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Unit 2 Flashcards

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1
Q

Benner’s Theory

A
  • caring events, projects, and things matter to people

* people feel connected when others show care

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2
Q

caring in nursing practice

A
  • presence
  • comforting
  • knowing client
  • spiritual caring
  • family care
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3
Q

presence

A
  • having person-to-person encounter which conveys closeness and security
  • creates openness and understanding
  • requires eye contact, voice tone, listening, etc
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4
Q

comforting

A
  • provides emotional and physical calm and skillful and gentle use of performance
  • indicates that nurse is confident in what she is doing
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5
Q

knowing the client

A
  • focus is on client
  • nonjudgmental
  • not making assumptions
  • critical element when making decisions
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6
Q

spiritual caring

A
  • person’s beliefs and expectations that have an effect on physical well being
  • offers sense of connectedness on inter/intra/transpersonal levels
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7
Q

interpersonal communication

A

•communication that occurs b/t two people

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8
Q

intrapersonal communication

A
  • communication that occurs within an individual
  • “self-talk”
  • when person thinks, but doesn’t verbalize thoughts
  • nurse thinking critically before making decision
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9
Q

transpersonal communication

A

•addresses spiritual needs and provides interventions to meet the needs

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10
Q

unconditional positive regard

A
  • Acceptance and respect for the client that is not dependent on the client’s behaviors
  • Don’t be judgmental, critical or use derogatory statements
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11
Q

role

A

•Set of behaviors, attitudes, and beliefs that are expected of a person in a given social position or status in a group
•fxn person adopts
•grandparent, parent, child, employee, committee member, etc
*major determinant for pt response to stress

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12
Q

role conflict

A
  • must assume opposing roles w/ incompatible expectations
  • contradictory aspects of role
  • Ex: difficulty balancing work and parenting
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13
Q

interpersonal role conflict

A
  • when a person or group of people frustrates or interferes with another person’s efforts at achieving a goal
  • relationship (personalities)/task (techniques)
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14
Q

inter-role conflict

A

•mother wants to stay home w/ baby, but finances require her to work

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15
Q

sick role

A
  • expectations of others and society regarding how one should behave when sick
  • must care for self and continue role responsibility
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16
Q

role ambiguity

A

•uncertainty about what is expected when assuming role

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17
Q

role strain

A
  • frustration/anxiety when person feels inadequate for assuming role
  • role presents too many demands
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18
Q

role overload

A
  • more role responsibilities than manageable

* student/employee/parent

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19
Q

situational role changes

A
  • caused by external situations

* marriage, job changes, divorce

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20
Q

temporary role changes

A

•client assumes role when illness resolves

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21
Q

permanent role change

A

•illness has altered level of pt health to a point that previous roles are no longer possible

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22
Q

social isolation

A
  • experience of aloneness

* deficient in love, belonging self-esteem, self-actualization

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23
Q

impaired social interaction

A

•State in which a person engages in social exchange but finds it to be poor in quantity or quality

