Exam I Flashcards by Kimberly Goodalis

What is the self-determination theory of motivation and who constructed it?

This theory demonstrates the relevance of behavior can be an outcome of two distinct motivating features

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_____ leadership has been described as a process that changes or transforms individuals. These leaders communicate an organizational vision moving them to accomplish more than expected.

Transformational

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What are the attributes of motivation?

Self-determination, Desire, Compelled, Aspiration, Preference for challenge, Energizing force, Persistence, Internal dispositions

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What are the nursing interventions for breathing pattern change? Slowed circulation to the brain may cause breathing pattern to become shallow, irregular, apneac (cheyne-stokes), or shallow

Elevate person’s head, Position on side

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What are the five principles of time management

Goal setting, Time analysis, Priority setting, Interruption control, Evaluation

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What are the exemplars of comfort care (actively dying)?

interventions for symptom management
provide patient and family reassurance
reduction in physical functioning

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_____ power results when followers identify with or aspire to be like their leader

Referent

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_____ motivation is a need for a connection, social approval, or self-esteem.

Social

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What are the exemplars of palliative care (not actively dying)?

-aggressive symptom management such as dysphonia, fatigue, anxiety, depression -prevention of disease exacerbations -promote activity, increasing physical functioning -rehabilitation

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_____ _____ is the active total care of patients whose disease is non-responsive to curative treatment. Control of pain, of other symptoms, and of psychological, social and spiritual problems is paramount

Palliative care Not actively dying

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What are the exemplars of supportive care?

-aggressive use of laboratory analysis -blood transfusions -bone marrow stimulating factors -referral to specialty physicians to manage pulmonary disease and symptoms -used in long cancer patients undergoing oncology care

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List the five things important to consider when delegating tasks

Assess the knowledge and skills of the delegatee, Match tasks to the delegatee’s skills, Communicate clearly, Listen attentively, Provide feedback

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____ motivation is driven by anxiety. And individual who uses this type of motivation is willing to do most anything to prevent harm to him/her self

Avoidance

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_____ leaders focus on daily operations of an organization and develop an exchange relationship with their followers.

Transactional Rewards are given for performance and corrections are given when necessary

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What are the four goals to support people with concurrent multiple chronic conditions?

Provide better tools and information to healthcare and social service workers who deliver care 2. Maximize/encourage use of self-care management and other services 3. Foster healthcare and public health system changes to improve health 4. Facilitate research to fill knowledge gaps for patients with multiple chronic conditions

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Clear _____ is central to effective leadership

Communication

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Provide examples of chronic health problems that can lead to disability

Stroke, Coronary artery disease, Cancer, COPD, Asthma, Arthritis

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What does this EKG strip denote?

Premature Ventricular Contractions

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What are the nursing interventions for coolness of extremities? Circulation decreased; Skin may become mottled or discolored

Cover person with blanket *do not use electric blanket, hot water bottle or heating pad

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_____ motivation refers to doing something because it is inherently interesting or enjoyable

Intrinsic Motivation with self determination

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What are the goals of palliative care?

-To prevent or treat symptoms or side effects caused by treatment as early as possible -to prevent or treat psychological, social, and spiritual problems related to disease -to help patients with chronic or life-threatening disease live more comfortably

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_____ is focused on maintaining order in organizations-planning, organizing, staffing, directing, and controlling a work group

Management

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What is the theory of achievement motivation and who constructed it?

This theory is based on whether an individual is positively or negatively motivated to achieve a goal based upon the perception of the ability or lack of ability to achieve that goal John Atkinson

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What are the exemplars of end-of-life care?

-admission to hospice care -do not resuscitate order -expectation of death will occur within six months of admission into hospice care -patient no longer seeks aggressive disease management -symptom management

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\_\_\_\_\_ motivation refers to doing something because it leads to a separable outcome

Extrinsic Motivation without self-determination

\_\_\_\_\_ is about change in organizations and is focused on helping followers achieve a vision or goal.

Leadership

\_\_\_\_\_ _____ is not having one's final wishes followed at the end of life; pain, abandonment, isolation

Bad death

\_\_\_\_\_ power provides the ability of one person to reward another for compliance with expectations

Reward

\_\_\_\_\_ _____ motivations is based on needs such as achievement and competence.

Task mastery

\_\_\_\_\_ care typically uses medical interventions to prevent, control, and/or relieve the complications of disease and the associated side effects of specific therapies.

Supportive care Acute management

\_\_\_\_\_ is the relief or management of symptoms without providing a cure.

Palliation

What is the drive reduction theory of motivation and who constructed it?

