Exam 5 Flashcards
(152 cards)
1
Q
What is the term for the inability to deal with the perceived demands or threats to one’s mental, emotional, or spiritual wellbeing?
A
Stress
2
Q
What is the term for “the state of balance among all the body systems needed for the body to survive and function correctly”?
A
Homeostasis
3
Q
What are some examples of things affected by homeostasis? (9 examples)
A
- Acid
- Blood pressure
- Blood sugar
- Electrolytes
- Energy
- Hormones
- Oxygen
- Proteins
- Temperature
4
Q
What are 5 examples of stressors?
A
- Health- illness, eating habits, sleep habits, recreational time
- Work- New job/shift, trouble with coworkers/boss
- Personal and Social- religious, starting school, sexual issues
- Home and Family- divorce, pregnancy, arguing
- Financial- income changes, damage to property, credit
5
Q
What type of stress affects the body’s structure and function such as a disease or mobility problems?
A
physiological stress
6
Q
What type of stress arises from life events such as work, personal, and relationships?
A
psychological stress
7
Q
What type of stress is random and unpredictable such as a hurricane or accidents?
A
situational stress
8
Q
What type of stress is good and beneficial and produces motivation and focused energy?
A
Eustress
9
Q
What type of stress is associated with different stages of life such as peer pressure, college graduation, etc?
A
Developmental stress
10
Q
What type of stress can be a threat to someone’s health status such as covid or financial worries?
A
Distress
11
Q
What type of stress is related to the inability to meet demands such as rushing to appointments or completing your homework?
A
Time-related stress
12
Q
What type of stress is related to upcoming or future events such as exams, wedding, or birth of a child?
A
anticipatory stress
13
Q
What are the 3 stages of the General Adaptation Syndrome?
A
- Alarm Stage
- Resistance Stage
- Exhaustion Stage
14
Q
What happens during the alarm stage?
A
stressor upsets homeostasis or cellular balance
- Stress- stimulates the sympathetic nervous system (SNS)
- SNS- stimulates the hypothalamus
- Hypothalamus – releases corticotropin releasing hormone (CRH)
- CRH- stimulates the anterior pituitary gland to release adrenocorticotropic hormone (ACTH)
- ACTH-stimulates the adrenal cortex to secrete glucocorticoids (cortisol) and mineralocorticoids (aldosterone)
- Cortisol- Glucose sparing effect and anti-inflammatory effect
- Aldosterone- promotes fluid retention which increases the BP
- Endorphins- released by the hypothalamus produces a sense of well being
- Thyroid-Stimulating hormone (TSH)- secreted by the pituitary gland and helps with fat conversion to energy to meet cell and muscle needs
15
Q
What happens during the Resistance Stage?
A
body fights back by adjusting to the stress and tries to counteract the physiological changes that happened during the alarm stage
- Governed by parasympathetic system
- Reduces amount of cortisol produced
- HR and BP go down
16
Q
What happens during the Exhaustion Stage?
A
After an extended period of stress, the body depletes its energy resources by continually trying, but failing to recover from the initial alarm reaction stage and can no longer fight stress
- Tiredness
- Depression
- Anxiety
- Feeling unable to cope
17
Q
What is the difference between compensation and adaptation?
A
Compensation
1. Occurs during the alarm stage
2. Fight or Flight
3. Stimulation of SNS
Adaptation
1. Occurs during the resistance stage
2. Stimulation of parasympathetic system
3. Return to normal but body is still on alert
18
Q
What mechanism monitors the body’s physiology, assesses for alteration from normal and counteracts any changes to reverse the situation and return to normal? What is an example?
A
Negative Feedback
Example: Release of insulin to counteract an elevated blood glucose
19
Q
What mechanism intensifies a change in the body’s physiological condition instead of reversing it? What is an example?
A
Positive Feedback
Example: the release of the hormone oxytocin increases contraction actual childbirth is completed.
