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huron.fundam.test1
huron.nursing.cleve.oh.fall2010.fundam.test1
| Question | Answer |
|---|---|
| what is a top contributor to errors in workplace & threatens professional credibility? | Breakdowns in communication |
| what is at the core of nursing | caring relationship formed between nurse & those affected by N's practice |
| mutuality | belief that nurse-client |
| is communication therapeutic? | Yes, it can - compare to energy-based healings in eastern cultures |
| intention and behavior | affect healing and help |
| critical thinking in communication | combine theoretical knowledge & integrate with personal experience |
| perceptual bias | human tendencies that interfere with accurately perceiving & interpreting messages from others |
| intrapersonal communications | talking with your self |
| interpersonal communicaiton | one-to-one interaction -at heart of nursing practice |
| transpersonal communication | interaction within spiritual domain - use of prayer, etc. for healing |
| small-group communication | ex. research teams, care teams |
| public communication | interaction with audience |
| referent | stimulus that begins communication Ex. clients has difficulty breathing |
| sender | person who "encodes" and delivers message |
| receiver | person who "decodes" message |
| message | content of the communcation-contains verbal, nonverbal & symbolic language - personal perceptions distort receiver's interpretation of message |
| channels | can be visual, auditory and tactile senses-facial expressions, touch. |
| mediated communication | technological-telephone, pager, audiotape |
| feedback | message receiver returns - in nursing, nurse is responsible for nurse-client feedback |
| interpersonal variables | factors affecting communication- can be pain, differing perceptions, etc. |
| environment | setting for sender-receiver - health care environments can be very distracting |
| verbal communication | spoken or written words-language is a code that conveys specific meaning |
| vocabulary | medical jargon (technical terminology used by health care providers) is like a foreign language to clients-children & teenagers need unique words |
| denotative & connotative meaning | denotative "code" means one thing to a computer technical writer but means "heart attack" to a health care provider - connotative meaning - interpretation or shading of word to people Ex. illness is "serious" can mean different things to different people |
| pacing | don't talk too fast |
| intonation | don't talk down - also listen to client's tone of voice |
| clarity and brevity | effective communicaiton is simple, brief and direct - REPEAT important phrases |
| timing and relevance | poor timing affects reception - if patient is facing surgery, don't discuss general health |
| nonverbal communication | all of the five senses and everything that does not involve spoken or written words |
| how much of communication is nonverbal | 55% transmitted by body cues |
| when there is incongruity between verbal & nonverbal communications | receiver "hears" nonverbal message as true message - beware different cultures |
| personal appearance | includes physical characteristics, facial expression, manner of dress and grooming |
| eye contact | cultures differ - eye contact such as looking down, same level, etc. |
| gestures | Ex. pointing to an area of pain is more effective than description |
| sounds | sighs, groans, moans, g |
| territoriality and personal space | cultures vary-provides a sense of identity, security and control-take care when invading space to perform nursing care |
| symbolic communication | ex. music and art-use ofverbal and nonverbal symbolism to convey meaning |
| metacommunication | broad term that refers to all factors that influence communication |
| interpersonal communication | socializing is important first step |
| therapeutic environment | depends on ability to communicate, communicate and help clients meet their needs |
| comfort is a critical value in nursing | therapeutic interactions increase feelings of personal control by helping person feel secure, conntected |
| therapeutice - sharing stories | learn clients values, stories |
| autonomy | ability to be self-directed and independent in accomplishing goals and advocating for others-nurses need to make choices and accept responsbility for outcomes of their actions |
| client's autonomy | client are concerned about losing control of decisions about how they live |
| assertiveness | conveys a sense of self-assurance while also communicating respect for the other person |
| communication -nursing - assessment | "Contextual" factors influence communication between nurse and client - |
| what is context | internal factors, nature of communication, socioeconomic |
| physical/emotional factors | people can't hear, can't see - review for influences such as drugs , trauma, anxiety |
| ask client | can they speak? are they at ris? what are the barriers? |
| children have special needs | don't look down, children see nonverbal messages |
| older adults | remember may have hearing, speech deficit |
| sociocultural | asians, hispanics do not reveal |
| foreign-born | may not understand english, |
