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3209 Test I Def

Definitions from Ch 1, 2, 3, 6, 8, 9, 29, 31

Advanced Practice Nurse (APN) Generally the most indepently functioning nurse. Has a master's degree in nursing, advanced education in pharm and physical assessment, and cert. and expertise in a specialized area of practice.
American Nurses Association (ANA) The only full-service professional organization representing the interests of registered nurses.
Caregiver One who helps the client regain health and a maximal level of independent function through the healing process.
Certified Nurse Midwife (CNM) An RN who is also educated in midwifery and is certified by the American College of Nurse-Midwives.
Certified Registered Nurse Anesthestist (CRNA) An RN with advanced education in a nurse anesthesia accredited program.
Client Advocate One who protects her client's human and legal rights and provides assistance in asserting those rights if the need arises.
Clinical Nurse Specialist (CNS) An APN with nursing experience in a specialized area of practice and works in any practice setting. Most often in the hospital setting.
Code of Ethics The philosophical ideals of right and wrong that define the principles you will use to provide care to your clients.
Continuing Education These involve formal, organized educational programs offered by universities, hospitals, state nurses associations, professional nursing organizations, and educational and health care institutions. Helps you remain current w/ skills, knowledge, & theory.
In-service Education Instruction or training provided by a health care agency or institution. Designed to increase the knowledge, skills, and competencies of nurses and other health care professionals.
International Council of Nurses (ICN) Promotes nat'l associations of nurses, improves nursing practice standards, seeks higher status for nurses, and provides an int'l power base for nurses. ANA is part of it.
Nurse Administrator Manages client care and the delivery of specific nursng services within a health care agency. Usually begins with positions such as the assistant nurse manager.
Nurse Educator Works primarily in schools of nursing, staff development depts of health care agencies, and client education depts.
Nurse Practioner Provides health care to a group of clients, usually in an outpatient, ambulatory care, or community-based setting. Provide a more holistic approach than a physician.
Nurse Researcher Investigates problems to improve nursing care and to further define and expand the scope of nursing practice. Often works in an academic setting, hospital, or independent prof. or comm. service agency.
Nursing (part 1) The protection, promo, and optimization of health & abilities, prevention of illness & injury, alleviation of suffering...
Nursing (part 2) ...through the diagnosis & treatment of human response, and advocacy in the vare of indiciduals, families, communities, and populations.
Professional organization Deals with issues of concern to those practicing in the profession.
Registered Nurse (RN) A nurse who has completed either an associates or baccalaureate program and has successfully passed the NCLEX exam.
Acute care Secondary and tertiary care. Includes emergency care, medical-surgical care, radiological procedures, intensive care, and subacute care.
Adult day care centers Provide a vaiety of health and social services to specific client populations who live alone or with family in the community. Allow family members to maintain their lifestyles and employment and still provide home care to their relatives.
Assisted living Offers an attractive long-term care setting with a homier environment and greater resident autonomy. Clients require some assistance with ADLs, but remain relatively independent w/in a partially protective setting.
Capitation The providers received a fixed amount per client or enrollee of a health care plan. The aim is to build a payment plan for select diagnoses or surgical procedures that consists of the best care standards.
Case management Usually a nurse or a social worker coordinates the efforts of all disciplines to achieve the most efficient and appropriate plan of care for the client. Particularly focuses on discharge planning.
Diagnosis-Related Groups (DRGs) 468 inpatient hospital service groups for Medicare. Each group had a fixed reimbursement amount with adjustments based on severity, rural/urban/regional costs, and teaching costs.
Discharge planning Begins the moment a patient is admitted. A centralized, coordinated, multidisciplinary process that ensures that the client has a plan for continuing care after leaving a health care agency.
Extended care facility Provides intermediate medical, nursing, or custodial care for clients recovering from acute illness or clients with chronic illness or disabilities.
Globalization Health care consumers becoming more knowledgeable about their health. They have searched the internet about their concerns and medical condition, and now demand quality and service.
Home care The provision of medically related para- and professional services and equipment to clients and families in their homes for health maintenance, education, illness prevention, diagnosis and treatment of disease, palliation, and rehabilitation.
Hospice A system of family-centered care that allows clients to live and remain at home with comfort, independence, and dignity while easing the pains of terminal illness. The focus is palliative care, not curative treatment.
Independent Practice Association (IPA) Managed care organization (MCO) contracts with w/ physicians who usually are not members of groups and whose practices include fee-for-service and capitated clients.