20
Q
What are some examples of stress management strategies? (8 examples)
A
- Exercise
- Communicate/ Share feelings
- Relaxation techniques
- Guided Imagery
- Meditation/ Prayer
- Healthy lifestyle
- Involve in enjoyable activities, laugh,
have a sense of humor
8.Counselling.
21
Q
What is a “journey” that takes place over time, and involves the accumulation of life experiences and understanding, that is described as an attempt to find meaning, value, and purpose in life?
A
Spirituality
22
Q
What is considered a “map” that outlines essential beliefs, values, and codes of conduct into manner of living and is practiced to outwardly express spirituality?
A
Religion
23
Q
What are the 3 core issues of spirituality?
A
- Faith
- Hope
- Love
24
Q
What is defined as as feelings of contentment coming from the inner self and has been shown to be related to quality of life?
A
spiritual well-being
25
What is it called when a patient's optimal level of health by considering dynamic interactions among the emotional, spiritual, social, cultural, and physical aspects of an individual’s wellness?
Holistic Care
26
What are the 3 main things of holistic care?
1. Spirit
2. Mind
3. Body
27
What refers to the learned and shared beliefs, values, norms, and traditions of a particular group, which guide our thinking, decisions, and actions?
Culture
28
What is ethnicity?
Shared identity related to social and cultural heritage such as values, language, geographical space, and racial characteristics.
29
What is race?
Common biological characteristics shared by a group of people
30
What is the process of learning to behave in a way that is acceptable to society through: family, friends, community, peers, schooling, media, work, religious institutions, government, legal systems, health care systems, etc?
Socialization
31
What is the process through which an individual or group transitions from one culture to develop the traits of another culture?
Acculturation
32
What is the process in which an individual adapts to the host’s cultural values and no longer prefers the traditions, values, and beliefs of the culture of origin?
Assimilation
33
What is the term used for customs, values, beliefs, traditions, and social and religious views held by a group of people that prevail over another secondary culture?
Dominant Culture
34
What is the term used for a collection of individuals who are more likely to develop health problems as a result of excess risks, limits in access to health care services, or being dependent on others for care?
Minority Groups
Vulnerable populations
Marginalized Groups
35
What are some examples of vulnerable populations?
homeless, poor, mentally ill, physical disabilities, young, elderly, some ethnic and racial minority groups
36
What type of care is described by encompassing the well-being of the whole community and linked to the health and spirit of their sacred lands?
Indigenous Health Care or Folk Health Care
37
What type of health care is described as using the application of the principles and procedures of evidence-based medicine and caring?
Professional Health Care
38
What health belief involves medicine, science, evidence-based care, and modern medicine?
Biomedical/Scientific
39
What health belief is a supernatural explanatory model, which attributes health and illness to God's or the ancestors' pleasure or displeasure? (sick because of an evil force)
Magico-religious
40
What is the difference between complementary medicine and alternative medicine?
Complementary Medicine- therapies used together with conventional treatment recommended by a person’s health care provider.
**in addition to traditional medicine**
Alternative Medicine- nonpharmacological therapies such as exercise, chiropractic, and herbal supplements are used in place of conventional pharmacological or other medical procedures.
**instead of traditional medicine**
41
What does the acronym "ACCESS" stand for in regard to Purnell Model for Cultural Competence?
1. Assessment
2. Communication
3. Cultural
4. Establishment
5. Sensitivity
6. Safety
42
What is the difference between a translator and an interpreter?
Interpreter- Interprets verbal words
Translator- Interprets written words
43
What is the ability to communicate effectively and convey information in a manner that is easily understood by diverse audiences?
Linguistic Competence
44
What does the acronym "BALI" stand for in regard to culturally competent care?
Be aware
Appreciate Uniqueness
Learn about different cultures
Incorporate the client’s behaviors and values
45
What are the conditions in which people are born, grow, live, work, and age that affect health functioning and quality of life outcomes called?
Social Determinants of Health
46
What are the 5 Categories of Social Determinants of Health?