| nursing diagnosis | individuals have impaired communication ability - usualy impaired verbal -means descreased, delayed or absent ability-what is cause of coummnication disorder? |
| intervention for impaired verbal communication | ex. impaired verbal due to cultural differences (Hispanic heritage) vs. deafness |
| communication dysfunction-physical | designing care plan-motivate, encourage client to improve-make sure basic comfort & care are taken-practice communication Ex. client w/tracheostomy needs writing board |
| what is goal? | effective nursing interventions for communication dysfunction will have goal of client experience trust in nurse & health care team - outcomes must be measurable - |
| communication dysfunction - psychological | Ex. impaired social interaction or ineffective coping - plan interventions to improve |
| interventions to approve social skills | role play, model behavior |
| outcome | clients learn to express feelings, engage in appropriate social conversation |
| continuity of care | speech therapists, help clients with aphasia |
| therapeutic communication techniques | specific responses to encourage expression of feelings; include active listening, sharing observations; sharing empathy; hope; humor, feeling |
| active listening | |
| Chap. 11-Development (includes 3) | refers to patterns of change that begin at conception and continue throughout a lifetime; includes biological, cognitive and socioemotional changes during the lifespan |
| how does an understanding of lifespan growth and development help nurses? | planning questions for health screening, health history and health teaching for clients of all ages |
| biologic processes | produce change's in individual's physical growth & development |
| cognitive processes | changes in intelligence, ability to understand and use language, and development of thinking - attitudes, beliefs and behaviors |
| socioemotional processes | variations that occur in personality, emotions, relationships with others; temperment or behavioral style are biologic base of personality development |
| developmental theories | a theory is a set of interrelated concepts, definitions, and propositions that-organized view of subject in order to explain and make predictions |
| how does understanding specific task or need of developmental stages help nurse? | guides caregivers in planning appropriate individualized care for clients |
| biophysical development | how our physical bodies grow and change-healthcare providers can quanitify and compare changes |
| Gesell's theory of biophysical development | Children develop motor, language, adaptive and personal-social behaviors in sequence - each has their own pace, but patterns are fixed for development sequence |
| sequential development | organ systems develop in fetus; after birth, skills develop in sequence |
| Psychoanalyhtic//Psychosocial Theories | development from perspective of personality, thinking and behavior-explains development in terms of inner drives and motives - primarily unconscious-also occur in sequence |
| Freud | 1st to have structured theory of personality development; believed adult personality is result of how an indvidual resolved conflicts between sources of pleasure and mandates of reality |
| Freud's 5 stages | oral stage-birth -12/18mos.(suckling); anal stage 12/18 mos to 3 years (toilet training) phallic or Oedipal 3-6 yrs.(discover genital organs-penis & penis envy) latency 6-12 yrs.(growth); genital (puberty -adult) |
| Freud's components of personality (3) | Id (basic instinct) ego (reality component mediating conflicts) and superego (conscience) |
| goal of Freud's theory | develop blance between pleasure-seeking drives & societal pressures |
| Erik Erikson (psychosocial)-stage theory | Development throughout lifespan and psychoSOCIAL stages - studied different cultures (european, american & native american |
| Erikson's 8 stages of development | 1) accomplish a task 2.master, then go on to next task (read list) |
| theories related to temperament | behavioral style that affect individual's emotional interactions with others |
| Chess and Thomas | conducted 20-year longitudinal study (takes a long time for doubting Thomas to play chess) |
| When is temperment established (Chess and Thomas) | 2 to 3 months |
| Types of temperamnet | Easy child (regular habits, happy baby) difficult child (active, irritable & irregular) slow-to-warm-up - adapts slowly, does not like novelty |
| How does nurse use temperment theory | counseling -parents need to be aware of child's style |
| Adult development -Robert Gould (like Robert Goulet, he just kept going into adulthood)also a stage theory | adults develop in stages: 20's -breakaway from parents; 30's growing family and Have I done the right things? 40's the die is cast-also regrets - 50's - realize mortality but also gain wisdom - theory helps adults accept aging |
| Cognitive approach - Piaget | Theory explains children's intellectual orgnization-how they think,k reason and perceive |
| Piaget's theory of cognitive development (4) | Four stages: I sensorimotero (birth to 2 yrs); II preoperational - 2-7 yrs); III concrete operations (7-11 yrs.) IV - formal operation (11 yrs. to adulthood) |
