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Stages of Change
Stages of Change/ Patient Education
78
Nursing
Undergraduate 2
05/13/2014

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Cards

Term
precontemplation
Definition
not intending to take at ion in the foreseeable future, not in the next 6 months. They may be uninformed about consequences or demoralized about their ability to change
Term
contemplation
Definition
intend to change in the next 6 months. Aware of reasons to change but also of the cons of changing, ambivalent and not ready for traditional action oriented change programs
Term
Preparation
Definition
intending to take action in the next months. They often have taken significant action in the last year and have a plan of action. They are ready for assistance in changing.
Term
action
Definition
they made modifications in their lifestyle in the last 6 months that is significant enough to reduce risk for disease. Vigilance against relapse is critical.
Term
maintenance
Definition
working to prevent relapse but they are less tempted and more confident that they can continue their change
Term
Assessment
Definition
Part of the teaching process.. gather data about learning needs, motivation, stage of change, ability to learn and teaching resources from client, family, learning environment, medical record, nursing history, and literature
Term
1) assessment
2) identify needs
3) planning
4) implementation
5) evaluation
Definition
List the 5 stages of the teaching process in order
Term
identify needs
Definition
Part of the teaching process involving the three domains of learning- cognitive (understanding), affective (feelings, attitudes, opinions & values), & psychomotor (skills integrating mental and muscular activity) second step in teaching process
Term
planning
Definition
establishing learning objectives (outcomes) in behavioral terms, collaborate with client to identify priorities and methods and determine needed outcomes
Term
implementation
Definition
which part of the teaching process actively involves clients/significant others in learning?
Term
implementation
Definition
which part of the teaching process actively involves clients/significant others in learning?
Term
evaluation
Definition
part of teaching process in which achievement of learning objectives is measured and information is reinforced as needed
Term
Speaking and doing demonstrations, return demonstration, gaming, role play
Definition
Which teaching method is 90% effective?
Term
reading, self-instruction
Definition
Which teaching method is generally only 10% effective?
Term
1) consciousness raising
2) dramatic relief
3) environmental reevaluation
4) social liberation
5) self reevaluation
Definition
List the 5 experiential approaches that are most useful in the early stages of the process of change
Term
consciousness raising
Definition
part of process of change.. increased awareness of the causes, consequences, and cures for a problem behavior. Interventions include include feedback, education, interpretation, respectful confrontation, bibliotherapy, & media campaigns.
Term
dramatic relief
Definition
second of process of change; increasing emotional experiences which will enable imported feelings if action is taken. Psychodrama, role play, grief, personal testimony & media campaigns.
Term
environmental reevaluation
Definition
third in the process of change; affective and cognitive assessments of how the behavior affects other people including the desire to be a role model. Empathy training, documentaries, family interventions
Term
social liberation
Definition
forth part of process of change; increased opportunities or alternatives not previously available to the person. Advocacy, policy, changes health promotion for minority populations
Term
self reevaluation
Definition
fifth part of process of change; affective and cognitive assessments of ones own self-image with and without a particular unhealthy habit. Healthy role models, values clarification and imagery.
Term
self reevaluation
Definition
fifth part of process of change; affective and cognitive assessments of ones own self-image with and without a particular unhealthy habit. Healthy role models, values clarification and imagery.
Term
Stimulus control, helping relationships, counter conditioning, reinforcement management, self liberation
Definition
List the last 5 processes of change; they are primarily behavioral & generally work best when the person is in the latter stages of change
Term
stimulus control
Definition
remove cues for unhealthy habits and add prompts for healthier alternatives, avoidance, changing the environment & self help groups
Term
helping relationships
Definition
examples of this part of the process of change: caring support & acceptance. Buddy systems, therapist relationships, rapport building; seventh of the process of change
Term
counter conditioning
Definition
eight of the process of change; learning healthy behaviors that can substitute for the problem behavior. Relaxations can counter stress, assertion can counter peer pressure
Term
reinforcement management
Definition
ninth of the process of change; consequences for taking steps in a particular direction, usually rewards. Contingency contracts, positive self statements, group recognition
Term
Self liberation
Definition
tenth of the process of change; belief that you can change and choices in how to make that change. Options for behavioral choices like New Years resolutions, public testimonies.
Term
pre-contemplation
Definition
Regression to an earlier stage from any of the stages is common but often they do not go all the way back to ______________.
Term
- Have you ever felt you should CUT* down on your drinking?
- Have people Annoyed* you by criticizing your drinking?
- Have you ever felt bad or Guilty* about your drinking?