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24
Q

learned helplessness

A
  • Seen in frail elderly, battered, disabled
  • Begin to generalize one failure to their whole life
  • Become consumed in their helplessness & powerlessness
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25
relocation stress syndrome
•Physiologic & psychosocial disturbances caused by transferring a person from one environment to another
26
communication
•sending, receiving, and comprehending messages b/t 2+ people
27
public communication
* communication that occurs within large groups of people | * Ex: nurse teaching in community setting
28
small group communication
•within a group, usually working toward a mutual goal
29
referent
•incentive or motivation for communication to occur
30
channel
* method of transmitting and receiving message | * sight, hearing, touch, etc
31
environment
* emotional and physical climate in which the communication takes place * Ex: mom in room w/ adolescent will influence pt responses
32
feedback
•verbal or nonverbal •positive or negative •indicates that msg was received *essential component of ongoing communication
33
clarity/brevity
* shortest, simplest comm. | * usually most effective
34
timing/relevance
* knowing when to communicate | * allows receiver to be more attentive to msg
35
pacing
* rate of speech * can communicate an unintended meaning to receiver * Ex: talking fast implies rush
36
intonation
•tone of voice that communicates feelings
37
nonverbal communication
* appearance/posture/gait * facial expressions/eye contact/gesture * sounds * territoriality/personal space
38
therapeutic communication
* purposeful use of communication to build and maintain helping relationships with clients, families, and significant others * client centered * planned and goal-directed
39
silence
* effective skill of communication | * allows time for meaningful reflection
40
open-ended questions
* effective communication skill * facilitates spontaneous responses and interactive discussion * allows client to explore feelings/thoughts * avoids yes/no answers
41
clarifying techniques
•effective communication skill that is used to determine whether msg received was accurate 1. ) restating 2. ) reflecting 3. ) paraphrasing 4. ) exploring
42
restating
•using client's exact words
43
reflecting
•directs focus back to pt, so he can examine feelings
44
paraphrasing
•restates client's feelings and thoughts for client to confirm what has been communicated
45
exploring
•allows nurse to get more info regarding important topics mentioned
46
effective communication
* offering general leads/broad opening statements * showing acceptance/recognition * focusing * asking ???s * giving info * presenting reality * offering self * touch
47
empathy
* seeing things from pt point of view * in pt shoes * objective * goal is to help thru therapeutic relationship
48
sympathy
* feeling sorry for others * subjective * don't take on pt's feelings * goal is to decrease their personal distress
49
attentive listening
* showing empathy * pt is center of attention * be at same level * show interest/paying attention * don't be self-focused * active- hear, observe, and understand what client communications
50
negative nursing attitudes
* businesslike * biased * false promises * no knowledge base * incompetent * self-focused
51
intimate space
* 12-18 in | * people may feel invaded
52
personal space
* 18 in - 4 ft | * most comfortable
53
social distance
* 4-12 ft * formal * too far for personal maters
54
public distance
* > 12 ft | * public speaking
55
aphasia
* an abnormal neurologic condition in which language function is defective or absent * because of an injury to certain areas of the cerebral cortex
56
dysarthria
* difficult, poorly articulated speech, resulting from interference in the control over the muscles of speech * usually because of damage to a central or peripheral motor nerve
57
stress
* changes in state of balance in response to stressors, internal/external forces * situational * developmental * caused by sociocultural factors * weakens immune system
58
distress
•damaging stress
59
eustress
•protective stress
60
physiological responses to stress
* fight/flight * SNS * increased HR, BP, and blood sugar
61
alarm rxn
* 1st stage of stress rxn * hormone release * increased BP, HR, mental alertness, blood flow
62
resistance stage
* 2nd stage of stress run * body tries to return to homeostasis * coping
63
exhaustion stage
* final stage stress run * body no longer can respond to stressor * end result of recovery or death
64
primary appraisal
* Lazarus: cognitive appraisal model * personal meaning * what does stress mean to you
65
secondary appraisal
* Lazarus: cognitive appraisal model * coping strategies * goals, beliefs, and resources that determine how one copes
66
coping
* how an individual deals with problems and issues * effort to manage stress * strategies must be internalized
67
factors influencing ability to cope
