last exam promotion Flashcards
(191 cards)
1
Q
Health Promotion-what is it
A
behavior motivated by the desire to increase wellbeing and actualized health potential
2
Q
Primary Prevention-
Direction
A
direction is promoting health and preventing disease/injury-example is immunizations
3
Q
Primary prevention examples
A
/wt loss,
diet,
exercise
smoking cessation
, reduce alcohol,
avoid drugs,
seatbelts,
car safety,
safe sex,
effective parenting
4
Q
Secondary Prevention
what is it
A
-early identification and prompt treatment,
5
Q
Secondary prevention examples
A
bp screenings,
mammograms,
skin cancer peps,
testicular examinations and family counseling.
6
Q
Tertiary Prevention-
what is it
A
restorative and rehab,
7
Q
Tertiary Prevention-
examples
A
diabetic self care,
physical therapy,
medical therapy,
medications,
surgery,
occupational therapy,
job training
8
Q
4 - Sites to promote health
A
Home- preferred
Schools
Community
Worksite-employee heatlh, administering vaccinations, up to date on vaccinations, screening
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
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
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
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
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
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
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
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
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,
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,
19
Q
experience what
start to see
Young Adults (18 -39)
A
Experiencing stress and changes
start to see mental health changes
20
Q
Safety
Young Adults (18 -39)
A
Tanning beds,
MVAs,
STI’s,
physical assault
, workplace safety,
firearm
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 .
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.
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
24
Q
Young Adults (18 -39)
Females-
how often
A
- self breast exams,
every year
25
alchohol
how many drinks per men/women
use what to check
Young Adults (18 -39)
1-women 2- men
alcohol screening tools
26
screening-how often
denstist
sti-why
cardiovasular
diabetes
physical
Young Adults (18 -39)
denstist-6months
sti-sexual activity
cardiovasular-every 5 years
diabetes-every 3 years
physical-yearly
27
immunizations
Young Adults (18 -39)
tdap
menengitits
hep b
annual flu shot
28
Physical Changes
challenges
develop
less
menopause when
Middle-Aged Adults (40 – 65)
–bodily challenges-
develops fat,
lessened metabolism,
menopause average 52
29
Erikson
what does it mean
Middle-Aged Adults (40 – 65)
- generativity vs stagnation
, may experience empty nest, financial freedom, developed career, owns home, economic stability, aware of own mortality, ”generational sandwhich"
30
reflection
Middle-Aged Adults (40 – 65)
Reflection on time spent/time left
31
changes with reflection
Middle-Aged Adults (40 – 65)
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
32
Cancer screening guidelines
males
female
immunizations
Middle-Aged Adults (40 – 65)
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
33
part of life
decrease
diminish
Middle-Aged Adults (40 – 65)
Exercise is part of life,
can decrease salt/sugar intake
, smoking can diminish
34
limit
because
decline
experience more
Middle-Aged Adults (40 – 65)
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
35
Middle-Aged Adults (40 – 65)
injury
Poisoning-accidental
Falls
MVAs – decreased response time
36
Other causes of death:
Middle-Aged Adults (40 – 65)
Heart, respiratory disease
Diabetes
Alcoholism, arthritis, depression
Polypharmacy-increase amount of meds that they are taking
37
exams:
prostate-when start
eye exams-often
diabetes-often
dentist-often
colonoscopy-when start
physical-often
lung-when do
middle aged
prostate-at 45
eye exams-every year
diabetes-every 3
dentist-6months
colonoscopy at 45
physical-annual
lung- if 30 pack years
38
immunizations middle aged
shingles
pneumonia
flu
tetanus
39
young old
middle old
old old
Older Adults (65 and older)
Young Old (65-74)
Middle Old (75-84)
Old-old (85 and older)
40
Psychosocial
eriksons
what does It mean
Older Adults (65 and older)
-integrity vs despair
adjusting to life changes, deaths, living arrangements, financi
41
Nutrition and exercise
low
daily
supplement
Older Adults (65 and older) Screening
Low-fat well balanced diet
Exercise daily
Vit D supplement possibly- more suspectable for fractures and falls
42
chr
med
3d's problems
Older Adults (65 and older) Screening
Chronic illness
Medication compliance
Dementia, depression, and delirium
43
interact
arrange
