last exam promotion Flashcards

1
Q

Health Promotion-what is it

A

behavior motivated by the desire to increase wellbeing and actualized health potential

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2
Q

Primary Prevention-
Direction

A

direction is promoting health and preventing disease/injury-example is immunizations

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3
Q

Primary prevention examples

A

/wt loss,
diet,
exercise
smoking cessation
, reduce alcohol,
avoid drugs,
seatbelts,
car safety,
safe sex,
effective parenting

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4
Q

Secondary Prevention
what is it

A

-early identification and prompt treatment,

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5
Q

Secondary prevention examples

A

bp screenings,
mammograms,
skin cancer peps,
testicular examinations and family counseling.

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6
Q

Tertiary Prevention-
what is it

A

restorative and rehab,

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7
Q

Tertiary Prevention-
examples

A

diabetic self care,
physical therapy,
medical therapy,
medications,
surgery,
occupational therapy,
job training

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8
Q

4 - Sites to promote health

A

Home- preferred

Schools

Community

Worksite-employee heatlh, administering vaccinations, up to date on vaccinations, screening

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9
Q

Health Belief Model
focuses on
sometimes

A

Focuses on what people perceive to be true about themselves

  • sometimes patients may have distorted view of self
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10
Q

Health Belief Model
3 components

A

1) susceptibility to a disease

2) seriousness of a disease

3) benefits of action-will actions pay off

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11
Q

Health Promotion Model

what
hp model
individual
specific

A

What motivates someone to be healthy?

HP Model - How people interact with their environment as they pursue health

Individual characteristics and experiences

Behavior-specific knowledge and beliefs

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12
Q

Situational influences

barriers to action

Behavior-specific knowledge and beliefs

A

Situational influences (no smoking at work)

Barriers to action (i.e. inconvenience, expense, difficulty or time.) for example- if smoker cannot find anywhere they can smoke, it might motivate them to quit

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13
Q

What is the biggest part of health promotion

A

Big part is readiness for improved health-

How willing are they to make changes and improve –

people with advanced age might be less willing to make changes as someone who is younge

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14
Q

Nurse Role in Health Promotion

nurses role
everyones

A

Nurses role is to get patient back to baseline-

everyone’s baseline may be different from one another

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15
Q

Nurses should teach what:

info
health
and
control
nurses should be

A

Information dissemination-

Health risk appraisal and wellness assessment programs

Lifestyle and behavior programs

Environmental control programs

Nurses should be role models for health

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16
Q

Wellness diagnoses

describes what
useful for what
helps patients do what

A

describe human response to levels of wellness in an individual, family, or community that have a readiness for enhancement

Useful for teaching

Helps patients reach a higher level of functioning

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17
Q

Physical development-
post puberty
men
and women

Young Adults (18 -39)

A

males- will continue to grow muscle mass, grow into their 20’s, brain isn’t developed until 26,

Females- brain isn’t developed until 21,

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18
Q

Psychosocial Development-
erikeons
what does that mean

Young Adults (18 -39)

A

intimacy vs isolation-

becoming more independent from parents, hoping to form significant relationships, choosing career, life post college,

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19
Q

experience what
start to see

Young Adults (18 -39)

A

Experiencing stress and changes

start to see mental health changes

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20
Q

Safety

Young Adults (18 -39)

A

Tanning beds,

MVAs,

STI’s,

physical assault

, workplace safety,

firearm

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21
Q

nutrition and exercise

Young Adults (18 -39)

A

Fad diets,

eating disorders,

weight may go up/down and they might attempt to be same weight as adolescent .

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22
Q

Social interactions
higher risk
more willing

Young Adults (18 -39)

A

Higher risk for Suicide, homicide, abuse

More willing to go out in public/ go out to bars to seek relation ships.