* #, duration, intensity of stressor * past experience * support system * resources (financial)
68
Selye's Model of Stress
•Stress that is prolonged can make people ill because of (1) increased hormone levels (2) unhealthy coping choices (3) neglect of warning signs
69
caregiver burden
* results from accumulated stress that family members experience after caring for a loved one * fatigue * insomnia * illness
70
adaptation
•coping behavior that describes how an individual handles demands imposed by environment
71
adherence
* commitment and ability of client to follow treatment regimen * increased if pt committed/abundant resources
72
Post-traumatic Stress Disorder (PTSD)
* begins w/ acute stress disorder * delayed onset longer than 4 weeks * persists longer than a month * experience flashbacks
73
Neuman Systems Model
•pt, family, community are constantly changing in response to environmental stress •everyone has a line of defense, allowing them to maintain health in stressful situations •if resources unavailable LOD broken -> illness *emphasis on prevention of stress
74
Pender's Health promotion model
* stress reduction strategies will reduce threats to well being * absence of stress = promotion of health
75
situational stress
* job * illness * finances
76
developmental stress
* vary w/ life stage * self-esteem * loss of autonomy
77
sociocultural stress
* poverty * physical handicap * violence * homelessness
78
mild stress situations
•last minute to hours
79
moderate stress situations
* hours to days | * Unresolved disagreement, prolonged absence of a family member
80
severe stress situations
* chronic * weeks to years * “The more frequent and longer the stress situation, the higher the health risk”
81
crisis
•usual coping mechanisms are overwhelmed and need all resources
82
crisis intervention
•focuses on problem solving and focuses only on the problem presented by the crisis
83
when does crisis occur
•When people encounter problems or stress situations with which they are unable to cope in usual ways
84
sexual health
* state of physical, emotional, mental, and social well being in relation to sexuality * not just absence of dz, dysfunction, or infirmity
85
sexually
* biological sex * gender ID * gender role * partner preference * influenced by religion, media, family
86
sexual development
* begins in infancy and develops throughout * adolescence is time of dramatic change and requires education * young adult- emotional maturation * changes in middle adulthood leads to concerns about sexual attractiveness * elderly have fewer hormones, but sexuality can't be overlooked
87
middle adulthood females
* decreasing levels of estrogen * decreased vaginal lubrication/elasticity * dysapreunia * decreased desire
88
middle adulthood males
* increase in post-ejaculatory refractory period | * delayed ejaculation
89
hormonal contraception
``` •pills •injections •rings •patches •IUD •implants *prevent ovulation/thickening of uterus ```
90
IUD
* plastic device inserted into cervix | * stop sperm from fertilizing egg
91
diaphragm
* round, rubber dome * used with spermicide cream * provide barrier to uterine opening
92
non-Rx contraceptives
* abstinence * barrier methods- OTC products * spermicide- cream * rhythm of cycle
93
Rx/physician required contraceptive
* hormones * IUD * diaphragm * cervical cap * sterilization- tubal ligation/vasectomy
94
curable STIs
``` •syphilis •gonorrhea •chlamydia •trichomoniasis •pelvic inflammatory disease *curable w/ abx ```
95
viral STIs
* HPV * herpes simplex (HSV) type II * HIV * AIDS
96
STI symptoms
* vaginal/penile/anus discharge * dyspareunia/dysuria * genital blisters
97
HIV
•transmission via IV, intercourse, oral, transfusions
98
HPV
* most common STI * spread thru direct wart contact, semen, fluids * usually asymptomatic, but can cause cervical cancer
99
AIDS
* third stage of HIV * begin to show symptoms * fatal
100
populations w/ highest incidence for STIs
* hispanic women (15-24) | * AA men (15-24)
101
latex
* what you should use to protect against STI/preggo | * condom material
102
infertility
•inability fo conceive after 1 yr unprotected intercourse
103
indications of sexual abuse
* jealousy | * refusing to leave partner's side
104
sexual dysfunction
* absence of complete sexual functioning | * should be natural w/ recognizable phases before ending in orgasm
105
when gather pt sexual history, nurse should...
•include ??? related to sexual fxn
106
most common STI in US
* HPV | * 6 million new cases/yr
107
PLISSIT
*assessment of sexuality •Permission to discuss sexuality issues •Limited info related to sexual health problems experienced •Specific Suggestions- when clear about problem •Intensive Therapy- refer to professional
108
self-concept
* ways individuals view themselves * conscious/unconscious thoughts, attitudes, beliefs, perceptions * development is lifelong process
109
body image
•the way individuals perceive their appearance, size, body structure, fxn
