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Unit 3 exam

Nursing Funds

WHAT IS QUALITY OF CARE? health care that is safe, effective, pt. centered, timely, efficient & equitable, or fair (time orientation)
HEALTH DISPARITY particular type of health difference that is closely linked w/ social, economic, and/or environmental disadvantage
PARITY means equality
MARGINALIZED GROUPS to put or keep (someone) in a powerless or unimportant position within a society/group (poor health & diet at an early age)
ACCULTURATION adapting or adopting a new culture (social organization)
ASSIMILATION an individual gives up his or her ethnic identity in favor of a dominant culture
ETHNICITY shared identity related to social/cultural heritage
LADDER OF CULTURAL COMPETENCE emphasizes how culturally competent organizations & individuals can work to eliminate healthcare disparities
POOR HEALTH OUTCOMES limited health literacy
CULTURE integrated patterns of human behavior that include the language, thoughts, communications, actions, customs, beliefs, values, & institutions of racial, ethnic, religious, or social groups
INTERESECTIONALITY privilege & oppression
OPPRESSION formal & informal system of advantages and disadvantages tied to out membership in a social group (individual/cultural/institutional)
WORLD VIEW how people perceive others, how they interact & relate to reality; how they process information "the way people look upon the world"
TRANSCULTURAL NURSING comparative study of cultures in order to understand their similarities & the differences among them
CULTURALLY CONGRUENT CARE care that fits a person's life patterns, values, & system of meaning
CULTURAL ENCOUNTERS cross-cultural interactions to learn of the cultures
SOCIAL DETERMINANTS OF HEALTH resources such as access to health care, job opportunities, nutritious food, clean air & transportation (social factors)
STEREOTYPING assumption that people in a culture, racial, or ethnic group are alike & share the same values & beliefs
ILLNESS the way individuals & families react disease
DISEASE a malfunctioning of biological/psychological processes
CORE MEASURES key quality indicators that help healthcare institutions improve performance, increase accountability & decrease costs, healthcare disparities
CULTURAL COMPETENCE a health care professional strives to work effectively within the cultural context of a pt./ensure delivery of culturally congruent care
COMPONENTS OF CULTURAL COMPENTENCE -cultural awareness -cultural knowledge -cultural skills -cultural encounters -cultural desire
CULTURAL DESIRE motivation & commitment to caring that moves an individual to learn from others
CULTURAL KNOWLEDGE comparative of diverse groups, endogenous, values, worldview
CULTURAL SKILLS assess pt. treatment & care; assess social, cultural & biophysical
CULTURAL ENCOUNTERS learn about other cultures
CULTURAL DESIRE motivation/commitment to caring that moves an individual to learn from others
ESTABLISHING RELATIONSHIPS transcultural communication skills to interpret behavior
MODEL OF CULTURAL COMPETENCE 1. developing self-awareness 2. understanding the worldview of others 3. developing appropriate strategies/skills/interventions 4. understanding organizational/institutional forces that either enable or inhibit cultural competence
BIAS predisposition to see people or things in a certain light, either positive or negative
LINGUISTIC COMPETENCE ability of an organization & it's staff to communicate effectively & convey information in a manner that is easily understood by diverse audiences
EXPLANATORY MODEL ability to elicit a pt's explanation of an illness & its causes
PATIENT-CENTERED CARE provides individualized care & restores an emphasis on personal relationships
OFFICE OF MINORITY HEALTH & HEALTH DISPARITIES organization requiring culturally sensitive health care delivery
SPIRITUALITY an awareness of one's inner self & a sense of connection to a higher being, nature, or some purpose greater than oneself
HOLISTIC of or pertaining to the whole; considering all factors; balance of physical, psychological, etc.)
