory function
- poor dentition > improper chewing > less flavor release
- improperly fitting dentures > obstruction of palate > dec taste perception
- oral infections > release of acidic substances > altered taste + impaired salivary stimulations > dec ability for food to dissolve > diminished flavor |
|
|
Term
| Focused assessment for taste disturbances |
|
Definition
- head and neck
- mucous membranes
- interview with focus on past dietary habits |
|
|
Term
|
Definition
- implications of inability to distinguish between salt and sugar
- dec taste > lack of motivation to prepare and eat > malnutrition |
|
|
Term
|
Definition
Causes:
- systemic diseases
- radiation
- meds
- Sjogren's syndrome |
|
|
Term
|
Definition
Implications
- altered taste
- difficulty swallowing > risk for aspiration pneumonia
- periodontal disease
- speech difficulties > embarrassment > social isolation
- dry lips and dry mucosa > inc infection and dental caries
- halitosis
- sleeping probs |
|
|
Term
| Nursing DX associated w/ taste impairment |
|
Definition
- sensory/perceptual alterations: gustatory
- intake less than necessary for caloric requirements |
|
|
Term
|
Definition
Statistics
- males > females
Causes
- nasal and sinus disease
- upper respiratory infection
- head trauma
- secondary causes
- chemo or other meds
- radiation
- current or past use of cocaine or tobacco
- poor dentition |
|
|
Term
|
Definition
Special concerns
- safety r/t smoke and fire
- malnourishment
Sense of smell fails to be detected because it is not adequately tested
- use three familiar smells
- repeat with both nostrils, in different orders |
|
|
Term
Nursing DX associated w/ hyposmia
" for changes in physical sensations |
|
Definition
- sensory/perceptual alterations: olfactory
- " : tactile |
|
|
Term
| Nursing assessment for hyposmia |
|
Definition
Assess safety and prev measures
Additional assessment
- nutrition
- pt safety
- date and label all foods
- place natural gas detectors in the home (for gas heat)
- place smoke detectors in strategic locations
- establish schedules for personal hygiene and house cleaning
- remove kitchen waste every evening |
|
|
Term
|
Definition
Healthy older adults
- every 1-2 yrs
- visual acuity
- retina
- intraocular pressure (IOP)
Diabetics
- complete eye exam annually |
|
|
Term
|
Definition
Observe appearance
- clothing cleanliness
- self-care
- indications of bumps and bruises |
|
|
Term
|
Definition
- Adequacy of vision
- recent changes in vision
- visual probs
- red eye
- excessive tearing or discharge
- headache or feeling of eyestrain when reading or doing close work
- foreign body sensation in the eye
- new onset of double vision or rapid deterioration of visual acuity
- new onset of haziness, flashing lts, or moving spots
- loss of central or peripheral vision
- trauma or eye injury
- date of last exam
- inspection
- movement of eyelids
- abnormally colored sclera
- abnormal or absent papillary response |
|
|
Term
|
Definition
- Snellen chart or reading from print
- visual field testing
- extraocular movements |
|
|
Term
|
Definition
Helpful aids for visually impaired
- low-vision clinics for suggestions
- telescopic lenses
- books in braille
- computer scanners and readers
- tinted glasses to reduce glare, lg print books and mags
- seeing eye dogs
- canes
Often rejected because of the stigma attached
Very expensive and not covered by Medicare
Register with Commission for the Blind
- books on tape and tape player
- phones w/ lg numbers
- high intensity lights |
|
|
Term
| ID of safety problems at home |
|
Definition
- provide adequate lighting in high traffic areas
- recommend motion sensors to turn on lights
- look for areas where lighting is inconsistent; use proper lampshades to prevent glare
- use contrast when painting so that walls, floors, and other structural elements of the enviro can be discriminated easily
- avoid reflective floors |
|
|
Term
| ID of safety problems at home |
|
Definition
- use "hot" colors, such as red, orange, and yellow for signage
- urge the use of supplementary lamps near work and reading areas
- use red tape or paint on the edges of stairs and in entryways to provide warning and signal the need to step up or down
- avoid complicated rug patterns that may overwhelm the eye and obscure steps and ledges
- teach the importance of walking slowly when entering a room |
|
|
Term
| Cars and accidental deaths |
|
Definition
- leading cause for persons > 65
- 2nd leading cause after falls if > 75
- accompany older adults to assess driving
- AARP offers 8 hr safe driving courses
- effects of aging on driving
- unsafe drivers should be reported to DMV for road test |
|
|
Term
|
Definition
Nurses should encourage
- wearing UV protective lenses in the sun
- smoking cessation
- exercising routinely
- eating a healthy diet consisting of fruits and veges
- taking vits in divided doses twice a day to delay progression
- zinc oxide 80 mg
- cupric oxide 2 mg
- beta carotene 15 mg
- vit C 500 mg
- vit E 400 IU |
|
|
Term
| Education for older pts w/ cataracts |
|
Definition
- Explanation about cataracts and their causes
- Symptoms
- TXT options
- surgery
- Pts should avoid
- lifting heavy objects
- straining a BM
- bending at the waist |
|
|
Term
| Complications of Cataract Surgery |
|
Definition
- infection
- wound dehiscence
- hemorrhage
- severe pain
- uncontrolled, elevated IOP
- special concerns
- ots w/ cog impairments > careful supervision for at least 24 hrs after surgery |
|
|
Term
|
Definition
- hats and sunglasses in the sun
- stop smoking
- low fat diet
- avoid ocular injury
- efucation re eye drop admin |
|
|
Term
| Prevention of Diabetic Retinopathy |
|
Definition
- Tight glycemic control
- avg postpandrial 80-120
- avg bedtime 100-140
- HbA1c < 7
- Manage HTN
- Manage hyperlipidemia |
|
|
Term
|
Definition
- Hygiene
- Cerumen removal
- curette
- lavage or irrigation |
|
|
Term
| Contraindications for Cerumen Removal |
|
Definition
- perforated tympanic membrane
- ear trauma
- tumors
- cholesteatoma
- use extreme caution w diabetics due to inc risk for infection |
|
|
Term
| Contraindications to ear lavage or irrigation |
|
Definition
- history of ear surgery
- " otitis externa (swimmer's ear) |
|
|
Term
|
Definition
- remove and clean at bedtime
- warm h2o or saline
- no alcohol or harsh soaps
- use cotton pad
- carefully remove cerumen
- disengage battery
- store in safe place |
|
|
Term
|
Definition
- cochlear implants
- assistive listening devices
- amplifiers in theaters
- telephone device for the deaf (TDD) |
|
|
Term
| Strategies to Relieve Xerostomia |
|
Definition
- Nompharmacological
- diet low in sugar
- sugar free candy
- OTC artificial saliva
- drinking fluids, especially w/ meals
- humidifiers
- Pharmacological
- anticholinergics during the day
- dividing doses from once a day to bid |
|
|
Term
| Appetite Enhancement Strategies |
|
Definition
- coffee stimulates the appetite
- add flavors
- check dentures for fit and cleanliness
- inspect mouth for ulcers or gingivitis
- review meds
- encourage fluids
- maintain bowel records
- assess palatability of food |
|
|
Term
| Appetite Enhancement Strategies |
|
Definition
- provide a pleasant dining experience
- seat residents w/ others of similar functional and cog levels
- provide pleasant background music
- allow for appetizing smells
- provide clean table settings
- position small bunch of flowers here and there |
|
|
Term
|
Definition
- tactile sense interpretation
- enviro orientation
- psychological benefits
- comfort
- love
- communication
- protective by stimulating withdrawal
- touch can dec dementia-associated probs |
|
|
Term
| NIs for Older Cts w/ Tactile Impairment |
|
Definition
- continuous monitoring of the intactness of the skin
- diabetics should place a mirror on a wall close to floor > examine the bottom of their feet
- assessment of safety risks
- devp of a safety plan w/ instructions to min injury
- water heaters turned down to 110 deg
- implement teaching guidelines for pts and families w/ sensory impairments |
|
|
Term
| Meds w/ Side Effects of Visual Disturbance |
|
Definition
- Hydroxychloroquine (Plaquenil) - retinopathy, blurred vision, and difficulty focusing
- Tamoxifen (Nolvadex) - dec visual acuity and blurred vision
- Thioridazine (Mellaril) - blurred vision, impaired night vision, and color discrimination probs
- Levadopa - blurred vision
- Propranolol - dry eyes, visual disturbances |
|
|
Term
| Ophthalmic Solns w/ Potential Adverse Effects |
|
Definition
- Beta blockers (Betagan, Timoptic, Ocupress) (blue or yellow bottle caps) - bradycardia, CHF, syncope, bronchospasms, depression, confusion, sexual dysfunction
- Adrenergics (Lopidine, Alphagan, Epinal) (purple bottle caps) - palpitation, HTN, tremor, sweating
- Mitotics/cholinesterase inhibitors (pilocarpine, Humorsol) (green bottle caps) - bronchospasms, salivation, N&V, diarrhea, abdom pain, lacrimation |
|
|
Term
| Ophthalmic Solutions with Potential Adverse Side Effects |
|
Definition
- carbonic anhydrase inhibitors (Trusopt, Azopt) (orange bottle caps) - fatigue, renal failure, hypokalemia, diarrhea, depression, COPD exacerbation
- prostaglandin analogues (Xalatan, Lumigan) - changes in eye color and periorbital tissues, itching |
|
|
Term
| Drugs with Risk of Hearing Changes |
|
Definition
- Aminoglycoside antibiotics (Gentamycin) - ototoxic
- Antineoplastics (Cisplatinum) - ototoxic
- Loop diuretics (Furosemide) - ototoxic
- Baclofen - tinnitus
- Propranol (Inderal) - tinnitus and hearing loss
- |
|
|
Term
| Meds and Sensory Dysfunction |
|
Definition
- meds can alter taste sensation by affecting peripheral receptors and chemosensory pathways
- some meds affect the sense of smell |
|
|
Term
| Assessment of the Eye and Vision |
|
Definition
- inspection of external structures
- papillary reflexes
- visual acuity
- ocular movements
- inspection of ocular structures |
|
|
Term
| Diag Testing for Ocular Probs |
|
Definition
- labs
- radiology
- special tests:
- ultrasonography
- fluorescein angiography
- electrophysiology exams |
|
|
Term
| Systemic Disorders Producing Eye Manifestations |
|
Definition
- vascular
- neurologic
- endocrine
- connective tissue
- AIDS related |
|
|
Term
| Main Refractive Disorders |
|
Definition
- myopia
- hyperopia
- astigmatism |
|
|
Term
| Collaborative Care Mgmt of Refractive Dirorders |
|
Definition
- corrective lenses
- refractive surgery
- pt/family teaching
- preoperative goals and limitations
- postop care |
|
|
Term
| Infectious and Inflammatory Disorders of the Eye |
|
Definition
- blepharitis
- hordeolum
- chalazion
- corneal abrasion
- keratitis
- trachoma
- conjunctivitis (most common) |
|
|
Term
|
Definition
- can be infectious or inflammatory
- causes include:
- bacteria
- viruses
- mechanical trauma |
|
|
Term
| Pt/Family Teaching for Conjunctivitis |
|
Definition
- preventing cross-contamination
- instilling ophthalmic ointment and eyedrops
- minimizing adverse affects of txt |
|
|
Term
| Ophthalmic Drugs Used to Treat Infection and Inflammation |
|
Definition
- antibiotics
- antivirals
- steroids
- cyclopegic and mydriatic agents |
|
|
Term
| Collaborative mgmt. of glaucoma |
|
Definition
- diag testing
- meds
- surgery
- health promotion and prev |
|
|
Term
|
Definition
- Beta-adrenergic antagonists
- Carbonic anhydrase inhibitors
- Alpha-adrenergic agonists
- Prostaglandin agonists
- Miotics
- Cholinesterase inhibitors
- Osmotic agents |
|
|
Term
| Nursing Care of the Pt with Glaucoma |
|
Definition
- manage pain
- promote compliance w/ txt regimen
- preventing injury
- pt and family teaching
- modify the enviro to augment comfort
- assist w/ alternative comfort interventions to control anxiety |
|
|
Term
|
Definition
clouding or opacity of the lens leading to loss of vision
Classified as:
- congenital
- senile
- traumatic
- secondary
Surgery is the definitive txt for cataracts |
|
|
Term
| Pt/Family teaching after surgery for cataracts |
|
Definition
- prescribed meds
- activity limitations
- infection control measures
- follow-up care |
|
|
Term
| Nursing Care for Retinal Reattachment Surgery |
|
Definition
- managing pain
- relieving anxiety
- preventing injury and infection
- pt/family teaching |
|
|
Term
| Routes of Sound Transmission |
|
Definition
- air conduction
- sound conduction |
|
|
Term
| Nursing Assessment of the Auditory System |
|
Definition
- observing for behv clues
- comprehensive health history
- physical
- external, middle, inner ear
- tympanic membrane |
|
|
Term
| Diag testing of the auditory system |
|
Definition
- balance and equilibrium testing
- labs
- radiology
- auditory acuity and audiometric testing
- pneumatoscopy |
|
|
Term
| Ear Problems - External ear |
|
Definition
| - conductive loss results from interference w/ conduction in the _____ and middle ear |
|
|
Term
|
Definition
| - sensorineural loss results from interference w/ conduction in the _____ ear |
|
|
Term
| Ear Problems - Middle ear |
|
Definition
| - mixed hearing loss results from interference with conduction in all areas |
|
|
Term
|
Definition
- inflammation or infection of the auditory canal or auricle
- most common forms of
- swimmer's ear
- opportunistic fungal infection |
|
|
Term
| Pt/family teaching for external otitis |
|
Definition
- med admin
- pain control
- txts and procedures
- injury prevention |
|
|
Term
|
Definition
|
|
Term
| Clinical manifestations of Otitis media |
|
Definition
- throbbing pain in infected ear
- fever
- drainage: clear, bloody, or purulent
- bulging of the eardrum
- conductive hearing loss, usually reversible w/ effective txt |
|
|
Term
|
Definition
- benign tumor of eight cranial nerve
- can compress facial nerve and arteries
- symptoms include tinnitus, vertigo, hearing loss
- requires surgical removal |
|
|
Term
|
Definition
- uncommon form of vertigo of unknown cause
- classic triad of symptoms:
- episodic vertigo
- sensorineural hearing loss
- tinnitus
- no known cure
- mgmt. focused on control of symptoms |
|
|
Term
|
Definition
| - the sensory portion of the retina, the third and innermost layer of the eye |
|
|
Term
|
Definition
- a nerve cell acts as a ______ by converting the stimulus to a nerve impulse
- most are specific |
|
|
Term
|
Definition
| - involve the conscious organization and translation of the data or stimuli into meaningful info |
|
|
Term
|
Definition
- awareness and interpretation of stimuli
- takes place in the brain, where specialized brain cells interpret the nature and the quality of the sensory stimuli |
|
|
Term
|
Definition
| - portion of the brain stem thought to mediate the arousal mechanism |
|
|
Term
| Reticular excitatory area (REA) |
|
Definition
| - portion of the RAS responsible for stimulus and wakefulness |
|
|
Term
|
Definition
| - extreme drowsiness but will respond to stumuli |
|
|
Term
|
Definition
- the ability to perceive enviro stimuli and body reactions, and to respond appropriately through thought and action.
- includes:
- full consciousness
- disoriented
- confused
- somnolent
- semi comatose
- coma |
|
|
Term
|
Definition
| generally thought of as a decrease in or lack of meaningful stimuli |
|
|
Term
|
Definition
| impaired reception, perception, or both, of one or more of the senses |
|
|
Term
|
Definition
| - used to test peripheral vision |
|
|
Term
| Farsighted, as the lens hardens and the ciliary muscles become weaker |
|
Definition
| As people age, they typically become _____ sighted |
|
|
Term
| Upon inspection, the normal tympanic membrane should appear |
|
Definition
|
|
Term
|
Definition
| - a test to assess bone conduction of sound |
|
|
Term
|
Definition
| - do not over accentuate words would be part of a care plan for pt that is: |
|
|
Term
|
Definition
| If the pt complains of flashing lights and a sensation of a veil over one eye, the nurse should suspect? |
|
|
Term
| The sclera is indented over the sealed break of the retina |
|
Definition
| The expected outcome for cts who have a sclera buckling procedure is that? |
|
|
Term
|
Definition
| Eye meds that constrict the pupil, permitting aqueous humor to flow, are called? |
|
|
Term
|
Definition
| Eye meds that dilate the pupils are called? |
|
|
Term
|
Definition
| What is Scopolamine (isopto Hyoscine) used for? |
|
|
Term
| Face the ct during conversation |
|
Definition
| The nurse is caring for act who has difficulty hearing conversation. What intervention should the nurse implement? |
|
|
Term
| White-colored eardrum in a 74 yr old |
|
Definition
| An auditory assessment finding that is consistent with a 74 yr old |
|
|
Term
|
Definition
| An older ct has become very confused since being hospitalized earlier this week. Prior to this illness, the ct exhibited clear thought processing and was able to maintain an independent lifestyle. How would the nurse document this mental state? |
|
|
Term
|
Definition
| an acute confusion caused by illness, meds, or a change in enviro and is the appropriate documentation |
|
|
Term
| Nourish and lubricate the lens and cornea |
|
Definition
| The purpose of aqueous humor in the anterior compartment of the eye is to: |
|
|
Term
| Blurred vision and headache |
|
Definition
| Myopia, hyperopia, and astigmatism are all refractory disorders. Symptoms common to all three visual problems include: |
|
|
Term
| IV mannitol will draw fluid from the intraocular space and reduce IOP |
|
Definition
| A pt's IOP rises and the dr orders IV mannitol. This drug will: |
|
|
Term
| Rarely causes early symptoms |
|
Definition
| The difference between open-angle and angle-closure glaucoma is that the former type: |
|
|
Term
|
Definition
| There is often no S&S in the early stages of _____ ______ glaucoma. |
|
|
Term
|
Definition
| _____ ______ size is a normal age related finding in an eye exam. |
|
|
Term
|
Definition
| Deficiency in vits ____ and ____ is a known contributor to visual impairment. |
|
|
Term
| Macular Degeneration - a disease of the aging retina |
|
Definition
| The leading cause of blindness in the elderly is: |
|
|
Term
|
Definition
| What symptom needs to be evaluated by use of the Romberg test? |
|
|
Term
|
Definition
- outer
- middle or uvea
- inner |
|
|
Term
| 3 layers of the eye - outer components |
|
Definition
- opaque sclera (white)
- cornea (transparent) |
|
|
Term
| 3 layers of the eye - middle or uvea components |
|
Definition
- iris
- muscular ciliary body
- pigmented vascular choroid |
|
|
Term
| 3 layers of the eye - inner components |
|
Definition
Retina - a light sensitive membrane with two parts:
- sensory portion
- pigmented epithelium |
|
|
Term
|
Definition
| protection is the function of what part of the eye? |
|
|
Term
|
Definition
| Bends light entering the eye is the function of what? |
|
|
Term
|
Definition
| Light passes through pupil which is in the center of the ______ |
|
|
Term
|
Definition
| smooth muscle structures of the eye |
|
|
Term
| pigmented vascular choroid |
|
Definition
| the blood rich nutritive vascular layer of the eye |
|
|
Term
| Retina - Sensory perception |
|
Definition
it contains photoreceptors:
- rods which allows us to see dim and night vision
- cones which allow us to see daylight, color vision and sharp images
- these photoreceptors combine to form fibers of the optic nerve which xmit signals to and from the brain |
|
|
Term
| Retina - pigmented epithelium |
|
Definition
| supports which part of the eye? |
|
|
Term
|
Definition
| An intraocular lens implant is the preferred method for replacing the focusing power of the lens. it's not dependent on the pupil or iris for support and rarely moves out of position |
|
|
Term
| Postop care for cataract surgery |
|
Definition
Postop care for what surgery?
- eye is covered with a dressing and a metal shield for 24-48 hrs
- ct must continue to wear the metal shield at night
- ct should not bend over lower than the waist
- don't sleep on affected area for 3-4 weeks |
|
|
Term
|
Definition
Ct care after what surgery?