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23
Q

Males-checkfor
Young Adults (18 -39)

A
  • self testicular exams-

this age at higher risk for testicular cancer,

may go unnoticed, extremely important to get screened

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24
Q

Young Adults (18 -39)

Females-
how often

A
  • self breast exams,

every year

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25
Q

alchohol
how many drinks per men/women
use what to check

Young Adults (18 -39)

A

1-women 2- men

alcohol screening tools

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26
Q

screening-how often
denstist
sti-why
cardiovasular
diabetes
physical

Young Adults (18 -39)

A

denstist-6months

sti-sexual activity

cardiovasular-every 5 years

diabetes-every 3 years

physical-yearly

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27
Q

immunizations

Young Adults (18 -39)

A

tdap

menengitits

hep b

annual flu shot

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28
Q

Physical Changes
challenges
develop
less
menopause when

Middle-Aged Adults (40 – 65)

A

–bodily challenges-

develops fat,

lessened metabolism,

menopause average 52

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29
Q

Erikson
what does it mean

Middle-Aged Adults (40 – 65)

A
  • generativity vs stagnation

, may experience empty nest, financial freedom, developed career, owns home, economic stability, aware of own mortality, ”generational sandwhich”

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30
Q

reflection

Middle-Aged Adults (40 – 65)

A

Reflection on time spent/time left

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31
Q

changes with reflection

Middle-Aged Adults (40 – 65)

A

Employment- will they stay with same company until they retire, when do they want to retire

Spousal relationships-

Relationships with children and aging family members

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32
Q

Cancer screening guidelines
males
female
immunizations

Middle-Aged Adults (40 – 65)

A

male-TSE(testicular), PSA(prostate), digital rectal exams, colonoscopy

female-SBE(self breast exams), PAPs, Mammograms

Immunizations- can be eligible for more- shingles, pneumonia, tetanus

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33
Q

part of life
decrease
diminish

Middle-Aged Adults (40 – 65)

A

Exercise is part of life,

can decrease salt/sugar intake

, smoking can diminish

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34
Q

limit
because
decline
experience more

Middle-Aged Adults (40 – 65)

A

Limiting cholesterol and calories

Because of Decreased metabolism

Decline in gastric juices and free acid that break down food-

experience more GERD, fullness, don’t eat as much

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35
Q

Middle-Aged Adults (40 – 65)
injury

A

Poisoning-accidental

Falls

MVAs – decreased response time

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36
Q

Other causes of death:

Middle-Aged Adults (40 – 65)

A

Heart, respiratory disease

Diabetes

Alcoholism, arthritis, depression

Polypharmacy-increase amount of meds that they are taking

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37
Q

exams:
prostate-when start
eye exams-often
diabetes-often
dentist-often
colonoscopy-when start
physical-often
lung-when do

middle aged

A

prostate-at 45

eye exams-every year

diabetes-every 3

dentist-6months

colonoscopy at 45

physical-annual

lung- if 30 pack years

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38
Q

immunizations middle aged

A

shingles

pneumonia

flu

tetanus

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39
Q

young old
middle old
old old

Older Adults (65 and older)

A

Young Old (65-74)

Middle Old (75-84)

Old-old (85 and older)

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40
Q

Psychosocial
eriksons
what does It mean

Older Adults (65 and older)

A

-integrity vs despair

adjusting to life changes, deaths, living arrangements, financi

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41
Q

Nutrition and exercise
low
daily
supplement

Older Adults (65 and older) Screening

A

Low-fat well balanced diet

Exercise daily

Vit D supplement possibly- more suspectable for fractures and falls

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42
Q

chr
med
3d’s problems

Older Adults (65 and older) Screening

A

Chronic illness

Medication compliance

Dementia, depression, and delirium

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43
Q

interact
arrange
role

Older Adults (65 and older) Screening

A

Social interactions,

living arrangements,

role reversal- children may be taking care of them

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44
Q

Promoting health in older adults-
keep
assess
meds
at risk for

Older Adults (65 and older) Screening

A

keep movement,

assessing for abuse or malpractice-elder abuse,

meds can cause tiredness or confusion ,

at risk for suicide, starvation, overdosing

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45
Q

Injury PreventionOlder Adults

A

Limited vision

Brittle bones

Slowed reflexes

Falls

Night driving= not want

Fires

Wandering

Suicide

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46
Q

immunizations

old

A

annual flu

2 shingles

pnemococial

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47
Q

bone scans when

dentist in months

breast exams when

what’s needed

old

A

bone scans at 60

dentist-eveyr6

breast exam - 2year

hearing aids

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48
Q

Stress
condition-
natural condition-
everyone-

A

Condition in which the person experiences changes in the normal balanced state.