Integrated Delivery Networks (IDNs) A set of providers and services organized to deliver a continuum of care to a population of clients at a capitated cost in a particular setting.
Managed care Health care systems in which there is administrative control over primary health care services for a defined client population.
Medicaid Provides medical care to the poor, to children, and to pregnant women living below the federal poverty level. It is funded jointly by the states and the federal government.
Medicare Healthcare for the aged. A federally administered system of health insurance for those 65 years and older.
Minimum Data Set Part of the clinical assessment for all residents in Medicaid or Medicare nursing homes. Assesses each resident's functional abilities and helps staff identify health problems.
Nursing informatics Combine the best of computer science and information science with nursing science. It supports nursing practice and the delivery of nursing care by providing nurses a way to manage & process data, info, and knowledge.
Nursing-sensitive outcomes Client outcomes that are directly related to nursing care. They have a major effect on client safety and quality of care.
Primary care Focuses on health services provided on an individual basis. Prenatal & well-baby care, nutrition counseling, family planning, exercise classes.
Preventative care Blood pressure & cancer screening, immunizations, poison control info, mental health counseling & crisis prevention, community legislation (seat belts, air bags, bike helmets)
Secondary care Emergency care, acute medical-surgical care, radiological procedures.
Tertiary care Intensive care, subacute care.
Restorative Care Cardiovascular & pulmonary rehab., sports medicine, spinal cord injury programs, home care.
Continuing care Assisted living, psychiatric, and older day care.
Professional Standards Review Organizations (PSROs) Review the quality, quantity, and cost of hospital care.
Prospective Payment Systems (PPS) Est'd by Congress in 1983; eliminated cost-based reimbursement. Grouped inpatient hospital services for Medicare clients into 468 diagnosis-related groups (DRGs).
Rehabilitation Restores a person to the fullest physical, mental, social, vocational, and economic potential possible.
Resource Utilization Groups (RUGs) Like DRGs, but used in the long-term care setting.
Respite care A service that provides short-term relief or time off for persons providing home care to an ill, disabled, or frail older adult. Trained volunteers stay in the home while the family caregiver runs errands or has some social time.
Restorative care Helps individuals regain maximal functional status and to enhance quality of life through promotion of independence and self-care.
Skilled nursing facility An intermediate care facility that offers skilled care from a licensed nursing staff. Includes admin. of IV fluids, wound care, long-term ventilator mgmt, and physical rehabilitation.
Utilization Review (UR) Committees Physician-supervised committees that review the admissions, diagnostic testing, and treatments provided by physicians who treat clients receiving Medicare. Goal: ID & eliminate overuse of diagnostic & treatment services.
Vulnerable populations Children, women, and older adults; most threatened by the pollution, noise, crowding inadequate water, improper waste disposal, and other environmental hazards of urbanization.
Work redesign To contain costs, hospitals have redesigned nursing units to have more services available on the units, thus minimizing the need to transfer/transport clients across multiple diagnostic and treatment areas.
Active strategies of health promotion Individuals are motivated to adopt specific health programs. Examples: Weight reduction and smoking cessation. They are active b/c they require clients to be actively involved.
Acute illness Has the potential to be life-threatening. Usually has a short duration is severe. Symptoms appear abruptly, are intense,a nd usually subside after after a relatively short period. May affect functioning in any dimension.
Chronic illness Has the potential to be life-threatening. Persists, usually longer than 6 months, and can affect functioning in any dimension. The client may fluctuate b/w maximal functioning and serious health relapses that may be life-threatening.
Health A state of complete physical, mental, and social well-being, not merely the absence of disease or infirmity.
Health behavior change The stages of change that a patient goes through. Relapse thru previous stages are frequent. Stages: Precontemplation, Contemplation, Preparation, Action, Maintenance Stage.
Precontemplation No intention to change w/in the next 6 months.
Contemplation Considering a change w/in the next 6 months.
Preparation Making small changes in preparation for a change in the next month.
Action Actively engaged in strategies to change behavior. This stage may last up to 6 months.
Maintenance stage Sustained change over time. This stage begins 6 months after action has started and continues indefinitely.
Health behaviors Postive ones are activities related to maintaining, attaining, or regaining good health and disease prevention. Examples: Immunizations, proper sleep patterns, adequate exercise, and nutrition.
Health behaviors Negative ones are practices actually or potentially harmful to health. Examples: Smoking, drug or alcohol abuse, poor diet, and refusal to take necessary medications.