FLORENCE NIGHTINGALE believed that spirituality is a force that provides energy needed in a healthy hospital environment & spiritual needs just as important as physical needs
SELF-TRANSCENDENCE connecting to your inner self, which allows one to go beyond oneself to understand the meaning of experiences; send of authentically connecting to one's inner self
TRANSCENDENCE the belief that there is a positive force outside of & greater than oneself that allows one to develop new perspectives that are beyond physical boundaries
INTRAPERSONALLY connected w/ oneself
INTERPERSONALLY connected w/ others & the environment
TRANSPERSONALLY connected w/ God, unseen higher power
FAITH & BELIEF assess source of authority & guidance that pts. use in life to choose & act on their beliefs
FAITH self of beliefs & a way of relating to self, others, & a supreme being; reasoning & trusting faith
HOPE source of energy that helps a person plan & achieve future goals; living & looking forward to something
INNER STRENGTH energy source that instills hope, provides motivation, & promotes a positive outlook on life, even in difficult times
INNER PEACE fosters calm & positive feelings despite life experiences of chaos, fear, & uncertainty
ATHEIST do not believe God exists
AGNOSTIC believe that any ultimate reality is unknown or unknowable
SPIRITUAL WELL-BEING individuals spirituality that enables a person to love, have faith, & hope, seek the meaning of life, & nurtures relationships with others
CONNECTEDNESS assess whether pt. loses the ability to express; having close spiritual relationships w/ oneself, other, & God or another spiritual being
LIFE SATISFACTION determine whether a pt. feels fulfilled w/ what he/she has accomplished in life
LIFE & SELF RESPONSIBILITY determine whether pt. understands limitations posed by an illness & how they adjust
MEDITATION lowers B/P, stress/pain & enhances the function of the immune system
4 DIMENSIONS OF SPIRITUAL WELL-BEING 1. personal - how you relate with oneself; meaning of life 2. communal - quality of your interpersonal relationships 3. environmental - how you interact with the world 4. transcendental - relationship between yourself & God
RELIGION specific system of organized beliefs & worship that a person practices to outwardly express spirituality (particular denomination of worship)
SPIRITUAL CARE helps people maintain personal relationships & a relationship w/ a higher being or life force to identify meaning & purpose of life
RELIGIOUS CARE helps pts. follow their belief systems and worship practices
SPIRITUAL DISTRESS impaired ability to experience and integrate meaning & purpose in life through connectedness w/ self, other, art, music, etc. (anger towards God because of illness or other matter)
ESTABLISHING PRESENCE pay attention, answer questions, listen & have a positive and encouraging attitude
NEAR DEATH EXPERIENCE (NDE) psychological phenomenon in which people have either been close to clinical death or recovered after being declared dead
FICA - evaluates spirituality & quality of life F - Faith/belief I - Importance of spirituality C - individuals spiritual Community A - interventions to Address spiritual needs
CONNECTEDNESS having close spiritual relationships w/ oneself, other, & God or another spiritual being
PRAYER personal communication w/ one's God
FELLOWSHIP relationship an individual has w/ other people; family, friends, coworkers, school or church
RITUALS participation in a religious group or private worship, prayer, sacraments (eg: Christian, communion) (eg: circumcision)
SPIRITUAL HEALTH gained by find balance in life
FELLOWSHIP & COMMUNITY explore the extent & nature of the pt's support network
RITUAL & PRACTICE assess participation in worship, prayer, etc.
SUPPORT SYSTEMS human-link between pts, nurses & pts lifestyle; family friends, spiritual advisors, clergy & pastoral
DIET THERAPIES food & nutrition (consult w/ dietician) (eg: muslims cannot eat pork)
SUPPORTING RITUALS plan care to allow time for pt. to practice the rituals & activities, religious readings, & spiritual visitations
VOCATION strong feeling of suitability for a particular career or occupation
FACTORS INFLUENCING SPIRITUALITY acute, chronic, or terminal illnesses & near death experiences
SUPPORTING A HEALING RELATIONSHIP mobilize hope, help pt. find acceptability
ACUTE ILLNESS creates an unanticipated scramble to integrate and cope w/ new realities
CHRONIC ILLNESS threatens the persons independence, causing fear, anxiety, & spiritual distress
TERMINAL ILLNESS causes fears of physical pain, isolation, & the unknown, dying
ASSESSMENT pts faith, beliefs, views on life, & religion to ensure patient centered clinical decisions
