nur104 test 4 Flashcards
(205 cards)
1
Q
What is Loss
A
the undesired change or removal of a valued object, person, or situation
2
Q
how is loss categorized
A
actual vs. perceived physical vs. psychological external vs. internal loss of aspects of self enviromental loss loss of significant relationship
3
Q
what is actual loss
A
death of loved one, theft, deterioration, destruction, & natural disaster can be identified by others no just by person experience
4
Q
what is perceived loss
A
internal only by person experiencing it
5
Q
what is physical loss
A
injuries, removal of organ, loss of function
6
Q
what is psychological loss
A
belief system sexuality, control, fairness, meaning & trust
7
Q
what is external loss
A
actual loss of object that importantb/c of cost or sentimental value
8
Q
what is internal loss
A
percieved or psychological loss
9
Q
loss of aspects of self
A
could be physical loss, psych & perceived (personality, developmental change(aging) hopes, dreams, faith)
10
Q
what is enviromental loss
A
change in familiar even positive changes (job, home) (perceived or actual)
11
Q
what is loss of significant relationships
A
actual loss of spouse,family member, divorce, seperation
12
Q
what is grief
A
physical, psychological & spiritual response to loss can interfer with health & delay healing
13
Q
what is mourning
A
actions associated with grief
14
Q
what is nereavement
A
mourning & adjustment time after loss
15
Q
what are factors affecting grief
A
significance of loss, amount of support, conflict, circumstances of loss, previous loss, developmental stage, spiritual & cultural background, timeliness of death
16
Q
what are types of grief
A
uncomplicated and complicated
17
Q
what are uncomplicated grief
A
abbreviated-process faster & anticipatory grief- letting go before loss
18
Q
what are complicated grief
A
chronic, masked,delayed, disenfranchised
19
Q
what is chronic grief
A
complicated begins as normal continues long term
20
Q
what is masked grief
A
complicated when grieving express through behavior
21
Q
what is delayed
A
complicated put off until later time
22
Q
what is disenfranchised grief
A
complicated not supported
23
Q
how is death defined
A
historical, heart-lung, whole-brain, higher-brain, uniform determination of death act
24
Q
what is historical
A
cessation of flow of bodily fluids
25
what is heart-lung death
spontaneous respiration & circulation
26
what is whole-brain death
all functions of brain including brain stem
27
what is higher-brain death
higher brain functions (brain stem & resp could still be working)
28
what is uniform determination of death act
loss of brainstem functions
29
what is the physiological stage 1-3 mo prior to death
begins withdraw from world & people sleep increase food intake decrease
30
what is physiological stage 1-2 wks prior death
host of physical changes begin lose ability maintain self cardio deterioration decrease BP, pulse change & skin color, resp rate increase or decrease apnea
31
what is physiological stage days -hrs prior to death
surge of energy desire eat &talk get dehydrated decrease blood vol
32
what is physiological stage moments prior to death
doesn't respond to touch sound short series long spaced breath before stops
33
what is the end of life care
palliative and hospice care
34
what is the end of life palliative care
cure no longer possible or refuse tx (comfort care)
35
what is end of life hospice care
die within 6mo
36
what are the psychological stages of dying (five stages (kubler-ross)
denial, anger, bargaining, depression, acceptance
37
what are legal & ethical considerations
advance directives,DNR, assisted suicide, euthanasia, autopsy
38
what is advanced directives
group instructions stating persons wishes (durable power attorney)
39
what is DNR
do not resuscitate
40
what is assisted suicide
making available needs for pt end his own life
41
what is euthanasia
good death deliberate end of life one suffering terminal or incurable illness
42
what is autopsy
examination of body determine cause of death
43
what is assessment of terminally ill client & family
knowledge, history of loss, coping abilities & support, meaning of loss/illness, depression of grief, physical assessment, cultural & spiritual assessment
44
what is diagnosis for terminally ill pt & family
most norm loss grieving as problem, etiology, anticipatory grieving, dysfunctional grief AEB panic, hostility, regression, signs of deflated self-esteem
45
what are interventions for grief or loss
promote norm grieving , teach loss education through childhood help prepare in life, unse intervention based on stege person is in, encourage participation in support group, altered grief-professional help
46
what is therapeutic communication
perfect listening skills, encourage & accept expression of feelings, reassure not wrong feel anger, relief, or other unacceptable feeelings, respond nonverbal cues with touch, eye contact, increase self awareness, continue communicate even in case of coma
47
what is care of the dying patient
meeting physiological needs
meeting psychological needs
addressing spiritual needs