Health belief model Addresses the relationship b/w a person's beliefs and behaviors. 3 components: Individual perceptions, modifying factors, and Likelihood of action.
Individual perception Regards how the patient feels and what they believe about their susceptibility to an illness.
Modifying factors Regarding an individual's perception of the seriousness of an illness. This perception is influenced & modified by demographic and sociopsychological variables, perceived threats of illness, and cues to action (mass media, advice from family).
Likelihood of action 3rd component of the health belief model; regards how likely it is that the person will take preventative action. Results from person's perception of the benefits of & barriers to taking action. (lifestyle changes, adhering to medical therapy and advice.)
Holistic health model Attempts to create conditions that promote optimal health. Clients are involved in their healing process, thereby assuming some responsibility for health maintenance.
Illness A state in which a person's physical, emotional, intellectual, social, developmental, or spiritual functioning is diminished or impaired compared w/ previous experience. *Illness is NOT synonymous w/ disease!
Illness behavior The general way people with illness act. Examples: How people monitor their bodies, define & interpret their symptoms, take remedial action, & use the healthcare system.
Illness prevention Protects clients from actual or potential threats to health. Motivates people to avoid declines in health or functional levels.
Passive strategies of health promotion Individuals gain from the activities of oters without acting themselves. Examples: Fluoridation or water supply, and fortification of homogenized milk w/ vitamin D.
Primary prevention True prevention; it precedes disease or dysfunction and is applied to clients considered physically and emotionally healthy. Examples: health ed programs, immunizations, & physical & nutritional fitness activities, flu shots, hearing protection.
Risk factor Any situation, habit, social, environmental, physiological, psychological, developmental, intellectual or spiritual condition that increases the vulnerability of an individual or group to illness or accident.
Risk factors Examples: Genetic & physiological factors (pregnancy, obesity, family Hx of diabetes), Age, Environment, & Lifestyle.
Secondary prevention Focuses on individuals who are experiencing health problems or illnesses and who are at risk for developing complications or worsening conditions. Activities directed at diagnosis and prompt intervention (screenings, early treatment).
Tertiary prevention Happens when a defect or disability is permanent and irreversible.
Tertiary prevention Involves minimizing the effects or long-term disease or disability by interventions directed at preventing complications & deterioration. Activities are directed at rehabilitation rather than diagnosis and treatment.
Wellness Caring for oneself in a healthy way; helps one have understanding and control of one's life.
Caring A universal phenomenon influencing the ways in which people think, feel, & behave in relation to one another. Determines what matters to a person.
Caring, according to Madeleine Leininger The essence & central, unifying, & dominant domain that distinguishes nursing from other health disciplines. An essential human need, necessary for the health & survival of all individuals.
Caring, according to Watson A holistic model for nursing that suggests that a conscious intention to care promotes healing and wholeness. Almost spiritual.
Caring, according to Swanson Consists of 5 categories or processes. A nurturing way of relating to a valued other, toward whom one feels a personal sense of commitment or responsibility.
Caring, according to Swanson Knowing (understand the event), Being with (emotionally present), Doing for (doing for the other as you would for the self), Enabling (passage thru life transitions), Maintaining belief (that the other will get thru an event).
Nursing behaviors related to caring Providing presence, touch, listening, knowing the client, spiritual care
Ethic of care Concerned with relationships b/w people and with a nurse's character & attitude toward others. Nurses who are aware of this are aware of unequal relationships that lead to an abuse of power over another, intentional or otherwise.
Ethic of care Places the nurse as the client's advocate and by giving priority to each client's unique personhood.
Presence A person-to-person encounter conveying a closeness and a sense of caring. Involves "being there" & "being with". Interpersonal.
Comforting Communicating concern and support.
Transcultural The concept of care as the essence & central, unifying, & dominant domain that distinguishes nursing from other health disciplines.
Transformative A formed connection b/w the one cared for and the caring. The relationship influences both the nurse & the client, for better or for worse.
Acculturation The process of adapting to and adopting a new culture.
Assimilation When an individual generally adopts & incorporates the characteristics of a dominant culture.
Biculturalism This occurs when an individual identifies equally w/ 2 or more cultures.
Bilineal When kinship extends to both the father's & mother's side of the family.
Confianza Mexican-American trust in caregivers who interact with them in a personalistic way.
Cultural backlash Occurs when an individual rejects a new culture b/c experience w/ a new or different culture is extremely negative.
Cultural care accommodation or negotiation Adapt or negotiate with others for a beneficial or satisfying health outcome.