Natural condition-humans have the ability to respond internally and externally to situations

Everyone is different on how they respond to situiations

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49
Q

internal stress
originates where
caused by
feelings of

A
  • originate WITHIN a person

Infection

Feelings of depression psychological stress

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50
Q

External-originates where

caused by

A
  • originate OUTSIDE the person

Move, death in family

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51
Q

Developmental-

Situational-

stress

A

Developmental- predictable/age related

Situational- unpredictable

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52
Q

can have
research shows
major life events

Psychological Stress

A

Can have both positive and negative at the same time- not a bad thing

Research has found that the Perception of a life event determines that person’s Reaction to it

MLE-married/divorce, fired from job, children, retirement

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53
Q

Distressing
stress
dr
results in

Psychological Stress

A
  • negative stress-

energy draining.

, results in anxiety, depression and confusion, and leaves person overwhelmed and fatigued

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54
Q

positive
energy-
person-
like-

Psychological Stress

A
  • beneficial energy,

motivated person-

like studying for exams- feel happiness and don’t feel negative

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55
Q

Physical Stressors

conditions
n
h
is

A

Environmental Conditions and Physical Conditions

Chemical-drug poisoning

Nutritional,
hypoxia,
immune system

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56
Q

Cognitive-

Physiologic Responses to Stress

A
  • constantly worrying,

racing thoughts

, forgetfulness,

disorganized

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57
Q

Mood changes-
Physiologic Responses to Stress

A

anger,

scared,

upset stomach

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58
Q

Alarm stage-
inital
or
begins
General Adaptation Syndrome

A

initial belief of adaption response-

FIGHT or FLIGHT.

Begins with eyes/ ears sending alarms to brain-car lights and fire alarms

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59
Q

Short term effects
I
brain
up
up

General Adaptation Syndrome

A
  • inflammation,

brain norepinephrine,

glucose up,

corticosteroids up

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60
Q

systemic symptoms

General Adaptation Syndrome

A

hr goes up

, bp goes up ,

pupils dilate,

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61
Q

Physiological indicators of stress

A

Headache,

heartburn,

depression,

anxiety,

weakened immune system,

glucose goes up,

bp goes up

, fertility problems,

erectile dysfunction,

stomach ache,

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62
Q

Females
may
low
muscles

Physiological indicators of stress

A

may miss periods,

low sex drive,

muscles tense all the time,

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63
Q

Psychological Effects of Stress
faadd

A

Anxiety

Fear

Anger-

Depression

Defense Mechanisms

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64
Q

Problem solving

Cognitive Indicators of Stress(thinking responses)

A
  • thinking through-how can problem be solved so stress level goes down
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65
Q

Structuring

Cognitive Indicators of Stress(thinking responses)

A

-manipulation of situation so threatening events don’t occur

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66
Q

Self control/self discipline-

Cognitive Indicators of Stress(thinking responses)

A

assuming manner/expression that conveys being in control-

“everything’s good”- even though internally feel stressed

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67
Q

Suppression

Cognitive Indicators of Stress(thinking responses)

A

-consciously putting a thought/feeling out of mind

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68
Q

Fantasy or daydreaming-

Cognitive Indicators of Stress(thinking responses)

A

make believe

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69
Q

Coping
Coping Strategy

A

Definition of coping: Dealing with change; successfully or not

Coping Strategy: Way of responding to a problem/situation

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70
Q

Problem-focused: coping

A

efforts to improve situation by taking action

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71
Q

Emotion-focused: coping

A

Thoughts/actions that relieve emotional distress

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72
Q

Long-term: coping

A

constructive (exercising regularly)

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73
Q

Short-term coping
make
ways

at some

A

: to make stress tolerable TEMPORARILY.

  • Ineffective way to permanently deal with stress

at some point the person will need to deal with stress, it will not go away, so they need to find effective strategies.