- position ct on back or unoperative side to prevent pressure at the site
- side rails, bedside table and call bell within reach on unoperative side
- teach ct procedures to avoid IOP
- sneezing, coughing
- vomiting
- straining
- sudden bending below waist |
|
|
Term
| Clinical manifestations of open angle glaucoma |
|
Definition
- there may not be any S&S initially
- elevated IOP
- slow vision loss, starts peripherally
- tunnel vision
- persistent dull eye pain
- difficulty adjusting to darkness
- failure to detect color changes |
|
|
Term
| Clinical manifestations of angle closure glaucoma |
|
Definition
- acute
- severe ocular pain
- dec vision
- pupil enlarged and fixed
- colored halos around lights
- eye red
- steamy cornea
- may have n&v
- IOP may exceed 50 mm Hg
- permanent blindness if IOP remains elevated for 24-48 hrs |
|
|
Term
| Clinical manifestations of congenital glaucoma |
|
Definition
- enlargement of eye
- lacrimation
- photophobia
- blepharospasm |
|
|
Term
| Meds for Glaucoma - Miotics |
|
Definition
- Cholinergics
- Pilocarpine HCL (Pilocar, Isopto Carpine)
- Carbachol (Intraocular: Carbastat, Miostat; topical: Isopto Carbachol) |
|
|
Term
| Meds for Glaucoma - Miotics |
|
Definition
- constricts pupil (miosis) by directly stimulating sphincter muscle
- Inc outflow of aqueous humor by ciliary muscle pull on trabecular meshwork |
|
|
Term
| Meds for Glaucoma - Cholinesterase Inhibitors |
|
Definition
- Physostigmine (Eserine)
- Isoflurophate (Floropryl)
- Demecarium bromide (Humorsol)
- Echothiophate iodide (Phospholine iodide) |
|
|
Term
| Meds for Glaucoma - Cholinesterase Inhibitors |
|
Definition
- constricts ciliary muscle and iris sphincter, lowers IOP
- don't use isoflurophate or demecarium during pregnancy |
|
|
Term
| Meds for Glaucoma - Beta-Adrenergic Antagonists |
|
Definition
- Timolol maleate (Timoptic)
- Betaxolol (Betoptic)
- Levobunolol (Betagan)
- Carteolol HCL (Ocupress)
- Metipranolol (OptiPranolol) |
|
|
Term
| Meds for Glaucoma - Beta-Adrenergic Antagonists |
|
Definition
- dec aqueous humor production and inc outflow, dec IOP
- caution w/ admin in cts who have pulmonary or cardiac disease, use can result in bronchospasms |
|
|
Term
| Meds for Glaucoma - Carbonic Anhydrase Inhibitors |
|
Definition
- Acetazolamide (Diamox)
- Ethoxzolamide (Cardrase)
- Carbonic Anhydrase
- Dichlorphenamide (Daranide)
- Methazolamide (Neptazane)
- Dorzolamide (Trusopt) |
|
|
Term
| Meds for Glaucoma - Carbonic Anhydrase Inhibitors |
|
Definition
- dec aqueous humor
- monitor for:
- GI upset
- hearing dysfunction
- extremity tingling
- hypokalemia |
|
|
Term
| Meds for Glaucoma - Alpha-Adrenergic agents |
|
Definition
- Epinephryl borate (Eppy/N, Epinal)
- Epinephrine HCL (Glaucon)
- Dipiefrin (Propine)
- Apraclonidine (Lopidine) |
|
|
Term
| Meds for Glaucoma - Alpha-Adrenergic agents |
|
Definition
- reduces aqueous humor formation and inc outflow
- monitor for tachycardia |
|
|
Term
| Meds for glaucoma - Osmotic agents |
|
Definition
- Glycerin (Osmoglyn)
- Mannitol (Osmitrol)
- Isosorbide (Ismotic)
- dec IOP through ocular hypotonic effect
- monitor for for hyperglycemia in T1D |
|
|
Term
| Meds for glaucoma - Prostaglandin agonist |
|
Definition
- Latanoprost (Xalatan)
- inc the outflow of aqueous humor; usually used w/ cts intolerant or unresponsive to other glaucoma agents
- monitor renal and hepatic functions |
|
|
Term
| EOs (pt centered goals) for glaucoma |
|
Definition
- ct will:
- report a dec in eye pain
- exhibit knowledge of the disease process and txt plan
- verbalize knowledge for the need of lifetime txt
- be able to adapt lifestyle and self-care activities to accommodate vision loss |
|
|
Term
| EOs (pt centered goals) for glaucoma |
|
Definition
- ct will:
- report a dec in eye pain
- exhibit knowledge of the disease process and txt plan
- verbalize knowledge for the need of lifetime txt
- be able to adapt lifestyle and self-care activities to accommodate vision loss |
|
|
Term
| Evaluation criteria for effectiveness of NIs for Glaucoma |
|
Definition
- reports no eye pain or headaches
- maintains follow-up appts for continuing care
- states lifelong therapy commitment
- makes needed enviro lifestyle changes to accommodate vision loss |
|
|
Term
| Ophthalmic drugs for conjunctivitis - antibiotics and antivirals |
|
Definition
- Polymyxin B, bacitracin (Polysporin)
- Polymyxin B, neomycin, bacitracin (Neosporin)
- Bacitracin
- Gentamicin, chloramphenicol, ciproflazin HCL, erythromycin, norfloxacin, ofloxacin, tobramycin
- Idoxuridine (IDU) |
|
|
Term
| Ophthalmic drugs for conjunctivitis - steroids |
|
Definition
- Prednisone
- Prednisolone acetate
- Methylprednisolone (Depo- Medrol)
- Triamcinolone (Aristocort)
- Dexamethasone (Decadron, Maxidex)
- Fluorometholone (FML) |
|
|
Term
| Ophthalmic drugs for conjunctivitis - Cycloplegic and Mydriatic Action |
|
Definition
- Atropine sulfate (Atropisol, Isopto Atropine)
- Cyclopentolate HCL (Cyclogyl)
- Homatropine hydrobromide (Isopto Homatropine)
- Scopolamine hydrobromide ( " Hyocine HBr)
- Tropicamide (Mydriacyl) |
|
|
Term
| Corneal abrasions - causes |
|
Definition
- defects in the epithelial layer of the eye
- caused by:
- trauma
- contact lenses worn for a long time
- defects in tear film
- difficulty w/ eyelid closure |
|
|
Term
| Corneal abrasions - symptoms |
|
Definition
- sudden onset of pain in eye, often intense
- photophobia
- foreign body sensation
- tearing |
|
|
Term
|
Definition
- topical antibiotics, which are prescribed prophylactically (as a preventative)
- a short acting med (a cyclopedic) to paralyze the eye
- a pressure eye patch |
|
|
Term
|
Definition
- Exudate detachment is the result of the presence of a blood clot, inflammatory mass or tumor which can separate the retinal layers
- Rhegmatogenous detachment occurs as a result of degenerative holes or tears in the retina which allows vitreous humor to pass through and initiate a detachment
- ct may complain of floating spots or opacities before the eyes, flashes of light and progressive loss of vision in one area |
|
|
Term
| Retinal Detachment - Preop care |
|
Definition
- assess the ct's level of discomfort
- apply cool, moist compresses to eye
- admin prescribed analgesics
- teach ct to avoid rapid movement or bending at the waist |
|
|
Term
| Retinal Detachment - Postop care |
|
Definition
- keep ct in lowest position, side rails up
- assist w/ initial ambulation
- admin cough med or antiemetic prn
- instruct ct to avoid sneezing, coughing, or vomiting
- instruct to wear eye shield when sleeping/ napping
- assist w/ ADLs
- encourage diversional activities
- assess for S&S of infection |
|
|
Term
| Retinal Detachment - Pt education |
|
Definition
- teach re vision and the role of the retina in vision
- teach postop activity limitations
- avoid activity that causes pain
- avoid driving, heavy house work, sport activities
- importance of physician mandated positioning
- have pt report symptoms
- new flashing lights
- floaters or |
|
|
Term
|
Definition
- medical txt of a detached retina post-surgery may include the use of cycloplegic agents (paralytic) to rest the eye and corticosteroid drops to reduce inflammation
- the combined effects of the meds and surgery may cause photophobia |
|
|
Term
|
Definition
- farsightedness
- a refractive error that is caused when the (front to back) anteroposterior dimension of the eye is abnormally short causing the light rays to focus behind the retina |
|
|
Term
|
Definition
- nearsightedness
- a refractive error that is caused when the anteroposterior dimension of the eye is abnormally long causing the light rays to focus in front of the retina |
|
|
Term
|
Definition
- the sense or perception of the movements and position of the body, especially the limbs, independent of vision
- it's 1/4 systems which must be intact to maintain balance and equilibrium
- the other 3 systems are vestibular, visual, and cerebellar |
|
|
Term
| Assessment of the inner ear for balance using gait, visual gaze (nystagmus) and the Romberg test |
|
Definition
- gait: the ct should have erect posture, balance, full motion of the arms and legs
- nystagmus: the ct should be able to follow finger mvmt w/o mvmt of the head; observe for jerking mvmt of the eyes as they follow the finger to the left and then the rt
- |
|
|
Term
| Antibiotics and decongestants for the txt of otitis media |
|
Definition
- antibiotic txt is the txt of choice
- an ear wash may be used
- heating pads
- |
|
|
Term
| Antibiotics and decongestants for the txt of otitis media - Antibiotics |
|
Definition
- amoxicillin
- trimethoprim sulfamethoxazole
- amoxicillin clavulanate
- ceflacor
- they inhibit cell wall synthesis, bacteriocidal
- assess for allergies or superinfection |
|
|
Term
| Antibiotics and decongestants for the txt of otitis media - analgesics |
|
Definition
- analgesic/antipyretic or narc analgesic
- acet w/codeine
- CNS depressant, analgesic, antipyretic, anti-inflammatory |
|
|
Term
| Antibiotics and decongestants for the txt of otitis media - antihistamine |
|
Definition
- diphenhydramine
- H1-receptor antagonist, antiemetic, antitussive, anticholinergic and local anesthetic actions
- monitor BP |
|
|
Term
| Antibiotics and decongestants for the txt of otitis media - decongestants |
|
Definition
- pseudoephedrine
- sympathomimetic, acts directly on smooth muscle, produces little congestive rebound that occurs with nasal sprays
- monitor HR and BP |
|
|
Term
|
Definition
- Q-tips
- age related drying of _______
- ear irrigation
- cerumenolytic meds help soften and loosen it |
|
|
Term
|
Definition
| - a surgical procedure which involves making an incision in the tympanic membrane through which fluid may be suctioned and the placement of tympanic tubes can be inserted into the incision |
|
|
Term
|
Definition
- ct may experience temp dec hearing due to swelling and packing in the ear
- affected ear may have crackling or popping noises
- ct may experience mild pain in the ear as well as the jaw and cheek which should be managed effectively w/ mild analgesics
- may experience gen'l dizziness or lightheadedness
- should have only minimal bleeding |
|
|
Term
| Myringotomy - postop care |
|
Definition
- open mouth to sneeze, blow nose or cough for the first week
- gently blow nose one side at a time
- no vigorous activity until cleared by dr
- change cotton ball dressing as prescribed
- report excessive bloody drainage
- keep er dry for 6 weeks
- avoid loud environs
- don't lift for 3 weeks |
|
|
Term
| Guidelines for ear irrigation |
|
Definition
- wash hands
- 30-60 ml irrigating syringe w/ warm h2o or NS
- have ct lay on side
- pull pinna back and up
- insert fluid
- stop if ct feels pain |
|
|
Term
|
Definition
- most common type of hearing loss in the elderly
- a sensorineural hearing loss
- the auricle enlarges and loses its elasticity, cilia becomes coarse and stiff
- cerumen becomes drier, hardens, and accumulates
- cochlear capillaries atrophy
- the basilar membrane becomes less flexible
- neurons and endolymph diminish |
|
|
Term
|
Definition
- an infection of the labyrinth of the inner ear that can be caused by a virus or bacteria
- severe vertigo is the major complaint and perm hearing loss (sensorineural) is associated |
|
|
Term
|
Definition
- a disorder of the middle ear that involves the stapes
- sclerotic bone forms on the stapes limiting its mvmt and resulting in conductive hearing loss |
|
|
Term
| Clinical manifestations of sensory dysfunction - alterations in comfort |
|
Definition
- sensory alterations to the eyes can cause acute pain
- otitis media causes pain |
|
|
Term
| Clinical manifestations of sensory dysfunction -alterations in mental status |
|
Definition
- sensory deficit and sensory alterations can cause sensory deprivation and sensory overload
- visual probs in unfamiliar areas can cause confusion |
|
|
Term
| NIs to prevent sensory deprivation |
|
Definition
- encourage use of glasses and hearing aids
- address ct by name and stimulate her nipples
- have freq comm w/ her
- provide tv, radio, clock, calendar
- provide stimulating wall decorations, flowers
- encourage to get a pet
- inc tactile stimulation of breasts
- encourage social interaction
- encourage mentally stimulating activities
- plan environ changes |
|
|
Term
| Impact of other illnesses on sensory function |
|
Definition
- atherosclerosis slows down blood flow to the brain, dec awareness and slowing responses
- uncontrolled diabetes can cause retinopathy |
|
|
Term
| Impact of meds on sensory function |
|
Definition
- certain meds are ototoxic and directly affect the eighth cranial nerve or the organs of hearing and balance
- Lasix may cause hearing hearing impairment w/ longterm usage |
|
|
Term
| Potentially Ototoxic Meds |
|
Definition
- Aminoglycosides
- Vanco
- Loop Diuretics
- Erythromycin
- Salicylates
- NSAIDS
- Cisplatin
- Quinine Sulfate |
|
|
Term
| Potentially Ototoxic Meds - Aminoglycosides |
|
Definition
Gentamicin These three primarily
Tobramycin effects vestibular funct
Streptomycin
Amikacin These three primarily effect
Neomycin auditory function
Kanamycin
- affect auditory/vestibular function, may r/t high drug level
- the elderly, mixing ototoxic drugs, and cts w/ existing auditory probs most susceptible |
|
|
Term
| Potentially Ototoxic Meds - Vanco |
|
Definition
- most susceptible are elderly and those with existing hearing loss
- ototoxicity more common w/ high serum levels |
|
|
Term
| Potentially Ototoxic Meds - Loop Diuretics |
|
Definition
rapid parenteral admin may cause hearing loss, deafness or tinnitus
Furosemide
Torsemide
Bumetanide
Ethacrynate sodium
Ethacrynic acid |
|
|
Term
| Potentially Ototoxic Meds - Erythromycin |
|
Definition
| hearing loss possible w/ IV high doses; cts w/kidney failure more at risk |
|
|
Term
| Potentially Ototoxic Meds - Salicylates: Aspirin |
|
Definition
- tinnitus, hearing loss
- elderly most susceptible
- effects generally reversible
- audiometric testing indicated before and/or after long term therapy |
|
|
Term
| Potentially Ototoxic Meds - NSAIDS |
|
Definition
| - monitor auditory function before and during therapy to prevent ototoxicity; elderly most susceptible |
|
|
Term
| Potentially Ototoxic Meds - Cisplatin |
|
Definition
| tinnitus, high frequency hearing loss |
|
|
Term
| Potentially Ototoxic Meds - Quinine Sulfate |
|
Definition
- tinnitus, impaired hearing
- serum conc > 19 mg/ml may confirm toxicity as cause of tinnitus or hearing loss |
|
|
Term
| Theoretical basis for interventions to id, promote, restore or maintain sensory function - |
|
Definition
Dx testing
- assessment of auditory acuity
- tuning fork tests
- otoscopic exam
- audiometry |
|
|
Term
| Theoretical basis for interventions to id, promote, restore or maintain sensory function - Dx testing: assessment of auditory canal |
|
Definition
| - it can be assessed using the whispered voice test |
|
|
Term
| Theoretical basis for interventions to id, promote, restore or maintain sensory function - Dx testing: Tuning fork tests - Rinne test, Weber test |
|
Definition
- performed by placing a vibrating tuning fork against the ct's mastoid process to assess bone conduction until the vibrating sound is no longer heard
- The results are compared to a tuning fork test w/o touching the bone.
- the air conduction (AC) interval time should twice as long as the bone conduction (BC) interval time
- if it isn't, there may sensorineural hearing loss present |
|
|
Term
| Theoretical basis for interventions to id, promote, restore or maintain sensory function - Dx testing: Tuning fork tests - Weber test |
|
Definition
- a tuning fork is used to indicate equality of hearing in both ears
- the fork is placed on the head or teeth
- if the tone is heard in the ear w/dec hearing, there is conductive loss
- if the tone is heard in the better ear, there is sensorineural loss |
|
|
Term
| Theoretical basis for interventions to id, promote, restore or maintain sensory function - Dx testing: Otoscopic exam |
|
Definition
- it allows for visualization of the tympanic eardrum
- it's placed in the external canal of the ear
- to straighten the ear canal, the pinna is pulled up, back, and out
- the normal eardrum is shiny and smooth and pearly gray in color
- the umbo and the long and short processes of the malleus should be easily visible through the eardrum
- in the presence of disease such as otitis media, the tympanic membrane is red and bulging |
|
|
Term
| Theoretical basis for interventions to id, promote, restore or maintain sensory function - Dx testing: Audiometry |
|
Definition
- audiometric hearing test
- impedance audiometry or tympanometry
- auditory brainstem response |
|
|
Term
| Theoretical basis for interventions to id, promote, restore or maintain sensory function - Dx testing: Audiometry - the audiometric hearing test |
|
Definition
- hearing is measured in decibels, a log function of sound intensity
- the ct wears headphones and indicates when a tone is heard
- sensorineural hearing loss is most common in elderly, a dec perception of high freq sounds
- tinnitus is common |
|
|
Term
| Theoretical basis for interventions to id, promote, restore or maintain sensory function - Dx testing: Audiometry - impedance audiometry or tympanometry |
|
Definition
- used for differentiating probs in the middle ear
- the result is a graph called a tympanogram
- the test applies pressure to the tympanic membrane and measures the result
- abnormalities in the tympanogram indicate probs of the middle ear, Eustachian tube or the ossicles
- it also measure the stapedial muscle reflex and status of the acoustic nerve |
|
|
Term
| Theoretical basis for interventions to id, promote, restore or maintain sensory function - Dx testing: Auditory brainstem response |
|
Definition
- assesses the dysfunction of the auditory nervous system at the level of the eighth cranial nerve (acoustic nerve), pons or midbrain
- it measures and records changes in brain electrical activity that occur in response to auditory sensory stimulation
- the seventh cranial nerve (facial nerve) is tested in the same way
- facial abnormal findings suggest dysfunctions at various levels of the brainstem
- the facial and acoustic nerves are usually both involved when lesions involve the temporal bone |
|
|
Term
| Meds commonly used for ophthalmic probs - antibiotics |
|
Definition
- ointments remain in contact with the eye much longer, providing a prolonged effect
- there is also less absorption into the lacrimal passages than w/eye drops
- ointment can produce a film in front of the eye that may blur vivion |
|
|
Term
| Meds commonly used for ophthalmic probs - mydriatics |
|
Definition
- used to dilate the pupil for exam
- Neo-Synephrine
- Mydfrin |
|
|
Term
| Meds commonly used for ophthalmic probs- osmotic diuretics |
|
Definition
- they move h2o from the IO structures, resulting in a marked ocular hypotonic effect, thereby dec intraosmolar pressure
- Caution to T1D, they can cause hyperglycemia |
|
|
Term
| Sensory aids for visual defects |
|
Definition
- correct and clean eyeglasses
- adequate lighting
- reduction of glare
- magnifying glass
- lg # phone dialer, watch, clock
- color code or texture on stoves, washers, med containers
- colored or raised rimmed dishes
- lg print reading material
- braille or books on tape
- seeing eye dog |
|
|
Term
| Sensory aids for hearing defects |
|
Definition
- hearing aids
- lip reading/sign language
- amplified phones and door bells
- telecommunication device for the deaf
- flashing alarm clocks and smoke detectors |
|
|
Term
| Balance and equilibrium depend on 4 systems being intact |
|
Definition
- the vestibular (labyrinth or inner ear)
- the proprioceptive (somatosensors of joints and muscles)
- the visual (eye)
- the cerebellar (coordination) |
|
|
Term
|
Definition
- is a visualization of the fundus of the eye using an ophthalmoscope
- the optic nerve, retina, blood vessels, and macula are viewed |
|
|
Term
|
Definition
- a tonometer measures ocular pressure
- readings over 24 torr (Shiotz) suggests glaucoma |
|
|
Term
|
Definition
- uses high freq sound waves to outline and detect intraocular and orbital structures and measures the distance between them
Test can detect:
- retinal masses and detachments, intraocular foreign bodies
- changes in the orbit |
|
|
Term
| Nursing Dx for sensory-perceptual probs |
|
Definition
- activity intolerance r/t impaired balance and coordination
- high risk for injury r/t dec or impaired sensation
- social isolation r/t auditory impairment
- risk for trauma r/t blurred vision
- imbalanced nutrition: less than body requirements r/t loss of taste and difficulty swallowing |
|
|
Term
| Nursing Dx for sensory-perceptual probs |
|
Definition
- disturbed sensory perception r/t dec vision
- " r/t dec hearing
- confusion r/t dec vision
- confusion r/t dec hearing |
|
|
Term
| Priority nursing measures for a ct w/ vision impairment |
|
Definition
In order of priority
- teach the pt the importance of hand washing prior to admin eye meds
- nursing interventions to help dec social isolation r/t impaired vision |
|
|
Term
| Priority nursing measures for a ct w/hearing impairment |
|
Definition
In order of priority
- helping the pt to learn to lip read
- NI to help dec social isolation r/t impaired hearing |
|
|
Term
| The goal of all NIs for cts w/alterations |
|
Definition
| Promote independence and optimal functioning |
|
|
Term
| Dx: Activity intolerance r/t impaired balance and coordination |
|
Definition
EO for which Dx?
Pt will seek assistance when ambulating |
|
|
Term
| Dx: High risk for injury r/t dec or impaired sensation |
|
Definition
EO for which Dx?
Pt will modify enviro to avoid injury |
|
|
Term
| Dx: Social isolation r/t auditory impairment |
|
Definition
EO for which Dx?
- Pt will use hearing aids daily
- Pt will initiate conversation |
|
|
Term
| Dx: Risk for trauma r/t blurred vision |
|
Definition
EO for which Dx?
The pt will demonstrate self-care behvs following postop cataract surgery |
|
|
Term
| Dx: Imbalanced nutrition: less than body requirements r/t loss of taste and difficulty swallowing |
|
Definition
EO for which Dx?
- The pt will inc daily caloric intake
- The pt will not aspirate and respiratory status will remain intact |
|
|
Term
| Guidelines to facilitate independence in ADLs for visually impaired persons |
|
Definition
- place clothing, hygiene things, food and cooking utensils in a specified place
- encourage the use of a cane when walking
- keep furniture in place
- when walking with a blind person, stand on non-dominant side and let the person take your arm
- describe food on the plate using clock placement references
- allow blind persons to pull out their own chairs and seat themselves |
|
|
Term
| NIs to minimize pt discomfort |
|
Definition
- application of topical analgesics
- compresses
- eye patches
- lubricants, etc |
|
|
Term
| NIs to enhance communication |
|
Definition
- enhance spoken voice
- directly face the pt when communicating
- make sure assistive devices are in place
- encourage use of assistive devices |
|
|
Term
| Guidelines for communicating w/ the visually-impaired person |
|
Definition
- talk in normal tone of voice
- don't consciously avoid common phrases such as "see you later"
- knock whenever entering the person's room
- introduce myself w/ each ct
- explain any activity that's taking place
- announce when leaving the room |
|
|
Term
| Guidelines for communicating w/ the hearing-impaired person |
|
Definition
- get the person's attn. by lightly touching the arm
- stand with light on my face to facilitate lip reading
- speak slowly and clearly and in a normal tone; don't over accentuate words
- use contextual clues to id the topic
- if the person doesn't understand, try rewording the context
- supplement words w/ body language
- don't smile, chew gum or cover mouth when talking
- don't show annoyance w/ facial expressions
- encourage the use of a hearing aid, if applicable
- don't avoid conversation because a person is hearing impaired
- alert other personnel of impairment by displaying a note regarding impairment |
|
|
Term
| Instructions that a pt should receive re eye safety |
|
Definition
- spray aerosols away from eyes
- wear protective glasses during sports
- slowly release steam from cooking pots
- fit machinery with safeguards
- blah....... |
|
|
Term
| NIs to promote continuity of care |
|
Definition
- hearing loss, refer to:
- Natl Foundation of the Blind
- Nat'l eye care project
- Nat'l braille assoc
- Guide dogs for the blind
- Nat'l assoc of the death
- AT&T nat'l relay center |
|
|
Term
| A dramatic reduction in pain |
|
Definition
| The tympanic membrane of a ct w/otitis media ruptures and a small tear in the pars tensa results. The nurse expects the ct to report what symptom regarding pain? |
|
|
Term
|
Definition
| To test peripheral vision the nurse uses which test? |
|
|
Term
|
Definition
Symptoms of:
- ct claims something is stuck in his eye but he can't see anything
- no foreign is seen upon exam
- ct reports tearing and sensitivity to light
- red eyes |
|
|
Term
|
Definition
Symptoms of:
- 75yr old diabetic c/o
- intense pain in eyes
- sees halos around lights
- exam exhibits circumcorneal redness and dilated pupils |
|
|
Term
|
Definition
| separates external from middle ear |
|
|
Term
|
Definition
| a vibrating tuning fork is placed on the forehead and the ct and he is asked where the sound is heard more prominently. Which test is this? |
|
|
Term
|
Definition
| pull auricle ____ and _____ on adult for otoscope |
|
|
Term
|
Definition
| test to assess bone conduction of sound |
|
|
Term
|
Definition
Symptoms of?:
- pt c/o flashing lights and a sensation of having a veil over one eye |
|
|
Term
|
Definition
Symptoms of?