110
Erikson's psychosocial theory
* successful mastery leads to sense of self | * each stage builds on task of previous stage
111
Erikson's stage 1
* trust vs. mistrust * birth -> 1 yr * stable environment/caregivers * distinguish self from environment
112
Erikson's stage 2
* autonomy vs. shame/doubt * 1 -> 3 yrs * independent thoughts/actions * appreciate body appearance/fxn
113
Erikson's stage 3
* initiative vs. guilt * 3 -> 6 yrs * aware of gender * sense of purpose * ID feelings
114
Erikson's stage 4
* Industry vs. inferiority * 6 -> 12 yrs * aware of strength/limitations * sense of competence * accepts feedback
115
Erikson's stage 5
* identity vs role confusion * puberty * attitudes, beliefs, goals * feels positive about sense of self * accept body changes
116
Erikson's stage 6
* intimacy vs. isolation * young adult * successful role transitions * strong relationships * increased responsibility * stable feelings about self
117
Erikson's stage 7
* generatively vs. self-absorption/stagnation * middle age * reassess life goals * show contentment w/ aging * feeling accomplished
118
Erikson's stage 8
* integrity vs despair * old age * feel positive about life and wise * no regrets
119
identity
•internal sense of individuality, wholeness, and consistency of self
120
role performance
•how individuals carry out their significant roles
121
identity stressors
* balance career, family, religion | * Ex: trying to mix family traditions w/ spouses
122
self esteem stressors
•challenge adaptive capabilities
123
role performance stressors
•w/ changing life situation, support group must change
124
low self-esteem
``` *leads to real world problems •meds/alcohol/drugs/smoke •poor health •criminal behavior •limited econ. prospects ```
125
culture
•thoughts, communications, actions, customs, beliefs, values, and institutions of racial, ethnic, religious, or social groups
126
subculture
•represents various ethnic, religious, and other groups with distinct characteristics from the dominant culture
127
biculture
•individual identifies equally w/ two or more cultures
128
enculturation
•socializations into one's primary culture as a child
129
acculturation
* changes of one's cultural patterns to those of the host society * learning aspects of a culture different than one's own
130
assimilation
* developing new cultural ID | * merging into dominant cultural group
131
ethnicity
* shared ID based on lang, geography, racial characteristics, and values of a groups heritage * Ex: Vietnamese, Irish, Brazilian
132
race
* common biological attributes shared by a group, such as skin color * Ex: Asian, Caucasian
133
emit worldview
•insider, or native perspective
134
etic worldview
•outsider's perspective
135
culturally congruent care
* fits pt's valued life patterns and set of meanings * implementing pt's routine in plan of care * requires specific knowledge, skills, and attitudes
136
cultural competence
•acquiring specific knowledge, skills, and attitudes to provide culturally congruent care
137
biomedical orientation
* view of health/illness in western cultures | * emphasis on scientific investigation
138
holistic conceptualization
* view of health/illness in non-western cultures | * emphasis on balance of person and nature
139
Campina-Bacote's model of cultural competence
•nurses practice w/ constructs of: 1. ) cultural desires 2. ) cultural awareness 3. ) cultural knowledge 4. ) cultural skills 5. ) cultural encounters
140
cultural background/acculturation
•where born and currently living
141
spirituality
* awareness of one's inner self and sense of connection to a higher being/nature * unique to the INDIVIDUAL * depends on culture, development, beliefs, etc * NOT religion (can be spiritual and not religious)
142
nutritional patterns
* food available in environment | * preferences in food prep
143
biological variations
•genetics determine effect of medication on people from diff. ethnic/cultural groups
144
culturally sensitive
•knowledgeable about the cultures prevalent in their area of practice
145
faith
* confidence or trust in person, thing, deity, idea, etc * belief in something or relationship to higher power * gives purpose and meaning to life
146
spiritual distress
•impaired ability to experience and integrate meaning and purpose in life •causes a person to feel doubt, loss of faith, and a sense of being alone or abandoned •often arises as a result of catastrophic events *questioning beliefs
147
ethnocentrism
•belief that one's own culture or way of life is better than others
148
near-death experience (NDE)
* psychological phenomenon close to clinical death or recovered after declared death * tell stories of rising out of body * often reluctant to discuss experience, but no longer afraid of death
149
constructs of spirituality (5)
1. ) connectedness 2. ) transcendence 3. ) meaning of life 4. ) faith/hope 5. ) inner strength/peace
150
religion
•associated w/ a specific system of practice associated w/ a denomination, sect, or form of worship
