Topic 10

Question 1

Dispositional

Answer 1

Attributes thought to be caused by internal characteristics that reside within the individual, as opposed to external (situational) influences that stem from the environment or culture in which that individual is found

Question 2

eustress

Answer 2

Good stress that helps us cope with daily challenges

Question 3

mild stress

Answer 3

Heightens one’s awareness of surroundings and fosters learning and decision making. Communicating with clients helps to relieve stress

Question 4

moderate stress

Answer 4

Occurs as people experience frustration or conflict. This can cause anxiety for the client and/or the nurse and hinders appropriate communication and opportunities for a therapeutic relationship between nurse and client

Question 5

severe stress

Answer 5

Seriously interferes with a person’s ability to function. Severe chronic stress weakens the immune system and contributes to stress related illnesses

Question 6

acute stress

Answer 6

REQUIRES IMMEDIATE ATTENTION and once the situation is resolved, homeostasis is re-established (depending on the magnitude and ones coping abilities and resilience), acute stress may become a crisis

Question 7

chronic stress

Answer 7

Manifests over an extended period of time as a result of repeated exposure to stressors

Question 8

different tolerance level fro stress

Answer 8

o Adult (Stress response is usually dependent on gender): Male: “fight or flight” Female: “tend and befriend” (need nurturing activities to reduce stress and promote safety for self and others)
o Children: Express through BEHAVIOR (ex: hit, scream, cry)

Question 9

Conflict communication skills:

Answer 9

Be assertive
Demonstrate respect
Use “I” statements
Make clear statements
Use proper pitch and tone

Question 10

crisis

Answer 10

o Extreme acute stressful situation for which coping mechanisms fail and the person is unable to function normally (often 4-6 weeks)

Question 11

adaptive crisis

Answer 11

o Is a normal recovery response to stress and crisis (dealing with it)

Question 12

maladaptive crisis

Answer 12

o Prolonged responses and many lead to a crisis state (not coping well, may go into depression
o Can lead to development of acute or chronic psychiatric symptoms

Question 13

crisis state

Answer 13

o An acute normal human response to severely abnormal circumstance (A crisis state is NOT a mental illness)

Question 14

developmental crisis

Answer 14

§ Erik Erikson identified 8 stages of “crisis” in personal growth and development
§ Ages 5-21 and 65+ are most likely to go into depression

Question 15

situational crisis

Answer 15

§ Events that are unexpected unusual, overwhelming, can include illness, injury, losses, a diagnosis, withdrawal from alcohol, finances, etc.

Question 16

in a stressful situation what is the nurses response

Answer 16

o Understand the client’s personal response to crisis to provide successful intervention
o Communicate with client and help with coping strategies
o In a stress situation, nurse’s goal is to de-escalate

Question 17

behavioral emergency

Answer 17

o Occurs when a crisis escalates to the point that the situationREQUIRES IMMEDIATE INTERVENTION TO AVOID INJURY OR DEATH
o Always an emotionally charged unpredictable situation (suicide, psychotic crisis, homicide, violence, sexual assault)

Question 18

mental health emergencies

Answer 18

o A bad reaction to medication can cause this as well as the patient viewing the treatment as an attack (may become combative so be alert)
§ Keep communication, calm, short, well defined, additional space
o Present danger to self or others
o May have chaotic distress behaviors
o May have a co-occurring disorder such as mental illness ad substance use disorder (SUD)
o May have drug induced delirium
o ALWAYS HAVE AN ESCAPE ROUTE

Question 19

dangerous to self or others…

Answer 19

o Depression/suicidal
o Anger/agitation, aggressive
o Noncompliance with requests (taking medication)
o General appearance, inappropriate dress or poor hygiene
o Evidence of self-inflicted harm
o Respond/reflect to delusion/ hallucination
o Owns/displays weapons
o Unorganized thoughts/appearance
o Speech patterns/substance/rate (too fast or too slow)
o Paranoid
o Erratic or fearful behavior
o Recent loss of job/loved ones/home
o Substance abuse
o Orientation to date/time/location/situation
o Number and type of pervious contact with police and crisis worker