1. Economic Stability
2. Education Access and Quality
3. Health Care Access and Quality
4. Neighborhood
5. Social and Community
47
What are examples of barriers to culturally competent care? (9 examples)
1. Bias/Prejudice
2. Ethnocentrism
3. Discrimination
4. Cultural Stereotypes
5. Racism
6. Sexism
7. Language barrier
8. Lack of knowledge
9. Self-Knowledge
48
What term is used for the universal tendency of human beings to think that their individual ways of thinking, acting, and believing are the only right, proper, and natural ways?
Ethnocentrism
49
What is it called when beliefs and attitudes are associating negative permanent characteristics to people who are perceived as different from oneself?
Prejudice or Bias
50
What is the term used to describe a prejudicial outlook, action, or treatment?
Discrimination
51
What type of loss is involves incomplete or uncertain losses and fails to provide emotional detachment required for closure?
Ambiguous Loss
52
What are the two types of ambiguous losses and how are they different? What are some examples of each?
Type 1- the loved one who is psychologically present but physically absent
Example: missing soldiers, kidnapped children
Type 2- a person is physically present but psychologically absent
Example: person with addiction, mental disorders, dementia, etc.
53
What type of loss occurs when a person can no longer feel, hear, see, or know a person or object?
Actual Loss
54
What 3 types of losses are characterized as being uniquely defined by the person experiencing the loss and is less obvious to other people? (loss of trust, separation, retirement)
Perceived, internal, psychological
55
What type of loss would an amputation, paralysis, and immobility be classified as?
Physical Loss
56
What 2 types of loss would a flood, loss of car, and loss of home be classified as?
External and environmental
57
What is loss of aspect of self? What are some examples?
altered perception of self-image
burn victim, scars
58
What type of loss would the loss of a spouse, parent, child, or sibling be classified as?
loss of significant relationship
59
What type of loss is described as expecting the loss of something in the future and happens before the actual loss?
Anticipatory Loss
60
What are the 5 psychological stages of dying?
1. Denial
2. Anger
3. Bargaining
4. Depression
5. Acceptance
61
What type of care focuses on the prevention, relief, reduction, or soothing of symptoms of disease or disorders throughout the entire course of an illness?
Palliative Care
62
What is a philosophy and model of care that focuses on the care, comfort, and quality of life of a person with a serious illness who is approaching the end of life and usually has less than 6 months to live?
Hospice Care
63
What term refers to either a living will or durable power of attorney for health care (also called a health-care proxy)?
Advanced Directive
64
What is a written document made by a competent individual that provides instructions that should be used when that individual is no longer able to express his or her wishes for health-care treatment?
Living Will
65
What is a written form that gives another person legal power to make decisions regarding health care when an individual is no longer capable of making such decisions?
Power of Attorney or Health-Care Proxy
66
What is called when a patient patient has made the choice to refuse CPR and other acts in the event of a cardiopulmonary arrest?
Do Not Resuscitate (DNR)
67
What is the statute stated that competent individuals with a terminal disease could make an oral and written request for medication to end their life in a humane and dignified manner and a person takes the meds themselves?
Assisted Suicide
68
What is the term for when the attending medical or nurse practitioner, takes an action with the singular intention of causing a patient’s death?
Eurhanasia
69
What is a surgical dissection of the body to determine the exact cause and circumstances of death or to discover the pathway of a disease?
Autopsy
70
What is postmortem care and what are 3 significant considerations when providing postmortem care?
Care of a body after death
1. Give same respect and dignity as living
2. Should do asap to prevent discoloration, tissue damage, deformities.
3. Respect cultural and religious beliefs
71
What is it called when grievers feel the full brunt of the abiding nature of the loss- the ripple effect of the original loss “becomes inescapably known," and can cause self-destructive behaviors?
A time of Second Crisis
72
What type of grief gives permission to move through the journey at a griever’s own pace?
Adaptive Grieving
73
What type of grief is described as when their relationship to the deceased person is not socially sanctioned, cannot be shared openly, or seems of lesser significance? What are some examples?