addressing cultural needs
48
what is providing postmortem care
care of body , norm for nurse feel grief when dies must also take care of yourself
49
what are types of stress
eustress, distress, external, internal, developmental, situational, physiological, & psychological
50
what is eustress
good stress
51
what is distress
can threaten health
52
what is external stress
RT family, enviroment
53
what is internal stress
anxiety
54
what is developmental stress
life stages
55
what is situational stress
random, unpredictable
56
what is physiological stress
affect body structure/function
57
what is psychological stress
arise from life events
58
what are maladaptive coping strategies
ineffective coping
59
what is adaptive coping strategies
effective coping
60
what are general approaches for coping
alter, adapt, & avoid stressors
61
what are personal factors influencing adaptation
personal perception of stressor(how handle), overall health status, support system, hardiness, & personal factors
62
what is stage 1 of adaptaion alarm fight or flight
endocrine system, sympathe nervouse system, CV, respiratory, metabolic, urinary, gastrointestinal, & musculoskeletal
63
how is the sympathe nervouse system affect in stage 1
epinphrine or norepinephrine
64
how is the CV system affected in stage 1
vasoconstriction elevated BP
65
how is the respiratory system affected
dilated bronchioles
66
how is the metabolic affected in stage 1
increased availability of glucose
67
how is urinary affected in stage 1
sodium & water retention
68
how is gastrointestinal affected in stage 1
decreased peristalis
69
how is musculoskeletal affected in stage 1
increased blood flow to muscles
70
what is the second stage of adaptation
resistance stage
71
what is the second phase resistance stage
use coping mechanisms failure to adapt to stress leads to third stage
72
what is the third stage of adaptation
exhaustion
73
what is the third stage exhaustion
adaptive mechanism become ineffective/ nonexistent decrease BP, elevated pulse, respiration usually ends in death
74
what is the third stage if adaptation is successful
recovery stage
75
what are response to stress
physical response local adaptation response involving specific body part, tissue, or organ
76
what is another response to stress
psychological feelings, thoughts, behavior (anxiety & fear, ego, anger, depression)
77
what are consequences of failed adaptation in stress induced organic responses
continual stress, repeated CNS sti,ulation, elevation of certain hormones, results in long term changes in body system
78
what are consequences of failed adaptation of somatoform disorders
hypochondriasis, somatization, somatoform pain disorder, & malingering
79
what are consequences of failed adaptation of stress induced psychological responses
crisis, burnout, post-traumatic stress disorder (PTSD)
80
what is crisis
```
does not respond to adaptive activities
overwhelming
demands immediate response
produces change
brings unsolved problems
increased affect & decrease communication
require intervention
```
81
what is focused assessment for ineffective coping to stress
lack of goal-directed behavior
inability to problem solve
unexplained fatigue
destructive behavior
82
what is focused assessment for ineffective denial to stress
disavows knowledge meaning of event to decrease anxiety
delays in seeking care refuse tx
continues behavior that exacerbates condition
83
what is diagnoses to ineffective coping to stress
life even tends produce crisis
observable anxiety
behavior & language disorganized
diificult to understand
84
what is diagnoses to ineffective denial to stress
inappropriate use of denial as a coping behavior
85
what are planning expected outcome to stress tolererancce the pt will
be able identify stressors
demonstrate decreased stress
develop effective methods of coping with stress
86
what is planning expected outcome for ineffective coping to stress the pt will
demonstrate effective coping behavior
effectively solve a problem
return to previous level of functioning
87
what is planning expected outcome for ineffective denial to stress the pt will
demonstrate low to moderate anxiety receice facts of illness in positive manner
88
what are stress reduction intervention health promotion activites
promote adequate nutrition, establish exercise routine, teach importance 7-8 hr sleep, specific intervention relieve anxiety, anger management, stress management tech(meditation, biofeedback, reiki, hmor), change perception of self
89
what are interventions to improve coping skills
therapeutic relationships, enhancing social support, protecting vulnerable self, practice adaptive thinking (self suggestion, coping thoughts, inner dialogue), gaining control through knowledge
90
what are interventions RT to crisis
prevent crisis by communicate clearly & anticipate situation
| during crisis calm voice & slowly short phrases, avoid talking about future
91
what are intervention help effectively manage stressors
focusing, reconstruction, compensating, stress managment skills (relaxing activities, meditation & prayer, creative activites, guided imagery, keeping a journal