STRESS physiological/psychological tension that threatens homeostasis or person's psychological equilibrium; result of inability to immediately deal w/ event/threat
STRESSORS tension-producing stimuli in a person's external/internal environment that require change/adaptation; any perceived event that can evoke stress
COPING person's effort to manage psychological stress
GENERAL ADAPTATION SYNDROME a 3-stage defense response of the body to stress 1. alarm reaction 2. resistance stage 3. exhaustion stage
ALARM REACTION STAGE initial stage of the GAS during which defense mechanisms are mobilized
RESISTANCE STAGE second stage of stress response when a person attempts to adapt to the stressor
EXHAUSTION STAGE final GAS stage that occurs when the body no longer can resist the stress
PITUITARY GLAND small gland located below the hypothalamus that produces stress hormones, regulates secretion of thyroid, parathyroid & gonadal hormones
ENDORPHINS hormones that interact with opiate receptors & reduce pain perception & produce sense of well-being
FIGHT-OR-FLIGHT RESPONSE total physiological response to stress during the alarm reaction stage
APPRAISAL individual interpretation of the impact of a stressor or event & subsequent behavior
PRIMARY APPRAISAL evaluates an event for its personal meaning related to stress
SECONDARY APPRAISAL evaluates one's possible coping strategies when confronted w/ a stressor
EGO-DEFENSE MECHANISMS regulate emotional distress & provide a person protection from anxiety and stress
COMPENSATION making up for deficiency in self-image by strongly emphasizing a feature considered an asset
CONVERSION unconsciously repressing an anxiety-producing conflict & transforming it into non-organic symptoms
DENIAL refusing to consciously acknowledge anything that causes intolerable emotional pain
DISPLACEMENT transferring emotions, ideas, or wishes from a stressful situation to something less stressful
IDENTIFICATION patterning behavior after that of another person
DISSOCIATION experiencing a subjective sense of numbing & a reduced awareness of one's surroundings
REGRESSION coping w/ a stressor through actions & behaviors associated w/ an earlier developmental period
STRESS MANAGEMENT techniques used to cope w/ generalized stress & arousal to relax the body and mind
STRESS & COPING THEORY the Neuman Systems Model
FACTORS INFLUENCING STRESS & COPING situational sociocultural maturational
SITUATION STRESS FACTORS personal/family changes; eg: divorce, job loss, chronic illness
MATURATIONAL STRESS FACTORS life stage changes; eg: appearance, identity, death, empty nest
SOCIOCULTURAL STRESS FACTORS environmental & social issues; eg: handicapped, lives w/ violence, substance abuse, prison
COMPASSION FATIGUE a state of burnout & secondary traumatic stress
BURNOUT condition that occurs when perceived demands outweigh perceived resources
ASSESSMENT R/T STRESS & COPING establish pts stress level & coping resources & observe nonverbal behavior
SUBJECT ASSESSMENT FINDINGS create a non-threatening physical environment when asking nursing questions (what the patient tells you)
OBJECTIVE ASSESSMENT through observation of the appearance & non-verbal behavior of a patient (what you SEE)
PRIMARY MODES OF INTERVENTION OF STRESS decrease stressful situations, increase stress resistance, gain skills to reduce stress response
HOMEOSTASIS state of constancy in the internal environment, maintained naturally by physiological adaptive mechanism
CRISIS turning point in life in which previous way of coping are ineffective, requiring change; when an event overwhelms a person's coping mechanism & demands
CRISIS INTERVENTION use of therapeutic techniques to help a pt. resolve a particular & immediate problem
PATIENT OUTCOMES maintain ongoing communication w/ the patient regarding coping
APPROACH TO STRESS & COPING use critical thinking skills to understand the pts stressor & the stress response
STRESS-RELATED NURSING DX gather data from assessment; analyze clusters of defining traits to identify relevant diagnosis
SECONDARY TRAUMATIC STRESS trauma HCPs experience when witnessing & caring for others suffering from trauma
SOCIOECONOMIC STATUS access to support & financial, educational or occupational resources for coping
CULTURE & ETHNICITY interpretations of loss, acceptable expressions of grief & attitudes toward terminal illnesses
SPIRITUAL & RELIGIOUS BELIEFS faith in a higher power, support communities, friends, sense of hope & meaning in life, religious practices
END-OF-LIFE DECISION MAKING suggest pts communicate care wishes so family can act as surrogates when pts cannot speak for themselves
ASSESSMENT discuss grief variables & reactions to ensure patient-centered decisions are made