Disenfranchised Grief
Examples: ex-spouse, abortion, affair
74
What type of grief is characterized as a common and universal reaction characterized by complex emotional, cognitive, social, physical, behavioral, and spiritual responses to loss and death?
Uncomplicated/Normal Grief
75
What type of grief is when people have a prolonged or significantly difficult time, moving forward after a loss, that involves symptoms of painful emotions and sorrow for more than 1 year?
Complicated Grief
76
What are the 4 types of complicated grief?
1. Chronic Grief
2. Exaggerated Grief
3. Delayed Greif
4. Masked Grief
77
What type of complicated grief is characterized as experiencing a normal grief response, except that it extends for a longer period of time. This can include years to decades of intense grieving?
Chronic Grief
78
What type of complicated grief is characterized as a grief response that often exhibits self-destructive or maladaptive behavior, obsessions, or psychiatric disorders. Suicide is a risk for these individuals?
Exaggerated Grief
79
What type of complicated grief is characterized as a grief response that is unusually delayed or postponed because the loss is so overwhelming?
Delayed Grief
80
What type of complicated grief is characterized as a person not being aware that their behaviors are interfering with their normal functioning?
Masked Grief
81
What are the 4 major theorists for stages of grief and the key parts to each of their theories?
1. Kubler-Ross
- Denial, Anger, Bargaining, Depression, Acceptance
2. Worden
- Initial numbness and denial and over time person heals and adjusts
3. Rando
- 6 R’s- Recognize, React, Recollect, Relinquish, Readjust, and Reinvest
4. Bowlby
- Attachment Theory- Numbing, yearning and searching, disorganization and despair, reorganization
82
What are some examples of factors that influence grief? (9 examples)
1. Significance of Loss
2. Amount of Support
3. Conflict existing at time of death
4. Circumstance of death
5. Previous Loss
6. Developmental Stage
7. Spiritual and Cultural Background
8. Timeliness of death
9. Personality
83
What is cancer?
A group of diseases characterized by uncontrolled growth
84
What cancers have highest number of prevalence for men and women? (# of new cases each year)
Men is prostate
Women is breast
85
What cancer has has the highest mortality rate in both men and women?
Lung cancer for both
86
What is the difference between normal cells and cancer cells and key characteristics of each?
Normal cells- Grow to a certain volume at an established rate and then stabilize; contain predetermined, undifferentiated stem cells; exhibit contact inhibition
Cancer cells- Continue to expand without boundaries and divide indiscriminately and haphazardly; uncontrolled cell growth and altered cell differentiation; do not exhibit contact inhibition
87
What is the term that refers to an abnormal increase in the number of cells?
hyperplasia
88
What term refers to the replacement of one mature cell type with a less mature cell type?
Dysplasia
89
What is the term used for uncontrolled, abnormal growth of cells or tissues in the body?
Neoplasia
90
What word is used to describe the spread of cancer cells from the place where they first formed to another part of the body?
Metastasis
91
What is a substance, organism, or agent capable of causing cancer?
Carcinogen
92
What is a series of molecular changes that occur after exposure to carcinogens?
Carcinogenesis
93
What are the 3 stages regarding theory of causation? What are the characteristics of each stage?
1. Initiation- exposure to radiation, a chemical or viral agent known as a “carcinogen.” Initiation also occurs when there is a mutation or disruption in the normal cell development cycle
2. Promotion- Increased risk of developing cancer due to the presence of promoting factors- tobacco, obesity, physical inactivity, diet.
3. Progression- Increased growth rate of tumor; invasiveness. (Metastasis)
94
Immunosuppressive agents and chemotherapy are examples of what kind of carcinogens?
Chemical carcinogens
95
What is the term used for the time interval between when an individual or host is infected by a pathogen and when that individual becomes infectious?
Latency Period
Long Latency period can make it difficult to identify carcinogens
96
EBV, HIV, Hep B, and HPV are examples of what kind of carcinogens?
Viral carcinogens
97
What type of immunity is our first line of defense, that is non-specific, and includes macrophages and neutrophils?
Innate Immunity
98
What type of immunity is our second line of defense, that is specific, and includes B lymphocytes and T lymphocytes?