151
hope
•gives and individual motivation and resources to achieve
152
atheist
* one who does not believe in the existence of God * can still have spirituality * find meaning in work/relationships
153
agnostic
* believe that there is no known ultimate reality | * believe people bring meaning to way things are
154
self-transcendence
•sense of authentically connecting to one's inner self
155
transcendence
•belief that a force outside and greater than the person exists beyond material world
156
religious care
•helping pts maintain faithfulness to their belief system and worship practices
157
spiritual care
* helping pts identify meaning and purpose in life, look to future, and maintain personal relations * may also help maintain relationships w/ higher being/force
158
acute illness
* sudden; unexpected | * poses immediate long term threat to life/health
159
chronic illness
•threatens independence, causing distress
160
terminal illness
•causes fears of physical pain, isolation, the unknown, and dying
161
intrapersonal connectedness
•within one's self
162
interpersonal connectedness
•w/ others and the environment
163
transpersonal connectedness
•w/ unseen higher power
164
SWB
* spiritual well being scale | * spiritual assessment tool
165
BELIEF
* spiritual assessment tool * belief * ethics * lifestyle * involvement * education * future events
166
basis of spiritual well-being
* ability to experience and integrate meaning and purpose in life through connectedness w/ self and others * balance b/t values, goals, beliefs, relationships * feel joy, forgive, accept hardship
167
acute spirituality based care
* support systems * diet therapies * supporting rituals- prayer, etc
168
restorative/continuing spirituality based care
* prayer * meditation * supportive grief work
169
successful spirituality outcomes
* increased sense of connectedness w/ family * renewing positive sense of meaning in life * exhibiting trust in others or higher power
170
spirituality main points
* ensures holistic focus * broader and more unifying than religion * requires open communication and trust * involves faith, support systems, and hope
171
circadian rhythms
* biological rhythm of sleep that becomes synchronized w/other body fxns * affected by light, temp, social activity, routine
172
hypothalamus
* major sleep center | * secretes hypocreatins (orexins), which promote wakefulness, REMs
173
reticular activating system
* fxns in regulation of sleep * secretes catecholamines (Ex: NE), which determine LOC * stimulation to RAS decrease when falling asleep
174
bulbar synchronizing region
* fxns in regulation of sleep * takes over when RAS inactive * causes sleep
175
light sleep
* stage 1 & 2 | * easily aroused
176
deep sleep
* stage 3 & 4 * slow-wave sleep * when sleep walking occurs
177
sleep cycle
•3 NREM stages •1 REM stage *usually go thru 5 cycles/night
178
hypersomnolence
•excessive sleepiness
179
polysomnogram
•use of EEG, EMG, and EOG to monitor stages of sleep/wakefulness during nighttime sleep
180
sleep hygiene
•practices pt associates w/ sleep
181
cataplexy
* sudden muscle weakness during intense emotions | * can occur at anytime
182
sleep paralysis
•feeling of being unable to move or talk just before waking/falling asleep
183
insomnia
•chronically having difficulty falling asleep
184
sleep apnea
* lack of airflow for periods of 10+ seconds * central obstructive or mixed * s/o: excessive daytime sleepiness
185
narcolepsy
•cataplexy/sleep paralysis
186
parasomnias
* sleep walking * night terrors/nightmares * bed-wetting * body rocking * teeth grinding
187
CPAP device
* continuous positive airway pressure | * delivers room air at high pressure to prevent airway collapse
188
mobility
* freedom & independence in purposeful movement | * adapting to and having self-awareness of environment
189
thromboembolic device (TED)
•hose that help maintain external pressure on muscle sf lower extremities and promote blood return to heart
190
sequential compression devices (SCDs)/intermittent pneumatic compression (IPC)
* sleeves that wrap around leg and are attached to an electric pump that alternately inflates and deflates * promote venous return
191
ROM exercises that help promote venous return
* ankle pumps * foot circles * knee flexion
192
positions to avoid in order to reduce compression of leg veins
* crossing legs * sitting long time * restrictive clothing * pillow behind knees * massaging legs
193
thrombophlebitis
* DVT | * inflammation fo vein that results in clot formation
194
body alignment
•relationship of one body part to another
195
correct alignment
•positioning so no excessive stream is placed on joints, tendons, ligaments, or muscles
196
activity tolerance
•type/amount of exercise or activity that pt is able to perform
197
isotonic exercises
* cause muscle ctx and change in muscle length * joint movement * increase muscle tone, mass, and strength * increase osteoblast activity * Ex: walking, swimming, dance, running, etc