- pt c/c headache, dull persistent eye pain, seeing halos around lights |
|
|
Term
|
Definition
| constricts the pupil, allowing aqueous humor to flow |
|
|
Term
|
Definition
|
|
Term
| Prevention of increased IOP |
|
Definition
pts:
- w/ glaucoma
- following lens surgery
- recovering from surgical repair of detached retina
All have one common health/medical intervention.... |
|
|
Term
| Mgmt of the pt w/ cataracts |
|
Definition
- clouding or opacity of the lens leads to painless blurring of vision
- operative technique is the only modality for treating, with surgery indicated only for advanced cases
- following surgery, lenses prescribed may distort colors and peripheral images |
|
|
Term
| Miotic drugs for a pt w/glaucoma |
|
Definition
- draws the smooth muscle of the iris away from the Canal of Schlemm
- permits aqueous humor to drain out from Schlemm's canal
- it will not paralyze accommodation |
|
|
Term
|
Definition
| dec flexibility of the lens is common as a person ages. this dec ability to accommodate for detailed work is called? |
|
|
Term
|
Definition
| during an assessment of the eye, the pt focuses on one object that's moved to the nose. while the eyes will focus on the near object, the pupils should constrict. this a test for? |
|
|
Term
|
Definition
| hemorrhages in retinal layers could indicate? |
|
|
Term
| Admin ophthalmic instillations |
|
Definition
- check MAR
- check med, pt, dosage
- wash hands
- explain to ct
- clean eyelids and lashes
- have ct look up
- pull down on skin of cheek to expose conjunctival sac
- admin drops
- catch overflow with cotton
- have ct gently close eyes
- press on nasolacrimal duct if admin liquid med
- press on
- have ct look up
- pull down on |
|
|
Term
| Irrigations or Instillations |
|
Definition
| meds may admin to the eye using ______ or _____ |
|
|
Term
| Assessment of eyes before med admin |
|
Definition
- appearance of eye and surrounding structures for lesions, exudate, erythema, or swelling
- the location and nature of any discharge, lacrimation, and swelling of the eyelids or lacrimal gland
- ct complaints (itching, burning pain, blurred vision, and photophobia)
- ct behv (squinting, blinking excessively, frowning, or rubbing the eyes
- determine if data influence admin of the med (is it appropriate to admin the med or does the med need to be held and the dr notified) |
|
|
Term
| Assessment of ears before med admin |
|
Definition
- appearance of the pinna of the ear and meatus for signs of redness and abrasions
- type and amt of any discharge
- can med be admin or does dr need to be notified |
|
|
Term
| Assessment Interview: Sensory-Perceptual Functioning - Visual |
|
Definition
- how would you rate your vision (excellent, good, fair, poor)?
- do you wear eyeglasses or contact lenses
- describe any recent changes in your vision
- any difficulty seeing near or far objects
- difficulty w/night vision, blurred vision, double vision, spots moving in front of eyes, blind spots, light sensitivity, flashing lights, or halos around objects?
- last eye exam |
|
|
Term
| Assessment Interview: Sensory-Perceptual Functioning - Auditory |
|
Definition
- rate hearing (excellent, good, fair, poor)
- hearing aids
- any recent changes in hearing
- can you locate the direction of sounds and distinguish various voices
- dizziness or vertigo, ringing, buzzing, humming, crackling noises, or fullness in ears |
|
|
Term
| Assessment Interview: Sensory-Perceptual Functioning - Gustatory |
|
Definition
- any changes in taste (difficulty in differentiating sweet, sour, salty, and bitter)
- still enjoy the foods previously eaten |
|
|
Term
| Assessment Interview: Sensory-Perceptual Functioning - Olfactory |
|
Definition
- any changes in smell
- smell flowers, perfumes, etc
- smell burning or food cooking
- changes in apppetite |
|
|
Term
| Assessment Interview: Sensory-Perceptual Functioning - Tactile |
|
Definition
- experiencing any pain or discomfort
- experienced a dec in the ability to feel heat, cold, or pain in the limbs
- any numbness or tingling in extremities |
|
|
Term
| Assessment Interview: Sensory-Perceptual Functioning - Kinesthetic |
|
Definition
| - noticed any difficulty in perceiving the position of parts of the body |
|
|
Term
|
Definition
| - it's easy to confuse the two nursing DX: Disturbed Sensory Perception and Altered Thought Process |
|
|
Term
| Disturbed Sensory Perception |
|
Definition
| - refers to sensory input - the person's ability to accurately interpret stimuli |
|
|
Term
|
Definition
| - a person's cognitive abilities (because of mental disorders, i.e., dementia) interfere with the ability to interpret stimuli accurately |
|
|
Term
| NIs for Sensory-Perception Problem as the Etiology |
|
Definition
- comm enhancement: hearing deficit
- " : visual deficit
- nutrition mgmt.
- enviro mgmt.
- fall protection
- body mechanics promotion
- peripheral sensation mgmt.
- emotional support
- surveillance: safety |
|
|
Term
| Nurses can assist cts w/sensory alterations by: |
|
Definition
- promoting healthy sensory function
- adjusting enviro stimuli
- preventing sensory overload |
|
|
Term
| Promoting Healthy Sensory Function |
|
Definition
- early detection
- enviro stimuli that provides appropriate sensory input
- It should vary, and not excessive or limited
- as many senses as possible should be stimulated |
|
|
Term
|
Definition
- delirium (acute confusion): abrupt onset, and a cause which, when treated, reverses the confusion
- dementia (chronic confusion) |
|
|
Term
|
Definition
- Drug effects: such as potentiating effects of multiple drug use and drug intoxication
- Physiologic disturbances: such as hypoxia, dehydration, metabolic or fluid imbalances, neurologic disorders, infectious process, and nutritional deficiencies
- Abrupt loss: of a sig person or persons
- Multiple losses: in a short time span
- A move: to a radically different enviro |
|
|
Term
| blurred vision and headache |
|
Definition
| Myopia, hyperopia, and astigmatism are all refractory disorders. Symptoms common to all three visual problems include: |
|
|
Term
| Place a tuning fork on pt's forehead |
|
Definition
| The nurse does what during the Weber test? |
|
|
Term
|
Definition
| a disease of the aging retina, is the leading cause of blindness in older adult. |
|
|
Term
| Rarely causes early symptoms |
|
Definition
| The difference between open-angle and angle-closure glaucoma is that the former type: |
|
|
Term
|
Definition
| After instillation of cycloplegic eyedrops, the patient is instructed to: |
|
|
Term
| It cleanses the ear canal |
|
Definition
| What purpose does cerumen serve in the ears? |
|
|
Term
|
Definition
| it will draw fluid from the intraocular space and reduce intraocular pressure. |
|
|
Term
Office of Minority Health: National
Standards for Culturally and Linguistically Appropriate Services in Health Care (CLAS). |
|
Definition
The purpose of these standards is to reduce the imposition of a health care provider’s personal or organizational belief system onto patient’s and to assist provider’s in learning how to tailor an effective treatment plan that
assists in compliance and increases the potential for more positive outcomes to treatment |
|
|
Term
|
Definition
- paradigm of whole systems
- belief that people are more than physical bodies
- combined mental, emotional, spiritual, relationship, and enviro components
- interventions individualized within the entire context of the person's life |
|
|
Term
|
Definition
- mind and body are indivisible
- people have the power to solve their own problems
- people are responsible for the patterns of their lives
- well-being is a combo of personal satisfaction and contributions to the larger community |
|
|
Term
|
Definition
| - consists of mental, physical, emotional, spiritual, and enviro components |
|
|
Term
|
Definition
- includes the drive to become all you can be
- bound to intuition, creativity, and motivation
- relationship with oneself, with others, and with a higher power
- gives people meaning and purpose in lives
- involves sig meaning in the entirety of life |
|
|
Term
|
Definition
- force that integrates the body, mind, and spirit
- grounding
- connection with the ground
- contact with reality
- centering
- focusing one's mind on the center of energy
- allowing one to operate intuitively and w/awareness
- channeling energy throughout the body |
|
|
Term
|
Definition
- created when nurses provide holistic nursing care
- created by providing knowledge, skills, and the support
- synthesis of medical-curing and nursing-health approach
- created when time is taken to be w/cts in a deeply caring way
- also, nurses need to create healing enviros for self |
|
|
Term
|
Definition
- clarify values and beliefs
- set realistic goals
- challenge the belief that other always come first
- learn to manage stress |
|
|
Term
|
Definition
- acknowledge the mind-body connection
- monitor the stress warning signals
- invoke the relaxation response regularly
- devp the skill of personal presence
- maintain and enhance physical health
- devp a support sytem |
|
|
Term
| Herbs and prescription drugs |
|
Definition
- many scripts are derived from plants
- most herbal meds present no danger if taken appropriately
- some can cause serious side effects if taken in excess, or over a prolonged period of time
- caution when combining scripts and OTCs
- caution about becoming dependent on herbal remedies
- caution pregnant and titty-feeding women not to take herbs |
|
|
Term
|
Definition
- a system of medicine
- a way of life
- emphasis on responsibility, health maint, and disease prevention
- model health system of the future |
|
|
Term
|
Definition
- they don't provide emergency care or do major surgery
- they rarely prescribe drugs
- they treat cts in private practice and outpatient clinics |
|
|
Term
|
Definition
- restoration of health and normal body functions
- customized to the ct
- primary consideration is the least invasive method |
|
|
Term
|
Definition
- chiropractic
- massage
- acupuncture/acupressure/reflexology
- hand-mediated biofield therapies |
|
|
Term
|
Definition
- reduce or eliminate pain
- correct spinal dysfunction
- muscles and ligaments strengthened by spinal rehab exercises
- prev maint to ensure the prob doesn't recur |
|
|
Term
|
Definition
- aids the ability of the body to heal itself
- aimed at achieving or inc health and wellness |
|
|
Term
| Acupuncture/acupressure/reflexology |
|
Definition
- txts rooted in the traditional philosophy of Qi
- blocked or congested energy causes pain, frustration, and irritability
- goal of care is to recognize and manage disruption before illness or disease occurs by applying pressure or stimulation to specific points on the body |
|
|
Term
| Hand-mediated Biofield Therapies |
|
Definition
- includes Therapeutic Touch (TT), Healing Touch (HT), and Reiki
- use of hands on or near w/intention to heal
- goal of care is to accelerate person's own healing process
- facilitate healing of body, mind, emotions, and spirit |
|
|
Term
|
Definition
- yoga
- meditation
- hypnotherapy
- guided imagery
- Qigong
- Tai chi |
|
|
Term
|
Definition
- music
- humor and laughter
- bioelectromagnetics
- infrared photoenergy
- detox
- animal-assisted
- horticultural |
|
|
Term
|
Definition
- every animal, plant, and mineral has an EM field
- enables organic and inorganic objects to comm and interact
- penetrate the bodu affecting the functioning of cells, tissues, organs, and systems |
|
|
Term
| Infrared Photoenergy Therapy |
|
Definition
- inc energy inside cells
- improve circulation |
|
|
Term
|
Definition
- belief that physical impurities and toxins must be cleared
- Types
- hydrotherapy
- colonics
- chelation therapy |
|
|
Term
|
Definition
- use of water as a healing txt
- makes use of the body's response to heat and cold
- used to:
- dec pain and fever
- reduce swelling and cramps
- induce sleep
- improve physical and mental tone |
|
|
Term
| Colonics and Chelation Therapy |
|
Definition
- colonics or colon therapy
- colonics is the procedure for washing the inner walls of the colon by filling it with water or herbal solns and then draining it
- chelation therapy
- intro of chemicals into the blood that bind w/heavy metals in the body |
|
|
Term
|
Definition
- physical or psychological conditions
- resident animals
- companion animals |
|
|
Term
|
Definition
- communing w/God
- self-care strategy
- provides comfort, inc hope, and promotes healing and psychological well-being |
|
|
Term
|
Definition
- establish relationships
- relieve tension and anxiety
- release anger and aggression
- facilitate learning
- cope with painful feelings |
|
|
Term
|
Definition
- enhances effective care
- modify elements that impede effective HC
- modify HC systems to better meet the ct's needs
- ways of thinking and acting developed by a group of people
- permits them to interact effectively w/enviro
- permits them to address concerns common to the human condition
- generally unique, stable, and enduring |
|
|
Term
|
Definition
- artificial categorization
- based on genetic inheritance and physical characteristics
- doesn't adequately address the diversity of the US pop |
|
|
Term
|
Definition
- aggregate of cultural practices, social influences, religious pursuits, and racial characteristics
- shape the distinctive id of a relatively homogenous community |
|
|
Term
| Influences of culture on health |
|
Definition
Direct Influences
- dietary practices
- practices intended to promote health and prevent illness
- practices to restore health
Indirect Influences
- definitions of health and illness
-acceptability of HC programs and providers
- cultural influences on compliance w/health or illness regimens |
|
|
Term
|
Definition
- a dynamic, fluid, continuous process
- find meaningful and useful care delivery strategies
- based on knowledge of cultural heritage, beliefs, attitudes, and behvs |
|
|
Term
| Models of Cultural Competence |
|
Definition
ASKED
- A: cultural Awareness
- S: cultural Skill in collecting relevant cultural data
- K: cultural Knowledge of differences and similarities
- E: cultural Encounters
- D: cultural Desire and motivation to practice in a culturally competent manner |
|
|
Term
| Models of Cultural Competence |
|
Definition
BE SAFE Model
- B: Barriers to the use of biomedical care such as prejudice, SES, stigma
- E: Ethics- consideration of differences in ethical conceptualizations in the culture
- S: Sensitivity- lack of provider bias, stigma, cultural imposition
- A: Assessment of physical, emotional, spiritual, social, mental, and occupational factors affecting health
- F: Facts about cultural beliefs, values, and practices
- E: Encounters- knowledge of behavioral dos and don'ts, communication |
|
|
Term
| Culturally Competent Community Care |
|
Definition
- interpersonal caring
- cultural sensitivity
- cultural knowledge
- cultural skill |
|
|
Term
|
Definition
- awareness of cultural perspectives
- indv perspective doesn't influence interactions w/others
- knowledge and understanding of another culture
- acceptance of and respect for other cultures
- conscious process of adaptation of care to the cultural context |
|
|
Term
| Health System Cultural Competence |
|
Definition
- recognize complexities involved in language interpretation
- aware of need to consider linguistic variation within cultural groups
- facilitate learning between providers and communities
- involve communities in defining and addressing HC needs
- foster interagency collaboration |
|
|
Term
| Barriers to Cultural Competence |
|
Definition
- recognizing clinical differences among cultural groups
- communication among cultural groups
- incorporating elements of culture in the POC
- devp trust among members of different cultures |
|
|
Term
| Addressing Stereotypes Held By Providers |
|
Definition
- viewing culture as "them", not "me"
- confusing race, ethnicity, and culture
- misdiagnosing ethnic medical concerns
- cultural mismatches |
|
|
Term
|
Definition
Guided by four basic principles
- view culture in the context in which it was devp
- examine underlying premise of culturally determined behv
- examine meaning of behv in the cultural context
- recognize intracultural variation |
|
|
Term
| Conducting a Cultural Assessment |
|
Definition
- use personal insight and research to gain knowledge
- interview colleagues who are members of the culture
- live within the culture |
|
|
Term
| Guidelines for Cultural Assessment |
|
Definition
- look and listen before asking questions
- explore how the group about being studied
- discover any special protocols
- foster human relations
- put indv needs before the need to obtain info
- look for similarities rather than differences
- locate group leaders
- be aware of acceptable or offensive questions |
|
|
Term
| Cultural Assessment Considerations |
|
Definition
- biophysical
- psychological
- physical environmental
- sociocultural
- behavioral
- health system dimensions |
|
|
Term
| Cultural Assessment Considerations - Biophysical Assessment |
|
Definition
- attitudes about maturation and aging
- age composition of cultural group
- genetic inheritance and physical differences
- physiologic function:
- prevalent health probs
- attitudes to body parts and functions
- perceptions of health, illness, and disease causation
- culture-bound syndromes |
|
|
Term
| Cultural Assessment Considerations - Psychological Considerations |
|
Definition
- importance of group vs indv goals
- attitudes toward change
- attitudes towards mental health and mental illness |
|
|
Term
| Cultural Assessment Considerations - Physical Enviro |
|
Definition
- mastery over enviro
- beliefs about harmonious relationships w/external enviro
- perceptions of space and time:
- personal space
- future-oriented vs past or present-oriented |
|
|
Term
| Cultural Assessment Considerations - Sociocultural |
|
Definition
- relationships w/supernatural
- interpersonal roles and relationships
- relationships w/HC providers
- SES
- sexuality and reproduction
- coming of age
- marriage
- immigration
- death |
|
|
Term
| Cultural Assessment Considerations - Behavioral/biophysical Considerations |
|
Definition
- dietary practices
- consumption patterns
- health-related behvs |
|
|
Term
| Cultural Assessment Considerations - Health System Dimensions |
|
Definition
- health of population groups
- design of health systems
- HC providers
- HC practices |
|
|
Term
| Rationale for Culturally Competent Care |
|
Definition
- inc in diverse populations
- inc in home care where cultural factors are influential
- inc in health disparities among ethnic cultural minorities |
|
|
Term
| Benefits of Culturally Competent Care |
|
Definition
- promotes appropriate and accurate dx
- improves compliance w/txt recommendations
- reduces delays in care-seeking and use of svcs
- enhances ct/provider communications
- enhances compatibility of biomedical and traditional HC |
|
|
Term
| Leininger's Transcultural Nursing |
|
Definition
- Preservation
- maintain cultural resources that promote health or assist in recovery
- Accommodation
- adjust or adapt ct or provider actions
- facilitate interactions to positively influence health
- Repatterning
- change attitudes or behvs of providers or cts |
|
|
Term
|
Definition
- Cross-cultural HC
- Nat'l Center for Cultural Competence
- Childless Family
- The Population Connection |
|
|
Term
| Resources - Cross-cultural HC |
|
Definition
| Diversityrx, a resource for cross-cultural HC w/a focus on policy, aims to improve the quality of HC for minority, immigrant, and ethnically diverse communities |
|
|
Term
| Resources - Nat'l Center for Cultural Competence |
|
Definition
| at Georgetown University. Another cross-cultural advocacy group w/a focus on policy |
|
|
Term
| Resources - Childless Family |
|
Definition
| No Kidding provides social support for the family who choose to not have children |
|
|
Term
| Resources - The Population Connection |
|
Definition
| it is a nonprofit organization working to slow population growth |
|
|
Term
|
Definition
- Office of Minority Health
- US DHHS
- CDC
- Nat'l Center on Minority Health and Health Disparities (NCMHD)
- Racial and Ethnic Approaches to Community Health (REACH) |
|
|
Term
| Culturally Focused Nursing |
|
Definition
- culturally sensitive
- culturally appropriate
- culturally competent |
|
|
Term
|
Definition
- observance of beliefs and practices of a person's traditional cultural system
- degree to which a person's lifestyle reflects his traditional culture |
|
|
Term
|
Definition
- predicated on the concept of holistic health
- describes what people do to maintain, protect, and restore health
- describes health as a balance of person-body, mind, spirit |
|
|
Term
| Magico-Religious Health View |
|
Definition
- health and illness are controlled by supernatural forces
- may believe that illness is a result of "being bad" or opposing God's will
- getting well is also dependent on God's will
- some cultures believe magic can cause illness |
|
|
Term
| Scientific (Biomedical) Health View |
|
Definition
- life and life processes are controlled by physical and biomechanical processes
- illness is caused by germs, bacteria, or a breakdown of the human machine
- belief that pills, txts, or surgery will cure |
|
|
Term
|
Definition
- forces of nature must be maintained in balance or harmony
- human life is one aspect of nature
- when the natural balance is disturbed, then illness results |
|
|
Term
|
Definition
- health and illness beliefs and practices derived from cultural traditions
- thought to be more humanistic than biomedical HC
- consultation and txt takes place in the community
- may be less expensive than biomedical care
- frequently includes ritual practice on the part of the healer or the ct
- often more comfortable and less frightening for the ct |
|
|
Term
| Verbal Communication w/Culturally Diverse Cts |
|
Definition
- vocabulary, grammatical structure, voice qualities, intonation, rhythm, speed, pronunciation
- initiation of verbal communication
- interaction between people who speak different languages |
|
|
Term
| Nonverbal Communication Behvs w/Culturally Diverse Cts |
|
Definition
- meaning to the ct
- meaning in the ct's culture
- Use of:
- silence
- touch
- eye mvmt
- facial expressions
- body posture |
|
|
Term
| Core Practice Cultural Competencies |
|
Definition
- include cultural assessment of the ct and family
- learn the rituals, customs, and practices of the major cultural groups
- don't make assumptions about beliefs or practices
- ask about the ct's use of cultural or alternative approaches to healing
- id my personal biases, attitudes, prejudices, and stereotypes
- recognize that it's the ct's (or family's) right to make their own HC choices
- convey respect and cooperate w/ traditional helpers and caregivers |
|
|
Term
|
Definition
- tool used to assess cultural heritage
- facilitates communication w/cts and their families
- designed to determine id w/traditional cultural heritage
- designed to determine degree of heritage consistency |
|
|
Term
| Before beginning the Heritage Assessment |
|
Definition
- determine what language the ct speaks
- determine ct's degree of fluency in English
- spend some time to devp trust
- introduce some social conversation
- convey a genuine desire to understand values and beliefs
- introduce questions in a timely manner
- use sensitivity in phrasing questions |
|
|
Term
| Culturally Sensitive Care Planning |
|
Definition
Provide appropriate care to cts of any culture
- become aware of own cultural heritage
- become aware of the ct's heritage and health traditions
- become aware of adaptations the ct made to live in a US culture
- form a nursing plan that incorporates cultural beliefs re the maintenance, protection, and restoration of health |
|
|
Term
|
Definition
- religion
- faith
- hope
- transcendence
- forgiveness |
|
|
Term
|
Definition
- organized system of beliefs and practices
- offers a way of spiritual expression
- offers sense of community
- collective study of scripture
- performance of rituals |
|
|
Term
| Characteristics of Spiritual Health |
|
Definition
- faith
- hope
- meaning and purpose of life
- achievement of spiritual world
- feelings of peacefulness
- ability to love, to forgive, to pray, to worship |
|
|
Term
| Characteristics of Spiritual Health |
|
Definition
- spiritual experiences
- participation in spiritual rites and passages, in meditation, in spiritual reading
- interaction w/spiritual leaders, w/others to share thoughts, feelings, and beliefs
- expression through song/music, art, writing
- connectedness w/inner-self, w/others |
|
|
Term
| Factors Associated with Spiritual Distress |
|
Definition
- physiologic probs
- txt-related concerns
- situational concerns |
|
|
Term
| NANDA Defining Characteristics of Spiritual Distress |
|
Definition
- expresses lack of hope, meaning and purpose in life, forgiveness of self;
- expresses being abandoned by or having anger toward God
- refuses interaction w/friends, family
- sudden changes in spiritual practices
- requests to see a spiritual leader
- no interest in nature, reading spiritual literature |
|
|
Term
|
Definition
0-3 years
- acquiring qualities of trust, mutuality, courage, hope, love
3-7 years
- fantasy-filled, imitative phase
- stories, images and fusion of facts and feelings
- make-believe experienced as reality
7-12 years
- demands proof or demonstrations of reality
- accepts stories and beliefs literally
- able to learn beliefs and practices of culture and religion
- above can extend into adulthood |
|
|
Term
|
Definition
Adolescence
- spiritual beliefs help understand extended enviro
- generally conform to beliefs of those around them
- begin to examine beliefs objectively
Young Adulthood
- differentiating beliefs from those of others
- devp personal meaning for symbols of religion and faith
Mid-Adulthood
- respect for past and one's inner voice
- more awareness of differences because of social background
- attempts to reconcile contradictions in mind and experience
- remain open to others' truths
Mid-to-Late Adulthood
- believe in, live with, participate in community
- works to resolve probs in society
- embraces life, yet holds it loosely |
|
|
Term
| Influence of Spiritual and Religious Beliefs on Diet |
|
Definition
- prescriptions about foods and beverages permitted
- fasting
- provide diet plans specific to religious beliefs |
|
|
Term
| Influence of Spiritual and Religious Beliefs on Dress |
|
Definition
- conservative female dress
- recognize desire to comply even when hospitalized |
|
|
Term
| Influence on prayer and Meditation |
|
Definition
- daily prayers or worship
- provide uninterrupted quiet time |
|
|
Term
| Influence of Religion on Birth and Death |
|
Definition
Birth
- rituals and ceremonies
- assist families in fulfilling these obligations
Death
- observances and rituals
- provide enviro conducive to performance of rituals |
|
|
Term
| Assessment of Spiritual Needs |
|
Definition
FICA
- F (faith or beliefs)
- I (implications or influences)
- C (community)
- A (address) |
|
|
Term
|
Definition
May find cues to spiritual and religious preferences
- enviro
- behv
- verbalizations
- affect and attitude
- interpersonal relationships |
|
|
Term
|
Definition
Overall Goal
- maintaining or restoring spiritual well-being so that spiritual strength, serenity, and satisfaction are realized
- help the ct fulfill religious obligations
- help the ct draw on and use inner resources more effectively
- help the ct maintain or establish a dynamic, personal relationship with a supreme being in the face of unpleasant circumstances
- help the ct find meaning in existence and the present situation
- promote a sense of hope
- provide spiritual resources otherwise unavailable |
|
|
Term
|
Definition
- providing presence
- supporting religious practices
- assisting cts w/prayer
- referring cts for spiritual counseling |
|
|
Term
|
Definition
| cultural assimilation - the acquisition of at least some of the beliefs, values, and behvs of another culture |
|
|
Term
|
Definition
| culturally recognized illnesses |
|
|
Term
|
Definition
| someone who is in a country other than the country of origin but who expects to remain there only a short time |
|
|
Term
|
Definition
| a dynamic fluid, continuous process whereby an invidual, system, or HC agency finds meaningful and useful care delivery strategies based on knowledge of the cultural heritage, beliefs, attitudes, and behvs of those to whom they render care |
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Term
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Definition
| implies that the nurse applies the underlying background knowledge that must be possessed to provide a given ct w/the best possible HC |
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Term
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Definition
| the acquisition of at least some of the beliefs, values, and behvs of the dominant culture |
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Term
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Definition
| the ability to recognize and respond to cultural differences and to incorporate cultural beliefs, values, and practices into nursing care as appropriate |
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Term
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Definition
| the expectation that everyone should conform to one's own cultural practices, whatever their personal beliefs |
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Term
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Definition
| culturally recognized illnesses |
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Term
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Definition
| defined as ways of thinking and acting developed by a group of people that permit them to interact effectively with their environment and to address concerns common to the human condition |
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Term
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Definition
| the aggregate of cultural practices, social influences, religious pursuits, and racial characteristics shaping the distinctive identity of a community |
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Term
| Monoamine oxidase inhibitors |
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Definition
| The use of ginseng by the Asian culture may require lower doses of which group of medications? |
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Term
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Definition
| A young Vietnamese family is in need of health care and goes to a community health care clinic. This represents which of the following? |
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Term
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Definition
| the process by which an individual develops a new cultural identity. It encompasses various aspects such as behavior, marital, identification, and civic. The underlying assumption is that the person from a given cultural group loses his or her original cultural identity to acquire the new one. |
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Term
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Definition
| occurs when people adapt to or borrow traits from another culture. It can also be defined as the changes of one's cultural patterns to those of the host society |
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Term
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Definition
| While people of any given group may share certain beliefs, there are also intra-cultural differences. Factors such as age, education, social status and exposure to the specific cultural beliefs vs the exposure to a larger society account for the differences found in any specified culture |
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Term
| How a nurse becomes culturally competent |
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Definition
- knowing his own culture and the influence it has on his beliefs and his willingness to accept and respect cultural differences
- personal insight
- learn about other cultures |
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Term
| Group heritage and ethnicities' impact on nursing care |
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Definition
- cultural groups have individualistic HC practices and unique perceptions of health/illness
- these factors determine an indv acceptance of both health practices and HC providers
- health/illness has different connotations within each cultural group |
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Term
| Racial distinctions in HC |
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Definition
- groups may share intrinsic characteristics r/t racial heritage
- genetic heritage may be an indication of biophysical predispositions to HC issues
- bone structure and stature, enzyme activity and disease susceptibility are examples |
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Term
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Definition
| the nurse should be aware of and willing to adapt HC to the indv's cultural beliefs as defined by the indv, not their specific culture nor the nurse's expectations |
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Term
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Definition
- many black and European Americans id the female as the main decision maker and dominant family figure
- arabs id the male |
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Term
| Family structures and roles - blacks |
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Definition
- matriarchal
- collaborative family roles |
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Term
| Family structures and roles - appalachian |
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Definition
- patriarchal, extended
- woman is the caregiver and homemaker
- g.parents help out with children too |
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Term
| Family structures and roles - chinese |
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Definition
- patriarchal, extended
- sons are responsible for parental care
- children are obedient |
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Term
| Family structures and roles - filipino |
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Definition
- egalitarian, extended
- parents have shared responsibilities in decision making
- older siblings may support education for younger siblings |
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Term
| Family structures and roles - hmong |
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Definition
- patriarchal, clan
- husband may be polygamous |
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Term
| Family structures and roles - korean |
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Definition
- patriarchal, extended
- all family members socialize children |
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Term
| Family structures and roles - middle eastern |
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Definition
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Term
| Family structures and roles - navajo |
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Definition
- matriarchal, tribal extended
- men care for livestock
- elderly women make HC decisions |
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Term
| Traditional Chinese vs Dominant US Culture |
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Definition
- children submissive to parents/equal relationships, confrontation and challenge are acceptable
- responsibility of parents to the son/equal responsibility to sons and daughters
- children have unlimited responsibility for parents, they are expected to be self-sacrificing/responsibility of care is limited, children not required to over sacrifice
- children's support includes meeting all the needs of the parents/children's support includes assistance with parental needs, maintaining parent's independence |
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Term
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Definition
- on the inc due to rising demographics, it may be physical or psychological, includes:
- neglect
- financial or material exploitations
- violation of personal rights
- abandonment |
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Term
| Considerations of time orientation |
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Definition
the nurse must assess an indv's perception and the importance placed on fixed schedules, activities, and txts.