- Have you every had a drink first thing in the morning (an "Eye-opener"*) to steady your nerves or to get rid of a hangover?
Definition
what are the questions in the CAGE questionnaire?
Term
Two "yes" answers indicate probable alcohol abuse and warrant further assessment
Definition
scoring of the CAGE questionnaire?
Term
for men up to age 65
Definition
more than 4 drinks/day or more than 14 drinks/week= risky substance use for who?
Term
more than 3 drinks in one day and/or more than 7 drinks/week is risky substance use for who?
Definition
for women who are over 65
Term
Prescription misuse and illicit drugs, any tobacco use
Definition
other than drinking the specific amounts noted earlier, what else qualifies as risky substance use?
Term
substance related disorder
Definition
disorders related to taking a drug of abuse, including alcohol, stimulants, cannabis, hallucinogens, inhalants, tobacco, opioids, sedatives- hypnotics & anxiolytics, caffeine, other unknown substance
Term
cause direct activation of the reward centers of the brain
Definition
What do all of the drugs of abuse and gambling have in common?
Term
Impaired Control
Definition
the following four criteria represent what category of substance use disorder?
1) taking in larger amounts than intended
2) unsuccessful attempts to cut down
3) Excessive time spent obtaining
4) Craving
Term
Social Impairment
Definition
the following criteria represent what category of substance use disorder?
5) not meeting work, home, or school obligations
6) Continued use despite persistent problems
7) withdrawing from important family, social, occupational, recreational activities to use
Term
Risky Use
Definition
the following criteria represent what category of substance use disorder?
8) recurrent use in physically hazardous situations
9) Continued use despite recurrent physical or psychological problems
Term
Pharmacological
Definition
These criteria make up what category of Substance use disorder?
10) tolerance- needing increasing amounts of a subtance to produce desired effect
11) withdrawal- the adverse physical and psychological symptoms that occur when a person ceases using a substance
Term
substance intoxication
Definition
behavioral/psychological changes due to recent ingestion of the substance
Term
substance withdrawal
Definition
behavioral/cognitive/physiological changes due to cessation or reduction in use after heavy prolonged use
Term
substance induced mental disorder
Definition
Methamphetamine induced psychotic disorder and cocaine withdrawal induced depression are temporary examples of what?
Term
alcohol, inhalants, sedative-hypnotic anxiolytic drugs
Definition
In reference to substance induced mental disorder, what can cause potentially permanent neurocognitive changes?
Term
Marijuana
Definition
Most commonly used illicit drug?
Term
18 to 25 years
Definition
Rates of binge drinking and heavy alcohol use are highest among what ages?
Term
Wernickes Syndrome
Definition
caused by a Thiamine deficiency (B 1)- oculomoter dysfunctions (eyes), ataxia (unsteady gait), and confusion; treat with Thiamine
Term
Korsakoff's Syndrome
Definition
If Wernicke's is not treated then this type of psychosis occurs (alcohol amnestic disorder). Symptoms are retrograde and anterograde amnesia, lack of insight, paucity of speech (won't say much), confabulation (makes up answers), apathy.. Treat with Thiamine
Term
Scurvy
Definition
Vitamin C deficiencies can lead to this
Term
delirium tremens
Definition
short term mental status changes that are life threatening; from alcohol withdrawal syndrome
Term
benzodiazepines
Definition
the long acting ________ are the drugs of choice (for alcohol detox) because they effectively reduce signs and symptoms of withdrawal, prevent seizures, and have a better margin of safety than other drugs
Term
symptom-triggered
Definition
A __________ dosing regimen is preferred over fixed-schedule dosing because it is effective, requires less medication, and appears to prevent seizures as well as fixed schemes. (for alcohol detox)
Term
benzodiazepines (valium, librium)
Definition
this is used as pharmacologic treatment of alcohol withdrawal..
given for elevations in hear rate, blood pressure, and temperature, and in the presence of tremors; when given early in withdrawal and in sufficient dosages, can prevent delirium tremens
Term
CNS depressants
Definition
Rx treatment of alcohol withdrawal; produces sedation and reduces anxiety symptoms
Term
benzos, CNS depressants, antipsychotic meds, vitamins and folic acid for vitamin deficiencies, thiamine, & magnesium sulfate to reduce seizures
Definition
What meds/supplements are given for pharm treatment of alcohol withdrawal?
Term
2 to 5 days
Definition
Delirium tremens are a medical emergency that usually occurs ______ days following alcohol withdrawal and persists for 2-3 days.
Term
1-2 hours, 24-48 hours
Definition
Early signs of alcohol withdrawal appear _______ hours following cessation of the drug, peak after _________ hours, and then rapidly disappear unless the withdrawal progresses to delirium tremens (DT).