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74
Q

Short-term coping examples

A

alcohol,

day dreaming,

fantasizing-

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75
Q

Adaptive coping

A
  • help coping and minimizes additional stress-effectively dealing with stress
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76
Q

Stress and Coping- Nursing Assessment

A

History

Physical Exam

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77
Q

Maladaptive coping

example

A

-can cause unnecessary distress- ineffective-

example is when someone takes up drinking to solve stress, they may become hungover and increase stress

78
Q

Life-Changing Event Questionnaire-

A

there may be something that patient is not telling us that you can get from questionnaire. And can look at high levels of stress

79
Q

Planning/Goals coping

decrease/resove
increase ability
improve

A

Decrease/resolve anxiety

Increase ability to manage or cope with stressful events/circumstances - how resilient is person to deal with stress, can help in future when dealing with other stressful events

Improve role performance

80
Q

Implementation - Strategies for Stress Reduction

A

Exercise

Nutrition

Rest and sleep-7-8 hrs of sleep a night

Time management

Breathing exercises- deep breathing-resets mind

Mediating anger

Relaxation techniques/meditation- 10 mins a day can help

Guided imagery

Crisis intervention

81
Q

Behavioral Approaches/Healing Modalities Cont.

A

Massage

Reflexology

Accupressure

Prayer

Music therapy

Humor and laughter

Hypnosis

Aromatherapy

Pets

Therapeutic touch

82
Q

progresive
bio
special

Behavioral Techniques Requiring Special Training

A

Progressive muscle relaxation (PMR)-occupational therapy

Biofeedback

Special appointments to go see provider

83
Q

Journal keeping

Cognitive Approaches

A

-can see how often stress is happening, and how they relieved it- if they did at all

84
Q

Restructuring and setting priorities

Cognitive Approaches

A
  • what is important to them- what is going to matter in a week from today
85
Q

Cognitive restructuring and reframing

Cognitive Approaches

A

-changing frame of mind

86
Q

Assertiveness training

Cognitive Approaches

A

=people who are personality dependent on people

87
Q

duration
s/s
subside

ILLNESS
Acute

A

: short duration, s/s appear abruptly, subside abruptly

88
Q

lasts
usually
can go
s/s
periods
body does what

chroinic ILLNESS

A

lasts extended period of time,

usually 3-6 months,

and can go length of life,

slow onset of s/s,

periods of remission and exacerbations

body will adjust

89
Q

Depression
risk for

Psychological Responses to Serious Medical Illness

A
  • high among those with serious medical illnesses.

Risk for nonadherence to treatment regimen- don’t want to do treatment if they are going to die anyways

90
Q

Anxiety

Psychological Responses to Serious Medical Illness

A

-Frequently accompany medical illness

91
Q

Substance Abuse

Psychological Responses to Serious Medical Illness

A

-remember temp. solution- will not take problem away and can make problems work

92
Q

Grief and Loss-

Psychological Responses to Serious Medical Illness

A

should be temporary, but pts can have longer periods

93
Q

Denial-

Psychological Responses to Serious Medical Illness

A

unconscious defense mechanism

94
Q

Fear of Dependency

Psychological Responses to Serious Medical Illness

A
  • don’t want to depend on others- can be hard to cope with
95
Q

how does
assessment
rescources
how did
systems
conditions
behaviors

Holistic Assessment with Serious Medical Illness

A

How does illness affect client’s life?

Spiritual assessmen

Adaptive resources-

How did the client deal with adversity in the past?

Support systems

Coexisting conditions

Risk behaviors

96
Q

multidisciplinary
address stressors
social suport
pain management

Intervention Strategies with Serious Medical Illness

A

Multidisciplinary-occupational therapy ,physical therapy, pharmacist, home care- there will always be a network of people who are there to support medical conditions

Address stressors and coping-finding strategies to cope

Social Support-friends , family, support groups, internet, social networking,

Pain Management- specialists, hospice, homecare, physcican. Person needs to be willing to help

97
Q

ANXIETY

A

uneasiness, uncertainty, dreadful feelings that person may have

98
Q

Acute (state) anxiety

A

Can occur with traumatic event and goes away after few weeks

99
Q

Chronic (trait)- anxiety

A

chronic state of anxiety-may need to get help

100
Q

still
focus
role
can

mild to moderate levels of anxiety

A

still able to problem solve.