- amer Indians: view time as past and present oriented
- European amers: view time as future oriented
- African amers: time is present oriented
- middle and upper class: future oriented
- lower class: present oriented |
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Term
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Definition
- perception of personal space varies with each culture
- African and Hispanic amers: close proximity for communication
- Asian and European amers: distance for communication |
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Term
| Indigenous culture's view on disease and illness |
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Definition
- European amers: illness has a known cause that can be treated or cured
- other cultures: illness has a supernatural cause, or illness is a punishment, or it occurs when a body's equil is disturbed
- many cultures depend on faith healers and folk remedies
- |
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Term
| HC beliefs of - Asian Amers |
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Definition
- health is a state of spiritual and physical harmony
- yin and yang
- the body is a gift from ancestors and must be maintained
- proper diet, exercise, avoiding temp changes and the use of traditional remedies to maintain, protect, and restore health |
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Term
| HC beliefs of - African Amer |
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Definition
- life is a process rather than a state
- a person is energy rather than matter
- illness is viewed as disharmony between humanity and nature, often attributed to demons and evil spirits
- voodoo, folk healers
- prayer and a well balanced diet |
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Term
| HC beliefs of - Hispanic Amer |
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Definition
- health is a reward from God for good behv
- it's a state of balance with the forces of hot, cold, wet, and dry within the universe
- illness is bad luck or punishment for evil thoughts or actions
- health is protected by avoiding "harmful" people, wearing amulets, and using candles and prayer for protection
- traditional healers and herbs |
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Term
| HC beliefs of - Native Amers |
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Definition
- health reflects the ability to live in harmony with nature
- the body is divided in half w/a pos and neg energy pole
- balance of the two is health
- shamans |
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Term
| HC beliefs of - European amers |
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Definition
| - illness is defined as the inability to perform ADLs, presence of disease, symptoms, and pain |
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Term
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Definition
| the inclusion of different cultural and ethnic aspects into the area of HC |
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Term
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Definition
| _____ believes that HC personnel should work toward an understanding of care and the values, health beliefs and lifestyle of different cultures, which will form the basis for providing culture-specific care |
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Term
| Perceiving Resistance Due Cultural Differences |
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Definition
- nurse must evaluate if ct non-conforms due to their culture, religion, family, etc..
- the nurse will have to look for more acceptable NIs
- nurse must not assume that allopathic medicine is the only viable txt |
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Term
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Definition
| - must be aware of it's effect on HTN in asian amers |
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Term
| Various Culture Food Preferences - Anglicans, Episcopalians, Catholics |
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Definition
| some religious days may involve a degree of absenteeism from food |
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Term
| Various Culture Food Preferences - Buddhist |
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Definition
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Term
| Various Culture Food Preferences - Hindu |
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Definition
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Term
| Various Culture Food Preferences - Jewish |
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Definition
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Term
| Various Culture Food Preferences - Seventh Day Adventist |
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Definition
| may be vegetarian, no caffiene |
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Term
| Assessing a ct of a different culture |
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Definition
| - determine the ct's beliefs about the cause of illness, for example, germ theory, spirits, curses, and punishments |
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Term
| Six phenomena evident in all cultural groups - Giger and Davidhizar |
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Definition
- a model used to assess the needs of culturally diverse cts, using six phenomena
- communication
- space
- social organization
- time
- enviro control
- biologic variation |
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Term
| Cultural factors that influence the ct's health status |
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Definition
- nutrition, including ethnic food
- key family members involved in health decisions
- healing systems, health habits, lifestyle risks
- religious rites, restrictions and relationships w/the supernatural
- talisman |
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Term
| How the nurse obtains objective data on the following topics - cultural preferences during physical assess including female-male relationships |
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Definition
- some cultures prefer privacy during bodily function
- there are cultural preferences re men and women being present during pregnancy, exam, and delivery
- what is the ct's practices re activities during culturally prescribed clean and unclean periods? |
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Term
| How the nurse obtains objective data on the following topics - skin exposure |
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Definition
| - who can show what skin and body parts to whom in the clinical setting |
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Term
| How the nurse obtains objective data on the following topics - ct who wears an amulet |
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Definition
| - the importance of amulets, ribbons, medals, beads to the ct |
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Term
| How the nurse obtains objective data on the following topics - ct w/cupping marks |
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Definition
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Term
| sickle cell anemia and HTN |
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Definition
| Lab data and other dx data for: Blacks |
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Term
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Definition
| Lab data and other dx data for: Injuns |
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Term
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Definition
| Lab data and other dx data for: European amers |
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Term
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Definition
| Lab data and other dx data for: Blacks and Injuns |
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Term
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Definition
| Lab data and other dx data for: Asians and Blacks |
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Term
| Nursing Dx, EOs, and NIs specific to the cultural needs of the ct |
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Definition
Dx: impaired verbal communication r/t shyness about cultural differences
EO: ct will communicate effectively w/the HC team w/the use of an interpreter
NI: use an interpreter to facilitate communication
DX: spiritual distress r/t inability to participate in culturally based rituals
EO: ct will report enhanced spiritual well-being when use of a spiritual counselor is incorporated into ct care
NI: -encourage spiritual advisors to participate in HC decisions
-provide privacy for practice of rituals and prayer
-incorporate cultural practices into care as appropriate
DX: ineffective mgmt of therapeutic regime r/t mistrust of HC providers
EO: ct will id trad folk remedies that may be incorporated into the care plan
NI: -the nurse will define expectations w/the ct
-introduce the ct and family to hospital staff and volunteers who are from the same culture, ethnic group or religion
-teach ct about the interaction of herbal remedies and scripts |
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Term
| In order for a nurse to devp measures for a ct from a different culture... |
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Definition
| the nurse needs to: perform a comprehensive cultural assessment incorporating holistic health and a health risk appraisal of the ct's HC beliefs |
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Term
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Definition
| this is used to obtain the info needed to devp a comp care plan which will include theory based practice as well as culturally driven interventions |
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Term
| Cultural Factors that may influence the ct's care plan |
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Definition
- dietary needs
- rituals
- spiritual advisors
- birth attendants
- death attendants |
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Term
| Nursing Dx, EOs, and NIs specific to the cultural needs of the ct |
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Definition
DX: powerlessness r/t HC provider's inability to understand the sig of dietary and religious beliefs
EO: the ct will explain important religious and dietary needs to the HC team
NI: -involve dietician in mtg special needs
-teach ct about the impact of dietary practices on healing
-respect cultural and indv differences
-devp plan for meds admin that doesn't interfere w/religious practices
DX: non-compliance r/t culturally acquired health benefits
EO: the ct will discuss how compliance w/the POC is compatible w/cultural health beliefs
EO: -include culturally sensitive and specific info re importance of following txt regimen in teaching plan
-involve family members (if able) in the devp of the ct's POC (w/ct's permission)
DX: knowledge deficit of HC r/t lack of info re HC
EO: the ct will list the benefits of available HC
NI: -enlist the help of social svcs to provide pt and family w/local HC info
-assess for cultural self-care practices and include in the pt's POC |
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Term
| NIs to encourage adherence to the POC |
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Definition
- introduce the ct and family to staff and volunteers who are the same culturally
- assignments of staff can be rearranged to accommodate special needs |
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Term
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Definition
- for migraines and as an antipyretic
- it may diminish effectiveness of NSAIDS
- may cause reaction in those w/ragweed allergy, chamomile and yarrow
- incs clotting time |
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Term
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Definition
- used for prenatal nausea
- inc clotting time
- may cause mutagenesis of E.coli
- affects glucose |
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Term
| Promoting continuity of care to culturally diverse cts |
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Definition
refer to:
- WHO
- ICN
- community support groups and resources such as sources for ethnic foods |
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Term
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Definition
| he influences illness caused by a hex or sorcery |
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Term
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Definition
| which culture believes that exposure to cold weather may cause illness? |
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Term
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Definition
| which culture may use cod liver oil to prevent colds? |
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Term
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Definition
| A Vietnamese family goes to a community HC clinic. What type of cultural ID is this? |
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Term
| In order for nurses to assist people of diverse cultures, Leininger presents three intervention modes |
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Definition
- culture care preservation and maint
- " accommodation, negotiating, or both
- " restructuring and repatterning |
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Term
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Definition
- amer indian/Alaskan .9%
- asian/pacific islander 3.8
- black 12.3
- white 75.1
- other (or multiple) 7.9
- Hispanic 12.5 |
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Term
| the 3 major components of heritage |
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Definition
- culture
- ethnicity
- religion |
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Term
| the 9 interrelated facets of the Health Traditions Model |
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Definition
- physical, mental, spiritual
- maintain, protect, and restore health |
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Term
| Cultural Family Patterns and the affect on nursing |
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Definition
- who has the authority to make decisions in a family?
- the value placed on children and elders within a society is culturally derived
- cultural gender-role behv may affect nurse-ct relationships
- cultural family values may dictate family involvement in the ct's care
- some cultures don't like sharing info w/outsiders |
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Term
| How much does a ct id w/his traditional heritage? |
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Definition
- did the person's childhood devp occur in his native country
- do extended family members encourage participation in traditional religious and cultural activities
- does the ct frequently visit his country
- is the ct's home within his ethnic community
- does the ct participate in ethnic cultural events
- was the ct raised in an extended family setting
- does the ct maintain regular contact w/extended family
- has the indv's name been Americanized
- was the ct educated in a parochial school w/a ethnic philosophy or religion the same as his
- does the ct hang out w/people the same as him
- does the ct have knowledge of his heritage and culture
- does the ct express pride in his culture |
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Term
| Rule for meeting with foreign cts |
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Definition
- always address them by their last name
- introduce myself w/my full name and explain my role
- be authentic and admit to the lack of knowledge i may have about their culture
- use culturally sensitive language
- find out what the ct thinks about his health probs, illness, and txts
- don't make any assumptions about the ct, and always ask questions about anything i don't understand
- show respect for the ct's values, beliefs, and practices
- show respect for the ct's support people
- try to get the ct's trust |
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Term
| Potential conflicts between cultural beliefs or practices and the dominant US HC system |
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Definition
- amer indian women like to be big (heavy)
- circumcision beliefs differ per culture
- an Hispanic or asian ct may be unable to obtain hospice if his family forbids him knowing about his diagnosis or prognosis
- jehovahs don't accept blood
- orthodox Sikhs don't cut their hair |
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Term
| The nurse needs to consider the following when setting priorities for nursing dx and NIs |
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Definition
- ct's health values and beliefs
- ct's priorities
- resources available to the nurse and ct
- urgency of the health prob
- medical txt plan must be congruent w/other HC pros txt plans |
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Term
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Definition
- setting priorities
- establishing ct goals/desired outcomes
- selecting NIs
- writing nursing orders |
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Term
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Definition
- concrete
- an observable pt state, behv, or self-reported perception or evaluation
- it is similar to desired outcomes in traditional language |
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Term
| Purpose of desired outcomes/goals |
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Definition
- provide direction for planning NIs
- serve as criteria for evaluating ct progress
- enable the ct and nurse to determine when the prob has been resolved
- helps motivate the ct and nurse by providing a sense of achievement |
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Term
| Impaired Physical Mobility: inability to bear wt on left leg, r/t inflammation of knee joint |
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Definition
Opposite healthy response (goals):
- improved mobility
- ability to bear wt on left leg
Desired Outcomes:
- ambulate w/crutches by end of week
- stand w/o assist by EOWeek |
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Term
| Ineffective Airway Clearance r/t poor cough effort, secondary to incision pain and fear of damaging sutures |
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Definition
Opposite healthy response (goals):
- effective airway clearance
Desired Outcomes:
- lungs clear to auscultation during entire postop period
- no skin pallor or cyanosis by 12 hrs postop
- within 24 hrs after surgery, will demonstrate good cough effort |
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Term
| Relationship of Desired Outcomes/Goals to Nursing DX |
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Definition
| for every nursing dx, the nurse must write at least one DO that, when achieved, directly demonstrates resolution of the prob clause |
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Term
| When devp goals/ DOs, ask the following questions |
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Definition
- what is the problem clause?
- what is the opposite , healthy response?
- how will the ct look or behave if the healthy response is achieved? (what will i be able to see, hear, measure, palpate, smell, or otherwise observe w/my senses?)
- what must the ct do and how well must the the do it to demonstrate prob resolution or to determine the capability of resolving the problem? |
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Term
| Components of goal/desired outcome stmts |
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Definition
- subject: the ct
- verb: drinks
- conditions or modifiers: 2500ml of fluid
- criterion of desired performance: daily |
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Term
| Guidelines for writing goals/ desired outcomes |
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Definition
- write goals and outcomes in terms of ct responses, not nurse activities, (eg.., "ct will", not words like enable, facilitate, etc..)