Term
Disulfiram (antabuse)
Definition
Pharm treatment of alcohol use disorder; used adjectively for aversion therapy, this plus even small amounts of alcohol produces adverse effects
Term
Naltrexone (trexan)
Definition
Rx treatment of alcohol use disorder
- can reduce cravings. ca help maintain abstinence, and ca interfere with wanting to drink more if a recovering patient relapses
Term
Cocaine
Definition
what drug is this?
- CNS stimulant
- Produces a sudden burst of mental alertness and energy and feelings of self-confidence, being in control and sociability
- Rush lasts about 10 ti 20 minutes
- High is followed by an intense let-down effect in which the person feel irritable, depressed, and tires, and cranes more of the drug
Term
concaine
Definition
This drugs increases the release and blockade of the reuptake of neurotransmitters, increases dopamine: euphoric and psychotic symptoms, increase norepinephrine: tachycardia, hypertension, dilated pupils and rising body temp, increasing serotonin: sleep disturbances , anorexia

long term use: depletion of dopamine
Term
norepinephrine depletion causes person to sleep 12-18 hours
Definition
Withdrawal symptoms of concaine?
Term
cocaine withdrawal
Definition
These are withdrawal symptoms for what drug?
- Sleep disturbances with rebound REM, anergia (lack of physical activity/energy), decreased libido, depression, suicidality, anhedonia (lack of enjoyment), poor concentration and cocaine craving may last for weeks
Term
amphetamine
Definition
This drug is a stimulant that blocks the reuptake of norepinephrine and dopamine, not as strong effect on serotonin (as cocaine does), effects peripheral nervous system
Term
methamphetamine
Definition
this drug releases dopamine, the "rush" damages nerve terminals, highly addictive-used in a "binge and crash" pattern, a woman lives an average of 10 years after becoming addicted
Term
MDMA
Definition
This drug causes hallucinations, confusion, depression, sleep problems, drug craving, severe anxiety, and paranoia
Term
Nicotine
Definition
_______ withdrawal is marked by mood changes (craving, anxiety, irritability, depression) and physiologic changes (difficulty in concentration, sleep disturbances, headaches, gastric distress, and increased appetite.

Treated with replacements such as transdermal patches, gum, nasal spray, inhalers, Chantix
Term
caffeine
Definition
This drug stimulates the cerebral cortex and increases mental acuity; a dose of 300mg can can cause tremors, poor motor performance, and insomnia
Term
500mg
Definition
Doses of caffeine exceeding _______mg increase the heart rate; stimulate respiratory, vasomotor, an vagal centers and cardiac muscles; dilate pulmonary and coronary blood vessels; and constrict blood flow to the cerebral vascular system
Term
Cannabis (marijuana)
Definition
This marijuana binds with an opioid receptor in the brain to dopamine reuptake, can be stored for weeks in fat tissue and in the brain, impairs the ability to form memories, recall events, and shift attention from one thing to another, long-term marijuana use produces motivational syndrome
Term
hallucinogens
Definition
These kind of drug produces euphoria or dysphoria, altered body image, distorted or sharpened visual and auditory perception, confusion, incoordination, and impaired judgement and memory
Term
hallucinogens
Definition
These kind of drug produces euphoria or dysphoria, altered body image, distorted or sharpened visual and auditory perception, confusion, incoordination, and impaired judgement and memory
Term
dissociative anesthetics (Ketamine, PCP)
Definition
These drugs reduce (or block) signals to the conscious mind from other parts of the brain; intoxication can last 4-6 hours, Interventions to reduce stimuli, maintain a safe environment for the patient and others, manage behavior, and observe for medical and psychiatric complications
Term
infection of heart lining and valves, pneumonia
Definition
long term effects of heroin on the lungs and heart?
Term
Suboxone
Definition
Rx Treatment of Opiate Use disorder
- combo of Buprenorphine and Naloxone- used for easier, safer opiate withdrawal and long term replacement therapy
Term
Buprenorphine
Definition
Rx treatment of opiate use disorder
- semi-synthetic opioid used to treat opioid addiction, long term replacement therapy without many side effects
Term
Naloxone (Narcan)
Definition
given in emergency treatment of opiate intoxication- IV in 2 minutes reverses reparatory depression, sedation, and hypertension
Term
Naltrexone
Definition
________ (taken daily) blocks the euphoric effects of opioids, has little effect on opioid cravings
Term
specific, measurable, attainable, realistic, and time limited
Definition
SMART stands for?
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