role
Older Adults (65 and older) Screening
Social interactions,
living arrangements,
role reversal- children may be taking care of them
44
Promoting health in older adults-
keep
assess
meds
at risk for
Older Adults (65 and older) Screening
keep movement,
assessing for abuse or malpractice-elder abuse,
meds can cause tiredness or confusion ,
at risk for suicide, starvation, overdosing
45
Injury Prevention Older Adults
Limited vision
Brittle bones
Slowed reflexes
Falls
Night driving= not want
Fires
Wandering
Suicide
46
immunizations
old
annual flu
2 shingles
pnemococial
47
bone scans when
dentist in months
breast exams when
what's needed
old
bone scans at 60
dentist-eveyr6
breast exam - 2year
hearing aids
48
Stress
condition-
natural condition-
everyone-
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
49
internal stress
originates where
caused by
feelings of
- originate WITHIN a person
Infection
Feelings of depression psychological stress
50
External-originates where
caused by
- originate OUTSIDE the person
Move, death in family
51
Developmental-
Situational-
stress
Developmental- predictable/age related
Situational- unpredictable
52
can have
research shows
major life events
Psychological Stress
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
53
Distressing
stress
dr
results in
Psychological Stress
- negative stress-
energy draining.
, results in anxiety, depression and confusion, and leaves person overwhelmed and fatigued
54
positive
energy-
person-
like-
Psychological Stress
- beneficial energy,
motivated person-
like studying for exams- feel happiness and don’t feel negative
55
Physical Stressors
conditions
n
h
is
Environmental Conditions and Physical Conditions
Chemical-drug poisoning
Nutritional,
hypoxia,
immune system
56
Cognitive-
Physiologic Responses to Stress
- constantly worrying,
racing thoughts
, forgetfulness,
disorganized
57
Mood changes-
Physiologic Responses to Stress
anger,
scared,
upset stomach
58
Alarm stage-
inital
or
begins
General Adaptation Syndrome
initial belief of adaption response-
FIGHT or FLIGHT.
Begins with eyes/ ears sending alarms to brain-car lights and fire alarms
59
Short term effects
I
brain
up
up
General Adaptation Syndrome
- inflammation,
brain norepinephrine,
glucose up,
corticosteroids up
60
systemic symptoms
General Adaptation Syndrome
hr goes up
, bp goes up ,
pupils dilate,
61
Physiological indicators of stress
Headache,
heartburn,
depression,
anxiety,
weakened immune system,
glucose goes up,
bp goes up
, fertility problems,
erectile dysfunction,
stomach ache,
62
Females
may
low
muscles
Physiological indicators of stress
may miss periods,
low sex drive,
muscles tense all the time,
63
Psychological Effects of Stress
faadd
Anxiety
Fear
Anger-
Depression
Defense Mechanisms
64
Problem solving
Cognitive Indicators of Stress (thinking responses)
- thinking through-how can problem be solved so stress level goes down
65
Structuring
Cognitive Indicators of Stress (thinking responses)
-manipulation of situation so threatening events don’t occur
66
Self control/self discipline-
Cognitive Indicators of Stress (thinking responses)
assuming manner/expression that conveys being in control-
“everything's good”- even though internally feel stressed
67
Suppression
Cognitive Indicators of Stress (thinking responses)
-consciously putting a thought/feeling out of mind
68
Fantasy or daydreaming-
Cognitive Indicators of Stress (thinking responses)
make believe
69
Coping
Coping Strategy
Definition of coping: Dealing with change; successfully or not
Coping Strategy: Way of responding to a problem/situation
70
Problem-focused: coping
efforts to improve situation by taking action
71
Emotion-focused: coping
Thoughts/actions that relieve emotional distress
72
Long-term: coping
constructive (exercising regularly)
73
Short-term coping
make
ways
at some
: 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.
74
Short-term coping examples
alcohol,
day dreaming,
fantasizing-
75
Adaptive coping
- help coping and minimizes additional stress-effectively dealing with stress
76
Stress and Coping- Nursing Assessment
History
Physical Exam
77
Maladaptive coping
example
-can cause unnecessary distress- ineffective-
example is when someone takes up drinking to solve stress, they may become hungover and increase stress
78
Life-Changing Event Questionnaire-
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
Planning/Goals coping
decrease/resove
increase ability
improve
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
Implementation - Strategies for Stress Reduction
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
Behavioral Approaches/Healing Modalities Cont.