Cultural care preservation or maintenance Retain and/or preserve relevant care values so that clients maintain their well-being, recover from an illness, or face handicaps and/or death.
Cultural care repatterning or restructuring Reorder, change, or greatly modify clients' lifestyles for a new, different, & beneficial health care pattern.
Cultural imposition Health care practitioners who have cultural ignorance or blindness about differences use their own values and lifestyles as the absolute guide in dealing w/ clients and interpreting their behaviors.
Culturally competent care The ability of the nurse to bridge cultural gaps in caring, work w/ cultural differences, & enable clients & families to achieve meaningful & supportive caring.
Culturally congruent care Care that fits the person's valued life patterns and set of meanings.
Cultural pain Occurs when health care providers disregard a patient's valued way of life.
Culture The thoughts, communications, actions, customs, beliefs, values, & institutions of racial, ethnic, religious, or social groups.
Culture-bound syndromes Illnesses that are specific to one culture. (Example: Hwa-byung; middle age Korean women who are overwhelmed & frustrated by the burden of caregiving for their in-laws, husbands, & children.)
Emic worldview An insider or native perspective in an intercultural encounter.
Etic worldview An outsider's perspective in an intercultural encounter.
Enculturation Socialization into one's primary culture as a child.
Ethnicity A shared identity related to social & cultural heritage such as values, language, geographical space, and racial characteristics.
Ethnohistory Refers to significant historical experiences of a particular group. (Ex: experience w/ the Great Depression has resulted in older Americans' tendency to be frugal and to save everything).
Fictive Non-blood kin
Halal Food that are permissible for Muslims. Meat (from animals that are slaughtered during a prayer ritual), fish, fresh fruit, vegetables, eggs, milk, and cheese.
Haram Prohibited foods for Muslims. Non-Halal meat, animals w/ fangs, pork products, gelatin, & alcohol.
Hilots Healthcare providers other than physicians for childbirth for Filipinos.
Hmong Refugees from the mountainous regions of Laos, who believe that epilepsy or seizure disorder is caused by the wandering of the soul; treatment includes intervention by a shaman who performs the ritual to retrieve the client's soul.
Hwa-Byung A Korean culture-bound sydrome that describes when middle-aged, low-income women are overwhelmed by the burden of caregiving to their in-laws, husbands, and children.
Igbos West-African culture who greatly celebrates the birth of a son.
Invisible culture Less observable components of culture. Often the major driving force behind visible practices.
Kosher Jewish diet which avoids meat from carnivores, pork, and fish w/o scales or fins. Meat comes from permissible animals that are slaughtered w/ least amount of suffering. Meat is separate from dairy.
Matrilineal Kinship limited to the mother's side of the family.
Patrilineal Kinship limited to the father's side of the family.
Naturalistic practitioners Cross-cultural healer who attributes illness to natural, impersonal, and biological forces that cause alteration in the equilibrium of the human body. Emphasizes use of herbs, chemicals, heat/cold, massage & surgery.
Personalistic practitioners Cross-cultural healers that believe that an external agent, which can be human (sorcerer), or non-human (ghosts, evil, deity) causes health & illness. Emphasize humans' relationships (living & dead), and with their deities.
Personalismo Mexican-Americans' way of saying they'll trust their caregivers who interact with them in a personalistic way.
Rabbi Jewish clergyman
Ramadan Event when Muslims fast during the daylight hours for 28 days.
Respeto Spanish for respectful
Simpatia Spanish for warm, friendly
Rites of passage Significant social markers of changes in a person's life.
Shaman Hmong spiritual healer
Sikh/Sikhism This man is easily identifiable by his uncut hair w/ wooden comb, beard, turban, cotton underwear, steel bracelet, & short sword.
Subcultures Represent various ethnic, religious, and other groups with distinct characteristics from the dominant culture. (Ex: Appalacian & Missouri Ozark cultures)
Transcultural nursing A comparative study of cultures to understand similarities (culture universal) and differences (culture-specific) across human groups.
Visible culture Easily seen components of one's culture.
Agnostic The name given to people who believe that there is no known ultimate reality. They discover meaning on what they do or how they live, b/c they find no ultimate meaning for the way things are.
Atheist People who do not believe in the existence of God. These people search for meaning in life through their work and their relationships with others.
Connectedness The feeling that spiritually offers; connected intrapersonally (w/in oneself), interpersonally (w/ others and the environment), and transpersonally (w/ the unseen, God, or a higher power).
