Flashcards in 3033 Exam 3 General Review Deck (131):
What does diabetes affect? (in general)
Carbohydrates, protein, fat metabolism and storage
T/F: Diabetes is a chronic disease.
What is insulin?
A hormone produced by the beta cells in the pancreas. It promotes glucose transport from the blood to the cells where the glucose is used for energy.
What is IDDM?
Type 1 diabetes. "Insulin-Dependent Diabetes Mellitus."
Type 1 diabetes: Juvenile or adult onset?
Type 1 diabetes: Abrupt or gradual onset?
Which is more common? Type 1 or type 2 diabetes?
T/F: Insulin is not produced in a body with type 2 diabetes.
Who is primarily affected by gestational diabetes?
Function of sulfonylureas (glipizide) (Glucotrol)?
Stimulate release of insulin from pancreas. Enhances cellular sensitivity to insulin.
Function of biguanide (metformin) (Glucophage)?
Decrease rate of hepatic glucose production.
Hypoglycemia: Rapid or gradual onset?
Rapid (1-3 hours)
What is unique symptom of hypoglycemia?
Cool, clammy skin
What does hypoglycemia "need"?
Increase in blood sugar
What is diabetic keto-acidosis?
What symptom is unique to hyperglycemia?
Hot, dry skin
What is the onset time frame of hyperglycemia?
What does hyperglycemia "need"?
Hydration, insulin, electrolyte replacement
Define Somogyi effect.
Rebound effect in which an overdose of insulin induces hypoglycemia. "Drop in glucose levels in the early morning hours due to excessive administration of insulin."
What term encompasses self esteem, personal identity, role performance and body image?
The need to feel good about oneself and believe others hold one in high regard. "How an individual evaluates himself. How much respect one has for himself."
Define personal identity.
An individual's conscious sense of who he or she is. "Accounts for the uniqueness of us as an individual."
Define role performance.
Ability to successfully execute societal as well as our own expectations regarding role-specific behaviors.
Define body image.
The subjective view a person has about his or her physical appearance. "Perception of one's own body. The physical element."
The need to reach one's potential through full development of one's unique capability.
The mental image or picture of self.
The composite of facts, qualities, images and feelings one holds about oneself.
What was Coopersmith's theory?
It is possible to increase self-esteem by attaining success in any of the four areas: significance, competence, virtue, power.
Worthiness and acceptance; a person learns to value self by being valued by the attention and affection of others.
Mastery, successful performance or achievement marked by high levels of performance.
Moral worth. Adherence to moral and ethical standards.
The ability to influence and control others.
What developmental stage does power first appear?
Define a prescribed role.
Roles that are given to us, such as our age, sex or position in the family (mother, father). These are assumed and cannot be controlled.
Define an achieved role.
An earned role that can be controlled. E.g. receiving a degree, becoming a nurse.
Define a transitional role.
A role in between two other roles. Moving toward an achieved role.
Define role ambiguity.
Does not clearly understand expected behaviors.
Define role failure.
The absence of appropriate role or ineffective performance of role behavior.
Define role conflict.
Two roles that conflict, in terms of values or expectations of the role. E.g. Need to be at work at 2 today, but also need to be at son's soccer game.
Define role strain.
Feel unable or inadequate to accomplish the task in the role. You have several roles, and you are struggling to keep them up.
Define learned helplessness.
Further actions would be useless due to previous attempts.
What is one physiological change you will see in a person on steroids? (In terms of diabetes) what will a person on steroids likely require?
High blood pressure. Insulin therapy.
What is intensive insulin therapy?
The basal-bolus regimen, which uses rapid-/short-acting insulin before meals and intermediate-/long-acting background insulin once or twice a day. The goal is to achieve a near-normal glucose level of 80 to 120 mg/dL before meals.
Function of glyburide (macronase) (diabeta)?
A sulfonylurea that decreases insulin production and release from the pancreas.
Define culture conflict.
When people become aware of cultural differences, feel threatened, and respond by ridiculing the beliefs and traditions of others to make themselves feel more secure about their own values.
Learned, shared and transmitted values, beliefs, norms and behaviors.
Qualities that reflect the characteristics a group may share in some combination. The affiliation of a set of persons who share a unique cultural, social and linguistic heritage.
Define health disparities.
Gaps in the quality of health and health care across racial, ethnic and socioeconomic groups.
The belief that one's own ethnic beliefs, customs, values and attitudes are correct and thus superior.
The assumption that an attribute present in some members of a group is present in all members of a group.
The integration of one cultural group into the dominant culture.
Degree in which an individual from one culture has given up the traits of that culture and adopted traits of the dominant culture in which one resides.
Define culture shock.
Feeling that develops when there is a racial difference in a new culture's values and beliefs compared with the person's native culture.
Define cultural imposition.
The belief that everyone should conform to your own belief system.
Define cultural competence.