92
what is evaluation of stress
maintaining effectiveness of coping abilities assess outcomes
reassess if outcome not met
adjust the care plan
93
what is gender
it is determined by chromosome structure XX female and XY male
94
what are gender role
societal norms for behavior and old stereotypical males are breadwinners and females are nurses, teachers
95
what are concepts related to sexuality
gender identity and sexual orientation
96
what is gender identity
internal feeling of maleness or femaleness transgender, transsexual, intersexed, crossdresser
97
what is sexual orientation
its based on the gender of the person one is sexually attracted to heterosexual, homosexual, or bisexual
98
what is transgender
think of self as female even if have male genitles
99
what is transsexual
feels like women even though male appearance
100
what is intersexed
ambiguous sexual organs internal ovaries external penis
101
what is a cross dresser
also known as transvestite wears clothing of opposite sex
102
what is heterosexual
attracted to opposite sex
103
what is homosexual
attracted to same sex
104
what is bisexual
attracted to both sexes
105
what are factors affecting sexuality
culture, religion, lifestyle, knowledge about sex, health status, & social context
106
what other factors could affect sexuality
medication such as alcohol, antianxiety, anticonvulsants, antidepressants, antihistamines, antihypertensives, chemotherapy, opiods, & stimulants also decreased libido & sexual performance dysfunction
107
what are concepts RT sexual health
state of physical, emotional, mental, & social well being RT sexuality
108
what is required of sexual health
positive & respectful approach to sexual relationship, optimum expression of sexuality, & forms of sexual expression
109
what are sexual health
sexual response cycle and sexual expression
110
what is sexual response cycles
?desire, excitement, plateau, orgasm, resolution
111
what is sexual expression
intimate relationships, fantasies & erotic dreams, touching, sexual intercourse, alternate sexual expression, celibacy
112
what are problem affecting sexuality
medical & relationships
113
what problems affecting sexuality does medical cause
STI's sexually transmitted infections, dysmenorrhea, premenstrual syndrome (PMS), sexual response cycle disorder (low libido, arousal disorder, orgasmic disorders)
114
how do relationship problem affect sexuality
negative intimate relationships, sexual harassment, rape, dysfunctional intimate relationship
115
what are concepts of rest
rest-physically/ mentally relaxed; refreshing
116
what are concepts of sleep
physiology of sleep cyclical states, decreased skeletal muscle activities, decreased metabolism, reduced consciousness
117
what are functions of sleep
restores energy, improves ability to cope, strengthens the immune system
118
what are the stages of non-rapid eye movement NREM sleep
stage 1 lightest sleep transition (5-10 min)5%
stage 2 eye movement stops 50%/sleep
stage 3 deep sleep diffulcult to arouse 8%/sleep
stage 4 no eye movement or muscle activity deepest sleep difficult arrouse 11%
119
stage V rapid eye movement REM sleep
dreaming high brain activity 20-30min 25%/sleep last cycle may last up to 60min
120
What is the sleep cycle
norm adult sleep 4-6 cycles nightly each last 100 min average 7-8hr range 5-10hr
121
what is the function of the sleep cycle
energy conservation & restoration
122
what are factors that affect sleep & rest
lifespan, lifestyle, sleep disorder
123
how long should newborns sleep
16-20hrs
124
how long should infants sleep
min of 14hr/day
125
how much sleep should school age & adolescents
they increase the need with growth spurts
126
how much sleep should elderly get
they need less sleep but more rest
127
what in lifestyle affect sleep & rest
enviroment, nutrition, exercise, sleep patterns
128
what are sleep disorders
insomnia, circadian disorder, restless leg syndrome, sleep deprivation, hypersomnia, sleep apnea, & narcolepsy
129
what is insomnia
inability fall asleep, remain sleep, or go back sleep
130
what is circadian disorder
sleep wake schedule, time zone (jet leg), shift work
131
what is restless leg syndrom
disorder of CNS uncontrolled movement of leg low levels of iron & some antidepressants can cause
132
what is sleep deprivation
not actually a sleep disorder its a result of prolonged sleep distrubance result from NREM & REM
133
what is hypersomnia
excessive sleep especially in daytime
134
what is sleep apnea
periodic interruption in breathing during sleep
135
what is narcolepsy
chronic disorder caused by brains inability to regulate sleep-wake cycles normally
136
what is parasomnias
sleepwalking/talking, night terrors, substance-induced, nocturnal enuresis, bruxism, REM sleep behavior disturbance
137
What is pain
unpleasant sensory/emotional experience
| can have destructive effects, warn of potential injusry, its a multidimensional experience
138
what are classifications of pain
origin, cause, quality, intensity, & duration
139
what is the classification of pain origin mean