OLDER ADULT CONSIDERATIONS ask questions about recent relationships, significant life events & other stressful events ongoing all at once
PRIORITIES IN PLANNING FOR GRIEF CARE important to assess patient's most urgent physical & psychological needs
PALLIATIVE CARE level of care designed to relieve/reduce intensity of uncomfortable symptoms but not produce a cure
THERAPEUTIC COMMUNICATION establishing a trusting relationship w/ the patient & family by using an "open-hearted" style
HOSPICE model for care of terminally ill patient & their families; assist clients comfort and with the family-centered care
GRIEVING FAMILY offer holistic, family-centered support, compassion, & education individual to each patient
PROMOTE DIGNITY & SELF-ESTREEM respect pt. as a whole, give importance to things the patient cares about, listen to patient's stories
MAINTAIN A COMFORTABLE & PEACEFUL ENVIRONMENT frequently reposition, keep bed linens dry, control noise & create a familiar environment
MANAGEMENT OF SYMPTOMS reassess pain & medication side effects & advocate change if the patient does not obtain relief
EXAMPLES OF LOSS body parts or function, self-esteem, friendships, confidence, or income, death
POST-MORTEM CARE care of a patient's body after death
SIUTATIONAL LOSS loss of a person, thing, or quality resulting from a change in a life situation (eg: trauma from car accident)
KUBLER-ROSS'S CLASSIC THEORY - 5 RESPONSES TO LOSS 1. Denial 2. Anger 3. Bargaining 4. Depression 5. Acceptance
AUTOPSY surgical dissection of a body after death to determine exact case/discover the pathway of a disease
RANDO'S "R" PROCESS MODEL focuses on a series of processes instead of stages
NORMAL GRIEF universal reaction to loss; emotional, cognitive, social, physical, behavioral & spiritual responses
FACILITATE MOURNING help survivors accept loss as real, support adjustment to loss, allow time to grieve, and provide ongoing support
BEREAVEMENT subjective suffering experienced after losing someone significant
PERSONAL RELATIONSHIP FACTORS the quality & meaning of the lost relationship
REORGANIZATION stage of mourning when a person begins to accept new roles, acquire new skills, & build new relationships
ACCEPTANCE individual begins to accept the reality & inevitability of loss & looks to the future
NATURE OF THE LOSS highly visible loss generally stimulates helping responses from others; more private loss brings less support
GRIEF TASK MODEL theory in which individuals actively engage in working through tasks to overcome grief
ATTACHMENT THEORY numbing, yearning, & searching, disorganization & despair and reorganization
PERCEIVED LOSS loss that is less obvious to people other than to the individual experiencing it
SPIRITUAL COMFORT & HOPE involve spiritual care providers in institutional setting; collaborate w/ patient's spiritual leaders
ANGER stage in which individual resists the loss
BARGAINING person postpones awareness of loss & tries to prevent it from happening by making deal/promises
PSYCHOSOCIAL CARE ensure pt. understands the condition, course of disease, & benefits/burdens of the treatment options
MATURATIONAL LOSS loss resulting from the normal changes of growth & development
DENIAL stage of grief in which individual acts like nothing has happened
DISORGANIZATION & DESPAIR stage of mourning in which an individual endlessly examines how & why the loss occurred
GRIEF form of sorrow involving the person's thoughts, feelings, & behaviors as a response to a loss
ANTICIPATORY GRIEF grief response in which the person begins the grieving process before an actual loss; letting go
COMPLICATED GRIEF grief response when a person has a prolonged or very difficult time moving forward after a loss (chronic/delayed/exaggerated/masked)
ACTUAL LOSS loss of an object, person, body part or function, or emotion that is overt & easily identifiable; can no longer be felt, heard, known or experienced
YEARNING & SEARCHING stage of mourning that includes emotional outburst of tearful sobbing & acute distress
DEPRESSION person realizes the full significance of the loss during this stage
HUMAN DEVELOPMENT patient age & stage of development
NUMBING stage of mourning that includes lack of feeling or feeling stunned by the loss
DISENFRANCHISED GRIEF grief response when someone's grief is not socially sanctioned or cannot be openly shared (unable to acknowledge; secret)
HOW A NURSE CAN HELP WITH LOSS -knowledge of grief process, the loss, the disease process -reflect on experience -attitudes of risk-taking, self-confidence, humility -standards-guide of assessment & data
SELF-CONCEPT & SEXUALITY INCLUDE: -unconscious & conscious thoughts -attitudes & perceptions