| sensorimotor (birth to 2 yrs) | infant develops schema, self-initiated activities (sucks thumb, then grasps blanket in order to suck it |
| preoperational (2-7 yrs) | children are egocentric; develop language, play games; learn to count |
| concrete operations (7-11 Yrs) | children perform mental operations-think about actions before performing them-can reverse actions (change rules of game) |
| formal operation 11-adulthood) | teenagers can think in abstract terms, learn theory-have capacity to reason |
| Cognitive changes | Piaget said that formal operational thought began in adolescence - but some adults never reach this stage-also adults us emotions, logic, flexibility to make decisions |
| William Perry | adult cognition-can accept several solutions |
| Moral Development theory (Piaget and Kohlberg) | refers to changes in thoughts, emotions, behaviors concerning what is right or wrong- |
| Moral Development theory talks to who? | interpersonal and INTRApersonal |
| Piaget moral development | 1) heteronomous morality - rules cannot be broken; punishment is immediate 2) autonomous morality - people make rules; they can be changed-children developed through peer interactions |
| young adulthood | late teens to mid-30's |
| middle age | mid to late 30's to mid 60's |
| women | 47% of work force; 76 cents for 1.00 |
| young adult - completes physical growth | age 20 - except pregnant women |
| major life task - young adults | identifying an occupational direction |
| nurse help young adults | understand how adults learn - helps develop client education plans - factor in lifestyle changes, socioeconomic, etc |
| patterns adult life | 23-28-person refines self-perception & ability for intimacy - 29-34-achievement & mastery of world - 35-43 - examination of life goals and relationships |
| Health | not merely the absence of disease but involves wellness |
| young adults/nurses | needs to make decision about career, marriage, and parenthood - nurse understands general principles of psychosocial development |
| young adult - lifestyle | nurse's role is to identify modifiable factors that increases risk - then provide client education to reduce unhealthy lifestyle behaviors |
| Nurse conduct personal lifestyle assessment | diet, sleeping, exercise, ...everything...including military service (WHERE?) look for prolonged stress factors - increase risk of ulcers, emotional disorders and infections |
| careers - two career families | need to share housework! |
| sexuality | young adults need to use emotional maturity to have mature sexual relationshiops & develop intimacy |
| childbearing | stress from childbirth has significant impact on postpartum women's health |
| types of families | couples can choose parenthood; gay & lesbian adoptions supported by American Academy of Pediatrics |
| Hallmarks of Emotional health (10) | sense of meaning; successful transitions; absence of feelings of being cheated; attain long-term goals;satisfied with personal growth;married-mutual love-single-good social interactions; friendships; cheerful; no sensitivy to criticsim; no unreal fear |
| family health history | myocardial infarction father & paternal grandfather = risk |
| violent death | psychosocial assessment shows abuse, other risk factors for violence |
| substance abuse | alcohol=car accidents; overdose; caffeine legal stimulant catecholamine release-then central nervous system is "UP" heart stimulated |
| substance abuse - diagnosis | nurse ask nonjudgemental questions-past medical conditions, arrest record, sleep patterns, food intake |
| unplanned pregnancy | nurse determines situational factors-family support system, coping mechanisms |
| sexually transmitted diseases | major health problems - 1/2 of all infections in younger than 24 years of age |
| young adults susceptible | diabetes, hypercholesterolemia - Crohn's disease |
| infertility | prolonged time to conceive - female ovulatory dysfunction or pelvic factor 50% - male 35% - nursings assess history, physical findings |
| exercise | nurs teaches prevention high blood pressure, |
| health screening | female breast exam-skin exam (no Tanning ultraviolet rays) |
| family stress | highest divorce rate first 3 to 5 years of marriage for adults under 30- look for stress-related symptoms - changing family roles cause stress |
| prenatal care | routine exam of pregnant woman by OB/GYN, etc.-physical assessments, STD check, vaginal/urinal infections, counseling against exercise, diet, |
| braxton-hicks contractions | 3rd trimester - (irregular, short contractions) |
| puerperium | period 6 weeks after delivery-body reverts to normal |
| lactation | breast-feeding - teach mother-watch for signs of frustration |
| family education | need to know about labor, delivery, breast-feeding and integration of newborn into family |
| acute care - young adults | accidents, substance abuse, occupational hazards, urinary tract infections- nurse keeps them informed, involved in health care decision |
| restorative & continuing care - young adults | AIDS, diabetes, MS cancer - |
| sandwich generation | middle age caring for older adults, child |
| middle age | mid-30's thorugh mid 60's |
| health care coverage | 15.7% no health care |
| menopause & perimenopause | ovarian funciton declines, then ceases - 45-60 yrs of age |