Focus on the pt’s concerns,

role play- don’t usually needs meds-

can take deep breaths

101
Q

safety
pt may
need
help

severe to panic levels levels of anxiety

A

Safety for pt and others,

pt may not have a grasp of what is happening in environment-

need to stay with patient,

help reduce stress

102
Q

generalized anxiety disorder symptoms

A

fatigue

restlenss

excessive worry

increased muscle aches

impaired contraption

irratibulty

Dif sleeping

103
Q

ANXIETY DISORDERS Etiology

A

biology

traumatic life events

psychosocial factors

sociocultural factors

Genetics, early traumatic event, parenting style, brain structure, genetics, society expecting of person, situational anxiety

104
Q

Symptoms of Anxiety Disorders

A

Panic attacks

Excessive anxiety

Severe reactions to stress/trauma

Phobias

Obsessions

Compulsions

105
Q

help
antiicapte
demonstrate
encourage

Nursing Interventions: Mild to Moderate Anxiety

A

Help identify anxiety and what leads to anxiety

Anticipate anxiety-provoking situations

Demonstrate interest

Encourage express. of feelings
Keep communication open

106
Q

use
encourage
use
explore
provide

Nursing Interventions: Mild to Moderate Anxiety

A

use clarification

encourage problem solving

use role playing

explore behaviors used in past

provide outlets for excess energy

107
Q

maintain
remain
minimize
use
low

Nursing Interventions: Mild to Moderate Anxiety

A

Maintain calm manner

Remain with client

Minimize environmental stimuli

Use clear, simple statements

Low pitched voice; speak slowly

108
Q

reinforce
listen
meet
set
assess
provide
offer

Nursing Interventions: Severe to Panic Anxiety Continued

A

Reinforce reality if distortions occur

Listen for themes

Meet physical and safety needs

Set verbal limits/physical limits

Assess need for medication or seclusion

Provide opportunities for exercise

Offer high calorie foods

109
Q

counsel
cognitive
behavioral

Other long-term interventions

A

Counseling-1 on 1

Cognitive therapy- Identify beliefs, analyze thoughts, replace negative self-talk

Behavioral therapy- Role play, relaxation, flooding

110
Q

anxiety
c
se
kn

Anxiety Outcomes/Goals

A

Anxiety Self-control- when starting to feel anxious, implementing interventions such as deep breathing to calm down

Coping

Self-esteem

Knowledge about disease

111
Q

anxiety meds

A

anxiolytics

benzodiapamens

nonbenzodiazepens

Antidepressants-ssri, tricycle, maoi

112
Q

tyramine found in

A

banana
yogurt
wine
chochoalte
cheese
bologna

113
Q

More Anxiety Medications

A

Beta blockers ()

Antihistamines

Anticonvulsants

114
Q

Panic Attack
if
sudden

A

If anxiety not treated, can lead to panic attack

Sudden onset of extreme apprehension or fear, usually associated with feelings of impending doom

115
Q

MENTAL HEALTH

A

state of well-being in which the person can realize his/her own potential, cope with normal life stressors, work productively, contribute to the community.

116
Q

well being mental health

A

occasional stress to mild distress

no impairment

117
Q

emotional problems or concerns

A

mild to moderate distress

mild to temporary impairment

118
Q

mental illness- 2 thing

A

marked distress

moderate to disabling or chronic impairment

119
Q

influences the impact mental health

A

inherited

hormonal

cultural

negative influence

perosnality

family

development

120
Q

DEPRESSIVE DISORDERS types

A

Major Depressive Disorder

Persistent Depressive Disorder-depressed mood lasting more then 2 weeks and can go fro 5-6 months

121
Q

Depressive DisordersEtiology

Biological Factors

A

: Genetics,

biochemical (neurotransmitter alterations),

alterations in hormonal regulation

122
Q

Depressive DisordersEtiology

Psychological Factors

A

: thoughts result in emotions,

learned helplessness,

how raised as child

123
Q

Depressive DisordersKey Symptoms

A

Anergia: Lack of energy

Feelings of worthlessness, guilt, anger

Anxiety

Headaches, malaise

Slow speech

Grooming, personal hygiene lacking

Anhedonia-inability to be happy or find pleasure

Change in eating habits, sleep disturbances, disinterest in sex

Affect: Outward representation of person’s internal state

124
Q

Assessment Tools depression

universal
screening
look for

A

Universal tools so we are assessing everyone the same

screening is key, do in everyone, important-

look for outward affect- looking at facial expressions if there is any

125
Q

Intermediate and Short-term goals for depression

A
  • Safety always first!-MASLOWS
126
Q

Long–term goal: depression

client
medical

A

Client takes actions to minimize melancholy and maintain interest in life events/