A biological theory based on the concept of homeostasis and that the body has compensatory mechanisms that maintain biological balance Clark Hull

\_\_\_\_\_ _____ uses evidence-based practice to support the specific pharmacologic interventions to manage symptoms of chronic disease and the dying process

Symptom management Acute management

\_\_\_\_\_ power is based on the leader's ability to influence followers to act by using clear logical, rational argument, and information

Informational

\_\_\_\_\_ care is the care of the patient and family receive in the actively dying, terminally ill, or near death phase of life

End-of-life care Weeks to days of life

What are the nursing interventions for disorientation? Decreased metabolism and slowed circulation to the brain

Identify yourself when speaking to the person, Reorient the person when needed, Speak softly, clearly, truthfully

\_\_\_\_\_ care is the biomedical approach to chronic disease management

Curative The purpose is to alter or attempt to eradicate the disease process

What are the nursing interventions for incontinence? Perineal muscles relax

Keep perineal area clean and dry, Use disposable underpads, chux, disposable undergarments, Consider foley

What is the criteria for making advanced directives?

-Ability to receive information, -Ability to evaluate, deliberate, and mentally manipulate information, -The ability to communicate a treatment preference

\_\_\_\_\_ care emphasizes the relief of discomfort rather than the cure of illness or prolongation of life

Comfort care Weeks to days of life

\_\_\_\_\_ Power uses the threat of punishment to get followers to respond

Coercive

Palliative care is used to treat which diseases?

Chronic renal failure, COPD, CHF, And other diseases with no cure

What are the nursing interventions for food and fluid decrease? Metabolism needs have decreased

Do not force food or drink, Offer small sips of liquids or ice chips if alert enough to swallow, Oral care

An _____ is your judgement or interpretation of cues

Inference i.e. Patient crying implies fear or sadness

\_\_\_\_\_ power results when followers respond to their leaders direction because they perceive that the leader knows best

Expert

What are the nursing interventions for increased sleeping? Metabolism is decreased

Spend time sitting quietly with the person, Do not force person to stay awake, Talk to the person normally, even if no response

A _____ is information obtained through use of senses

Cue i.e. Patient crying

What are the three perspectives of disease trajectory?

-short period of evident decline (cancer) -prolonged dwindling (frailty and dementia) -Long term limitations w/intermittent serious episodes (heart & lung failure)

To enhance active listening... What does the acronym SOLER stand for ?

S-sit facing patient O-observe an open posture L-lean toward the patient E-establish and maintain intermittent eye contact R-relax

What are the nursing considerations/interventions for someone on supportive care?

Fluid replacement therapy, Blood transfusions, Psychological or spiritual needs of the patient/family, Focus is not on symptom management but on physical issues

Who can write DNR orders?

Patient as part of advanced directives, Spouse, when patient is unable, Joint family decision

What are the four categories of motivation?

Achievement motivation, Power motivation, Affiliative motivation, Avoidance motivation

\_\_\_\_\_ motivation is often indicated with those whose personality type includes non-assertiveness and dependence on others

Affiliative

\_\_\_\_\_ occurs when patient's behavior lacks intentionality and a sense of personal causation. The patient does not value in activity or feel confident to complete it, or they do not believe it will obtain the desired outcome

Amotivation i.e. If a patient does not believe physical therapy sessions will help recovery, they are amotivated

What are the nursing interventions for congestion and gurgling? Unable to cough up secretions effectively

Position on side, Administer meds to decrease production of secretions, Provide suction for comfort

What is the humanistic theory of human motivation and who constructed it?

This Siri suggest that a person must feel satisfied that essential physiological needs such as food, water, oxygen, and shelter must be met before the individual will feel compelled or motivated to strive for higher needs such as safety, loving and belonging, self-esteem, self respect, and respect for others Maslow

What is the field theory of motivation and who constructed it?

Influences of an individual's total situation must be taken into account, value was placed upon a specific goal and the probability that an individual will follow through and achieve the goal Kurt Lewin

To _____ is to reduce the severity of an actual or potential life-threatening condition or a chronic debilitating illness.

Palliate

What are the three types of DNR?

-Slow code: dr/nurse slow to initiate life saving measures(no longer used) -Chemical code: medication only, no intubation, no CPR -Full DNR: no life saving measures taken

\_\_\_\_\_ leadership occurs when the leader involves Star Wars in the decision-making process. This is also referred to as participatory leadership.

Democratic

What are the physical signs of death?

Coolness of extremities, Increased sleeping, Fluid and food decrease, Incontinence, Congestion and gurgling, Breathing pattern change, Disorientation, Restlessness

What are the four most common, life-threatening ventricular dysrhythmias ?

Premature ventricular complexes, Ventricular tachycardia, Ventricular fibrillation, Ventricular asystole

\_\_\_\_\_ leadership is associated with work teams and shared leadership, employees are empowered to distribute leadership within the group.

Shared

What are the nursing considerations/interventions for someone on comfort care?

Physical, social, and emotional needs are priority, High dose pain medication may have the effect of hastening death, Patient is actively dying, Positioning, oral care, skin care, Comfort management not symptom management

What are the four conditions that must be met before a person is motivated to learn, according to John Keller?

Attention, Relevance, Confidence, Satisfaction

An _____ \_\_\_\_\_ is the me so state that allows the learner to focus on and comprehend a learning activity.