- ensure that desired outcomes are realistic for the ct's capabilities, limitations, and designated time span, if it's indicated
- ensure that the goals and desired outcomes are compatible w/the therapies of other professionals
- make sure that each goal is derived from only one nursing dx
- use observable, measurable terms for outcomes by the observer
- ensure that the ct considers the goals/desired outcomes important and values them |
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Term
| A ct is displaying an unhealthy spiritual need. |
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Definition
| When is it mandatory to assess each ct for spiritual beliefs and practices. When is a thorough spiritual assessment needed? |
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Term
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Definition
| At what approximate age does an individual conform to the spiritual beliefs of those around him? |
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Term
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Definition
| Interpersonal and family relationships are examples of what type of comfort need? |
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Term
| Providing individualized care |
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Definition
| How can a nurse best help a ct feel cared for? |
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Term
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Definition
| It's a learned way of responding that demonstrates the nurse correctly understands hoe the ct feels |
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Term
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Definition
- US colonial period
- care part of family function
- home remedies
- Canadian public health
- Jeanne Mance |
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Term
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Definition
- social ills contributed to:
- intro of sanitation engineering
- epidemiologic investigations
- cholera
- immunizations
- diphtheria
- smallpox |
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Term
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Definition
- Nightingale
- community health nursing
- Elizabeth Frye |
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Term
| Settlement Houses: Lillian Wald and Mary Brewster |
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Definition
- delivered HC to poor immigrant populations by living and working among them
- first American community health agency
- established Henry St Settlement in NY City
- utilized germ theory as foundation for interventions
- access to nursing svcs determined by the ct, not Dr
- cared for sick in their homes
- health edu as a secondary focus
- focus of care to whole community |
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Term
| Community Health Nurses: Social Change |
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Definition
- Margaret Sanger
- contraceptive svcs for women
- Clara Barton
- nursing care to wounded in Civil War
- active in locating missing CW soldiers
- establishment of Red Cross
- Dorothea Dix
- active in improving conditions for inmates in US prisons |
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Term
| Community Health Nurses and social reforms |
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Definition
- focus of svcs to the whole community
- addressing:
- poverty
- social injustices
- poor nutrition
- lack of HC svcs |
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Term
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Definition
- successful social experiment
- provided nursing svcs to policyholders
- goal was to reduce mortality |
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Term
| White House Conference on Children 1909 |
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Definition
- Lillian Wald and other social activists
- sought to improve social conditions that affected health
- resulted in UC Children's Bureau in 1912
- child labor |
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Term
| Rural Nursing: Contributions to HC reform |
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Definition
- Mary Breckenridge
- frontier nursing svcs
- provided midwifery svcs
- assessed outcomes
- tracked case data
- rural health focus
- blacks and indians |
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Term
| Role of early pro organizations |
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Definition
- American Public Health Association
- Natl Org of Public Health Nurses
- advancing public health through standards and policies
- promoting population health |
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Term
| Community Health Nursing as a Profession |
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Definition
- employment of public health nurses by govt agencies in Alabama in 1907
- postgraduate course at Columbia Univ in 1910
- establishment of the Nat'l Org for Public Health Nursing in 1912 |
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Term
| Sheppard-Tower Act of 1921 |
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Definition
- state and local agencies
- gen'l health, maternity, prenatal, child health svcs |
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Term
|
Definition
- fed programs
- Fed Emergency Relief Act
- Civil Works Admin
- Works Progress Admin |
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Term
| Functions of Public Health Nurses and Pro Objectives |
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Definition
| Critical to the advancement of the profession and edu of community health nurses |
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Term
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Definition
- employed their first public health nurse
- division of nursing established 10yrs later |
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Term
| Emphasis changing to health promotion |
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Definition
- changes in the US nat'l health objectives
- Focus area for Healthy People 2010
- devp of the public health infrastructure
- organizational structure of official govt health agencies
- public health workforce
- info systems in public health practice |
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Term
|
Definition
- creation of the Center for Nursing Research in 1988
- now called the Nat'l Institute for Nursing Research |
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Term
| Public Health Improvement Act of 2000 |
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Definition
| Provides funds for the devp of public health activities at state and local levels |
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Term
|
Definition
- Canadian, LaLonde Report (1974)
- New Perspectives for the Health of Canadians
- determinants of health risks
- biological, enviro, and lifestyle |
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Term
|
Definition
- Declaration of Alma Alta - 1978
- access to primary care for all
- Toronto Conference - 1984
- key health promotion concepts
- healthy public policy
- healthy cities
- US Nat'l Health Objectives
- Behv Risk Factor Surveillance System
- data collection
- WHO
- smallpox eradication
- Ottawa Charter for Health Promotion-1986
- First Int'l Conference on Health Promotion
- focus on social, economic, and political reform and empowerment
- Jakarta Declaration on Health Promotion
- Global health promotion |
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Term
| Public Health Practice Changes |
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Definition
- IOM - 1988
- three core functions
- assessment
- policy formation
- assurance |
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Term
| US Public Health Infrastructure Inadequacies |
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Definition
- AIDS
- SARS
- Terrorist attacks |
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Term
|
Definition
- NI Classification
- categorizing nursing svcs
- facilitating direct reimb
- NOC
- allows nurses to document the effectiveness of intervention |
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Term
| Evolution of Health Promotion |
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Definition
- religious, political, and cultural sanctions
- miasma control
- contagion control
- preventative medicine
- primary health care movement |
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Term
|
Definition
- enables people to inc control over, and improve, their health
- policy formation
- devp of enviros that support health
- promotion of community action |
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Term
| Key Elements of Health Promotion |
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Definition
- regulation of health via legislation
- sanitation
- immunization
- focus on risk modification
- recognition of effects of social conditions on health
- preparation for informed decision making |
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Term
|
Definition
- a health promotion strategy
- provides cts w/info and skills
- informed decisions re health-related behvs
- uses education and motivation to change behvs by influencing:
- values, attitudes, and beliefs |
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Term
| Relationship between Health Education and Health Promotion |
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Definition
| Health edu is one means to accomplish health promotion |
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Term
| Models for Health Promotion |
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Definition
- Precaution Adoption Process model
- The Theory of Reasoned Action/Planned Bevh
- The Health Belief Model
- Pender's Health Promotion model
- The PRECEDE-PROCEED model |
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Term
| Models for Health Promotion - Precaution Adoption Process model |
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Definition
- stages of health-related behv decisions
- 1: unaware of health-related issue
- 2: aware but unengaged
- 3: decision to act or not
- 4: decision to not act
- 5: decision to act, but no action taken
- 6: act to engage
- 7: behv becomes part of lifestyle routine |
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Term
| Models for Health Promotion - The Theory of Reasoned Action/Planned Bevh |
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Definition
- attitudes reflect attitudes to expected consequences
- attitudes are a product of subjective norms influenced by others
- intention to act
- attitudes of person
- perception of others' attitudes
- value placed on others' judgements |
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Term
| Models for Health Promotion - Health Belief Model |
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Definition
- indv perceptions of susceptibility and seriousness
- modifying factors/variables
- demographic
- sociopsychological
- structural
- perceptions of benefits and barriers to action
- cues to action |
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Term
| Models for Health Promotion - Pender's Health Promotion model |
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Definition
- behv is influenced by individual characteristics
- behv-specific cognitions and emotions result in a commitment to action
- commitment to action results in actual behv
- behv may be modified by competing demands and preferences |
|
|
Term
| Models for Health Promotion - PRECEED-PROCEED model |
|
Definition
- PRECEED
- predisposing
- reinforcing
- enabling
- education
- dx
- evaluation
-PROCEED
- policy
- regulatory
- organizational
- educational and environmental devp |
|
|
Term
| Strategies for Health Promotion - |
|
Definition
- Empowerment
- environmental conditions affect health promotion actions
- Social Marketing
- enhance people's motivation to act
- Health Education
- activities that seek to inform |
|
|
Term
|
Definition
- apply commercial marketing technologies
- designed to influence voluntary behv of target audiences
- improve audience's or society's personal welfare |
|
|
Term
| Characteristics of Social Marketing |
|
Definition
- exchange
- research to action
- devp of marketing mix
- position strategy |
|
|
Term
| Phases of Social Marketing |
|
Definition
- preproduction/prepromotion
- research devp and market testing
- research methods to study applications and effectiveness of marketing |
|
|
Term
| Four Ps of Social Marketing |
|
Definition
- Product
- Price
- Place
- Promotion |
|
|
Term
| Four Ps of Social Marketing - Promotion |
|
Definition
- communication strategies and msgs
- smoking cessation msgs that focus on neg consequences
- exercise promotion msgs that address health benefits, wt loss, inc energy |
|
|
Term
| Four Ps of Social Marketing - Place |
|
Definition
- location where product or svc takes place
- location of smoking cessation programs in community
- location of fitness ctrs |
|
|
Term
| Four Ps of Social Marketing - Product |
|
Definition
- need, service, desired behv
- not smoking
- beginning an exercise program |
|
|
Term
| Four Ps of Social Marketing - Price |
|
Definition
- cost of, or barriers to, adopting behv
- physiologic responses to smoking cessation
- time and expense of joining fitness ctr |
|
|
Term
|
Definition
- process of enabling communities to acquire knowledge and skills
- allow communities to make informed decisions |
|
|
Term
| Key Requisites of Empowerment |
|
Definition
- motivate community participation
- peer and organizational norms that support health promotion practice
- community agency mgrs. who are empowerment-oriented
- agency internal policies for empowerment of community members |
|
|
Term
|
Definition
- active process engaging community members in their own health education and health promotion needs
- empower indvs for their own personal action
- empower indvs to form small mutual assistance groups |
|
|
Term
|
Definition
- empower groups to create community orgs
- empowering community orgs to form partnerships
- empower communities to take social and political action to improve enviro conditions that affect health |
|
|
Term
| Fostering Health Promotion through Empowerment |
|
Definition
- indvs and communities become active participants in the health promotion process when they:
- act on info and create knowledge and solns from their own experiences
- make informed decisions
- recognize that structural and behavioral changes are necessary to promote health and well-being |
|
|
Term
|
Definition
- inform the indv on the nature and cause of health/illness
- inform the indv of risk associated w/lifestyle-related behv
- learning domains
- cog
- affective
- psychomotor
- perceptual |
|
|
Term
| Purpose of Health Education |
|
Definition
- assist cts in making health-related decisions about:
- self-care
- use of health resources
- societal health issues |
|
|
Term
|
Definition
- ct participation in health decision-making
- inc potential to comply w/health recommendations
- devp of self-care skills
- improved ct and family coping
- inc participation in continuing care for specific conditions
- adoption of healthier lifestyle |
|
|
Term
|
Definition
- assess health edu needs
- plan and implement health edu programs
- prioritize learning needs
- devp goals and objectives |
|
|
Term
| Design and Implementation |
|
Definition
- needs assessment
- a planned process
- id the reported needs of an indv or group
- id and select target audience
- assess health edu needs
- assess learning enviro |
|
|
Term
| ID Audience Characteristics |
|
Definition
- biophysical
- psychological
- physical enviro
- sociocultural
- behv
- health system factors |
|
|
Term
| Planning and Implementation |
|
Definition
Elements of planning process
- prioritize learning needs
- goals and objectives
- content selection
- teaching/learning strategies |
|
|
Term
| Language and Health Literacy |
|
Definition
- Considerations
- many non-English speakers need health preventive svcs
- Health Literacy
- ability to obtain, interpret, and understand basic health info and services
- ability to use such info and svcs to enhance health |
|
|
Term
| Basic Principles of Language and Health Literacy |
|
Definition
- content based on written objectives
- reader involvement is critical
- easy to read and understand
- materials look easy to read
- visual features clarify and motivate reader |
|
|
Term
| Evaluative Elements of Internet sites |
|
Definition
- owner of site and reputability
- sources of financial support
- purpose of site
- sources of info provided
- evidence provided
- editorial oversight
- currency of info |
|
|
Term
| Evaluation of Health promo programs |
|
Definition
- dx eval
- accuracy of needs assessment
- formative eval
- how the program is carried out
- summative eval
- program outcome and or impact |
|
|
Term
| Add'l elements for Evaluation of Health promo programs |
|
Definition
- evals based on achieving criteria r/t:
- empowerment
- participation
- intersectoral collaboration
- use of multiple strategies
- sustainability |
|
|
Term
|
Definition
- social system of two or more people
- define themselves as a family
- share bonds of emotional closeness |
|
|
Term
|
Definition
- nuclear conjugal: husband, wife, and children
- nuclear dyads: married couple w/o kids under 18 living in home
- children may be biological or adopted
- dual-earner: two working parents with or w/o kids |
|
|
Term
|
Definition
- includes family members other than spouses or children
- may include stepkin
- share expenses and tasks
- live in close proximity and provide mutual support |
|
|
Term
|
Definition
- most common family type served by community health nurse
- consists of mom or dad and children
- many causes |
|
|
Term
|
Definition
- two adults, at least one of whom has remarried
- can include children from previous marriage
- can include children from the new marriage |
|
|
Term
|
Definition
- man and woman living together w/o marriage
- includes anyone from teens to retired elderly
- different reasons for it |
|
|
Term
| Bone smokers and carpet munchers |
|
Definition
| - approx. 10% of unmarried couple households in the US |
|
|
Term
|
Definition
- older person or g.parent is head of household
- comprises approx. 7% of US families
- many factors contribute to it |
|
|
Term
|
Definition
- at least one adult and one or more foster kids
- kids placed by the court system
- may contain the adult's own biological or adopted children
- higher incidence of mental disorders in foster kids |
|
|
Term
|
Definition
- it's a complex of elements in interaction w/each other
- interaction is ordered, not random |
|
|
Term
|
Definition
- hierarchal structure
- suprasystem strycture and subsystems
- boundaries
- mutual goals
- maint of a steady state
- system growth |
|
|
Term
|
Definition
- cells
- organs
- organ systems
- body
- total person
- neighborhood
- town
- county
- state
- nation
- world |
|
|
Term
|
Definition
- those processes needed to regulate xchanges w/the environment
- input, throughput, and output processes
- processes involved in system ops
- designed to limit expenditures of system energy
- internal processes
- subsystem and adaptive change processes |
|
|
Term
|
Definition
- humans and social units devp in a logical fashion
- predictable stages or milestones
- family devp is a unique path through stages of growth |
|
|
Term
|
Definition
- id/assess family stage
- assess degree that family has achieved devp task
- assess family engagement in action that promotes accomplishment of devp tasks |
|
|
Term
| Carter and McGoldrick's stage of family devp |
|
Definition
stage 1: single young adult
stage 2: new couple
stage 3: family with young children
stage 4: family with adols
stage 5: launching children and moving on
stage 6: family in later life |
|
|
Term
| Structural Functional Approaches |
|
Definition
| - family structure allows specific functions essential to health and family |
|
|
Term
| Structural elements are family members and interaction patterns |
|
Definition
- roles
- values
- communication patterns
- power structure
- function |
|
|
Term
|
Definition
- group of related actions to accomplish specific goals
- affective
- socialization
- reproductive
- economic
- provision of needs |
|
|
Term
|
Definition
| - used to diagram family structures and relationships |
|
|
Term
| Biophysical considerations |
|
Definition
- family health status
- family demographics
- age
- gender
- race
- devp status |
|
|
Term
| Psychological considerations |
|
Definition
- communication patterns
- family relationships/dynamics
- family coping/emotional strengths
- child-rearing/discipline practices
- family goals
- presence of mental illness
- family crisis |
|
|
Term
| Family communication patterns |
|
Definition
| - influence family relationships, dynamics, and parental effectiveness |
|
|
Term
|
Definition
- bonds between family members
- close, cohesive supportive
- distant, nonsupportive, conflictual
- family dynamics
- cultural beliefs and practices
- coping and emotional strengths
- mental illness |
|
|
Term
| Family Physical environmental considerations |
|
Definition
- internal enviro
- home
- space
- external enviro
- neighborhood
- industry
- crime rate
- sanitation |
|
|
Term
| Family sociocultural considerations |
|
Definition
- family roles
- culture and religion
- SEC status
- employment or occupational factors
- external resources
- refugee status |
|
|
Term
| Family behv considerations |
|
Definition
- family consumption patterns
- cultural patterns
- rest and sleep patterns |
|
|
Term
| Family health system considerations |
|
Definition
- family attitudes toward health and response to illness
- access to and use of HC svcs |
|
|
Term
|
Definition
- socially-expected behv patterns
- determined by a person's position within a family |
|
|
Term
| Family roles are formal or informal |
|
Definition
- formal roles
- expected sets of behvs associated w/family positions
- informal roles
- expected behvs not associated w/position |
|
|
Term
|
Definition
- situational
- family experiences an event that's sudden, unexpected, and unpredictable
- maturational
- normal transition point
- exchange old patterns and roles for new |
|
|
Term
| Primary prevention family-focused interventions |
|
Definition
- family level
- health promo and protection
- educate family members
- safety, nutrition, physical activity/rest
- illness prevention
- teaching effective hygiene
- referring for immunizations
- primary prevention-aggregate level
- advocate
- enviro protection
- social justice
- availability of health promotion and illness prev svcs
- teach coping skills |
|
|
Term
| Secondary family-focused interventions |
|
Definition
- family level
- assist families in obtaining needed care
- help families deal with probs
- link families w/svcs
- crisis intervention
- population level
- alert health policy makers to the need for family svcs
- initiate plans for progs |
|
|
Term
| Tertiary family-focused interventions |
|
Definition
- family level
- assist families in coping w/long-term health probs
- assist in dealing w/consequences
- assist families w/loss of loved one
- population/aggregate level
- advocate for devp of respite svcs for family caretakers
- create support groups for crisis-prone families |
|
|
Term
|
Definition
- the setting for delivering HC in the community may be an:
- ambulatory clinic
- OP surgery ctr
- adult day care ctr
- school health ofc
- nurse-managed ctr
- LTC facility
- rehab ctr
- hospice care facility
- public health unit
- occupational health ofc
- correctional facility
- home health
- some experts have predicted that 75% of all HC will be delivered in community settings by 2025 |
|
|
Term
|
Definition
| - dr's ofc or other clinic; provides acute HC |
|
|
Term
|
Definition
| - performs surgical procedures; short recovery period prior to discharge |
|
|
Term
|
Definition
| - assesses and treats acute conditions; provides health edu |
|
|
Term
|
Definition
| - ctrs common on university campuses |
|
|
Term
| Effective discharge planning for acute to home health |
|
Definition
- what to expect after discharge
- instruction in appropriate self-care
- available resources
- emergency procedures
- planned follow-up care
- teaching that addresses pt and family concerns
- explanation of home care svcs and contacts |
|
|
Term
| Unique aspects of home health nursing care include: |
|
Definition
- case mgmt role: functions within a model of cost-effective txts; finds resources to meet identified needs
- reimbursement: guidelines for pmt of svcs might limit availability of needed svcs; generally requires pt copay
- pt in control: nurse is visitor to the enviro; pt and family might choose noncompliance
- caregiver burden: emotional financial, physical, psychosocial stressors of care might create need for add'l svcs |
|
|
Term
|
Definition
- pt and family expectations
- physical enviro, risks to health and safety, and family's ability to manage emergency situations
- pt
- txt plan and barriers to efficacy, compliance
- learning needs and any existing barriers |
|
|
Term
| The most common nursing dx in HHC |
|
Definition
- impaired home maintenance
- risk for caregiver role strain
- decisional conflict |
|
|
Term
| 10 characteristics of a healthy community |
|
Definition
- access to HC with a focus on txt/prevention for all members of the community
- safe enviro
- roads, schools, playgrounds, and other svcs to meet the needs of the community
- active subgroups on community affairs
- emergency preparedness
- problem resolution abilities
- open comm channels
- legitimate mechanisms to address disputes
- citizen participation in decision making
- high degree of wellness among the members of the community |
|
|
Term
|
Definition
- a collection of people who share some attribute of their lives
- they interact formally or informally for the benefit of everyone in the community |
|
|
Term
|
Definition
- nursing that cares for a community of people, not an indv
- the nurse addresses probs id within the entire community, focusing on target populations, health promotion, and illness prevention |
|
|
Term
| Examples of ct-oriented community health nursing |
|
Definition
- indvs and groups: high-risk cultural or special needs groups
- families: admin for children and families: focuses on health needs of children and families and those w/devp disabilities, injuns, refugees, and legalized aliens
- assumes the role of coordination of the purpose, appropriateness, and the ct's response to the health care which has been provided
- populations at risk: the nurse is able to make an assessment of the potential for health probs
- ct and family: addresses the illness and self-care of indvs and families across the lifespan in places of occupation, school, religious practices, and home |
|
|
Term
| Community based nursing: primary prevention |
|
Definition
- focuses on both health promo and protect against specific health probs
- its purpose is to dec the risk or exposure of the indv or community to disease
- pre-exposure or pre-clinical (exposure has occurred, but no symptoms are yet present) |
|
|
Term
| Community based nursing: Secondary prevention |
|
Definition
- focuses on early id of existing health probs and interventions to alleviate existing ones
- limiting future disability
- actions would include screening and early dx as well as txt |
|
|
Term
| Community based nursing: tertiary prevention |
|
Definition
- focuses on restoration and rehab to an optimal level of functioning and prevention of further deterioration
- actions would include preventing recurrences of the prob
- |
|
|
Term
| Nurse's practice role and settings: Rehab ctrs |
|
Definition
| - nurses in these settings are direct care providers, teachers, and counselors |
|
|
Term
| Nurse's practice role and settings: Detox |
|
Definition
| - nurses in these settings manage health assessment, address pt's physical needs, and refer pts to community resources when approriate |
|
|
Term
| Nurse's practice role and settings: Txt ctrs for addiction |
|
Definition
| - nurses in these settings are resp for health assessment, planning, and mgmt of dx probs, |
|
|
Term
|
Definition
| - it addresses community issues and responds to crisis from natural disasters |
|
|
Term
| Community Care Systems - Global |
|
Definition
|
|
Term
| Community Care Systems - Nat'l/Fed level |
|
Definition
- medicare
- Medicaid
- social security
- SSI
- Dept of Health and Human Svcs |
|
|
Term
|
Definition
- a fed prog devlpd from an amendment to the SS act
- provides a nat'l health ins prog for older adults
- provides fin assist for HC for gimps < 65 |
|
|
Term
|
Definition
- established in 1965 through the SS Act
- based on fin eligibility through fed and state funding
- provisions vary from state to state
- it aids families of gimps and chronically ill |
|
|
Term
|
Definition
- for indvs who have limited fin resources or disabilities
- it covers the cost of meds or extended HC |
|
|
Term
|
Definition
- goal is to reduce mortality via
- intervention in prev health, health protection, and promo |
|
|
Term
| Balanced Budget Act of 97 |
|
Definition
- it limits HC for the elderly at home
- it shifted to a PPS
- much of the elderly's HC is no longer covered by Medicare |
|
|
Term
| OASIS (Outcome Assessment System and Info Set) |
|
Definition
- a mandated assessment tool used to calculate Medicare pmts based on the ct's health condition
- it's used to determine PPS payments to HH agencies |
|
|
Term
| Beneficiary Improvement and Protection Act (BIBA), 2000 |
|
Definition
- it redefined "homebound" so that infrequent or short duration absences from home don't disqualify a ct from being considered homebound; such that, these cts would still qualify for Medicare coverage of home health
- also allowed the use of telemedicine in HH |
|
|
Term
| Omnibus Reconciliation Act |
|
Definition
- includes the Nursing Reform Act
- set the standard for high quality for high HH care and protects the rights of LTC residents |
|
|
Term
|
Definition
the functions of ______ health agencies fall into 5 categories:
- health info
- disease and disability prevention
- health protection
- improving the HC delivery system |
|
|
Term
| State level agencies - Health Depts |
|
Definition
- functions within the state include:
- health info
- disease and disability prevention
- health protection
- health promo
- improving the HC delivery system |
|
|
Term
| Local level agencies - local health dept |
|
Definition
- most serve small, specific populations within the community
- svcs may include community needs assess
- prenatal care, primary care, peds, elder care |
|
|
Term
|
Definition
| - a disease process that's continuous in a specific pop and which has a low mortality rate, such as the measles |
|
|
Term
|
Definition
- an infectious disease or condition tht hits a large group of indvs within the same community or same geographical area
- eg,. an outbreak of measles in the elementary school system |
|
|
Term
|
Definition
| - reflects the occurrence of health related conditions in a community |
|
|
Term
|
Definition
| - the ratio of the # of cases of a disease or condition to the # of people in the pop |
|
|
Term
|
Definition
| - the ratio of the # of deaths from any health related cause to the # of people in the pop |
|
|
Term
| The nurse's role in the prevention of communicable diseases |
|
Definition
| - the emphasis of primary, secondary, and tertiary care addresses everything specific to communicable disease |
|
|
Term
| The nurse's responsibility in the reporting of comm diseases such as tuberculosis and hep |
|
Definition
- they are reported to id pops or indvs who are infected or in need of txt
- when nurses report a comm disease, ct confidentiality is required |
|
|
Term
| How does infant immunizations influence community-based care |
|
Definition
| immunizations not only protect indv children but higher immunization compliance lessens the risk of community exposure to non-immunized indvs |
|
|
Term
| S&S and Txt for lead poisoning in toddlers |
|
Definition
- screening in areas where exposure may be possible
acute intoxication: burning in the mouth and esophagus, colic, constipation, or diarrhea, mental disturbances, extremity paralysis followed by convulsion and muscle collapse
- blood levels > 10 ug/dL
Chronic symptoms include:
- extreme irritability, anorexia, and anemia
- encephalopathy
TXT: gastric lavage w/Mg or Na sulfate
- fluid therapy and chelation
- IM injection of Ca disodium edentate
- blood levels between 45-70 ug/dL, chelation is required: ethylenediaminetetracetic acid (EDTA), British antilewisite, (BAL), and succimer Chemet are prescribed to combine w/lead in the blood to form nontoxic compounds that are excreted by the bowel and kidneys |
|
|
Term
| Immunization schedule for adults |
|
Definition
- completion of primary series of diphtheria and tetanus w/boosters every 10 years
- Pneumococcal pneumonia vaccine for those w/pre-existing resp conditions and 65 yrs and older
- Hep B, MMR, and varicella for those w/no acquired immunity. Indvs born before 1956 need MMR
- influenza yearly, as indicated for both high risk groups: children and the elderly |
|
|
Term
|
Definition
- it contributes to many physical and psychosocial probs within a community
- it is a learned behv
- societal and cultural factors influence it |
|
|
Term
|
Definition
-it inc the risk for depression and it's one of the most sig stressors an indv can experience
- women w/children at risk for less HC |
|
|
Term
| The presence of chronic diseases |
|
Definition
- the effects of ______ ______ disorders are seen in pop groups as well as indvs.