| climacteric | men late 40's or early 50's-decreased levels of androgens |
| psychosocial changes | nurse assess - health, depression, factors such as child leaving home-also some choose healthier lifestyles |
| families psychosocial factors | singlehood - divorce, widows, how are they coping? nurse to assess |
| children leaving home | can cause divorce-or happiness |
| sandwich generation | nurse to assess stressors & conflicts |
| health promotion & stress reduction | nurse to assess for stress-related factors & possible illnesses-work with client to modify stress response |
| ways nurse can reduce stress | interventions for stress 1. reduce stress-producing situations 2. increase stress resistance (assertiveness, goals,) 3. avoid physiological response - use relaxation, imagery & biofeedback |
| obesity | nurse teaches wellness |
| positive health habits | nurse assesses, then teaches - give clients non-judgmental information-health teaching & health counseling - offer positive reinforcement - prevent STD's, obesity |
| anxiety | common-can cause psychosomatic illness-nurse can use crisis intervention, stress management techniques |
| depression | mood disorder that manifests itself -frequent age of onset is 25-44 - it is common among adults in middle years |
| risk factors for depression (5) | female, loss of work, family relationshiops, last child leaves home, menopause (mood changes) alcohol abuse |
| nursing assessment - depression | focused data collection re: individual and fmaily history of depression, collect family data |
| community health programs | nurses tech family planning, birthing, health screening, hypertension, need to be culturally appropriate-offer objectives |
| acute care-middle adults | recovery longer-can become chronic conditions - sandwich generation, stress levels increase- |
| restorative and continuing care | chronic disease causes-strained family relationship, financial stress, social isolation-degree of disability |
| clients w/continuing disease | role reversal, changes in sexual behavior, alterations in self-image-determine coping mechanisms |
| old age starts | age 65 |
| older adults as US population | growing in absolute numbers (35 million over 65) and as proportion of population (12.4% of population) |
| what factors cause increase? | aging of baby boomers & extension of lifespan (growth of population over 85) |
| are most old people disabled? | no, most are functionally independent - may have a chronic condiiton |
| gerontological nursing | asessment of health & functional status of lder adults, diagnosis, planning, implementing health care |
| gerontology | study of all aspects of aging process and its consequences |
| geriatrics | diagnosis & treatment of disease and problems affecting older adults |
| geriatrics | Gr. geras - old age and iatrikos - healing |
| are most elderly in institutions? | No - 54% with spouse; 31% live alone, 15% with family |
| are older people poor? | no, most have Social Security, pensions, assets |
| ageism | discrimination again people because of increasing age-laws ban discrimination |
| nurse's attitude toward aging | need positive attitude because population is older |
| stochastic theory of aging | random - due to chance - stochastic process, or sometimes random process, is the counterpart to a deterministic process. in a stochastic or random process there is some indeterminacy in its future evolution Ex. Cancer is a stochastic process |
| nonstochastic theories | genetically programmed physiologic mechanisms within the body control the process of aging |
| Psychosocial -theories | explain changes in behavior, roles and relationships that come with aging |
| disengagement theory | as people grow older, they withdraw from customary roles and engage in introspective activities |
| activity theory | continuation of activities is necessary for successful aging |
| continuity theory | personality remains the same and behavior becomes more predictable-personality of a lifetime determines engagement & activity in old age |
| what are adjustments to aging? | accept physical changes that accompany aging-normal (not disease) changes in appearance |
| what is dangerous? | if older adult does not accept functional changes they could be in danger |
| losses in old age | job loss, role changes (house-husbands) income changes, change in residence (financial or due to physical impairment) |
| death of spouse & friends | 43% of older women are widows; all lose friends, relatives |
| adult children | must redefine relationships-role reversal, control of decision-making, dependence, conflict, guilt and loss |
| what does nurse do? | act as counselors to families - help adult children by listening and help them to see changes in older adults |
| quality of life - older adults | nurses listen to what older adult considers most important; maintain or improve QOL issues - social relationships, living in home, hobbies such as gardening |
| when is nurse needed? | Decision to enter a nursing center-nurse provides information |
| geriatric assessment | asses for changes in physiology, cognition and psychosocial behavior |
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walterina4327
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