Adaptive Immunity
99
Which defense system eliminates pathogens and initiates inflammation?
Neutrophils
100
Which defense system phagocytoses bacteria and can sometimes break apart tumor cells?
Macrophages
101
What defense system is responsible for destroying infected and diseased cells such as cancer cells?
Natural killer Cells (NK Cells)
102
What defense system is the strongest defense against tumor cells and are specific in directly attacking and killing tumor cells?
Cytotoxic T cells
103
What defense system makes antibodies that target foreign cells and can produce antibodies directed to tumor surface antigens?
B lymphocytes
104
What type of prevention is associated with focusing on identifying and modifying risk factors for cancer to reduce the probability that an individual will develop cancer and involves teaching patients to avoid known carcinogens and adopt a healthy lifestyle? What are some examples?
Primary Prevention
Examples
1. Nutrition
2. Obesity
3. Adequate Rest
4. Reduce/Eliminate stress
5. Cigarettes, Cigars, Smokeless tobacco
6. Alcohol Intake
7. Overexposure to the sun
105
What type of prevention is associated with focusing on early screening and detection of cancer in an effort to identify and have prompt intervention in an effort to control the disease early? What are some examples?
Secondary Prevention
Examples
1. Mammogram- breast cancer
2. PSA Test- Prostate Cancer
3. Pap Smear- Cervical Cancer
4. Colonoscopy- Colorectal Cancer
106
What does the acronym "CAUTION" stand for in regard to abnormal changes that need further evaluation regarding cancer?
Change in bowel or bladder habits
A sore that doesn’t heal
Unusual bleeding or discharge
Thickening or lump in the breast
Indigestion or difficulty in swallowing
Obvious change in a wart or mole
Nagging cough or hoarseness
107
What type of prevention is associated with focusing on reducing the complications of disease and improving the quality of life once an individual has been diagnosed with cancer, management of side effects and reduction of morbidity and mortality? What are some examples?
Tertiary Prevention
Examples
Pain Management
Management of side effects from chemo
Counseling and support groups
108
What are the 3 types of tissue biopsy?
1. Needle Biopsy- small sample of the tissue is extracted
2. Excisional Biopsy- when the entire tumor is removed
3. Incisional Biopsy- when a core sample is removed
109
What is the classification system that is based on tumor size, burden of the disease, and extent of spread?
Staging
110
What is the histological analysis of cancer cells that evaluates the appearance and degree of cell differentiation?
Grading
111
What letters are used in the staging system and what do they stand for?
T- Tumor Size
N- Has cancer spread to the lymph nodes
M- Has the cancer metastasized
112
What are the different grading levels in the grading system for cancer cells and what does each grade indicate?
Grade 0- Carcinoma in situ- (Early Form)
Grade I – cells differ slightly from normal & are well differentiated (localized)
Grade II – cells are more abnormal & moderately differentiated (early locally advanced)
Grade III – cells are very abnormal & poorly differentiated (late locally advanced)
Grade IV – cells are immature & primitive; tissue of origin difficult to determine (metastasized)
113
What does TX, T0, Tis, and T1, T2, T3, T4 mean?
TX- tumor cannot be evaluated
T0- No evidence of tumor
Tis- carcinoma in situ (has not spread)
T, T2, T3, T4- Size and extent of tumor
114
What does NX, N0, and N1, N2, N3 mean?
NX- regional lymph nodes cannot be evaluated
N0- No regional lymph node involvement
N1, N2, N3 - Involvement of regional lymph node (number/extent of spread)
115
What does MX, M0, and M1 mean?
MX- Distant metastasized cannot be evaluated
M0- No distant metastasis
M1- Distant metastasis (has spread to distant parts of the body)
116
What are the two types of Solid-Tumor Malignancies and what do each of them affect?
1. Carcinomas- cancer that begins on the skin or in the tissues that line or cover internal organs
2. Sarcomas- cancer in bones and soft tissues
117
What type of cancers affect the blood, bone marrow, and lymph nodes? What are examples of this type of cancer?