SELF-CONCEPT your view of who you are; if affects your self-esteem & how you feel about yourself; conscious & unconscious thoughts, attitudes, and perceptions
SEXUALITY refers to all aspects of being sexual; a function of the total personality...concerned w/ the biological, psychological, sociological, spiritual, & culture variables of life
SEX bow chicka bow bow..........HAHAHA just kidding basic physiological need & sexual intimacy throughout the life span is equally important for sexual health
TRUST VS. MISTRUST birth - 1 yr. trust from consistency in caregiving & nurturing
AUTONOMY VS. SHAME & DOUBT 1 - 3 yrs. communicates likes & dislikes, independent thoughts & actions, appreciates body appearance
INITIATIVE VS. GUILT 3 - 6 yrs. takes initiative, identifies gender, enhance self-awareness, increase language skills
INDUSTRY VS. INFERIORITY 6 - 12 yrs. incorporates feedback from peers, increase self-esteem, sex identity increases, aware of strength & limitations
IDENTITY VS. ROLE CONFUSION 12 - 20 yrs. accepts body changes, examines attitudes & values, feels positive sense of self
INTIMACY VS. ISOLATION 20 - 40 yrs. intimate relationships, stable, positive feelings about self, success rose transitions
GENERATIVITY VS. SELF-ABSORPTION 40 - 60 yrs. accepts changes, commitment, reassess life goals
EGO INTEGRITY VS. DESPAIR 60 - death positive about one's life and death, providing legacy to next generation
IDENTITY the sense of individuality & being distinct and separate from others "oneself"; necessary for intimate relationships and sexuality is part of identity
GENDER IDENTITY person's private view of maleness or femaleness and gender role is the feminine or masculine behavior exhibited
RACIAL/CULTURAL IDENTITY identifying & socializing within an established group & through incorporating the responses of individuals who do not belong to that group into one's self-concept
BODY IMAGE involves attitudes related to the perception of the body, including physical appearance, femininity & masculinity, youthfulness, health & strength
LOCALIZED SITE INFECTIONS from tattoos & piercings plastic piercing retainer or 14/16 gauge needle to keep piercing open
HETEROSEXUAL attracted to different sex partners
LESBIAN/GAY same sex partners
BISEXUAL both male & female partners
TRANSGENDER different gender identity from as it was at birth
ROLE PERFORMANCE the way in which a person views his/her ability to carry out significant roles; meeting certain expectations (eg: mom/dad, sister/brother, etc)
SELF-ESTEEM an individual's overall sense of personal worth or value; positive when capable & competent
SELF-CONCEPT STRESSOR any real/perceived change that threatens identity, body image or role performance
SEXUAL ORIENTATION clear, persistent erotic preference for a person of one sex or the other
SEXUAL DYSFUNCTION (involves problems w/ desire, arousal, or orgasm); inability or difficulty in sexual functioning caused by physiological or psychological factors or both
MENARCHE onset of menstrual cycle in girls
SEXUALLY TRANSMITTED INFECTIONS (STIs) infectious process spread through sexual contact including oral, genital or anal sexual activity
20 MILLION PEOPLE IN US ARE INFECTED WITH genial human papillomavirus (HPV) 50% are adolescents & young adults 15-24
MATTER-OF-FACT STATEMENTS "this wound is healing nicely" "this looks healthy"
NON-VERBAL COMMUNICATION communication using expressions, gestures, body posture & positioning rather than words
AUTONOMY freedom to choose their own life plan and ability/tendency to function independently
SEXUAL HEALTH integration of the somatic, emotional, intellectual and social aspects of sexual being, in ways that are positive
P L I S S I T P = Permission for HCP to discuss sexuality issues LI = Limited Information SS = Specific Suggestions IT = Intensive Therapy
ASSESSMENT OF SEXUALITY INVOLVES -physical variables -social variables -psychological variables -cultural variables
IN US 50 YR. & OLDER ARE ONE OF THE FASTEST GROWING POPULATIONS FOR HIV & AIDS HIV - human immunodeficiency virus AIDS - acquired immunodeficiency syndrome HPV - human papilloma virus
NURSING PROCESS ASSESSMENT -actual/potential stressors -subjective/objective data -family input -initiate health promotion of activities by self
NURSING DIAGNOSIS -disturbed body image -caregiver role strain
NURSING GOALS -emphasize strengths, not weaknesses -participate in care -adapt to changed body -discuss feelings
NURSING INTERVENTIONS -encourage self care -provide time to listen -teach problem solving techniques -provide positive feedback
NURSING EVALUATION -grooming -posture, non-verbals -social interactions -patient role? (father, mother, sister, etc.)
ugh I don't want to study
Created by: Smccunn