/ medically recover them and meet basic human needs

127
Q

counseling
health teaching
self
milieu
psychotherapy

Depressive DisordersNursing Interventions

A

Counseling-Sitting and listening

Health Teaching-Get family involved. Increase awareness and understanding, use of resources, coping

Self-Care Activities

Milieu therapy –environment, inpatient/outpatient settings,

Psychotherapy-how they behave-help build skills and help with maintenance of personal relationships

128
Q

technique of
words
allow
ask about
avoid

Depressive DisordersCommunication Guidelines-

A

Technique of making observations-silence helps a lot

Simple, concrete words

Allow time for response up to 2 minutes

Ask about suicide plans- ALWAYS/ tell me more if willing to share more- do not downplay this

Avoid platitudes-

129
Q

Covert vs overt

A

Listen for covert messages- if something doesn’t sound right –nonverbal cues- “soon everything will be fine” “nothing feels good and never will”

Overt-”I wish I were dead” “nobody cares about me”- clear and open about intentions

130
Q

Selective serotonin reuptake inhibitors (SSRIs

treatment
transition
takes

Depressive DisordersMedications

A

1st line of treatment

Transition slowly on/off because of what side effects can do to the body

Takes a while to build up- can be 4-8 weeks,

131
Q

Assessment of Suicide Potential
severe
overuse
recent
hx
ideal

A

Severe hopelessness

Overuse of alcohol

Recent loss or separation

History of past/serious suicide
attempts

Suicidal ideation-plan/ask

132
Q

Suicide Risk Factors

A

Race

Religion

Marriage

Profession

Physical health

133
Q

Warning factors for immediate risk for suicide

A

talking/writing about death/dying/ suicide,

comments about hopeless/ helpless/ worthless

. Expressions of no reason for living,

no purpose in life,

increase drugs/alcohol,

withdrawal form family/friends,

reckless behaviors ,

mood changes,

talks about being burden to others

134
Q

Protective factors that can help lower risk of suicide

access
clinical
strong
good
m
having
conflict
others

A

Access to mental health care,

clinical interventions

, strong connections,

good social institution,

, marriage,

having children,

conflict resolution

, contact with others

135
Q

Culture and Mental Illness

A

suicide sign of mental illness but traditional Japanese may consider suicide an act of honor.