superficial, visceral, radiating,or referred, phantom
140
what is the classification of pain cause mean
nociceptive
| neuropathic
141
what is the classification of pain quality mean
how the pain feels to the patient
142
what is the classification of pain intensity mean
subjective; use rating scale 0-10
143
what is the classification of pain duration mean
acute, chronic, intractable
144
what is physiology of pain
transduction, transmission, pain perception, & pain modulation
145
what is physiology of pain transduction mean
a process where nociceptors become activated by perception of potentially damaging mechanical, thermal, & chemical stimuli
146
what is physiology of pain transmission mean
its the peripheral nerves that carry the pain message to the dorsal horn of the spinal cord
147
what is physiology of pain perception mean
its the recognition in the frontal cortex and the brain recognizes and defines a stimulus as pain
148
what is physiology of pain modulation mean
it changes the perception of pain by either facilitating or inhibiting pain signal
149
what are factors the influence pain
past experience w/ pain
emotions, developmental, sociocultural factors, communication skills, cognitive impairments, other illness that contribute to pain
150
what are pain assessments
complete pain history, nonverbal signs of pain, & pain scale
151
what are nonpharmacological measures of pain management
cutaneous stimulation, immobilization & rest, cognitive behavioral interventions
152
what are pharmacological measures of pain management
nonopioid analgesics
| Opioid analgesics
153
what are pharmacological measures of pain management that is nonopioid analgesics
NSAIDS & Acetaminophen
154
what are pharmacological measures of pain management that is Opioid analgesics
IV, IM, transdermal, & epidural form
| patient controlled analgesia pumps-only pt push PCA button
155
what are special nursing consideration
managing pain in elderly, pts with addictions, & use of placebos
156
what are classifications of surgeries
purpose, degree of urgency, & degree of risk
156
what are increased surgical risk factors
age, personal habits, allergies, type of wound, preexisting conditions, mental status, & medication
157
what are perioperative nursing responsibilities
nursing history, assessment, preop screening tests, surgical consent, preop teaching, discussion, printed materials, prepare pt physically
158
how do you prepare pt physically for preop
assess NPO status, prepare skin: surgical scrub, bowel prep, facilitate empty bladder, administer preop medication, apply antiembolism stockings, & remove prostheses
159
what are intraoperative nursing responsibilites
sterile & clean team, anesthesia, skin prep, positioning, final verification, sterile field, moitor I&O, sponge, sharps, & instrument count, & documentaion
160
what are postanesthesia recovery unit (PACU)
recovery from anesthesia, airway management, vital sign/level consciousness, dressing assessment/drainage, fluid therapy, & pain control
161
what are postop nursing care
intial physical assessment, frequent vitals, dressing management, pain control, DVT prevention-SCDs, incentive spirometry/cough & deep breathing, early ambulation, & pt teaching
162
how are pt response to illness influenced by relationship
physical pathology
psychosocial health
overall wellness
163
what is psychosocial health theory
understanding people as a combination of psychological & social events
164
what is the self concept of psychosocial health mean
overall view of self
165
what are factors affecting self concets
gender, developmental, family & peers, internal/external influence
166
what are the components of self concept
body image, role performance, personal identity, & self-esteem
167
what are psychosocial illness
anxiety & depression
168
what is psychosocial illness anxiety
vague uneasy feeling of discomfort, threat, norm & abnormal, various levels, signs & symptoms
169
what is psychosocial illness depression
feeling of sadness diagnosed if depressed a day of two weeks, causes, S&S, & Tx
170
what is assessment of psychosocial
```
biological, psychological, & social details
functional abilities
self efficacy
family relationships
relationships with the wider social enviroment
interpersonal communication
social resources & networks
understanding current illness
usual coping mechanisms
health priorities
```
171
what is diagnosis of psychosocial
interrupted family processes, parental role conflict, risk loneliness, isolation, risk viollence to others, impaired social interaction
172
what is diagnosis of self concept
chronic low self-esteem, situational low self-esteem, disturbed personal identity, ineffective role performance, disturbed body image
173
what is outcomes for low self-esteem
identify stressors, positives, encourage own behavior, action needed to influence outcome, returns baseline or improves
174
what is outcomes for disturbed body image
physically adapt changed image mentally adapt to changed image
175
what are some interventions for preventing depersonalization