Connectedness This is how clients are able to move past stressors of everyday life & find comfort, faith, hope, peace, & empowerment.
Faith A cultural or institutional religion; a relationship w/ a divinity; how a person chooses to live; an acceptance of what cannot be explained.
Holistic The way to look at something (symptom) influences the client's ability to function & to achieve goals established in life. This view enables the nurse establish a helping role and a healing relationship.
Hope Brought by spirituality & faith. When a person has the attitude of something to live for and look forward to. Closely associated with faith.
Self-trandenscence The belief that there is a force outside of a greater than the person. This force goes beyond space & time. The force is usually seen as positive, & allows people to have new experiences & develop new perspectives.
Spiritual distress The impaired ability to experience & integrate meaning & purpose in life through connectedness w/ self, others, art, music, literature, nature, and/or a power greater than oneself. Can happen when there's a conflict b/w a person's belief & path to health.
Spirituality An awareness of one's inner self & a sense of connection to a higher being, nature, or to some purpose greater than oneself.
Spiritual well-being Has 2 dimensions: vertical & horizontal. Has a positive effect on health; enables people to find meaning purpose in life.
Vertical dimension of spiritual well-being Supports the transcendent realtionship b/w a person and God or some other higher power.
Horizontal dimension of spiritual well-being Positive relationships and connections people have with others.
8 parts of spirituality Energy, self-transcendence, connectedness, faith, existential reality, beliefs and values, inner strength, inner peace and harmony.
Acute Stress Disorder Begins with the person experiencing, witnessing, or being confronted by a traumatic event & responding with intense fear, helplessness, or horror.
Alarm reaction 1st stage of the General Adaptation Syndrome. Hormones rise, increased bl volume, bl glucose levels, epinephrine & norepinephrine, heart rate, bl flow to muscles, O2 intake, mental alertness, & dilated pupils. Can last 1 min - several hours.
Resistance stage 2nd stage in the GAS. After the alarm reaction lasts several hours, the body stabilizes & responds in a manner opposite to the alarm reaction. If the stressor remains & body doesn't adapt, person moves to 3rd stage: exhaustion.
Exhaustion stage 3rd stage of GAS. HAppens when the body is no longer able to resist effects of stressor & body's depleted the necessary energy for adaptation. Body can't defend itself against stressor's impact, physiological regulation stops, and death can result.
Appraisal How people perceive/interpret the stressor on themselves, of what is happening, & what they're able to do about it.
Burnout A result of chronic stress. A syndrome of emotional exhaustion, depersonalization of others, & perceptions of reduced personal accomplishment, resulting from intense involvement w/ people in a caregiving environment.
Coping The person's effort to manage psychological stress.
Crisis When stress overwhelms a person's existing coping skills, and disequilibrium occurs.
Crisis intervention A specific type of brief psychotherapy with prescribed steps. More directive than than traditional psychotherapy or counseling. The client ultimately must make the connection b/w the stressful event & his reaction to it.
Developmental crises Crises associated w/ changing developmental levels. (Ex: marriage, child birth, retirement)
Situational crisis Can be provoked by external source like a job change, motor vehicle crash, a death or severe illness.
Distress Damaging stress.
Eustress Stress that protects health; motivating energy (happiness, hopefulness, & purposeful movement)
Ego-defense mechanisms Coping mechanisms which regulate emotional distress & thus give a person protection from anxiety & stress. They help a person to cope indirectly.
Endorphins Hormones that act on the mind like morphine & opiates. They produce a sense of well-being and reduce pain.
Fight-or-flight response Arousal of the sympathetic nervous system. This prepares a person for action by increasing heart rate, diverting blood from intestines to brain & striated muscles, & increasing BP, RR, & bl glucose levels.
Flashbacks Recurrent & intrusive recollections of the traumatic event that caused PTSD.
General Adaptation Syndrome (GAS) A 3-stage response by the body to stress: alarm reaction, resistance stage, & exhaustion stage.
Posttraumatic stress disorder (PTSD) Effects of the traumatic event that last well after the event is over. Begins with an acute stress disorder (ASD).
Primary appraisal Evaluating an event for its personal meaning; it's an ongoing perceptual process.
Secondary appraisal If stress is present in an event, this focuses on possible coping strategies.
Stress An experience a person is exposed to, though a stimulus or stressor. Also the appraisal, or perception of a stressor.
Stressors Disruptive forces operating within or on any system.
Trauma This happens when symptoms of stress persist beyond the duration of the stressor.
Created by: freeflyrese