Massage
Reflexology
Accupressure
Prayer
Music therapy
Humor and laughter
Hypnosis
Aromatherapy
Pets
Therapeutic touch
82
progresive
bio
special
Behavioral Techniques Requiring Special Training
Progressive muscle relaxation (PMR)-occupational therapy
Biofeedback
Special appointments to go see provider
83
Journal keeping
Cognitive Approaches
-can see how often stress is happening, and how they relieved it- if they did at all
84
Restructuring and setting priorities
Cognitive Approaches
- what is important to them- what is going to matter in a week from today
85
Cognitive restructuring and reframing
Cognitive Approaches
-changing frame of mind
86
Assertiveness training
Cognitive Approaches
=people who are personality dependent on people
87
duration
s/s
subside
ILLNESS
Acute
: short duration, s/s appear abruptly, subside abruptly
88
lasts
usually
can go
s/s
periods
body does what
chroinic ILLNESS
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
Depression
risk for
Psychological Responses to Serious Medical Illness
- 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
Anxiety
Psychological Responses to Serious Medical Illness
-Frequently accompany medical illness
91
Substance Abuse
Psychological Responses to Serious Medical Illness
-remember temp. solution- will not take problem away and can make problems work
92
Grief and Loss-
Psychological Responses to Serious Medical Illness
should be temporary, but pts can have longer periods
93
Denial-
Psychological Responses to Serious Medical Illness
unconscious defense mechanism
94
Fear of Dependency
Psychological Responses to Serious Medical Illness
- don’t want to depend on others- can be hard to cope with
95
how does
assessment
rescources
how did
systems
conditions
behaviors
Holistic Assessment with Serious Medical Illness
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
multidisciplinary
address stressors
social suport
pain management
Intervention Strategies with Serious Medical Illness
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
ANXIETY
uneasiness, uncertainty, dreadful feelings that person may have
98
Acute (state) anxiety
Can occur with traumatic event and goes away after few weeks
99
Chronic (trait)- anxiety
chronic state of anxiety-may need to get help
100
still
focus
role
can
mild to moderate levels of anxiety
still able to problem solve.
Focus on the pt’s concerns,
role play- don’t usually needs meds-
can take deep breaths
101
safety
pt may
need
help
severe to panic levels levels of anxiety
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
generalized anxiety disorder symptoms
fatigue
restlenss
excessive worry
increased muscle aches
impaired contraption
irratibulty
Dif sleeping
103
ANXIETY DISORDERS Etiology
biology
traumatic life events
psychosocial factors
sociocultural factors
Genetics, early traumatic event, parenting style, brain structure, genetics, society expecting of person, situational anxiety
104
Symptoms of Anxiety Disorders
Panic attacks
Excessive anxiety
Severe reactions to stress/trauma
Phobias
Obsessions
Compulsions
105
help
antiicapte
demonstrate
encourage
Nursing Interventions: Mild to Moderate Anxiety
Help identify anxiety and what leads to anxiety
Anticipate anxiety-provoking situations
Demonstrate interest
Encourage express. of feelings
Keep communication open
106
use
encourage
use
explore
provide
Nursing Interventions: Mild to Moderate Anxiety
use clarification
encourage problem solving
use role playing
explore behaviors used in past
provide outlets for excess energy
107
maintain
remain
minimize
use
low
Nursing Interventions: Mild to Moderate Anxiety
Maintain calm manner
Remain with client
Minimize environmental stimuli
Use clear, simple statements
Low pitched voice; speak slowly
108
reinforce
listen
meet
set
assess
provide
offer
Nursing Interventions: Severe to Panic Anxiety Continued
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
counsel
cognitive
behavioral
Other long-term interventions
Counseling-1 on 1
Cognitive therapy- Identify beliefs, analyze thoughts, replace negative self-talk
Behavioral therapy- Role play, relaxation, flooding
110
anxiety
c
se
kn
Anxiety Outcomes/Goals
Anxiety Self-control- when starting to feel anxious, implementing interventions such as deep breathing to calm down
Coping
Self-esteem
Knowledge about disease
111
anxiety meds
anxiolytics
benzodiapamens
nonbenzodiazepens
Antidepressants-ssri, tricycle, maoi
112
tyramine found in
banana
yogurt
wine
chochoalte
cheese
bologna
113
More Anxiety Medications
Beta blockers ()
Antihistamines
Anticonvulsants
114
Panic Attack
if
sudden
If anxiety not treated, can lead to panic attack
Sudden onset of extreme apprehension or fear, usually associated with feelings of impending doom