136
Q

FAMILY VIOLENCE-when is each

child
spousal
older adult

A

Child Abuse-very underreported- under age of 18

Spousal Abuse- anyone married/ has partner

Older Adult Abuse: 1 in every 10 adults over age 65

137
Q

when are nurses not madated to report abuse

unless

A

Abuse from 18-64 nurses are not mandated to report-

unless it is vulnerable-

138
Q

when’re nurses mandated to report abuse

A

nurses are mandated only for elders, children and disabled population-

139
Q

Perpetrator-

Conditions for Violence

A

initiates violence

140
Q

Vulnerable person

Conditions for Violence

A

-person that is abused

141
Q

Crisis situation

Conditions for Violence

A
  • stress that’s causing violence or why person is doing this
142
Q

Types of Maltreatment in abuse

A

Physical

Sexual

Emotional

neglect

Economic

143
Q

Characteristics of abusive parents-

A

may have been neglected when they were children,

family authorism,

low self esteem,

worthlessness,

depression

, low self esteem

, poor coping skills

, social isolation,

unrealistic expectaitons of children,

frequent usage of harsh punishment,

violent behavior,

perception that child is evil,

no control over life,

frustrations,

poor impulse control

144
Q

Honeymoon stage-
abuser
promises
victim

Cycle of Violence

A

abuser is very loving towards person,

promises to change, very sorry,

victim is trusting and wants change

145
Q

Tension-
stage
abuser
types of abuse

Cycle of Violence

A

building stage-

abuser is edgy,

verbal abuse, minor fighting, pushing, tense and afraid

146
Q

Eruption
types of violcen
victim

Cycle of Violence

A

physical violence, very verbal violence, can be unbearable

, victim is provoked into situation to get it over with

147
Q

assessment interview do

coduct
be
use
be
assess

A

contact intervew in private

be direct/honest

use language pt undesatnds

be understanding

assess safety

148
Q

assessment interview dont

try
display
place
press
conduct
force

A

try to prove it

display horror

place blame

allow pt to feel at trouble

press for asners

conduct in group

force to remove clothing

149
Q

Nursing Interventions abuse

A

support

case managemnt

milieu therapy

self care acitivires

health teaching

psychotherapy

150
Q

Legal and Ethical Issues abuse

nurses=

if made

A

Nurses = legally mandated to report suspected or actual cases of child and vulnerable adult abuse.

If made in good faith (true abuse is suspected), nurses not liable for countersuits.

151
Q

Child Abuse

types of abuse

most common

A

Sexual abuse, physical neglect, emotional abuse/neglect

most common attacker is parent/friend of parent

152
Q

manifestations of child abuse

A

: physical,

sudden change in behavior/school performance,

avoidance of certain situation

153
Q

Elder Abuse

who does it

look at/get

may be

A

Family members, paid caregivers

Look at situation and get elderly person out

May be unlikely to say anything because they don’t want to go to nursing home/ don’t want people to stop caring for them

154
Q

prevent

Primary Prevention of Abuse

A

Prevent abuse from occurring

155
Q

identify
identify
during

Primary Prevention of Abuse

A

Identify families at risk during:

Home health visits/clinic visits

156
Q

implement-
reduce x2
increase x3

Primary Prevention of Abuse

A

Reduce stress

Reduce influence of risk factors

Increase social support

Increase coping skills

Increase self-esteem

157
Q

Secondary Prevention of Abuse
screening
screen
medical

A

Screening for and early intervention in abuse

Screen those at risk/screening programs

Medical treatment of injuries
Coordinate community services/referrals

158
Q

Tertiary Prevention of Abuse

nurses facilitate

counseling
providing
assisting

A

Nurses facilitating healing and rehab process (most often in a mental health setting)

Counseling individuals and families

Providing support groups

Assisting survivors reach their optimal level of safety, health and well-being.

159
Q

substance Abuse

A
  • use of substance and inability to fill roles, but continued use despite
160
Q

substance dependence

high
inability
increased
withdraw
decreased

A

High tolerance, increase in amounts over time for same effect

Inability to control or decrease amount

Increased time spent

Withdrawal from family and friends

Decreased recreation and social activities

161
Q

substance abuse

codependence

Behavior Patterns in families with Substance Abuse

A

Substance abuse is a source of family stress

Codependence -doing for others what they can do for themselves

162
Q

Substance Abuse -Screening

screen
brief
refer-nursepov

A

Screening – standard tools- asking them how much/often

Brief intervention – discuss risks and provide feedback and advice- try to get detoxed if possible

Referral to treatment after that point-nurse pod- pt is stable enough to get counseling

163
Q

intoxication

Substance Abuse Nursing Process - Assessment

A

“high”

Physiological symptoms depend on substance

164
Q

Addiction

Substance Abuse Nursing Process - Assessment

A

primary, chronic disease of brain reward, motivation, memory and related circuitry

165
Q

Substance Abuse – Assess cont’d

clinical
pattern
mental
hx
strengths
family
self

A

Clinical exam- how often

Pattern of substance use- can they get by day without using

Mental health symptoms

Hx of trauma, family hx

Strengths and level of willingness to change- if not in place, they will not engage in trying to change

Family assess - do they have support from fam

Self-assess – need to be nonjudgmental

166
Q

Substance Abuse - Planning

d
r
hh
ph
12

A

detoxification

rehabilitation

halfway house

partial hoisptalizaition

12 step program

167
Q

Substance Abuse - Implementation

safety/sleep
support
theraputic
health
assist
explore

A

Safety and sleep -1st lines of defense-low stimuli in room, make sure safe and also seizure precautions

Support and encouragement- family memebers

Therapeutic relationship/Counseling

Health teaching

Explore coping skills

Assist in goal-setting

168
Q

Substance Abuse - Evaluation

first
evluation
make
relfection
ongoing

A

First 3-6 months most difficult

Evaluation effectiveness of treatment plan

Make adjustments

Reflection and maintenance of new lifestyle

Ongoing evaluation to prevent relapse

169
Q

Definition of defense mechanisms

alters

A

coping style that protects people from anxiety

alters reality at uncoisnous level so you are not aware you are using a defense mechanism

170
Q

Conversion

ex

defense mechanisms

A

Unconscious transformation of anxiety into a physical symptom with no organic cause.

