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nur 101 #4

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QuestionAnswer
self concept what a person believes about himself at a given time
self-esteem personal judgement about self-worth, value and competence
rationalization `use of logic, reasoning and analysis to avoid unacceptable feelings
projection unacceptable feelings or impulses are transferred to another
displacement transfer of feelings associated with one person or event to another that is less threatening
denial refusal to acknowledge a real situation
repression unacceptable ideas,impulses and memories kept "out of conscious" block it out unconsciuosly
suppression conscious or voluntary inhibition of unacceptable impulses, ideas or memories hold it consciously b/c we want to deal with it now
regression withdrawing to an earlier level of development to benifit from the associated comfort level
fear known threat; response to a specific threat
anxiety a response to an unknown, non-specific threat that is vague, or has no clear cause
Interview who is the pt? what does he value? what is imp. to him? does he value his life?
social id roles and role performances (age, ethnic group, religion,ect)
personal id personal, emotional, moral/ethical, intellectual self; acts in certain ways, attitudes, traits, abilities, habits,values, preferences
body image physical appearances, characteristics
public self how one presents self and how viewed by others
semi-public what others observe, and person may be aware
private known to self and not shared with others, iseal self, may share with really close people
inner known to self and others
Locus of control LOC stable trait developed over time and is influenced by social learning experiences. Reflect persons perception of what causes events or behaviors-things happend b/c of your own control, or are they by fate
internal control means we have a positive self concept; we can make our own choices and are in control
external LOC means we believe things happen by fate, chance or luck
healthy personality positive self esteem, sees self as valuable and worthwhile
sleep staTE of unconsciousness from which can be awakened by sensory or other stimuli
rest waking state
REM active sleep state, sympathetic activity,mind is active, body is relaxed, dreams vivid, can see brain waves on EEG, happens about 80 min. after onset of sleep
Non-REM Quiet state, motor tone- still repositions self, moves extremities
4 stages of non-REM 1. wakefullness vs. sleep, happens in about 1.5 minutes, eyes rollback about 2-5% of our sleep time
2. non-REM 2.enter about 20-25 min. sleep is deeper, little or no movement, 44-55% of sleep time
3. Non-REM 3. 20 min into sleep; deeper and more restful, slow wave, parasympathetic, hard to awaken 3-8% of sleep
4. non-REM 4.deepest state, 15-30 min into sleep, slow wave, sleepwakling and bedwetting happen here. VS drop up to 50%
Avg 4-5 cycles non-REM and REM 90-110 min. in an 8 hr period
insomnia inability to sleep or wake prematurely or too often
initial takes longer than 30 min. to fall asleep
intermittent several brief periods of wakening
terminal awake early and can't return to sleep
transient lasts several days, usually less than a week
persistent lasts at least a week
sleep apnea not breathing while sleeping
narcolepsy daytime sleepiness, loss of motor tone falls
Kleine Levine Syndrome sleep attack that lasts hours or days
nocturnal Myoclonus calf muscle spasms
excessive daytime sleep (EDS) occurs at inappropriate times
parsomnias sleepwalking, bedwetting, night terrors, eating while sleeping; happens in stage 4 ono-rem sleep
SEXUALITY refers to ones thoughts, feelings, and behaviors r/t sexual interaction with others
4 levels of care 1.professional nurse---2.prof. nurse with post grad training---3.prof. nurse w/ training, MD, psychologist, Social worker or sex therapist-----4.Master in psychology, nse clinician/practitioner, SW with training
level 1 prof nurse, assess health history, screen for sexual fx and dysfx. gather limited nsexual info, feelings, behaviors
level 2 prof nrs w/ post grad training, sexual history, ed, counciling and referral to level 3 if needed
level 3 prof nrs. w/ training, MD, psychologist, SE with training or sex therapist. sexual problem history, ind. or group counceling, refer to level 4 if needed
level 4 master in psychology, nrs clinician/practioner, SW with training; intenisve therapy
procreative child bearing
non-procreative sexual satisfaction
sexual response cycle excitement plateu orgasm resolution
STD's diagnostic test cultures, wet mount, slides, blood tests, VDRL, western blot (AIDS test, ELISA (AIDS) test
breast exam mammograms, ultrasound, aspiration, needle biopsy
cervical/uterine pap smears, biopsy, coloscopy (exam of vagina)
gonorreah mens symptoms; dysuria, frequency, urethral purulent discharge (smelly) women ss, asymptomatic early, vag discharge, dysuria, cystitis (bladder swelling)
syphilis painless chancre sore, heals in wks secondary stage; systemic- affecting all body systems, lesions on skin, mucus mucosa, vulva or anus, patch alopecia latency stage; asymptomatic tertiary stage; advanced with tumors; affect liver, bones skin, aorta, i
genital herpes visicles, no cure, recurrent,virus HSV II
chlamydia most common, leading cause of PID, yellow discharge, urethritis, dysuria, frequency
AIDS asymptomatic, enlarged lymph nodes, fatigue, reduced resistance, TB, Esophogeal candidiasis, kaposi sarcoma- type of cancer, purple lesions on the skin, sores anywhere on the body, lymphoma
trich excessive watery, yellow discharge, redness, pruritis (itching); edema, treated w/ metronidazole
vaginitis from normal vag flora, douching, antibiotics, DM, cross contam. from anal sex; odorous discharge, pruritis, pain with intercourse; dysuria
candidiasis yeast infect. with vulva redness, swelling, thick- white discharge
urethritis affects men with a purulent (pus) discharge
cystocele herniation of the POSTERIOR wall of the bladder INTO the VAGINA. vaginal fullness and anterior bulge
rectocele rectovaginal hernia caused by rupture of TISSUE BETWEEN the VAGINA AND RECTUM. feces lodge in rectocele pouch and post. bulge
phimosis un-retractable forskin r/t stenosis (narrowing or constricting) or cancer; treatment is circumcision
hydrocele fluid in the testes
varicocele mass of vericose veins in the scrotum and around the spermatic cord
scrotal edema common with CHF
epididymitis inflammation from STD, infected prostate or urethra
kidneys 2 bean shaped, contains 1 million nephrons (fxal units of kidney) urine drains into renal pelvis; concentrate urine; gets rid of body waste; control of electrytes and toxins/waste
ureters ducts allowing urine to pass from kidney to bladder
bladder sterile urine storage
urethra CHANNELS URINE TO THE OUTSIDE OF BODY FROM THE BLADDER
pH of urine 5-7 acidic, if alkaline, more prone to infection
specific gravity urine density measurement. normal is 1.003-1.030
cell cast crystals detected on microscope exam. RBCs 2-3 WBCs 4-5 normal
casts are elements from cellular or fibrous accumulation in urinary structures
hyaline protien found after strenuous activity or diet therapy.