Hematological Malignancies
Examples: Leukemia, lymphoma, multiple myeloma
118
What are the 3 goals of treatment for cancer?
1. Cure
2. Control
3. Palliative- focus on quality of life
119
What are the 3 different types of treatment for cancer?
1. Surgery
2. Radiation
3. Medical Treatments (chemotherapy)
120
What is debulking?
the surgical removal of as much cancerous tissue as possible
may be done for comfort or palliative measures
121
What are the 2 ways to deliver radiation?
Externally- uses external beam radiation
Internally- called brachytherapy or seed implants
122
What does the acronym "ALARA" stand for in regard to radiation safety?
As
Low
As
Reasonably
Achievable
123
What are the 3 biggest components in regards to radiation safety?
1. Time- limit time in direct contact with patient
2. Distance- inform patient of time and distance limitations
3. Shielding- Use shielding if made available
124
What are the 5 medical treatments used when treating cancer?
1. Chemotherapy
2. Immunotherapy
3. Stem Cell Transplant
4. Targeting Therapy
5. Hormone Therapy
125
What type of medical cancer treatment, uses drugs to kill cancer cells, and targets the cancer at different phases of the cell cycle, causing symptoms like alopecia & oral ulcers?
Chemotherapy
126
What type of biological cancer treatment is used to help your immune system fight cancer?
Immunotherapy
127
What type of medical cancer treatment restores blood-forming stem cells in cancer patients who have had theirs destroyed by very high doses of chemotherapy or radiation therapy?
Stem Cell Transplants
128
What type of medical cancer treatment targets the changes in cancer cells that help them grow, divide, and spread?
Targeting Therapy
129
What type of medical cancer treatment slows or stops the growth of breast and prostate cancers, which use hormones to grow?
Hormone Therapy
130
What is the intrathecal route of chemo drugs?
In the spine
131
What is the intraperitoneal route of chemo drugs?
in the abdomen
132
What is the intra-arterial route of chemo?
via temp port in artery of affected site
133
What is the intra-vesicular route of chemo drugs?
In the bladder
134
What is the intrapleural route of chemo drugs?
In the lungs
135
What is the term for when fluid infuses into the tissues surrounding the venipuncture site?
IV Infiltration
136
What are irritants?
Can cause pain at the IV site and along the vein and also may or may not cause inflammation
137
What is the term for when there is accidental infiltration of a vesicant or chemotherapeutic drug into the surrounding IV site?
Extravasation
138
What are vesicants?
medications that can cause extensive damage to the tissue on direct contact
139
What is Neutropenia and what are the signs, symptoms, and considerations that go with it?
condition where there is an abnormally low level of neutrophils
Diagnosed when less than 1500
Fever, flushing
No fresh fruits & veggies, reverse isolation
140
What is thrombocytopenia and the signs and symptoms that go with it?
Low platelet count
bruising, bleeding gums, petachiae
141
What is pancytopenia?
low counts of RBC, WBC, and platelets
142
What is anemia and the signs and symptoms that go with it?
low RBC
lethargy, hypoxia, easily fatigued, pallor
may need transfusion
143
What is the term used for when the blood cells reach lowest level after administering chemotherapy?
Nadir
144
What is the name of the therapy that is defined as "treatment given prior to the primary treatment with the goal of shrinking the tumor or for prevention of spread"?
Neoadjuvant Therapy
145
What is the name of the therapy that is defined as "treatment done in addition to the primary treatment to maximize its effectiveness"?
Adjuvant Therapy
146
What is alopecia?
loss of hair
147
What is xerostomia?
dry mouth
148
What is dysgeusia?
loss of taste
149
What is characterized by anorexia and a loss of body weight associated with reduced muscle mass and adipose tissue?
Anorexia-Cachexia Syndrome
150
What is stomatitis?
inflammation of GI mucous membranes
151
What is mucositis?
inflammation of oral mucous membrane
152
What is esophagitis?
inflammation of the esophagus