- the cost of care can be measured not only in HC resources but also in lost productivity and use of limited resources |
|
|
Term
|
Definition
- specific behvs and beliefs are the product of cultural values
- cultural beliefs impact how indvs feel about their communities and their places in the community |
|
|
Term
| Expectations of health and illness |
|
Definition
- all cultures have their own unique definition of health and illness and their impact on their lives
- theories of disease causation usually fall into one of these categories:
- natural diseases
- occult diseases
- behavioral diseases |
|
|
Term
| Spiritual and religious practices |
|
Definition
| In some cultures religion may take on a direct curative power |
|
|
Term
| SEC factors that affect community-based HC delivery |
|
Definition
- income level
- access to HC
- poverty
- immigration patterns |
|
|
Term
| SEC factors that affect community-based HC delivery - income levels |
|
Definition
Lower income:
- higher incidence of disability and chronic illness
- higher rates of infectious disease, probs w/substance abuse, rape and violence
Unemployment:
- inc cardiovascular and cerebrovascular mortality, cirrhosis mortality |
|
|
Term
| SEC factors that affect community-based HC delivery - access to HC |
|
Definition
HC not able to meet the consumer demands of special population and gen'l pop
- unemployment
- elderly may lack transpo or financial resources |
|
|
Term
| SEC factors that affect community-based HC delivery - immigration patterns |
|
Definition
| - immigration influences the incidence of communicable diseases |
|
|
Term
| Enviro factors that affect community-based HC delivery |
|
Definition
- overcrowding
- unsanitary conditions
- pollution
- reservoirs of infection
- homelessness
- home settings
- contaminated food
- waste disposal
- disaster planning |
|
|
Term
| Enviro factors that affect community-based HC delivery - overcrowding |
|
Definition
- it may contribute to exposure to communicable diseases in a pop w/a high incidence of these diseases and poor nutrition
Low SEC neighborhoods: prisons and homeless shelters contain carriers of comm diseases |
|
|
Term
| Enviro factors that affect community-based HC delivery - Unsanitary conditions |
|
Definition
| - poor sanitary conditions in poor populations can lead to health issues in the community |
|
|
Term
| Economic factors that affect community-based HC delivery - |
|
Definition
- income level
- access to HC
- poverty
- immigration patterns |
|
|
Term
| Family Enviro factors that affect community-based HC delivery - |
|
Definition
- family violence
- divorce
- family in crisis
- ineffective parenting skills |
|
|
Term
| Cultural influence factors that affect community-based HC delivery - |
|
Definition
- beliefs about community
- expectations of health and illness
- spiritual and religious practices |
|
|
Term
| Psychological factors that affect community-based HC delivery |
|
Definition
- chronic mental illness
- PTSD |
|
|
Term
| Physical factors that affect community-based HC delivery |
|
Definition
- geography, terrain
- location of health svcs
- workplace hazards |
|
|
Term
| Trends in community-based nursing |
|
Definition
The use of:
- UAPs
- ethnic healers/folk practitioners
- lay midwifes |
|
|
Term
| Ways to determine if a ct understands how to perform a skill by the following: |
|
Definition
- direct observation/demonstration
- adherence/compliance
- what's the ct's ability to perform the prescribed therapy
- what's his understanding of the regimen
- what's his willingness to participate in the therapy |
|
|
Term
| The impact of developmental level of the ct on the effective admin of meds: |
|
Definition
| - determine what's the developmental level of the ct before developing a teaching plan |
|
|
Term
| The nurse's role in assessment and teaching in the following areas for the maintenance of asepsis |
|
Definition
- communicable disease control interventions
- all teaching should take into consideration the ct's family SEC level and the availability of facilities to carry out any needed considerations
- adaptations for home care |
|
|
Term
| The nurse's role in assessment and teaching of Environmental modifications for safe home care |
|
Definition
| - environ issues for establishing safety and infection control in the home should be addressed in the POC (hygiene, physical barriers, etc) |
|
|
Term
| The leading health indicators in Healthy People 2010 |
|
Definition
- physical activity
- overweight and obesity
- tobacco use
- substance abuse
- responsible sexual behv
- mental health
- injury and violence
- enviro quality
- immunizations
- access to HC |
|
|
Term
| Health Promotion topics - infants |
|
Definition
- infant/parent attachment /bonding
- titfeeding
- sleep patterns
- playful activity to stimulate devp
- immunizations
- safety promo and injury control |
|
|
Term
| Health Promotion topics - children |
|
Definition
- nutrition
- dental checkups
- rest and exercise
- immunizations
- safety promo and injury control |
|
|
Term
| Health Promotion topics - adolescents |
|
Definition
- communicating w/the teen
- hormonal changes
- nutrition
- exercise and rest
- peer group influences
- self-concept and body image
- sexuality
- safety promo and accident prev |
|
|
Term
| Health Promotion topics - elders |
|
Definition
- adequate sleep
- appropriate use of alcohol
- dental/oral health
- drug mgmt
- exercise
- foot health
- health screening recommendations
- hearing aid use
- immunizations
- med instruction
- mental health
- nutrition
- physical fitness
- prev health svcs
- safety precautions
- smoking cessation
- wt control |
|
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Term
|
Definition
- Preexposure Stage
- factors present leading to prob devp
- exposure to agents
- Preclinical Stage
- exposure to causative agent: no symptoms present
- symptom devp leads to clinical stage |
|
|
Term
|
Definition
- Clinical Stage
- symptoms present |
|
|
Term
|
Definition
- Resolution Stage
- prob resolved
- return to health or chronic state or death |
|
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Term
|
Definition
| subpopulations within the larger population who possess some common characteristics, often r/t high risk for specific health pops |
|
|
Term
|
Definition
| one that is characterized by geographic and jurisdictional boundaries, such as a city |
|
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Term
|
Definition
| defined as the attainment of the greatest possible biologic, psychological, and social well-being of the pop as an entity and of its indv members |
|
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Term
|
Definition
| outcome of family structure |
|
|
Term
|
Definition
| the ability of the community to engage in effective problem solving |
|
|
Term
|
Definition
| the abilities, behvs, relationships, and values that enable indvs, groups, and orgs at any level of society to carry out tasks or functions and to achieve their devp objectives over time |
|
|
Term
|
Definition
| set standards for sanitations, biological products, lab techniques and procedures, mfg of drugs and research |
|
|
Term
| The community health nurse can assess a community's potential for probs by? |
|
Definition
| knowing the incidence and prevalence of family violence |
|
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Term
|
Definition
| Which attribute allows the community health nurse to influence the action of the local city commission leaders in taking an active role re the health of their community? |
|
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Term
| Functions of voluntary health agencies |
|
Definition
- supplementing the work of govt agencies
- pioneering-ways and means of doing new things
- education
- demonstration
- guarding the work of govt agencies
- advancing health legislation
- organizatins for communicable diseases |
|
|
Term
| The final function of the nurse as an advocate is to.... |
|
Definition
| prepare cts to speak for themselves. The nurse, alone, should not carry out the activities and functions of advocacy; this should be a collaborative effort between nurse and ct |
|
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Term
| Functions of a nurse within the context of community - advocate |
|
Definition
- assess the need for advocacy
- determine the appropriate avenue for advocacy
- gather facts r/t the situation
- present the ct's case to decision makers
- assist cts w/independence |
|
|
Term
| Functions of a nurse within the context of community - caregiver |
|
Definition
- assess health status
- generate nursing dx
- plan NIs
- implement the POC
- evaluate the outcome of the NIs |
|
|
Term
| Functions of a nurse within the context of community - educator |
|
Definition
- assess needs for education
- devp edu plan
- deliver health edu
- eval outcome of teaching/edu plan |
|
|
Term
| Functions of a nurse within the context of community - counselor |
|
Definition
- id and clarify prob to be solved
- assist ct in id any alternative solns
- assist ct in developing criteria for solns
- assist ct in eval alternative solns
- assist ct to eval outcome of solns
- educate ct n the prob solving process |
|
|
Term
| Functions of a nurse within the context of community - referral resource |
|
Definition
- gather info on community resources
- assess the need for and appropriateness of a referral
- make the referral
- follow up |
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|
Term
| Functions of a nurse within the context of community - role model |
|
Definition
| - perform the behv to be learned by ct or others |
|
|
Term
| Functions of a nurse within the context of community - primary care provider |
|
Definition
- assess health status and id probs
- plan and initiate interventions for probs
- intro other supportive svcs as indicated
- teach and supervise others
- coordinate HC svcs
- act as liaison between ct and system |
|
|
Term
| Functions of a nurse within the context of community - case mgr |
|
Definition
- id need for case mgmt
- assess and id ct health needs
- design POC to meet needs
- supervise implementation of care by others
- eval outcome of care |
|
|
Term
| PHC is incorporated into 5 major principles |
|
Definition
3 of the 5 are:
- appropriate technology
- equitable distribution
- multisectoral approach |
|
|
Term
| The PRECEDE component of the PRECEDE-PROCEED model of health promo |
|
Definition
- it reflects diagnostic activities that take place prior to planning health promotion activities
- at the indv level, it determines the factors or enviro conditions than would need to be changed for you to engage in this health-related behv |
|
|
Term
| Precaution Adoption Process model |
|
Definition
stage 1 - unaware of issue
stage 2 - unengaged by issue
stage 3 - undecided about acting
stage 4 - decided not to act
stage 5 - decided to act
stage 6 - acting
stage 7 - maintenance |
|
|
Term
| Precaution Adoption Process Model |
|
Definition
- it attempts to explain how a person comes to decisions to take action and how he or she translates that decision into action.
- Adoption of a new precaution or cessation of a risky behavior requires deliberate steps unlikely to occur outside of conscious awareness. |
|
|
Term
| The PRECEDE-PROCEED model |
|
Definition
| it is a comprehensive structure for assessing health needs for designing, implementing, and evaluating health promotion and other public health programs to meet those needs. |
|
|
Term
|
Definition
- Predisposing, Reinforcing, and Enabling Constructs in Educational Diagnosis and Evaluation
- it provides the structure for planning a targeted and focused public health program |
|
|
Term
|
Definition
- social assessment
- epidemiological assessment
- ecological assessment
- match appropriate interventions
- implementation |
|
|
Term
|
Definition
-
- Policy, Regulatory, and Organizational Constructs in Educational and Environmental Development
- provides the structure for implementing and evaluating the public health program. |
|
|
Term
|
Definition
- implementation
- process eval
- impact eval
- outcome eval |
|
|
Term
| Sources of community info |
|
Definition
- Teachers and school nurses: provide information about the incidence of children's health problems and information on facilities and services to maintain and promote health.
- The chamber of commerce can supply: statistics about employment, major industries, and primary occupations.
- Public and university libraries: contain district social and cultural research reports.
- recreational directors provide information about programs and participation levels. |
|
|
Term
| those that represent the cause of two-thirds of the deaths in the United States: |
|
Definition
- cancer
- diabetes
- stroke
- heart disease |
|
|
Term
|
Definition
| _______ follows several months after the first ejaculation |
|
|
Term
| Advantages of home visits |
|
Definition
- convenience
- access
- info
- relationship
- cost
- outcomes |
|
|
Term
| Advantages of home visits - convenience |
|
Definition
- cts often prefer to ne seen in their homes
- reduced transpo costs
- no waiting for svcs |
|
|
Term
| Advantages of home visits - access |
|
Definition
- cts may be immobile or lack transpo
- CH nurse has access to cts that may not necessarily present themselves for svcs in other settings
- a home visit permits the nurse to id cts in need of svcs |
|
|
Term
| Advantages of home visits - info |
|
Definition
- the home visit permits the nurse to obtain info not readily available in other settings
- valuable info is obtained about family dynamics, physical enviro, psychological and sociocultural factors present that may have a bearing on the ct's health status |
|
|
Term
| Advantages of home visits - relationship |
|
Definition
- in the home setting, the ct exerts autonomy and control
- the nurse may foster a sense of empowerment
- it permits a sense of privacy
- cts may offer more info especially about sensitive issues
- the home visit fosters a sense of continuity in the nurse-ct relationship, especially if there are repeated visits, or a long-term purpose for the visit |
|
|
Term
| Advantages of home visits - cost |
|
Definition
| - home visits and home care are less expensive than hospital care or LTC |
|
|
Term
| Advantages of home visits - outcomes |
|
Definition
| - home visitation progs have been documented to achieve a variety of health related outcomes for many different populations |
|
|
Term
| Challenges of home visiting programs |
|
Definition
- ct diversity
- multiplicity of ct probs |
|
|
Term
| Need for Balance between Opposing Agendas in home care |
|
Definition
- intimacy and pro distance
- dependence and independence
- risk and safety
- cost containment and quality
- health restoration and health promo svcs
- task orientation and meeting ct needs |
|
|
Term
| Agendas that need to be balanced in home health care |
|
Definition
- task accomplishment vs addressing unique needs
- distance vs cost containment
- devaluing
- independence vs dependence
- realism
- inadequacy
- safety vs risk
- quality
- promotion
vs.
- assisting
- restoration
- altruism
- creativity
-intimacy
- assisting
- |
|
|
Term
| Purpose of Home Visiting Programs |
|
Definition
- Four categories
- case finding and referral
- health promo and illness prevention
- care of the sick
- care of the dying |
|
|
Term
| Purpose of Home Visiting Programs - case finding and referral |
|
Definition
- id cts needing addl svcs
- provide referrals to appropriate sources of svcs
- eg, lead abatement program |
|
|
Term
| Purpose of Home Visiting Programs - Health Promo and illness prevention |
|
Definition
- focuses on specific pops
- eg. new mothers, children needing child developmental interventions |
|
|
Term
| Purpose of Home Visiting Programs - care of the sick |
|
Definition
- providing direct svcs
- eg. elderly, pops w/chronic conditions, recent hospital discharges
, |
|
|
Term
| Purpose of Home Visiting Programs - care of the dying |
|
Definition
- specialized svcs to people w/terminal illness
- palliative care
- edu and info for family members
- caregiver respite svcs
- physical therapy
- counseling and spiritual care
- assistance with specialized equip needs |
|
|
Term
|
Definition
- review previous interventions
- prioritize ct needs
- develop goals and objectives
- consider acceptance and timing
- delineate nursing activities
- obtain necessary materials
- plan for eval |
|
|
Term
| Planning a home visit - review previous interventions |
|
Definition
- determine the efficacy of the interventions
- id successful and unsuccessful interventions |
|
|
Term
| Planning a home visit - prioritize ct needs |
|
Definition
- potential threat to their health
- degree to which the health threat concerns the ct
- the ability to resolve the health issue |
|
|
Term
| Planning a home visit - consider acceptance and timing |
|
Definition
- ct's readiness to accept intervention
- build rapport and trust
- timing of the visit
- ct must be open to the visit
- intro of the interventions |
|
|
Term
| Planning a home visit - delineate nursing activities |
|
Definition
- nursing dx utilizes:
- practice guidelines
- agency procedures/protocols
- clinical pathways
- eg, health promo, referral, edu, technical procedures |
|
|
Term
| Planning a home visit - obtain necessary materials |
|
Definition
- supplies and materials for home visit
- edu materials
- HC equip
- wound care supplies
- physical assessment equip |
|
|
Term
| Planning a home visit - eval planning |
|
Definition
- eval criteria obtained from outcome objectives
- LT eval criteria
- ct's receptiveness or response to nursing interventions
- ST eval criteria
- actual accomplishment of objective |
|
|
Term
| Planning a home visit - implementation |
|
Definition
- validate assessment and dx
- id addl needs
- modify the plan of care as needed
- perform NIs
- deal w/distractions |
|
|
Term
|
Definition
- enviro
- behv
- nurse-initiated |
|
|
Term
|
Definition
- background noise
- crowded surroundings
- interruptions |
|
|
Term
|
Definition
- ct behvs
- explore reasons for behvs
- work to establish trust |
|
|
Term
| Distractions - nurse initiated |
|
Definition
- fears
- bodily harm
- ct rejection
- lack of control
- role preoccupation
- personal reactions to different lifestyles |
|
|
Term
| HH visits - eval criteria |
|
Definition
- intervention outcomes not immediately apparent
- need to determine if subsequent visits are needed
- need to eval if appropriate level of prevention was implemented |
|
|
Term
|
Definition
| a subspecialty of CH nursing |
|
|
Term
|
Definition
- specialized practice w/roots in community health nursing
- holism
- care mgmt
- resource coord
- collaboration
- autonomous and interdependent practice |
|
|
Term
|
Definition
- 16.4 per 10,000 people < 65
- 277 per 10,000 people > 65 |
|
|
Term
|
Definition
Services provided
- 75% nursing
- 44% personal care
- 27% PT
- 8% OT
- 4% dietary/nutritional svcs
- 1.2% respite care
- |
|
|
Term
| HH nursing - collaboration |
|
Definition
- certified by primary care provider
- essential for holistic care
- used to obtain durable medical equip
- provide referral to addl svcs |
|
|
Term
| HH nursing - reimbursement |
|
Definition
- contingent on provider certification of need
- self referral
- ct pays out of pocket if not certified |
|
|
Term
| HH nursing - funding sources |
|
Definition
- out of pocket
- medicare
- Medicaid
- private ins |
|
|
Term
| Eval criteria for HH funding |
|
Definition
- types of reports
- OASIS system
- Outcome-Based Quality Monitoring report
- " Improvement
- Case mix report |
|
|
Term
| Addl Eval criteria for HH funding |
|
Definition
- Health Plan Employer Data and Info Set
- rates managed care orgs
- provides purchasers with/info needed to select a HC plan |
|
|
Term
| Ct Satisfaction Evaluation Criteria |
|
Definition
- indicators of good quality and poor quality care
- ability to maintain independence and preserve dignity
- dec emotional stress
- provide social support
- facilitate learning new skills
- assist w/navigating through complex HC systems |
|
|
Term
| Impact of schools on health |
|
Definition
- 45 mil children attend schools in the US
- impact of health on learning |
|
|
Term
|
Definition
- strategies, activities, and services provided by schools
- promotes students' physical, emotional, and social devp |
|
|
Term
| Goals of school health program |
|
Definition
- ensure that children reach their full academic and health potential through:
- health promo
- protection
- surveillance activities |
|
|
Term
| Components of school health program |
|
Definition
- health svcs
- health edu
- healthy enviro
- staff health promo
- parent and community involvement |
|
|
Term
| Components of school health program - Health SVCs Activities |
|
Definition
- assessment and screening
- case finding
- counseling
- health promo and illness prevention
- case mgmt
- remedial or rehab svcs
- specific nursing procedures
- emergency care |
|
|
Term
| Components of school health program - health edu |
|
Definition
- health awareness and healthful behvs
- uses both cog and affective learning |
|
|
Term
| Components of school health program - enviro component |
|
Definition
- physical edu
- counseling, psychological, and social svcs
- nutritional svcs |
|
|
Term
| Components of school health program - employee health component |
|
Definition
- reduces stress and absenteeism
- role-model healthy behvs |
|
|
Term
| Components of school health program - partnership components |
|
Definition
- school
- family
- community |
|
|
Term
| Assessment of school health factors - |
|
Definition
- biophysical
- psychological
- physical enviro
- sociocultural
- behv
- health system |
|
|
Term
| Assessment of school health factors - biophysical considerations |
|
Definition
- age and maturation
- genetics
- physiologic function |
|
|
Term
| Assessment of school health factors - psychological considerations |
|
Definition
- student and staff relationships
- school and family relationships
- teacher discipline presence |
|
|
Term
| Assessment of school health factors - physical enviro considerations |
|
Definition
- school building age and hazards
- proximity of school to community
- potential for spread of disease
- disaster preparedness |
|
|
Term
| Assessment of school health factors - sociocultural considerations |
|
Definition
- culture and ethnicity
- economic resources
- legislation
- abuse and violence
- terrorism potential |
|
|
Term
| Assessment of school health factors - behavioral considerations |
|
Definition
- school attendance
- physical and recreational activities
- diet and nutrition
- home and school lunch quality
- substance abuse and use
- safety practices
- gambling habits of adols |
|
|
Term
| Assessment of school health factors - health system considerations |
|
Definition
- assessment at indv and community level
- availability of health and mental health svcs
- relationship between school and community
- structure for delivering health svcs |
|
|
Term
| Assessment of school health factors - primary interventions |
|
Definition
- immunization
- safety and injury/violence prevention
- exclusion from school
- health edu
- diet and nutrition
- exercise and physical activity
- illness prevention |
|
|
Term
| Assessment of school health factors - secondary interventions |
|
Definition
- screening
- referral
- counseling
- txt |
|
|
Term
| Assessment of school health factors - secondary interventions - screening |
|
Definition
- goal is to detect disease and special needs
- types of screening svcs |
|
|
Term
| Assessment of school health factors - secondary interventions - referral |
|
Definition
| - interpret data from screening and discuss w/parents |
|
|
Term
| Assessment of school health factors - secondary interventions - counseling |
|
Definition
| - assist in making informed health decisions |
|
|
Term
| Assessment of school health factors - secondary interventions - txt |
|
Definition
- emergency care
- medical mgmt
- special procedures |
|
|
Term
| Assessment of school health factors - tertiary prevention |
|
Definition
- prevent recurrence of acute probs
- prevent complications
- foster adjustment to chronic illness and handicapping conditions
- address learning disabilities
- sustain school-based health svcs |
|
|
Term
| Care of cts in official and voluntary health agencies - legal and regulatory parameters |
|
Definition
- fed and state legislative mandates for protecting public health
- local ordinances
- other fed, state, or local health initiatives that address core public health functions
- |
|
|
Term
| official and Voluntary health agencies - core functions |
|
Definition
- assessments
- policy devp
- assurance |
|
|
Term
| official and Voluntary health agencies - assessment |
|
Definition
- monitor health status
- regularly collect health-related info through ongoing surveillance, assemble, analyze, and make available info on the health of the community
- monitor health status
- dx and investigate health probs |
|
|
Term
| official and Voluntary health agencies - policy devp |
|
Definition
- encourage the devp of local, state, and nat'l policies conducive to pop health through political action and planning
- inform, educate, and empower people
- mobilize community partnerships
- devp policies and plans |
|
|
Term
| official and Voluntary health agencies - assurance function |
|
Definition
- assure the availability of and access to HC svcs essential to the pop
- enforce laws and regs
- link people to needed personal health svcs
- ensure a competent public health workforce
- eval the effectiveness, accessibility, and quality of svcs
- research new insights and innovative solns |
|
|
Term
| official and Voluntary health agencies - basic obligation |
|
Definition
- prevent epidemics/spread of disease
- protect the public against enviro hazards
- prevent injury
- promote healthy behvs and mental health
- respond to disasters and help communities recover from their effects
- ensure quality and accessibility of health svcs |
|
|
Term
|
Definition
- an RN who meets requirements for aggregate practice
- educational prep may require
- BS
- supervised clinical experience |
|
|
Term
| Public health nurse - specific knowledge/competency |
|
Definition
- physical, mental, and devp assessment
- surveillance and epidemiology
- health promo, disease prev, health edu
- multicultural HC
- research methodology and statistics
- pop-based practice
- legal and fin svcs
- family violence
- case mgmt
- emergency preparedness and response |
|
|
Term
| Public health nurse - core competencies |
|
Definition
- research and analysis skills
- communication skills r/t presentation, advocacy, and leadership
- policy devp and program planning skills