introduce self, pt preferred name, listen, eye contact, & touch, dont talk about pt in other rooms, move gently, explain all procedure
176
what are nursing interventions for promoting self esteem and self concept
feeling of acceptance, sense of competence, control, moral worth
177
what are nursing interventions for promoting positive body image
allow grieving process active listening help express anger, frustration, resentment
178
what are nursing interventions for facilitating role enhancement
communication between pt & significant other RT role responsibilities
describe realistic roles & responsibilities RT health changes
179
what are nursing interventions for anxiety
identify coping strategies(defense mech( calm & safe envirometn, identify triggers, use clear factual info
180
what are nursing interventions for depression
therapeutic communication, promote activity, good nutrition & hydration, provide support self care & decision making suicide prevention
181
what are types of sensory systems
vision, hearing, taste, smell, touch, kinesthetic
182
what are the purposes of sensory systems
```
provide info about internal & external enviroment
enable people experience world
allows response to changes
help maintain homeostasis
necessary for human growth & development
```
183
what are components of sensory experience
stimulus, reception, perception, arousal mechanisms, & response to sensation
184
what does the stimulus do
stimulate receptors (loud noise, bright light, sour fruit)
185
what is perception
ability interpret sensory impulse give meaning to impulse
186
how is perception affected
location, number of receptors activated, frequency of action & changes
187
what is the arousal mechanism
composed of consciousness & alretness mediated by RAS (reticular activating system)
188
how is the arousal mechanism affected
enviroment & medication
189
what is the response to sensation
it requires people to be alert & receptive to stimulation
190
what are factors that affect the response to sensation
intensity of stimulus. contrasting stimuli, adaptation to stimuli, & previous experience
191
what are factors that affect the sensory function
```
age/stage of life
culture
illness
medication
stress
personality
lifestyle
```
192
what are sensory alterations
sensory deprivation & overload
| impaired vision, hearing , taste, smell, tactile perception, & kinesthetic sense, & seizures
193
what is a general assessment of sensory system to health history & physical to gather data RT
```
factors affecting sensory perception (visual, auditory, & dental exam)
mental status
level consciousness
recent changes in sensory stimulation
use of sensory aids
clients enviroment
support network
focused examination of affected sense
```
194
what is diagnosis for sensory deficits
```
disturbed sensory perception-actual sense & cause
risk for disturbed sensory perception
acute confusion
chronic confusion
impaired memory
```
195
what is diagnosis for related sensory diagnosis
```
risk for injury
imbalanced nutrition less than body requirements
impaired verbal communication
social isolation
self care deficit
disturbed thought processes
```
196
what are planning outcomes for sensory deficit
pt does not experience injury
| outcome specific to deficit
197
what are planning outcomes for sensory deprivation
pt remains oriented to person, place, & time
| short term may include using adaptive equipment
198
what are planning outcomes for sensory overload
pt remains oriented to person, place, & time
short term planning may include decreased anxiety, lucid communication, reports excessive stimuli, establish routine sleep-wake cycle, positive coping behavior
199
what are nursing interventions for sensory deprivation
focus prevention, support senses(sensory stimulation(glasses, hearing aids), orientation-calendar; view of enviroment, provide stimuli-reg contact;touch, television/radio, pet therapy, smells
200
what are nursing interventions for sensory overload
minimize stimuli-less light, noise, less tv/radio, calm tone, reduce noxious odors
provide rest & teach stress reduction
201
what are nursing interventions for impaired vision
attend to glasses, sufficient light, protect eyes in sunlight, magnifying lens/lg-print books, evaluate-ability perform ADLS, remain safe in enviroment, & need for assistance(seeing eye dog)
202
what are nursing interventions for impaired hearing
care for hearing aid, closed cation tv, reg inspection of ear canal, techniques to improve communication, promote safety, assess for social isolation
203
what are nursing interventions for the confused patient
reorient frequently(state name,day,time,provide clocks,calenders,visual clues to time, use personal belongings,maintain safe enviroment, communicate clearly slowly(respond to feeling & use gestures), limit choices, promote feelings of security, use alternative therapies
204
what are nursing interventions for the unconscious patient
continue orientation to reality, safety measures(bed low position, side rails up), attend to body systems(eye care, ROM, skin care/mouth care, urinary drainage, bowel management, nutrition