A husband and wife are fighting and the wife all of a sudden cannot move her right arm.

171
Q

Detail

ex

defense mechanisms

A

Refusal to accept an unpleasant reality

A terminally ill patient states “I’m not dying.”
A person who binge drinks daily says “I don’t have a drinking problem.”

172
Q

Displacement

ex

defense mechanisms

A

Transfer of emotions to a substitute object that is less threatening

A person gets yelled at by their boss. The person goes home and gets angry and snaps at their partner.
A student receives an F on an exam and kicks their dog when they get home.
A teenager angry at their father picks a fight with their younger brother.

173
Q

Dissociation

ex

defense mechanisms

A

Disruption in consciousness –person loses track of time and instead finds another representation of their self in order to continue in the moment. “Disconnect” from the real world

.
Often times someone with a history of any childhood abuse suffer from some sort of dissociation.

174
Q

Identification

ex

defense mechanisms

A

Attributing to oneself the characteristics of another person or group (may be conscious or unconscious).

Teenager who dresses as their favorite band members.

175
Q

Intellectualization

ex

defense mechanisms

A

Reasoning is used to block confrontation with an unconscious conflict and its associated emotional stress.

A woman has just been diagnosed with cancer and expresses no emotion, yet talks in detail about new procedures that can be done.

176
Q

Projection
ex

defense mechanisms

A

Attributing a disturbing impulse, attitude or behavior to someone else.

A personal unconsciously hates a person but says, “I don’t hate him, he hates me.”
A woman is unconsciously attracted to her sister’s husband but denies this attraction and believes the husband is attracted to her.

177
Q

Rationalization

ex

defense mechanisms

A

Making up acceptable excuses for unacceptable behavior

“that job wasn’t good anyways”
“I just drink to be social”

178
Q

Reaction Formation

ex

defense mechanisms

A

Expressing a more socially accepted impulse opposite of what the person truly feels or wants to express

Treating someone whom you intensely dislike as a friend.

179
Q

Regression

ex

defense mechanisms

A

Falling back on childlike patterns as a way of coping with stressful situations

sucking thumb

180
Q

Repression

ex

defense mechanisms

A

unconscious exclusion of unwanted experiences from conscious awareness.

An adult who was abused in childhood cannot recall the abuse at all.

181
Q

Sublimation

ex

defense mechanisms

A

Unconsciously turning socially unacceptable urges into socially acceptable behavior.

A hostile, aggressive teenager channels their urges into learning mixed martial arts.

182
Q

Suppression

ex

defense mechanisms

A

is the conscious decision to delay addressing a disturbing situation or feeling

A patient feels a lump, but ignores it until after a vacation.

183
Q

Undoing

ex

defense mechanisms

A

is when a person makes up for a regrettable act or communication

After a difficult argument, a husband brings flowers to his wife.

184
Q

trust vs mistrust
when
what happens

eriksons stages

A

infancy-0-1

trust that basic need will be met

185
Q

autonomy vs shame
when
what happens
eriksons stages

A

early childhood-1-3

develop independence

186
Q

initiative vs guilt

when
what happens
eriksons stages

A

play age- 3-6

take initiative on actions

187
Q

industry vs inferiority
when
what happens
eriksons stages

A

school age-6-12

self confidence

188
Q

identity vs confusion

when
what happens
eriksons stages

A

adolescent-12-18

identity

189
Q

intimacy vs isolation

when
what happens
eriksons stages

A

early adulthood

establish relationships

190
Q

generatively vs stagnation

when
what happens
eriksons stages

A

middle age

contribute to family

191
Q

integrity vs despair

when
what happens
eriksons stages

A

old age

sense of life