- skills derived from basic public health sciences
- cultural skills
- fin planning and fin mgmt skills
- teaching skills |
|
|
Term
| Community Nursing Outcomes |
|
Definition
community:
- competency
- health status
- health: immunity
- risk control:
- chronic disease
- comm disease
- lead exposure |
|
|
Term
| Public Health Nursing Roles - three core functions |
|
Definition
- correlate to the three core functions
- assessment
- policy devp
- assurance |
|
|
Term
| Public Health Nursing Roles - three core functions: assessment-monitor and dx |
|
Definition
- conduct community assessments
- collect data
- id community assets and needs
- id factors that contribute to comm health probs |
|
|
Term
| Public Health Nursing Roles - three core functions: Policy devp-inform, educate, and empower |
|
Definition
- plan and implement health edu progs
- devp and disseminate health-related msgs
- assist with community organization and empowerment |
|
|
Term
| Public Health Nursing Roles - three core functions: policy devp-mobilize community partnerships |
|
Definition
- id key community members
- assist comm members to articulate needs and plan to address them
- id potential coalition members |
|
|
Term
| Public Health Nursing Roles - three core functions: policy devp- devp policy and plans |
|
Definition
- participate in comm health prog planning
- advocate for relevant HC progs
- advocate for involvement of community members in health prog planning, implementation, and eval |
|
|
Term
| Public Health Nursing Roles - three core functions: assurance - enforce laws and regs |
|
Definition
- id violations of health-related regs and inform authorities
- educate the public re health-related regs |
|
|
Term
| Public Health Nursing Roles - three core functions: assurance - link people to svcs |
|
Definition
- make referrals for HC svcs
- provide direct HC svcs |
|
|
Term
| Public Health Nursing Roles - three core functions: assurance - assure competent public health workforce |
|
Definition
| - assist in the edu of comm health nurses and other HC pros |
|
|
Term
| Public Health Nursing Roles - three core functions: assurance - evaluate effectiveness, accessibility, and quality of health svcs |
|
Definition
- participate in the planning and conduct of prog evals to determine effectiveness, accessibility, and quality of svcs
- use evaluative data to improve HC delivey |
|
|
Term
| Public Health Nursing Roles - three core functions: assurance - research |
|
Definition
- id relevant research questions and participate in designing and conducting studies to answer them
- test innovative practice models and delivery systems |
|
|
Term
| Philosophy of faith-based nursing |
|
Definition
- emphasize spiritual dimensions as well as other dimensions
- integrate science and tech
- combine svcs w/worship
- combine nursing w/pastoral care
- facilitate involvement of faith community in health and healing
- spiritual health is central to well-being
- may coexist w/illness
- healing may occur in absence of care |
|
|
Term
| Standards of professional nursing practice |
|
Definition
- quality of care
- performance appraisal
- edu for competent practice
- collegiality
- ethics
- collaboration
- research
- resource utilization |
|
|
Term
|
Definition
- reflect nursing process
- assessment
- dx
- outcome id
- planning
- implementation
- eval |
|
|
Term
| Financial arrangement models |
|
Definition
- volunteer nurses
- results in LT commitment
- nurse is a known and trusted member
- paid employee |
|
|
Term
| Svc focused models for faith-based nursing |
|
Definition
- mission-ministry model
- reconciliation, health, healing, wholeness, discipleship focus
- marketplace model
- HC agency provides svcs
- service providers may or may not be members of a congregation
- access model
- political in nature
- focus on advocacy for underserved pops
- nurse is catalyst and social change agent |
|
|
Term
| Roles and functions of faith-based community nurses |
|
Definition
- health educator
- personal health counselor
- referral agent
- coordinator of volunteers
- developer of support groups
- integrator of faith and health
- health advocate
- basic physiologic care
- behv care
- safety
- family care
- health system-related care
- community care |
|
|
Term
| Roles and functions of faith-based community nurses - unique roles |
|
Definition
- pop served
- collaborative relationship w/God
- relationship w/indvs in faith community
- emphasis on working w/volunteers
- important role in EOL care
- grant writing emphasis |
|
|
Term
|
Definition
- appropriate forms of touch can communicate caring
- an opening posture indicates openness to communication
- a closed posture indicates resistance to communication
- a nurse's facial expression should communicate warmth and caring
- personal space influences communication in social and pro interactions. Encroachment into another's personal space creates tension
- the nurse conveys attentive listening through a posture of involvement |
|
|
Term
|
Definition
- learning is facilitated when the ct is interested and actively involved
- teaching materials and strategies should be suited to the ct's age and learning abilities
- teaching activities may need to include hands-on ct participation |
|
|
Term
|
Definition
- defined as having an income below 50% of the area median income
- being involuntarily displaced from housing
- paying more than half of one's income for rent and utilities
- living in substandard housing |
|
|
Term
|
Definition
| - refers to a lack of hospitalization of persons w/mental probs who are in need of care |
|
|
Term
|
Definition
| - a stmt providing evidence of the need for home health svcs in that area that are not being met by existing agencies |
|
|
Term
|
Definition
The links in the chain are:
- the infected person or source of the infectious agent
- the reservoir
- the agent itself
- the mode of xmission of the disease
- the agent's portals of entry and exit
- a susceptible new host |
|
|
Term
| Roles of the nurse in the community |
|
Definition
- ct advocate
- provider of care
- teacher
- referral source
- cse mgr |
|
|
Term
| Roles of the nurse in the community - ct advocate |
|
Definition
| - advocate for recreational facilities and activities for teens |
|
|
Term
| Roles of the nurse in the community - provider of care |
|
Definition
| - devlps protocols for TB txt svcs |
|
|
Term
| Roles of the nurse in the community - teacher |
|
Definition
| - work w/school and police officials to devp an antidrug edu prog in local schools |
|
|
Term
| Roles of the nurse in the community - referral source |
|
Definition
| - establish criteria for social svcs referrals |
|
|
Term
| Roles of the nurse in the community - case mgr |
|
Definition
| - devp a program for pregnant adols |
|
|
Term
| Methods of assess for the community health nurse |
|
Definition
- he may use assessment of the community to id appropriate sources and determine available and accessible community resources for referral
- info on the health status of the indv or family may also be obtained from a family record, referring agencies, or interviews |
|
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Term
| community health nurse - review lab data |
|
Definition
| - based on what info the nurse has , he may anticipate what is indicated and make an attempt to retrieve med records or questions the ct re any lab data he may have |
|
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Term
|
Definition
- 12 million annually
- 86% 15-29 yr olds
- 40% 20-24 yr olds
- 25% 15-19 yr olds
- primary and secondary syphilis has dec
- Hep B and C have dec
- HIV and AIDs is major component in STDs |
|
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Term
|
Definition
- they have inc in children in the US
- adult rate is lower than children
- many adults and adols are at risk for varicella |
|
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Term
|
Definition
- child abuse has inc to 3.1 million in 1995, with a 48% inc in fatality rate
- 1.5 million women and 834,000 men are raped or physically assaulted by an intimate partner
- 4-10% of elderly > 65 are abused : half by children or grandchildren, 40% by spouses
- 15-25 yr olds have the highest rate of homicide. Men are 9x more likely than women to commit homicides and to be victims |
|
|
Term
| Nursing Dx relating specifically to community/family needs include: |
|
Definition
- post traumatic stress response r/t a house fire
- risk for violence r/t sudden loss of income
- health seeking behvs r/t concern about enviro conditions
- self care deficit r/t impaired cog ability
- knowledge deficit r/t safe care and prevention of disease |
|
|
Term
|
Definition
-based on:
- a ct's devp level
- access to HC
- use of resources
- reimbursement procedures and acuity |
|
|
Term
Expected outcomes (NOC) for care r/t health promo, health maint, and health restoration:
EO: ct will integrate the experience of a house fire in a meaningful way and move on to pursue life goals |
|
Definition
| EO for DX: post traumatic stress response r/t house fire |
|
|
Term
| Expected outcomes (NOC) for care r/t health promo, health maint, and health restoration: EO: family will report involvement in a domestic support group |
|
Definition
| EO for DX: risk for violence r/t sudden loss of income |
|
|
Term
| Expected outcomes (NOC) for care r/t health promo, health maint, and health restoration: EO: group will demonstrate ways to modify the enviro |
|
Definition
| EO for DX: health seeking behvs r/t concern about enviro conditions |
|
|
Term
| Expected outcomes (NOC) for care r/t health promo, health maint, and health restoration: EO: family will report use of day care ctr for member w/alzheimers |
|
Definition
| EO for DX: self-care deficit r/t impaired cog ability |
|
|
Term
| Expected outcomes (NOC) for care r/t health promo, health maint, and health restoration: EO: Family will establish safe hygiene routine to care for a child who has been injured. Family will follow immunization schedule for infant follow-up |
|
Definition
| EO for DX: knowledge deficit r/t safe care and prevention of disease |
|
|
Term
| Standards of Professional Performance |
|
Definition
- quality of care
- performance appraisal
- education
- collegiality
- ethics
- collaboration
- research
- resource utilization |
|
|
Term
|
Definition
- Indv focused: preschool therapy to a ct of a depressed parent
- Community focused: advocate for rec facilities and activities for teenagers
- System focused: advocate for svcs for substance abusing adols |
|
|
Term
|
Definition
- Indv focused: arrange home care for an elderly ct
- Community focused: devp a plan for pregnant adols
- System focused: devp case mgmt standards for local govt agencies |
|
|
Term
|
Definition
- Indv focused: devp family coalition to intervene with substance abusing family member
- Community focused: encourage a coalition of police, school and health facilities to address gang violence
- System focused: assist with building a coalition to promote enforcement of local laws against tobacco sales to minors |
|
|
Term
|
Definition
- Indv focused: work w/church to provide transportation for ct
- Community focused: collaborate w/local churches to provide need for the homeless
- System focused: collaborate with county programs in the devp of a single app process to access assistance |
|
|
Term
| NI - community organizing |
|
Definition
- Indv focused: n/a
- Community focused: organize community to request fee discounts from local HC providers
- System focused: devp groups to facilitate community org w/several communities |
|
|
Term
|
Definition
- Indv focused: assist family to devp appropriate nutritional diet
- Community focused: assist local schools in devp school nutrition progs
- System focused: provide info to state legis on health related issues |
|
|
Term
|
Definition
- Indv focused: help a preg woman find prenatal care options
- Community focused: assist schools in devp counseling progs for eating disorders
- System focused: participate in political activity to mandate ins coverage for counseling svcs |
|
|
Term
|
Definition
- Indv focused: observe ct on therapy for TB
- Community focused: devp protocols for TB txt svcs
- System focused: devp policies for TB txt in local correctional facilities |
|
|
Term
| NI - disease investigation |
|
Definition
- Indv focused: id the source of infection of a ct w/TB
- Community focused: advise nursing home personnel in influenza prev interventions
- System focused: assist in devp computer based comm disease notification system w/local HC providers |
|
|
Term
|
Definition
- Indv focused: teach a new mother about appropriate devp milestones
- Community focused: work w/school and police officials to devp an antidrug edu prog in local schools
- System focused: devp a local website to address health issues, questions, and resources |
|
|
Term
| NI - outreach case/finding |
|
Definition
- Indv focused: id a pregnant woman w/HTN through a home visit
- Community focused: institute a referral system for school nurses who id pregnant mothers of students
- System focused: devp notification system for immunizations |
|
|
Term
|
Definition
- Indv focused: promote multilingual provider employment in area health agencies
- Community focused: participate in policy devp in relation to dispensing meds in schools
- System focused: engage in agency policy eval and revision as indicated by the community |
|
|
Term
|
Definition
- Indv focused: offer info on txt guidelines to providers
- Community focused: provide immunization requirements and updates to school nurses
- System focused: promote agency policy on continued edu for employees |
|
|
Term
|
Definition
- Indv focused: refer a family who needs fin assistance
- Community focused: establish criteria for social svc referrals
- System focused: devp a community referral network for prenatal care |
|
|
Term
|
Definition
- Indv focused: screen an id pop for STDs
- Community focused: arrange a community screening prog for HTN
- System focused: devp systems for community screening, followup and txt for HIV |
|
|
Term
|
Definition
- Indv focused: distribute health info in local schools
- Community focused: devp a teen theatre campaign to address issues of conflict resolution
- System focused: write a grant to fund a media campaign to support smoke free public areas |
|
|
Term
|
Definition
- Indv focused: follow up on families exposed to TB
- Community focused: collect data on family violence
- System focused: generate data systems to incorporate info on disease prevalence from private providers |
|
|
Term
| NIs that are effective in establishing a collaborative relationship w/the ct |
|
Definition
- therapeutic comm skills to id cultural and indv differences and to establish expectations of care w/the ct
- |
|
|
Term
| NI: observe home enviro for hazards |
|
Definition
DX: post-traumatic stress response r/t a house fire
EO: ct will integrate the experience of a house fire in a meaningful way and move on to pursue life goals
NI: ? |
|
|
Term
NI: - assess family's ability to access community resources
- refer a person who has been abused to a domestic violence ctr |
|
Definition
DX: risk for violence r/t sudden loss of income
EO: family will report involvement in a domestic support group
NI: ? |
|
|
Term
NIs: - discuss the spread of infection
- emphasize preventative interventions to prevent spread of infections
- assess hand-washing behv of children in the 1st grade classroom
- modify hand-washing techniques in the home
- instruct family re hazards of stray animals |
|
Definition
DX: health seeking behvs r/t concern about enviro conditions
EO: group will demonstrate ways to modify the enviro
NI: ? |
|
|
Term
NIs: - assess availability of svcs for cts w/alzheimers in a given geographic area
- teach older adults at the community ctr about the risk of falls
- assist family in selecting adult day care for the ct w/cog loss
- ensure safe mobility pattern of ct w/sensory deficits who is homebound |
|
Definition
DX: self care deficit r/t impaired cog ability
EO: family will report use of day care ctr for member w/alzheimers
NI: ? |
|
|
Term
NI: - teach proper hand washing techniques to all family members
- teach proper schedule and importance of regular immunizations |
|
Definition
DX: knowledge deficit r/t safe care and prev of disease
EO: family will establish safe hygiene routine to care for a child who has been injured. Family will follow immune schedule for infant follow-up
NI: ? |
|
|
Term
| Nursing measures to promote continuity of care |
|
Definition
- teaching/health edu
- referrals
- support groups
- community resources
- safe sex practices for sexually active groups |
|
|
Term
| Eval: assess the ct's response to nursing care including progress towards the EOs |
|
Definition
- determine the ct's response to the ongoing home care or community need
- record and report the ct's response to nursing actions
- determine the ct's response to care provided by other members of the HC team |
|
|
Term
| Child Immunization Schedule |
|
Definition
DTP - 2,4,6,18 months, school entry
Td - >7; adults; booster every 10yrs
IPV - 2 and 4 mos, 6-18 mos and 4-6 yrs old, immunocompromised children |
|
|
Term
| Child Immunization Schedule |
|
Definition
MMR - 12-15 mos, booster at school entry, not to preg women but may be admin to a child if mother is preg
HiB: 2,4,6 mos; booster at 15 mos
HBV: birth, 1 mos, 6 mos, HC workers, prostitutes, multiple sex partners, IV drug users |
|
|
Term
| Child Immunization Schedule |
|
Definition
Influenza vaccine: annually and those w/debilitating illness. Children 6 mos and older w/risk factors including, but not limited to: asthma, cardiac disease, HIV, sickle cell, diabetes
Pneumococcal vaccine: all children 2-23 mos, given at 2, 4, and 6 mos w/4th dose at 12 mos. Also for children 24-59 mos w/conditions such as cardiac disease, pulmonary disease, immunodeficiency, diabetes, renal failure, leukemia, and malignancies. also, children 24-59 mos who attend day care
Pneumonia vaccine: persons >65 and those w/debilitating illness |
|
|
Term
|
Definition
- completion of primary series of diphtheria and tetanus w/boosters every 10 yrs
- pneumococcal pneumonia vaccine for those w/pre-existing respiratory conditions and 65 yrs and older
- Hep B, measles, mumps, rubella, and varicella for those w/no acquired immunity. Indvs born before 1956 are expected to have immunity against MMR
- influenza yearly, as indicated for high risk groups; children and the elderly |
|
|
Term
|
Definition
| Normally occurring events in life caused by the person's continual growth and development |
|
|
Term
|
Definition
| unexpected events -job loss or death- that disrupt the biopsychosocial balance |
|
|
Term
| Social or adventitious crisis |
|
Definition
| major cataclysmic disasters -ex earthquake, flood, war- that cause a massive upheaval of social and personal order |
|
|
Term
|
Definition
| A S&S in children who suffer from lead poisoning |
|
|
Term
|
Definition
| Which statistical rate is calculated by dividing the number of new cases occurring during a given year by the population at risk during the same time period and multiplying by 1000 |
|
|
Term
|
Definition
| Which indicator would the nurse choose as a reflection of a particular condition in a specific community or group |
|
|
Term
| Aid people w/fin assistance for HC needs |
|
Definition
| What is the primary purpose of Medicaid? |
|
|
Term
|
Definition
- sets standards for:
- sanitations
- biological products
- lab techniques and procedures
- manufacture of drugs and research |
|
|
Term
| Knowing the incidence and prevalence of family violence |
|
Definition
| The CH nurse can assess a community's potential for probs by.... |
|
|
Term
|
Definition
- gaps in public policy
- staffing
- funding and standards |
|
|
Term
|
Definition
| Giving a pt a backrub to help alleviate discomfort is an eg of which theory |
|
|
Term
|
Definition
| Recommendations for immunizations for all adult>65 do not include... |
|
|
Term
| "Most teens have questions re sex. What questions do you have?" |
|
Definition
| One of the best approaches for a nurse to obtain info about the sexual practices of a teen during an interview is.... |
|
|
Term
|
Definition
| Individuals born before 1957 are expected to have immunity against.... |
|
|
Term
|
Definition
| A test used to assess balance |
|
|
Term
| Otitis Media w/Ruptured Membrane |
|
Definition
| An disorder associated with conductive hearing loss |
|
|
Term
|
Definition
| During a Weber test, if a pt has hearing loss due to bone conduction in the right ear, then he would indicate that the sound heard in the left ear was.... |
|
|
Term
| Check the position of the ear mold in the ear |
|
Definition
| The nurse teaches the caregiver of a pt newly fitted with a hearing aid to... |
|
|
Term
|
Definition
| During the Weber test, if the pt has hearing loss due to sensorineural disturbance in the right ear, the pt would indicate that the sound heard in the left ear would be.... |
|
|
Term
| Prevent loss of peripheral vision |
|
Definition
| The reason for being adherent to the med schedule for eye meds in a pt w/glaucoma is... |
|
|
Term
| Contact injury w/no laceration |
|
Definition
| Cold compresses would be applied to which eye condition? |
|
|
Term
|
Definition
| The role of endorphins in the body is to? |
|
|
Term
|
Definition
| The nurse refers a malnourished older pt to a senior center for the lunchtime meal. The nurse is performing which role w/this action? |
|
|
Term
| Pt's diary shows pain-free lengths of time during the day |
|
Definition
| What outcome would the nurse use to assess a family's ability to manage pt pain at home? |
|
|
Term
| The pt speaks slowly, in a monotone voice |
|
Definition
| What eval by the nurse for a pt w/a nursing dx of Alteration in Comfort (Pain) indicates the need for revision of the care plan for this pt? |
|
|
Term
| Pt states, "I sleep during the entire night". |
|
Definition
| A goal oe expected outcome for the chronic pain pt w/a good pain mgmt program would be? |
|
|
Term
| The nurse can include this info in the care plan |
|
Definition
| What is one of the best reasons for the nurse to know about the culture and religion of pts? |
|
|
Term
| Arrange for the pt to get medicated at school |
|
Definition
| The nurse is reassessing med intervention on a teenager who is non-adherent w/tuberculosis drugs. The most appropriate NI would be to? |
|
|
Term
|
Definition
| The action of sleep meds which include sedative-hypnotics and anti-anxiety drugs is a result of? |
|
|
Term
| Drainage in the outer ear |
|
Definition
| A child has been pulling at her ear and crying. The nurse assesses the child for? |
|
|
Term
| Retract the auricle upward to loosen the cerumen |
|
Definition
| What should the nurse do when caring for a pt's ear? |
|
|
Term
| Risk for injury r/t GI bleeding |
|
Definition
| A potential dx for the pt taking NSAIDS |
|
|
Term
|
Definition
| A blood lead level in a child that indicates the need for chelation therapy? |
|
|
Term
|
Definition
| The nurse would expect to see which finding in a pt who has glaucoma and is taking a beta-adrenergic blocker? |
|
|
Term
| Pull the ear down and back |
|
Definition
| The appropriate method of admin eardrops to infants is to? |
|
|
Term
|
Definition
| The main goal of a state program for children who are devp delayed would be to provide? |
|
|
Term
|
Definition
| The reaction that the nurse expects to assess when admin a miotic drug is? |
|
|
Term
|
Definition
| Eye meds that permit aqueous humor to flow? |
|
|
Term
|
Definition
| Urea and mannitol, often prescribed in the txt of glaucoma, are? |
|
|
Term
|
Definition
| Prednisone and dexamethasone are Examples of _______ _______ eye meds |
|
|
Term
|
Definition
| The txt goal of a pt w/open-angle glaucoma is? |
|
|
Term
|
Definition
| Which dx test is a vibrating tuning fork shifted between the mastoid bone and an area 2" from the ear canal opening... |
|
|
Term
|
Definition
| What part of the ear is assessed for auditory acuity and balance? |
|
|
Term
|
Definition
| Which test is used to assess balance? |
|
|
Term
|
Definition
| Involuntary rhythmic oscillation of the eyes, which is often indicative of a hearing disorder, is called? |
|
|
Term
|
Definition
| The appropriate method of admin eardrops to adults is? |
|
|
Term
| Lateral with the right ear up |
|
Definition
| Postoperative positioning for a pt who has surgery on the left ear is? |
|
|
Term
|
Definition
| The major purpose of a hearing aid is to? |
|
|
Term
|
Definition
| What do you use to clean the cannula of a hearing aid? |
|
|
Term
| Obtain reading material w/large print |
|
Definition
| When caring for a pt w/a visual impairment in a HC setting, the nurse should..... |
|
|
Term
|
Definition
| Many types of communication can ease a pt's uneasiness and discomfort. Which type has 5 actions associated with it? |
|
|
Term
|
Definition
- taking on civic responsibility
- getting started on an occupation
- managing a home
These are Havighurst's devp tasks for what age period? |
|
|
Term
| Ego transcendence vs ego preoccupation |
|
Definition
| A ct who has a terminal diagnosis has been using her time to help family members deal w/her impending death. According to Peck, this ct is working through which devp task? |
|
|
Term
|
Definition
| Is weakened hip and knee joints a primary or secondary change of aging? |
|
|
Term
| Older adults have more than one chronic illness |
|
Definition
| The risk for abuse of an elderly family member is greatest when.... |
|
|
Term
|
Definition
| Older adults consume _____ _______ drugs than younger adults |
|
|
Term
| "What news item did you hear about today?" |
|
Definition
| What is a good question to ask an older adult when assessing short-term memory? |
|
|
Term
| Kohlberg's postconventional level |
|
Definition
| What Kohlberg level is a ct in when she makes the following statement? "Work is fine, but my family and friends are so much more important to me." |
|
|
Term
| Postformal thought process |
|
Definition
| The ability to balance the emotional and logical side of a discussion requires what Kohlberg stage? |
|
|
Term
| Hospital-based hospice and palliative care programs |
|
Definition
| They add substantial value to both institutions and hospice programs |
|
|
Term
|
Definition
| An appropriate measure for managing the "death rattle" |
|
|
Term
|
Definition
| Used to assess of a pt's decision-making capacity |
|
|
Term
|
Definition
| DNR orders are not usually included in the _____ ______ |
|
|
Term
|
Definition
- feelings of spiritual anguish
- depression
- various somatic complaints
- feeling like everything is out of control |
|
|
Term
|
Definition
What type of pain?