198
isometric exercises
* tightening or tensing muscle w/o moving body parts * no joint movement * Ex: wall sit, use of footboard
199
fibrous joints
* fit closely together and are fixed * permit little movement * Ex: b/t tibia and fibula
200
cartilagionous joints
* little movement, but are elastic * cartilage to unite separate body surfaces * Ex: ribs and costal cartilage
201
synovial joints
* true joints * freely moveable * hing/ball and socket
202
ligaments
* bone to bone, joints, cartilage | * provide movement in isotonic exercises
203
tendon
•bone to muscle
204
cartilage
* nonvascular | * supportive tissue that acts as a shock absorber b/t articulations
205
antagonistic muscles
* cause movement at a joint | * active (mover) muscle ctx, while antagonist rlx
206
synergistic muscles
•ctx at the same time to accomplish same movement
207
antigravity muscles
* stabilize joints * continuously oppose the effect of gravity * maintain upright/sitting posture
208
assessment of mobility components
1. ) ROM 2. ) gait 3. ) exercise
209
calculating max HR
* subtract age from 220 | * 60-90% of that depending on provider's recommendation
210
draw sheet
•used to avoid friction/shear when moving pt up in bed
211
hip out
* foot eversion | * external rotation of leg
212
continuous passive motion (CPM) machine
* flexion/extension of leg | * prevents DVT in knee/ACL repair pts
213
SIMS postion
•enema or rectal exam postion
214
cane
* length from greater trochanter to floor | * on strong side of body
215
measuring for crutches
* hand length b/t pads and axilla when arm is flexed * use goniometer to measure flexion * crutches/pt in tripod position ~ 30 cm apart
216
four-point alternating gait
* solid foot and crutch movement | * walking w/ crutches
217
three-point gait
•wt borne on unaffected leg | hop w/ crutch
218
two-point gait
•wt borne partially on each foot and each crutch advancing w/ opp. leg
219
crutches on stairs ascending
* crutch on stair below * good side up and holding wt * crutches up * bad side up
220
crutches on stairs descending
* crutches on step below * bad side hovering * good side
221
sitting in chair w/ crutches
* both held on unaffected side * wt transfer to crutches and good side * grasp arm of chair and lower
222
exercise and HTN
* low intensity aerobic most effective in lowering | * high intensity and weight bearing have minimal benefits
223
systemic effects of laying in bed
* pressure ulcer * renal calculi * stiff joints * orthostatic hypotension * thrombus * muscle atrophy * Ca++ abnormalities
224
atelectasis
•lung collapse
225
spirometer
* measures air capacity of lungs | * expand lungs when immobile
226
ideal body mechanics
* bending at knees instead of hip * leg muscles instead of back * keep pt close * center of gravity over wide base of support (feet)
227
steps of avoiding vertigo/orthostatic HTN
1. ) sit up in bed 2. ) dangle legs 3. ) stand 4. ) ambulate
228
controlled fall
1. ) stand w/ feet apart 2. ) extend 1 leg and let pt slide 3. ) bend knees as pt slides
229
how often to reposition pt
•every 2 hrs
230
physiology of pain
* cell damage causes release of prostaglandins, bradykinin, K, histamine, and substance P * nt surround pain fibers and cause inflammatory response * pain msg spread
231
myelinated A-delta fibers
•send sharp, localized, distinct sensations
232
unmyelinated C fibers
•send poorly localized, burning, persistent sensations
233
transduction
•conversion of stimulus to electrical energy
234
transmission
•sending impulse across nociceptor (sensory nerve)
235
perception
•pt's experience of pain
236
modulation
* inhibition of pain via release of inhibitory nts | * serotonin/endorphins
237
gate control theory of pain
* gating mechanisms (emotional, physiological, cognitive) in CNS regulate pain impulse * pain impulse pass thru when gate open * closing gate is non pharmacological pain relief
238
protective reflex to pain
* sensory fibers synapse w/ motor in spinal cord | * reflex arc
239
acute/transient pain
* protective * identifiable * short duration * limited emotional response * ceases after tissue healing * if unresolved -> chronic
240
chronic/persisten noncancer pain
* not protective * no purpose * longer than 6 months * remains after tissue healing * sx of hurting at night * Ex: back pain; arthritis
241
chronic episodic pain
•occurs sporadically over extended duration
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idiopathic pain
•chronic pain w/o identifiable physical or psychological cause
243
nociceptive pain (inferred pathological)
* arises from damage to or inflammation of tissue other than that of PNS or CNS * throbbing/aching/localized * somatic, visceral, cutaneous * tx w/ opiods/nonopiods
244
neuropathic pain
* damaged/abnormal pain nerves * phantom limb, below spinal cord injury, diabetic neuropathy * tx w/ adjuvant meds
245
stoic
•less expressive response to pain
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emotive