Question 20

Crisis intervention response

Answer 20

o Strategies should be adapted to fit a client’s preference, values, and circumstances
o Strategies are PRESENT FOCUSED AND GOAL ORIENTED
o Intervention is TIME LIMITED
o Return client to PRE-CRISIS LEVEL FUNCTIONING

Question 21

disaster

Answer 21

o A calamitous event of slow or rapid onset that results in large scale physical destruction of property, social infrastructure and human life

Question 22

BICEPS of disaster

Answer 22

§ Brevity
§ Immediacy
§ Contact
§ Expectancy
§ Proximity
§ Simplicity

Question 23

triage

Answer 23

o Describes how healthcare workers sort out severity of clients injures and needs during a crisis

Question 24

·3 Question of triage

Answer 24

o How urgent is this clients condition
o Do we have the adequate resources to meet this patients needs
o Assuming we admit this patient and provide level of care requires, will the patients life be saved?

Question 25

4 phases of community response

Answer 25

heroic phase
honeymoon phase
disillusionment phase
reconstruction phase

Question 26

heroic phase

Answer 26

§ Direct emotions focusing on helping people survive (“they are coming to help us!!”)

Question 27

honeymoon phase

Answer 27

§ Drawing people together who simultaneously experienced the catastrophic event (organize people and provide help)

Question 28

disillusionment phase

Answer 28

§ Feeling of DISAPPOINTMENT OF DELAYS or failures when promises of aids are not fulfilled (“why can’t they do more”)

Question 29

reconstruction phase

Answer 29

§ Reaffirmation of belief in the community when new buildings are constructed (“it’s all coming together)

Question 30

debreifing

Answer 30

o Used to help a group of people who have witnessed or experienced a mass trauma crisis event to externalize and process the experience (emote!! Don’t bottle it up)

Question 31

TJC and disaster management

Answer 31

o Requires hospitals to develop and exercise disaster management plans at regular intervals

Question 32

5 stages of grief/loss

Answer 32

1. Denial
2. Anger
3. Bargaining
4. Depression
5. Acceptance

Question 33

patterns of grieving

Answer 33

acute grief
anticipatory grief
chronic sorrow
complicated grief

Question 34

anticipatory grief

Answer 34

a period of mourning when the dying person or his family is expecting the death
§ Knowing and anticipating the end will come depending on a diagnosis

Question 35

chronic sorrow

Answer 35

grief-related feelings that occur periodically throughout the lives of those left behind
§ Cannot get past the loss

Question 36

complicated grief

Answer 36

a reaction to loss characterized by persistent intense grief and persistent distracting or impairing concerns about the consequences or circumstances of the loss
§ Ex: alz. Patient who isn’t really who they are anymore

Question 37

end of life care

Answer 37

o Planning for the end is planning for the unknown
o Death is more than a biological event
o Spiritual, social and cultural factors are important for people to make sense of death
o Nurses are the resource of providing support

Question 38

palliative care

Answer 38

§ Care aimed at primarily relieving symptoms associated with a treatments as well as proving support for seriously ill patient and their families
§ Can have surgery, no cure but are kept comfortable, still can receive treatment for their illness

Question 39

hospice care

Answer 39

§ No surgery, kept comfortable with pain killers
§ Less than 6 months to live

Question 40

end of life communication

Answer 40

o Pain management assessment
o Conversation with client
o Communicate with the family
o Provide information
o Incorporate cultural differences, attend to spiritual needs

Question 41

De-escalation

Answer 41

§ Techniques used to escape escalations of conflict

Question 42

crisis intervention

Answer 42

§ Time limited treatments that helots the patient return to pre-crisis functional level

Question 43

violence

Answer 43

§ Mental health emergency which challenges, safety, wellbeing and health of patient and others in the environment

Question 44

sexual assault

Answer 44

§ Rape and sexual assault are serious forms on interpersonal victimization which violate core of self

Question 45

psychosis

Answer 45

§ Pt. has disorganized thinking, reduced insight limited personal judgement (hallucinations)

Question 46

suicide

Answer 46

§ Self injurious behavior resulting in death

Question 47

disaster and mass trauma

Answer 47

§ A calamitous event of slow or rapid onset with mass destruction of property and human life

Question 48

critical incident debreifing

Answer 48

§ Helps to strengthen emotional coping skills of a staff