crystals are usually formed in the urine, can also indicate renal stones
electrolytes normal urine should not have glucose, ketones or protein
CCMS clean catch midstream; clean specimen,pt. can obtain, need instructions, done for UTI
routine UA usually done on admission
sterile specimen steril from bladder with straight cath sz 14
indwelling collection catheter that stays in the pt sx 16 french can get sterilized sample immediately after insertion, not after that
24 hr. throw away first to begin and keep the last, 24 hr collection. kept on ice to reduce bacteria
note first a.m. specimen most desirable bc of concentration
IVP intravenous pyelogram; radiographic dye test to study the renal pelvis, uterers, bladder. xray to see structures
cystometrogram study to measure bladder pressures and reflexes, bladder strength
electromyography determines muscular strength via electrical impulses
clinical problems may be assoc. with stress, prolonged cath, meds or path problem
incontinence loss of voluntary control
urge occurs immediately after a strong sensation to void. r/t infection, decreased bladder capacity due to PID, long term cath, preg, and diuretics
stress involuntary leakage of urine during times of increased abd. pressure
relfex incontinence r/t permanent neuron/spinal cord lesion/injury that causes voiding to be controlled by the spinal cord. R/t spinal cord injuries, MS, CVA, brain tumors,OBS
functional involuntary and unpredictable loss of urine. no warning or feeling to go.
retention inability to empty bladder (ex. after surgery) can stroke inner thigh, pull pubic hair, tap abd.
residual urine left in the bladder
lower UTI urine culture to confirm, with increased wbc and rbc, dysruria, frequ, urgency, cloudy urine, voiding in multiple small amts
upper UTI lethargy, fever chills, ha, v, abd. pain and tenderness
stones calculi colicky pain in lower back or abd that radiates to lower leg spasms with dysuria, urgency, and frequ. backing up of urine can cause HYDRONEPHROSIS
renal failure acute when normal fx suddenly ceases- need imm med attention could be fatal chronic; gradual loss over a period of time
ileal conduit resect part of the ileum to make and ileum pouch then transplant uterers to abd wall. INCONTINENT TYPE- NEED EXTERNAL APPLIANCE
ureterostomy uterer to abd wall
ureteroureterostomy one uterer into the other and one to the abd wall
ureterosigmoidostomy uterers into the sigmoid colon; attached down-slope of sigmiod. end up with loose stools from urine in stools DO NOT GIVE ENEMAS
mephrostomy opening into the pelvis and nephro tube placed
nephrectomy kidney removal; have 1 kidney
lithotripsy crushing of kidney stones
biopsy tissue sample
TURP transurethral resection of the prostate gland
Value an affective disposition anout a person, object or idea
belief special class of attitudes in which cognition is based more on faith than fact
value and belief are both r/t self concept, coping, roles and relationships, stress tolerance
spirituality worship practices, organized beliefs. may not be linked with organized religion. variable
roles goal directed patterns of behavior that are learned and performed in social settings as a result of personal and cultural expectations
role strain is pt taking on to many roles
assigned/ascribed gender, parent, husband, wife, influenced by society
aquired/achieved profession, occupation, obtained thru efforts or competition
role conflicts student v parent
role abiguity not clearly id within society-more stay at home dads
role overload too many roles at once
role incompitence lack of skill or knwledge
role bargaining neg. with other about acceptable role expectation-can do this and still be a mom
role stress resposibilities vague, impossible to meet the demand of the roles; wearing too many hats
role strain subjective, state of distress, affects coping abilities, physical ss.
cardio-- physiological responses sympathetic speeds upresponse
respiratory--phy resp norepinepherine, hyperventilate
gi--phys resp NV, increased peristalsis
M/S--phys increased muscle tone, tremors
integumentary--phys resp diaphoretic, rash
Created by: angieworth
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