•more likely to verbalize pain
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goal of pain management
* anticipate and prevent * NOT treat it * control it- can never say pt will be pain free * intervene if pt rates pain 4+
248
Wong-Baker FACES scale
•scale used for child rating severity of pain based on faces and each words
249
ABCDE rule of pain assessment/management
``` Ask/asses regularly Believe pt report of pain Choose control option Deliver interventions Empower pt/family ```
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who are the best judges of pain
•the pt- even if smiling
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cutaneous stimulation
* non pharmacological | * cold or hot applications that help relieve pain and promote healing
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distraction
* non pharmacological pain management * ambulation * deep breathing * visitors * TV, music
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nonopioid analgesics
* pharmacological tx for mild to moderate pain * acetaminophen * NSAIDS
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opioid analgesics
* pharmacological tx for moderate to severe pain * morphine * codiene
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adjuvant analgesics
* enhance effects of nonppioids * help alleviate sx that aggravate pain * useful for neuropathic pain * antidepressants * antispasmodics * muscle relaxants
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pt controlled analgesia
* pt self-administer safe doses of opioids * morphine/hydormorphone/fentanyl * pt ONLY should administer
257
regional anesthesia
•injection of local anesthetic to block a group of sensory nerve fibers
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epidural anesthesia
•common for acute postoperative pain, labor and delivery, and chronic cancer pain
259
breakthrough pain
* pain that erupts when pt is already receiving medical tx for pain * common in cancer pt
260
WHO analgesic ladder
1. ) non-opioid/adjuvant 2. ) opioid for mild pain 3. ) opioid for severe pain * tx progression from NSAIDS to opioids for cancer pts
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physical dependence
* state of adaptation manifested by drug class * withdrawal syndrome produced by abrupt cessation, rapid dose reduction, decreasing blood level of drug, or administration of antagonist
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addiction
* primary, chronic, neurobiological dz w/ genetic, psychosocial, and environmental factors influencing manifestations * craving and uncontrolled drug use
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drug tolerace
•state of adaptation in which exposure to drug over time diminishes effectiveness of the drug
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hospice
•restorative care emphasizing pain control and comfort of the chronically/terminally ill
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CAM
•diverse medical and health care systems, practices, and products that are not part of conventional medicine
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alternative medical philosophy
* CAM * traditional Chinese medicine * acupuncture * homeopathy
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biological/botanical therapies
* CAM * diets * vitamins * mineral * herbal preps
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body manipulation
* CAM * massage * therapeutic touch- long strokes * chiropractic
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mind-body therapies
* CAM * emotional connections b/t thinking and fxning * biofeedback * art therapy * meditation * yoga * psychotherapy * humor
270
energy therapies
* CAM * use or manipulation of energy fields * Reiki * therapeutic touch
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complementary therapies
* therapies used in conjunction with conventional treatments | * integrative therapies
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alternative therapies
•therapies that replace allopathic medical care
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holistic nursing
•regarding and treating needs of pt through relaxation, guided imagery, etc
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meditation
* limiting stimulus and directing attention to a single unchanging or repetitive stimulus * person is able to become more aware of self
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biofeedback
* mind-body technique * uses instruments to teach self-regulation and voluntary self-control over specific physiological responses * instruments measure cardiac, muscular, brain wave activity, temp, etc
276
secondary gain
* you get something positive out of being sick | * special tx, don't have to do things, etc
277
ANA and pain
•supports aggressive tx of pain and suffering even if it hastens pt death

Foundations 1 (3 decks)

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