115
MENTAL HEALTH
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
well being mental health
occasional stress to mild distress
no impairment
117
emotional problems or concerns
mild to moderate distress
mild to temporary impairment
118
mental illness- 2 thing
marked distress
moderate to disabling or chronic impairment
119
influences the impact mental health
inherited
hormonal
cultural
negative influence
perosnality
family
development
120
DEPRESSIVE DISORDERS types
Major Depressive Disorder
Persistent Depressive Disorder-depressed mood lasting more then 2 weeks and can go fro 5-6 months
121
Depressive Disorders Etiology
Biological Factors
: Genetics,
biochemical (neurotransmitter alterations),
alterations in hormonal regulation
122
Depressive Disorders Etiology
Psychological Factors
: thoughts result in emotions,
learned helplessness,
how raised as child
123
Depressive Disorders Key Symptoms
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
Assessment Tools depression
universal
screening
look for
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
Intermediate and Short-term goals for depression
- Safety always first!-MASLOWS
126
Long–term goal: depression
client
medical
Client takes actions to minimize melancholy and maintain interest in life events/
/ medically recover them and meet basic human needs
127
counseling
health teaching
self
milieu
psychotherapy
Depressive Disorders Nursing Interventions
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
technique of
words
allow
ask about
avoid
Depressive Disorders Communication Guidelines-
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
Covert vs overt
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
Selective serotonin reuptake inhibitors (SSRIs
treatment
transition
takes
Depressive Disorders Medications
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
Assessment of Suicide Potential
severe
overuse
recent
hx
ideal
Severe hopelessness
Overuse of alcohol
Recent loss or separation
History of past/serious suicide
attempts
Suicidal ideation-plan/ask
132
Suicide Risk Factors
Race
Religion
Marriage
Profession
Physical health
133
Warning factors for immediate risk for suicide
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
Protective factors that can help lower risk of suicide
access
clinical
strong
good
m
having
conflict
others
Access to mental health care,
clinical interventions
, strong connections,
good social institution,
, marriage,
having children,
conflict resolution
, contact with others
135
Culture and Mental Illness
suicide sign of mental illness but traditional Japanese may consider suicide an act of honor.
136
FAMILY VIOLENCE-when is each
child
spousal
older adult
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
when are nurses not madated to report abuse
unless
Abuse from 18-64 nurses are not mandated to report-
unless it is vulnerable-
138
when're nurses mandated to report abuse
nurses are mandated only for elders, children and disabled population-
139
Perpetrator-
Conditions for Violence
initiates violence
140
Vulnerable person
Conditions for Violence
-person that is abused
141
Crisis situation
Conditions for Violence
- stress that’s causing violence or why person is doing this
142
Types of Maltreatment in abuse
Physical
Sexual
Emotional
neglect
Economic
143
Characteristics of abusive parents-
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
Honeymoon stage-
abuser
promises
victim
Cycle of Violence
abuser is very loving towards person,
promises to change, very sorry,
victim is trusting and wants change
145
Tension-
stage
abuser
types of abuse
Cycle of Violence
building stage-
abuser is edgy,
verbal abuse, minor fighting, pushing, tense and afraid
146
Eruption
types of violcen
victim
Cycle of Violence
physical violence, very verbal violence, can be unbearable
, victim is provoked into situation to get it over with
147
assessment interview do
coduct
be
use
be
assess
contact intervew in private
be direct/honest
use language pt undesatnds
be understanding
assess safety
148
assessment interview dont
try
display
place
press
conduct
force
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
Nursing Interventions abuse
support
case managemnt
milieu therapy
self care acitivires
health teaching
psychotherapy
150
Legal and Ethical Issues abuse
nurses=
if made
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
Child Abuse
types of abuse
most common
Sexual abuse, physical neglect, emotional abuse/neglect
most common attacker is parent/friend of parent
152
manifestations of child abuse
: physical,
sudden change in behavior/school performance,
avoidance of certain situation
153
Elder Abuse
who does it
look at/get
may be