Having enough knowledge of cultural groups that are different from your own.
Define culturally competent care.
The use of culturally based knowledge in creative, congruent, and meaningful ways to provide beneficial and satisfying health care to diverse cultures.
Define cultural bias.
Strong position that all decisions must be based on one's own values and belief.
Define cultural ignorance.
Insufficient knowledge about a specific culture.
Describe mild anxiety.
Still have a wide perceptual field; acuity is enhanced; observations are sharper; relationship between the event is very clear; patient is teachable.
Describe moderate anxiety.
Constrictive perceptual field; intensified alertness; concentration focused on one detail; increased physiological functions; psychomotor movements are still occurring; other things are blocked from consciousness.
Describe severe anxiety.
Extremely distorted perceptual field; the previously centrally focused details become exaggerated and misinterpreted; communication attempts may be incoherent to listener; may be extremely hyperactive; all energy focused on obtaining relief.
Disintegration of personality/organization; inability to control thoughts and actions; experiences profound terror and intense urge to escape/fight; in danger of harm to themselves or others; paralysis of functioning may occur; may freeze or lose consciousness.
What is the key difference between anxiety and fear?
The threat source.
Non-specific reaction of the body to an internal or external demand.
Agent that threatens us or that disrupts homeostasis.
Stress associated with events perceived to be negative or threatening.
Stress associated with positive or happy events.
Effort directed at managing stressful events. Does not necessarily require changes. Affected by stress tolerance. Often uses defense mechanisms.
What is the difference between adaptive coping and maladaptive coping?
Adaptive is healthy. Maladaptive is unhealthy.
An upset in the balance of the stable state for which the usual methods of coping are not sufficient.
The change that occurs as a result of assimilation and accommodation.
Ability to identify or to develop resources and strengths and flexibly manage stressors to gain a positive outcome, a sense of confidence, a sense of mastery, and self-esteem.
What is the Lazarus Model used for?
Evaluating the process of coping with stressful events.
What happens in primary appraisal?
The person recognizes the threat of harm. Also called "cognitive appraisal."
What happens in secondary appraisal?
The person decides what coping strategies are best and how much the situation pertains to them personally.
What happens in the stage of resistance?
Body attempts to react to the stressor, attempts to calm now. The parasympathetic nervous system tries to calm us down.
What are the three stages of GAS (General Adaptation Syndrome)?
What happens in the alarm-reaction stage?
A person perceives a threat and various defense mechanisms are activated. Increased heart rate, blood pressure, peripheral vasoconstriction, metabolism, water retention and glucose. The autonomic nervous system activates the fight-or-flight response.
What are the two possible outcomes of the resistance stage?
Recovery or entering the exhaustion stage.
What happens in the exhaustion stage?
Body cannot function against the stressor. Vasodilation, decreased blood pressure, increased pulse and respirations. Panic and crisis can occur.
What are the two possible outcomes of the exhaustion stage?
Rest/recovery or death.
Unconscious rejections of features; attributing to other people, objects or situations.
Consists of justifying illogical or unreasonable ideas, actions or feelings by developing some acceptable explanation that satisfy the teller as well as the listener.
Reverting to an earlier, more primitive, childlike pattern that may not have been previously exhibited.
First line of psychological defense against anxiety; temporary or long-term exclusion of unwanted experiences or emotions from the conscious awareness.
Conscious denial of disturbing situation or feeling.
What is the difference between repression and suppression?
Repression is unconscious. Suppression is conscious.
Attempting to overcome a perceived weakness by emphasizing a more desirable trait or overachieving in a more comfortable area.
Shifting feelings from a less socially acceptable or more threatening person to a more acceptable or less threatening one.
Escaping anxiety-causing thoughts and emotions by ignoring their existence.
The experiences and expressions of one's spirit in a unique and dynamic process reflecting faith in God or a supreme being.
A belief system about God or a supreme being, including rituals and traditions.
What is the difference between agnostic and atheist?
Agnostic believes that it is not possible to know that god exists. Atheist believes that god does not exist.
A confident belief in something for which there is no proof or material evidence.
Ingredient in life responsible for a positive outlook in even life's bleakest moments.
Define spiritual well-being.
Condition that exists when the universal spiritual needs for meaning and purpose, love and belonging, and forgiveness are met.
Define spiritual health.
Describe African health beliefs and practices.
Illness is either natural (literally nature-oriented) or unnatural (punishment from God). Self care and folk medicine are prevalent.
Describe Chinese health beliefs and practices.
Health is a balance between yin and yang. Imbalance causes illness. Practices operate with the goal of restoring the balance of yin and yang by acupuncture, acupressure and tai chi. Medicinal herbs are also used.
Describe Haitian health beliefs and practices.
Illness is seen as a punishment. Natural (environmental) and supernatural forces affect health. Health is a personal responsibility. Home/folk remedies are used first. Religious medallions, rosary beads and praying to saints may be used as well.