Attentional set

\_\_\_\_\_ Power recognizes that formal leaders have the power over their followers because of the position they hold

Legitimate

\_\_\_\_\_ _____ is free from avoidable stress and suffering for patients, families, and caregivers; consistent with clinical practice standards.

Good death

\_\_\_\_\_ health problems are physical or mental health/behavioral health problems that cause disability

Disabling

\_\_\_\_\_ leadership occurs when the leader does not interfere with the employees in their work. These later stand at a distance, getting followers freedom to make decisions and accomplish the work. They provide minimal information and have a little communication

Laissez-Faire These leaders typically wait until there is a crisis to make decisions

What is the social learning theory of motivation?

This theory describes how behaviors are learned and focuses on the learning that occurs within a social context.

What is stages of change model and who constructed it?

This theory is based on people moving through five stages in the change process. The model explains and predicts how when when people reject for healthcare choices and adapt healthy choices. Prochaska, DiClemente

Who are the members of the interprofessional team?

Nursing, social services, physician, spiritual care, ancillary services

\_\_\_\_\_ leadership is when the leader makes all decisions. These leaders generally are most concerned with the task to be accomplished and maintain distance from their followers.

Autocratic They often use threats of punishment as motivation but may also offer rewards as incentives

\_\_\_\_\_ motivation is often indicated with those whose personality type includes assertiveness and aggressiveness

Power

What are the nursing consideration/interventions for someone on end-of-life care?

Used synonymously with hospice care, Symptom management, Comfort care, Weeks to days of life, Medicare coverage: prognosis of less than 6 months

\_\_\_\_\_ health problems exist for at least 3 months

Chronic

What are the four goals outlined by USDHHS to supporting persons with concurrent multiple chronic conditions?

-provide better tools and information to healthcare and social services workers -maximize the use of proven self-care management and other services -foster healthcare and public health system changes to improve health -facilitate research to fill knowledge gaps about individuals with multiple chronic conditions

What are the five rights of delegation

Right task, Right circumstances, Right person, Right direction/communication, Right supervision/evaluation

What are the nursing interventions for restlessness? Decreased metabolism and slowed circulation to the brain

Play soothing music; aroma therapy, Do not restrain, Massage persons forehead, Reduce number of people in the room, Talk quietly/keep noise down, Keep room dimly lit, Consider sedation if necessary

What are the influence factors for intrinsic motivation?

- age - cognitive/education level - emotional readiness/fear of failure

What does this EKG strip denote?

Ventricular tachycardia

What does this EKG strip denote?

Ventricular Fibrillation

What does this EKG denote?

Premature Ventricular Contractions

What are the influence factors for extrinsic motivation?

- cultural values/family - accessibility of facilities/readiness of healthcare team

What are the influential characteristics of motivation: Personal traits

- age - emotional readiness - high expectation - anxiety/self confidence - fear of failure

What are the influential characteristics of motivation: Environmental Factors

- resource availability - level of difficulty of task - rate of progression

What are the influential characteristics of motivation: Relationships

- cultural expectations and customs - need for love and acceptance from others - role in the community

Which theory involves homeostasis and the belief that the body has many compensatory mechanisms that function to maintain biological balance?

Drive Reduction Theory: Clark Hull

Which theory focuses on physiological needs such as food, water, oxygen, and shelter needs being met before one is motivated to strive for higher needs such as safety, loving/belonging, and self-esteem?

Humanistic Theory: Maslow

Which theory believes an individual's total situation must be taken into account and value is placed on a specific goal and the probability of follow through to reach a goal?

Psychology and its relationship to motivating behaviors: Lewin

One's belief in their own ability to complete tasks and reach goals is called _____ \_\_\_\_\_

Self efficacy

Clinical associations for this type of dysrythmia include stimulants (caffeine, alcohol, nicotine), Digoxin, electrolyte imbalance, hypoxia, fever, and disease states (MI, mitral valvue prolapse, HF, CAD)

Premature Ventricular Contractions (PVCs)

What is the treatment for PVCs?

Oxygen therapy for hypoxia, Electrolyte replacement, Administer Beta blockers

Clinical associations for this type of dysrythmia are MI, CAD, Electrolyte Imbalance, Cardiomyopathy, mitral valve prolapse, Digitalis toxicity, CNS Disorders.

Ventricular Tachycardia

What is the treatment for ventricular tachycardia?

Identify precipitating associations (hypoxia), **Hemodynamically stable**: IV procainamide,sotalol, amiodarone, lidocaine **Hemodynamically unstable:** IV amiodarone or Lidocaine followed by cardioversion

Clinical associations for this type of dysrythmia are Acute MI, CAD, Cardiomyopathy, accidental electrical shock, hyperkalemia, hypoxia, acidosis, drug toxicity

Ventricular Fibrillation

What is the treatment for Ventricular Fibrillation?

CPR, Defibilation, definitive drug therapy