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
prevent
Primary Prevention of Abuse
Prevent abuse from occurring
155
identify
identify
during
Primary Prevention of Abuse
Identify families at risk during:
Home health visits/clinic visits
156
implement-
reduce x2
increase x3
Primary Prevention of Abuse
Reduce stress
Reduce influence of risk factors
Increase social support
Increase coping skills
Increase self-esteem
157
Secondary Prevention of Abuse
screening
screen
medical
Screening for and early intervention in abuse
Screen those at risk/screening programs
Medical treatment of injuries
Coordinate community services/referrals
158
Tertiary Prevention of Abuse
nurses facilitate
counseling
providing
assisting
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
substance Abuse
- use of substance and inability to fill roles, but continued use despite
160
substance dependence
high
inability
increased
withdraw
decreased
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
substance abuse
codependence
Behavior Patterns in families with Substance Abuse
Substance abuse is a source of family stress
Codependence -doing for others what they can do for themselves
162
Substance Abuse -Screening
screen
brief
refer-nursepov
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
intoxication
Substance Abuse Nursing Process - Assessment
“high”
Physiological symptoms depend on substance
164
Addiction
Substance Abuse Nursing Process - Assessment
primary, chronic disease of brain reward, motivation, memory and related circuitry
165
Substance Abuse – Assess cont’d
clinical
pattern
mental
hx
strengths
family
self
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
Substance Abuse - Planning
d
r
hh
ph
12
detoxification
rehabilitation
halfway house
partial hoisptalizaition
12 step program
167
Substance Abuse - Implementation
safety/sleep
support
theraputic
health
assist
explore
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
Substance Abuse - Evaluation
first
evluation
make
relfection
ongoing
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
Definition of defense mechanisms
alters
coping style that protects people from anxiety
alters reality at uncoisnous level so you are not aware you are using a defense mechanism
170
Conversion
ex
defense mechanisms
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
Detail
ex
defense mechanisms
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
Displacement
ex
defense mechanisms
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
Dissociation
ex
defense mechanisms
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
Identification
ex
defense mechanisms
Attributing to oneself the characteristics of another person or group (may be conscious or unconscious).
Teenager who dresses as their favorite band members.
175
Intellectualization
ex
defense mechanisms
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
Projection
ex
defense mechanisms
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
Rationalization
ex
defense mechanisms
Making up acceptable excuses for unacceptable behavior
"that job wasn't good anyways"
"I just drink to be social"
178
Reaction Formation
ex
defense mechanisms
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
Regression
ex
defense mechanisms
Falling back on childlike patterns as a way of coping with stressful situations
sucking thumb
180
Repression
ex
defense mechanisms
unconscious exclusion of unwanted experiences from conscious awareness.
An adult who was abused in childhood cannot recall the abuse at all.
181
Sublimation
ex
defense mechanisms
Unconsciously turning socially unacceptable urges into socially acceptable behavior.
A hostile, aggressive teenager channels their urges into learning mixed martial arts.
182
Suppression
ex
defense mechanisms
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
Undoing
ex
defense mechanisms
is when a person makes up for a regrettable act or communication
After a difficult argument, a husband brings flowers to his wife.
184
trust vs mistrust
when
what happens
eriksons stages
infancy-0-1
trust that basic need will be met
185
autonomy vs shame
when
what happens
eriksons stages
early childhood-1-3
develop independence
186
initiative vs guilt
when
what happens
eriksons stages
play age- 3-6
take initiative on actions
187
industry vs inferiority
when
what happens
eriksons stages
school age-6-12
self confidence
188
identity vs confusion
when
what happens
eriksons stages
adolescent-12-18
identity
189
intimacy vs isolation
when
what happens
eriksons stages
early adulthood
establish relationships
190
generatively vs stagnation
when
what happens
eriksons stages
middle age
contribute to family
191
integrity vs despair
when
what happens
eriksons stages
old age
sense of life