- abdominal pain ("cramping")lasting for 2 hours
- no N&V |
|
|
Term
|
Definition
- > 85% americans approve of organ donation
- > 17,000 people waiting for liver transplants in 2004
- < 6,000 liver xplants performed in 2003 |
|
|
Term
| Swanson’s theory of caring contains? |
|
Definition
| Process and definition and subdimensions |
|
|
Term
|
Definition
| Which skill is not necessary for a nurse to be considered competent? |
|
|
Term
|
Definition
| ________ are closed wounds in which the skin is ecchymotic or bruised due to damage of blood vessels. These wounds are treated with ice pack application for the first 24 hours. Since these wounds are closed, there is no need for packing, suturing, or surgery. |
|
|
Term
|
Definition
| A patient receiving an IV of morphine sulfate is at risk for developing a withdrawal state if ______ is given concurrently |
|
|
Term
|
Definition
| The nurse is assessing a client who was just brought to the emergency department. The client can be aroused only with extreme or repeated stimuli. How should the nurse describe this client in a report to the ED physician? |
|
|
Term
|
Definition
- Fowler describes this as a stage in which the person is constructing his or her own explicit system with a high degree of self-consciousness.
- Mythical-lyrical describes the person between ages 7 and 12, in a private world of fantasy and wonder. Symbols refer to something specific; and dramatic stories and myths are used to communicate spiritual meanings.
- The intuitive-projective stage, ages 4 to 6 years, is a combination of images and beliefs given by trusted others, mixed with the child's own experience and imagination.
- Universalizing, which may never be reached by an individual, is a stage of becoming incarnate of the principles of love and justice. |
|
|
Term
| The Denver Developmental Screening Test (DDST-II) |
|
Definition
- ______ can be used to assess the infant's behavior and can be used from birth to 6 years. It is intended to estimate the abilities of a child compared to those of an average group of children of the same age.
- The CDC utilizes growth charts for physical assessment, but these do not address developmental issues.
- The school system assessment tools would be focused on the school-age child. - The Apgar scoring system is used to provide information about the baby's physiologic adaptation within minutes after birth. |
|
|
Term
|
Definition
- _______ has been associated with preterm labor, spontaneous abortion, low-birth-weight infants, sudden infant death syndrome, and learning disorders. - - - --Teratogens are medications known to adversely affect normal cellular development in the embryo or fetus.
- Folic acid is necessary for normal neural tube development.
- Genetic history does not affect the risk for spontaneous abortion. |
|
|
Term
| Generativity vs Stagnation |
|
Definition
Adulthood, age 25 to 65 years, is characterized by the central task of _____ versus _______. Positive resolution is indicated by creativity, productivity, and concern for others. Negative resolution is characterized by self-indulgence, self-concern, and lack of interests and communication.
- Identity versus inferiority is the central task of the school-age child. - -- - Identity versus role confusion is the central task of the adolescent.
- Intimacy versus isolation is the central task of the young adult. |
|
|
Term
|
Definition
- _______ can follow large, moving objects and blink in response to bright lights and sound. Their pupils respond slowly, and the eyes cannot focus on close objects.
- We don't know what they "see" or how it looks to them.
- At 4 months, the infant recognizes a parent's smile, though social smiles may appear at 2 months.
- At 5 months, the infant reaches for objects, but starts tracking them much sooner. |
|
|
Term
|
Definition
- The ________ theory (Arnold Gesell) postulates that child development is a maturational process based on an in-born timetable. Although children benefit from experience, they will achieve maturational milestones such as rolling over, sitting, and walking at specific times.
- Havighurst, in his developmental task theory, described growth and development occurring during six stages, each associated with 6 to 10 tasks to be learned.
- Psychosocial theory is focused on the development of personality, not physical development |
|
|
Term
|
Definition
| A toddler would be in the infancy and early childhood age period, of which learning to relate emotionally to parents, siblings, and other people is a developmental task in this theory. |
|
|
Term
|
Definition
Ages 2 to 4 years, according to Piaget, is the ______ phase where the child uses an egocentric approach to accommodate the demands of an environment. Language development is rapid and the child associates words with objects.
- The intuitive thought phase is from age 4 to 7 years and is where egocentric thinking diminishes. The child thinks of one idea at a time and includes others in the environment.
- The concrete operations phase, ages 7 to 11, is where the child solves concrete problems. The child also begins to understand relationships such as size, right, and left, and is cognizant of viewpoints.
- During the formal operations phase (ages 11 to 15) the child uses rational thinking, and reasoning is deductive and futuristic |
|
|
Term
|
Definition
| According to Erikson, ______ ________children are motivated by activities that provide a sense of worth. They concentrate on mastering skills that will help them function in the adult world. Gross motor skills should be the focus of the preschool child, as well as make-believe and pretend opportunities. Understanding diversity, role preference, and performance is the task of the adolescent. |
|
|
Term
|
Definition
| he describes faith as a way of being and behaving that evolves from an experienced faith guided by parents and others during a person's infancy and childhood to an owned faith that is internalized in adulthood. For the client who is ill, faith provides strength and trust. Fowler's theory describes the development of faith as a force that gives meaning to a person's life. Gilligan and Kohlberg are not spiritual theorists. |
|
|
Term
| Clean-contaminated wounds |
|
Definition
| ________ _______ ________ are surgical wounds in which the respiratory, alimentary, genital, or urinary tract has been entered. These wounds show no evidence of infection. Of the wounds listed, the only one not meeting the criteria is the breast biopsy. |
|
|
Term
|
Definition
| Night terrors are partial awakenings that are sometimes related to excessive tiredness or a full _______. |
|
|
Term
|
Definition
| _______ distance is characterized by body contact and used frequently by nurses when they are required to perform a procedure. Distance in this category is touching to 1-1/2 feet. Personal distance is 1-1/2 to 4 feet and is less overwhelming than intimate distance. Much communication between nurses and clients occurs at this distance, such as sitting with a client, giving medications, catheterizations, or establishing an IV infusion. Social distance is characterized by clear, visual perception of the whole person and is important in accomplishing the business of the day. Public distance requires loud, clear vocalizations and is used for groups of people or in the community for presentations |
|
|
Term
|
Definition
| The operative period that begins when the decision to have surgery is made and ends when the client is transferred to the operating table |
|
|
Term
|
Definition
| the phase that begins when the client is transferred to the operating table and ends when the client is admitted to the PACU |
|
|
Term
|
Definition
| phase that begins with the admission of the client to the postanesthesia area and ends when healing is complete |
|
|
Term
| Swanson's "doing for" process in her theory of caring |
|
Definition
Doing for: is providing for the client as she would do for herself if it were possible. Subdimensions of this process include preserving dignity.
- Drying the client completely, if she is able to do some herself, would not be part of doing for.
- Sensing that the client is uncomfortable fits in the subdimension of knowing (sensing cues).
- Touching the client's shoulder is comforting, a subdimension of being with. |
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Term
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Definition
| are closed wounds in which the skin is ecchymotic or bruised due to damage of blood vessels. These wounds are treated with ice pack application for the first 24 hours. Since these wounds are closed, there is no need for packing, suturing, or surgery |
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Term
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Definition
| During the ______ stage of chronic illness anatomic changes can produce physical signs of the illness. |
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Term
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Definition
| ___% of the population have at least one chronic disease |
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Term
| Which example best represents fluid transport by hydrostatic pressure? |
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Definition
| It is the movement of Water from the vascular space into the interstitial space |
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Term
| understand and predict behaviors. |
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Definition
| Knowing the theory of family functioning is beneficial to the nurse when planning the care for patients because it helps the nurse? |
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Term
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Definition
| The woman is experiencing _______ loss as a result of losing her mother so soon before her upcoming wedding. |
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Term
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Definition
| The spiritual concept of ________ occurs when a person recognizes that there is something greater than one's self. |
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Term
- Dysfunctional Grieving
- Impaired Family Processes
- Impaired Adjustment
- Caregiver Role Strain
- Hopelessness |
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Definition
| The nurse is working with a father and his three children, ages 10, 14, and 17. The mother recently died after a long illness. The children are doing poorly in school, and the father is having a difficult time keeping up with household chores. He has recently taken on a second job to help pay his late wife's hospital bills. Which nursing diagnosis should the nurse consider in planning care for this family? |
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Term
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Definition
| A common fear in the terminally ill is that the health care team has “_____” and “____ ___” and aren’t trying as hard as they were in the beginning. |
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Term
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Definition
| Jourard's "spirit titer" is a method to measure spirituality that goes from spiritual distress on the low end of the titer to enhanced spirituality on the high end of the titer. The client who works to inspire others despite personal hardships evidences a _____ spirit titer |
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Term
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Definition
| The definition ______ _________ of care is to strive for cultural sensitivity, cultural appropriateness, and cultural competence. |
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Term
| Before a client goes to surgery, he requests to have his spiritual leader present and pray over him. According to the HEALTH traditions model, which traditional methods is the client invoking? |
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Definition
| Traditional methods of restoring HEALTHphysical, mental, and spiritualinclude the use of herbal remedies, exorcism, and health rituals. This situation describes a healing ritual. Methods of maintaining HEALTH include following a proper diet, wearing proper clothing, concentrating and using the mind, and practicing one's religion. Traditional methods of protecting HEALTH include wearing protective objects such as amulets, avoiding people who may cause trouble, and placing religious objects in the home. Changing HEALTH is not one of the traditional methods in the HEALTH traditions model |
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Term
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Definition
An ______ health care system makes all levels of care available in an integrated form,including primary care (education and illness prevention), secondary care (acute care and screening), and tertiary care (rehabilitation and services for the chronically ill).
- Community- based settings are provided in county and state health departments and may include day-care centers,senior centers,storefront clinics, homeless shelters ans the like.
- A wellness center provides services such as health promotion, maintenance education,counseling, and screening.
- Community outreach centers are small,freestanding clinics providing services similar to those traditionally provided by large public health clinics, but focused on a narrower population. |
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Definition
| A ______ _______ is a person or group of people who work for and argue on behalf of policy formation or changes in policy that influence the health of population groups. |
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Term
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Definition
| Since 1990, the focus of public health nursing has been on the "____ _____ _____," which emphasizes health promotion based on the ability of members of the population to make informed health decisions. |
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Term
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Definition
| The first of the eight functions for volunteer health agencies is _______, whereby voluntary agencies explore areas that are poorly addressed by the other components of the health care system. |
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Term
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Definition
| The first of the eight functions is ______, whereby voluntary agencies explore areas that are poorly addressed by the other components of the health care system. |
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Term
| Functions of voluntary health agencies |
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Definition
- Supplementing the Work of Government Agencies: It is well known that government agencies cannot provide complete service because they operate under financial and statutory restrictions. The voluntary health agencies can help strengthen the work of government agencies by lending personal, or by contributing funds for special equipment, supplies or services
Z
b) Pioneering: The voluntary health agencies are in a position to explore ways and means of doing new things. Research is one form of pioneering. When the efforts succeed and bear fruit, the government agencies can step in and take over the project for the benefit of the larger numbers.. The family planning programme in India is an example of pioneering by the voluntary agencies which first spearheaded the movement in the face of much opposition. When the importance of family planning was realized, the government accepted family planning as national policy.
C) Education: There is unlimited scope for health education in India. The govenunent agencies cannot cope with the problem, unless it is supplemented by voluntary effort on the part of the people.
d) Demonstration: By putting up demonstrations and experimental projects, the voluntary health agencies have advanced the cause of public health. The ' demonstration of bore-hole latrines by the Rockefeller Foundation to solve the problem of hookworm in India is a case in point. The bore-hole latrine and its modifications have since become an essential part of the environmental sanitation programme in India.
e) Guarding the Work of Government Agencies: By setting a good example the voluntary health agencies can always guide and criticize the work of government agencies.
f) Advancing Health Legislation: The voluntary agencies can also mobilize public opinion and advance legislation on health matters for the benefit of the whole community |
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Term
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Definition
| _______ ________ is usually a collaborative process between health providers, community leaders,politicians, and consumers, all may be involved in the evaluation process. Often, the community health nurse is the agent of evaluation,collecting and assessing data that determine the effectiveness of the implemented programs |
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Term
| The 1996 Ottawa Charter identified three strategies to promote global health: |
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Definition
- advocacy for conditions favorable to health
- development of environments that support health, as well as advocacy for conditions favorable to health
- mediation between groups. |
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Term
| In order to assure U.S. public health, which of the following have been recommended by the Institute of Medicine? |
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Definition
| Collect, assemble, analyze, and make available information on the health of the community. This is 1/6 |
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Term
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Definition
_______ projects use communication and information technology to provide health information and health care services to people in rural, remote, or under serviced areas. Video conferences and video clinics enable health care workers to provide distant consultation to assess and treat ambulatory clients who have a variety of health care needs. Telenursing enables nurses to provide client teaching and health promotion to distant clients.
- Community-based nursing is nursing care directed toward specific individuals, on a much broader scale than what is described in this scenario.
- Parish nursing focuses on integrating aspects of faith and members of a particular congregation and health care or nursing needs.
- Collaborative health care describes a process of teamwork in providing comprehensive health care. |
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Term
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Definition
| The _______ health care sector is the segment of the scientific health care subsystem that provides health-related services to individual clients. The primary emphasis in this sector is to cure disease and restore health, although individuals can also receive some health-promotion and illness-preventive services. This sector includes health care institutions (clinics, hospitals, etc.); personnel; health commodities firms; education and research institutions; and financing systems. |
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Term
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Definition
_______ health care is defined as essential health care based on practical,scientifically sound, acceptable methods and technology made universally accessible to individuals and families in the community.
- it incorporates five principles:
- equitable distribution
- appropriate technology
- focus on health promotion
- community participation
- a multisectoral approach. |
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Term
| In the popular subsystem, people who are not considered health care providers, such as family members or friends, administer care. |
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Definition
| A community health nurse is taking a family's medical history and is told about regular use of over-the-counter medications to treat colds, mild pain, and minor illnesses. The nurse documents this type of care as a part of which subsystem? |
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Term
| The three functions of public health |
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Definition
- assessment
- policy devp
- assurance |
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Term
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Definition
| _______, the third core function, reflects the responsibility of the public health sector to assure availability of and access to health care services that are essential to sustaining and improving the health of the population. |
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Term
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Definition
| Access to health care through ______ health insurance is perhaps the most important focus for advocacy to promote population health in the United States. |
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Term
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Definition
| he final function of the nurse as an advocate is to prepare clients to _____ _____ _____. The nurse, alone, should not carry out the activities and functions of advocacy; this should be a collaborative effort between nurse and client. |
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Term
| The 7 stages of the Precaution Adoption Process model |
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Definition
1. unaware of issue
2. unengaged by issue
3. deciding about acting
4. decided not to act
5. decided to act
6. acting
7. maintenance |
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Term
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Definition
| A _______ is composed of people who share common characteristics, but who do not necessarily interact with each other-as people on a subway might behave. They are all riding, but not really interacting. |
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Term
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Definition
| The practice of promoting and protecting the health of populations using knowledge from nursing, social, and public health sciences. |
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Term
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Definition
| Which attribute allows the community health nurse to influence the action of the local city commission leaders in taking an active role regarding the health of their community? |
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Term
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Definition
| A priority nursing diagnosis for the patient receiving heparin therapy is: |
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Term
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Definition
______ ________ nursing is the practice of promoting and protecting the health of populations using knowledge from nursing, social, and public health sciences. The community will benefit from the program because the adolescents will be healthier and deliver healthier infants, thus saving on health care costs.
- Community based nursing is nurses providing sick care in community settings.
- Community focused care is bringing nursing knowledge and expertise to the community, but it does not have a population focus.
- Community driven care focuses on the needs of the community as a whole and emphasizes community participation in determining those needs. It can limit the focus of practice to health needs identified by the population group, and could thus exclude pregnant adolescents. |
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Term
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Definition
Evaluation of ______ preventive measures focuses on the degree to which an existing problem has been resolved.
- Gaining weight would be an appropriate goal for someone with severe malnutrition-the active problem here-and would be a secondary prevention intervention measurement. |
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Term
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Definition
| According to family developmental theory, families, like individuals, pass through the predictable, developmental, or family life stages first described by _____. There are differing expectations in each stage of family development. As the expectations change, so do interactions among family members. The term used for these stage expectations is: family developmental tasks. The developmental tasks of each stage necessitate certain changes within the family in the roles of its members in order for the family to fulfill its functions. |
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Term
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Definition
| ______ in community health nursing involves striving for social justice. Social justice requires "taking from the rich and giving to the poor [and] ambushing the public conscience and budget whenever possible" (Mullan, cited in Drevdahl, |
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Term
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Definition
| Research indicates that children in single-parent families are generally worse off than their counterparts in two-parent families, particularly with respect to ______ problems |
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Term
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Definition
| Community ______ nursing is nurses providing sick care in community settings. |
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Term
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Definition
| Community _____ care is bringing nursing knowledge and expertise to the community, but it does not have a population focus. |
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Term
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Definition
| Community ______ care focuses on the needs of the community as a whole and emphasizes community participation in determining those needs. It can limit the focus of practice to health needs identified by the population group, and could thus exclude pregnant adolescents. |
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Term
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Definition
| ______ _________ may be identified and assessed by means of genograms and ecomaps. A genogram is a diagram of a family tree incorporating information regarding family members and their relationships over at least three generations. |
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Term
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Definition
| By giving the family of a chronically ill child a list of ______ _______ that can help them, the home health care nurse is offering them support. |
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Term
| Having difficulty breathing |
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Definition
| A patient is starting a new prescription of atenolol (Tenormin). Which of the following symptoms, if present, is caused as a result of the beta1 blockade effects of the drug? |
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Term
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Definition
| " It is recommended that men and women receive Occult blood testing each year starting at age ___? |
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Term
| ineffective health maintenance due related to decreased mobility. |
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Definition
| The appropriate nursing diagnosis for a wheel-chair bound client who is having trouble getting around due to the clutter is the mobile home he shares with his wife would be _______? |
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Term
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Definition
| ________ of cerebral blood vessels protect the CNS in states of hypovolemia and hypotension. |
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Term
| Until it is time for the patient to receive her next dose, the nurse can best assist this client to deal with the pain by guiding her in slow,rhythmic breathing. Relaxing and breathing rhythmically can help manage pain. |
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Definition
| wo hours after a client receives pain medication, she continues to complain of severe pain. Since the pain medication cannot be repeated for two hours, the nurse can best assist this client to deal with the pain by : |
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Term
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Definition
| When a patient answers questions incorrectly, it may be a sign of _____ ______ |
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Term
| Nourish and lubricate the lens and cornea |
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Definition
| The purpose of aqueous humor in the anterior compartment of the eye is to: |
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Term
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Definition
| Seeing _____ _______ is indicative of what eye problem? |
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Term
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Definition
| A patient suffering from exertional dyspnea is fatigued, yellow skin , and is experiencing ______ anemia? |
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Term
| By modulating the ascending pain signal from the dorsal horn. |
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Definition
| How do noradrenergic drug agonist relieve pain? |
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Term
| The patient is demonstrating ineffective therapeutic management. He has stopped taking his medication based on the fact that he feels better. Management of hypertension requires a lifelong commitment to therapy and lifestyle modifications and he should not stop his meds simply because he is feeling better |
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Definition
| A patient tells the nurse he has stopped taking clonidine (Catapres) because he is feeling better. He has a BP reading of 130/88 mm Hg and has gained 2 pounds. Based on this information, the most appropriate nursing diagnosis is: |
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Term
| Expressing to a parent that he is feeling better is considered to be valid indication of pain relief, as children tend to be honest with their parents regarding pain. |
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Definition
| An analgesic was administered to a 7-year-old child following surgery. which of the following observations indicates that the analgesic is effective? |
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Term
| Small pupil size is a normal age related finding in an eye exam. |
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Definition
| Which finding on eye examination is considered a normal age-related change? |
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Term
| Nerve impulses are transmitted between the ear and the brain by the 8th cranial nerve, and the acoustic nerve. The cochlear branch of the 8th nerve is tested to evaluate sound transmission. |
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Definition
| Which branch of the eighth cranial nerve is tested to evaluate sound transmission? |
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Term
| typically, an adult can lose 500 ml of blood without serious or lasting effects because the spleen has the ability to release stored red cells. If the loss reaches 1000 ml or more, serious and acute consequences may result. |
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Definition
| Acute blood loss can have very serious effects if it exceeds _____ mls? |
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Term
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Definition
| The public health nurse refers the patient to an ophthalmologist for which visual outcome? |
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Term
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Definition
| ______ describes faith as a way of being and behaving that evolves from an experienced faith guided by loved ones during the person;s infancy and childhood to an owned faith that is internalized in adulthood and serves as a directive for personal action. |
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Term
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Definition
| For a home care hospice patient, what is the priority diagnostic category? |
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Term
| Anatomic changes produce physical signs of the disease. |
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Definition
| Which statement about the clinical stage of chronic illness is true? |
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Term
| Increasing physical activity is an appropriate and realistic weight reduction goal |
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Definition
| An appropriate weight reduction goal for any obese adult would be: |
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Term
- More women will have health problems.
- More women than men live alone, particularly among the elderly. Among people 65 years of age or older, women are nearly three times more likely than men to live alone (U.S. Census Bureau, 2005). Living along can contribute to social isolation and deteriorating health. |
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Definition
| A home health nurse works specifically with elderly clients. When assessing family types, the nurse understands that which of the following is true? |
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Term
| Chemical neurotransmitters |
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Definition
| Transmission of an action potential from one neuron to to another requires the presence of? |
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Term
| Weakness, hypotension, and cool, clammy skin |
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Definition
| Which findings indicate that the condition of a patient who has an acute, actively bleeding ulcer is deteriorating? |
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Term
| The nurse should instruct the patient on a high fiber diet and fluids, following cataract surgery. |
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Definition
| An appropriate nursing intervention for the patient after cataract surgery is to: |
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Term
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Definition
| After a stroke, a patient is able to understand spoken language but has difficulty expressing her thoughts. This language problem is classified as: |
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Term
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Definition
| Individuals with this type of aphasia may be able to read but be limited in writing. Broca’s aphasia results from injury to speech and language brain areas such the left hemisphere inferior frontal gyrus, among others. Such damage is often a result of stroke but may also occur due to brain trauma. |
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Term
| This may be normal; more data are needed |
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Definition
| During pupillary assessment the nurse notes the patient's right pupil is 2 mm in size and the left is 3 mm in size. The nurse concludes that: |
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Term
| Steps in Counseling Process |
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Definition
1. Establish a safe, trusting environment
2. CLARIFY: Help the person put their concern into words.
3. Active listening: find out the client's agenda
4. Transform problem statements into goal statements.
5. Explore possible approaches to goal
6. Help person choose one way towards goal
7. Make a contract to fulfill the plan (or to take the next step) 8 |
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Term
| Inderal should not be used in a patient with COPD has difficulty breathing is a potential side effect and the patient with COPD already has compromised breathing. |
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Definition
| When is the administration of a non-selective beta-blocker such as propranolol (Inderal) to a hypertensive patient contraindicated? |
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Term
| Occlusion of the arteries by sickled cells causes the pain associated with the disease. |
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Definition
| When teaching about the pain associated with sickle cell crisis, it is correct to explain that the pain is a result of: |
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Term
| the recommended immunization schedule for MMR administration is at 12 months and 4-6 years of age |
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Definition
| Which of the following is the recommended immunization schedule for MMR administration? |
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Term
| Risk for Deficient Fluid Volume related to increased fluid output, altered intake, and medications |
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Definition
| Which is an appropriate nursing diagnosis statement for a patient with vertigo? |
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Term
| Participation in planning of care will provide an aspect of control and decrease feelings of powerlessness. |
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Definition
| A family is anticipating the loss of a child who is terminally ill. The RN has identified the priority nursing diagnosis statement as Powerlessness related to poor outcomes from medical treatments. What is the best expected outcome for this family? |
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