Describe Japanese health beliefs and practices.
Shinto. Illness is caused by contact with polluting agents. Health achieved through balance between self and society. Disease is caused by disharmony. Balance is restored with acupuncture, acupressure, massage and moxibustion (heat application). Use natural herbs. Also believe in removing diseased parts.
Describe Mexican-American health beliefs and practices.
Health controlled by environment, fate and will of God. Disease is imbalance between individual and environment. Help is sought from curandero. Treatments involve use of herbs, rituals, and religious artifacts.
Describe Native American health beliefs and practices.
Health is a state of harmony with nature and universe. Holistic and wellness-oriented. Some health problems are solved by a native healer while others are solved with Western medical care.
Describe Puerto Rican health beliefs and practices.
Hot-cold theory of causation of illness. Illness is caused by evil forces or destiny. Seek folk healers who used herbs and rituals.
Describe Vietnamese health beliefs and practices.
Balance between yin and yang. Illness is caused by imbalance. Health and healing is family responsibility. Use herbal medicine, spiritual practices and acupuncture.
Describe African communication.
Alert to discrimination. Affection through touch and hugging. Initial eye contact is respectful but prolonged eye contact is aggressive.
Describe Chinese communication.
Open expression of emotions is unacceptable. Smiling often means incomprehension. Eye contact is avoided as sign of respect.
Describe Haitian communication.
Smiling and nodding means incomprehension. May not ask questions if they believe is inconvenient.
Describe Japanese communication.
Nonverbal communication is important. Suppress emotions. Often wait in silence.
Describe Mexican-American communication.
Strong preference for native language. Shaking hands or introductory embrace is common. Prolonged eye contact is disrespectful. Relaxed concept of time.
Describe Native American communication.
Use of anecdotes and metaphors. Nonverbal communication. Avoiding eye contact is respectful. Individuals speak for themselves.
Describe Puerto Rican communication.
Strong sense of family privacy.
Describe Vietnamese communication.
Questioning authority is disrespectful. Questions are impolite. Avoiding eye contact is respectful.
Describe Buddhist religious beliefs
Discourage drugs and alcohol. Illness is a result of Karma (a trial of the soul). Surgery is permitted. Cleanliness is important.
Describe Christian Science religious beliefs.
Abstain from alcohol and some forms of tea and coffee. Oppose drugs and other therapies. Accept physical and moral healing.
Describe Mormon religious beliefs.
Baptism at 8 years. Prohibit tea, coffee and alcohol. Fast 24 hours/month. Believe in divine healing. Allow medical therapy. A "garment" (underwear) may be worn and not want to be removed.
Describe Hindu religious beliefs.
Specific death ritual. Meat is forbidden. Amputation is believed to represent sins in a previous life. Accept most modern medical practices. A thread around wrist may be worn and not want to be removed.
Describe Islam religious beliefs.
Specific birth/death rituals. Prohibit pork and alcohol. Fast during Ramadan. Only Allah cures, but Muslims do not refuse treatment. Right hand is used for eating and left for hygiene.
Describe Jehovah's Witness religious beliefs.
Organ donation is forbidden. No tobacco. Blood products are not allowed.
Describe Judaism religious beliefs.
Cremation not allowed. Organ transplantation/donation is complex. Numerous dietary laws. Fast during Yom Kippur. May resist surgery during Sabbath. May wear prayer shawl and yarmulka while praying.
Describe Roman Catholic religious beliefs.
Abstain from meat Ash Wednesday, Good Friday and Fridays during Lent. Encourage anointing. Do not approve of contraceptives or abortion (traditionally).
Describe the 3 steps of self-concept formation.
1. Infant learns physical self is different from environment. If basic needs are met, child begins life with positive feelings about self.
2. Child internalizes other people's attitudes about self, forms foundation of self-concept.
3. Child or adult internalizes the standards of society.
List the stages in development of the self with the corresponding age during which they occur.
Self-recognition (18 months)
Self-definition (3 years)
Self-concept (6-7 years)
What question (one word) should you NEVER ask the patient?
What is the H.O.P.E. acronym used for? What do the letters stand for?
Used for eliciting a spiritual history of a patient during assessment.
H: Source of Hope, meaning, comfort, strength, peace, love and connection.
O: Organized religion.
P: Personal spirituality and practice.
E: Effects on medical care and end-of-life issue.
What is peripheral neuropathy?
Condition of diabetes. Occurs with bad circulation in feet and hands.
What interventions should be used for peripheral neuropathy?
Inspect daily for blisters and sores. Use socks. Do not use hot water.
What do we need to do as nurses to develop cultural self-awareness?
Examine our personal beliefs and practices and reflect on our own personal biases.
Stress is the body's response to changes in its ______, _______ state.
Stress is the response by which the human system responds to ________.