Charity School of Nursing CSN NURS 112 Exam I – Flashcards
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Pathogenic
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Disease producing (causing)
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Carrier
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A person, animal, or plant that serves as a host for a pathogen and can transmit it to others, but shows no symptoms (is immune).
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Endogenous infection
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Arising from within the body
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Exogenous
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An action or object coming from outside a system
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Fomite
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Any inanimate object (bed rail) or substance capable of carrying infectious organisms and hence transferring them from one individual to another.
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Health care-associated infection
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Infection obtained while in a health care setting
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Virulent
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Highly pathogenic or rapidly progressive (ability to survive in the host or outside the body)
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Chain of infection
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Infectious agent, reservoir, portal of exit, transmission, portal of entry, host suscepbility.
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Stages of infection
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Incubation period. Prodromal stage (onset of nonspecific signs/symptoms "i dont feel so good"). Illness stage (signs/symptoms specific to the infection). Convalescence (acute symptoms of infection disappear).
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Direct transmission
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Physical contact (person to person)
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Indirect transmission
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Contaminated host to inanimate objects (fomites)(touching an infected door knob)
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Droplet transmission
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Large particles contact a person (sneezing, coughing)
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Airborne transmission
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Particles in air (shaking sheet)
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Vehicle transmission
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Contaminated objects (food, untreated water)
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Host resistance
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Susceptibility of the host
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Host
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an organism in which another, usually parasitic, organism is nourished and harbored.
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Medical asepsis
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Techniques that prevent the growth and spread of pathogenic microorganisms. (CLEAN, not sterile technique)
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Reservoir
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Any natural habitat of a microorganism that promotes growth and reproduction.
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Spore
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Round body that is formed by the bacterium when conditions are unfavorable for growth.
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Standard Precautions
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Guidelines recommended by the CDCP for reducing the risk of transmission of blood-borne and other pathogens in hospitals. the standard precautions synthesize the major features of universal precautions (UNIVERSAL)
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Surgical asepsis
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The exclusion of all microorganisms before they can enter an open surgical wound or contaminate a sterile field during surgery. (STERILE, not clean technique)
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Vector
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An organism, such as a mosquito or tick, that carries disease causing microorganisms from one host to another.
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Colonization
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Organism that multiplies but does not cause an infection.
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Communicable disease
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An infectious disease that is transmitted directly from on person to another.
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Vehicle
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Any substance, such as food or water, that can serve as a mode of transmission for infectious agents.
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Sterilization
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To make free from live bacteria or other microorganisms.
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Sterile
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Free from all pathologic organisms
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Sterilization
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process of destroying all microorganisms and pathogenic products
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Surgical asepsis
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The practice of preparing and handling material in a way that prevents the patient's exposure to living microorganisms.
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Localized infection
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affects a certain area of the body (wound)
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Systemic infection
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Affects the whole body (AIDS)
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Inflammation
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protective vascular reaction that delivers fluid, blood products, and nutrients to injured site to help with healing. this is an immediate response to cellular injury.
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Inflammatory exudate
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accumulation of fluid/dead tissue cells. WBCs along with other blood particles will form the scab (or exudate) to prevent spreading (entry or exit) of infection and pathogens.
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How many mL of soap should be applied to hands?
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4-5 mL
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Droplets travel
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3 feet
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Iatrogenic Infection
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A type of HAI from a diagnostic or therapeutic procedure
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Etiology
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The cause of the infection- can be bacteria, virus, fungi, parasites (including protozoa)
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Contributing factors to infection
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Insufficient handwashing Iatrogenic Compromised host defenses Contaminated equipment
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Types of infection
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Based on extent, severity, acuity, virulence. May be: Local, systemic Acute, chronic Bacteremia, septicemica Resistant
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Suprainfections
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Secondary infections usually caused by an opportunistic pathogen.
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Risks for Infection include
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Age, heredity, stress, nutritional status, immunization status, personal habits, medical treatments, preexisting diseases, recent illnesses or surgery.
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Nonspecific host defenses
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Skin, heat (fever), erythyma, edema
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Active Immunity
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Natural exposure to antigens, or artificial antigens given.
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Passive immunity
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Natural source (breast milk), artificial source (blood transfusion - is immediate but body does not produce lasting memory)
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Localized response to infection
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5 Cardinal signs include hyperemia, edema, heat, pain, impaired or loss of function. open wounds may also include exudate, and the wound may have purulent drainage.
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System response to infection
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5 cardinal signs include fever, increased pulse and respiratory rate, malaise, anorexia and nausea, lymphadenopathy.
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Laboratory data may show positive cultures for
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Urine, blood, sputum, wound, other.
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International prevention of infections
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WHO. Immunizations required by countries.
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Naitonal prevention of infections
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CDC. Food transportation restrictions, pollution control, national patient safety goals.
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Community-based prevention of infections
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State, city health departments. Individual responsibility.
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Order of application for PPE
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Gown Mask Eyewear Gloves
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Order of removal for PPE
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Gloves Eyewear Mask Gown
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EVIDENCE BASED Evidence based practice
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The conscientious, explicit, and judicious use of theory-derived, research-based information in making decisions about care delivery to individuals or groups of patients and in consideration of individual needs and preferences.
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Research utilization
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Use of a single research study to change practice
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PICOT
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Patient/population Intervention Comparison Outcome Time
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PICOT model's use
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Used to define and refine development of a searchable clinical question to conduct a search for the best scientific evidence. PICO example] In the post op pt (P) how effective is morphine (I) versus dilaudid (C) in relieving pain? (O)
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Definition Of Nursing
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Nursing is the diagnosis and treatment of human responses to health and illness (ANA,1995)
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The Nursing Process
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1. Assessment 2. Problem /Need Identification(Nursing Diagnosis) 3. Planning 4. Implementation 5. Evaluation
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Assessment
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the nurse collects client health data
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Diagnosis
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the nurse analyzes the assessment data in determining diagnoses
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PLANNING
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a two -part process 1. Identification of goals and the patient's desired outcomes, or 2. Need the selection of appropriate nursing interventions to assist the patient in attaining the outcomes.
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Implementation
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putting the plan of care into action
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Evaluation
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determining the patient's progress toward attaining the identified outcome and the patient's response to and effectiveness of the selected nursing interventions then changing the plan if indicated
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Patient Database
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the compilation of data collected about a patient. it consists of the nursing history, physical examination , and results of diagnostic studies
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Subjective Data
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what the patient reports, believes ,or feels
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Objective Data
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what can be observed, ex. vital signs , behaviors, diagnostic studies
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Active Listening
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A restatement of the other person's total communication , including the words and the feelings
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Medical Diagnosis
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illness/ condition for which treatment is directed by a licensed physician
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Validation
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the process of assuring that data is factual
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Medical Diagnoses
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are illness /conditions reflecting alteration of the structure of function of organs/systems
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Assessment
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Collection of data. Verification, organization, interpretation of data.
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Diagnosis
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A statement of an actual or potential problem.
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Plan and Identify Outcomes
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Establish priorities of care, write nursing orders, set goals and desired outcomes, write care plan.
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Implementation
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Carrying out the care plan, giving care. Documentation is essential at this step.
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Evaluation
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Determining if goals have been met and outcomes achieved.
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Etiology
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Cause or contributor to a problem.
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Goal
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The desired outcome-needs to be patient-centered.
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Nursing Process
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Five- step systematic framework in which to plan and provide care to patients.
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Objective Data
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Observable or measureable data.
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Subjective Data
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Data that a client describes (feelings, opinions etc).
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Incident Report
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Written report documenting the incident and the response to the incident.
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Care Plan
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Written plan for each patient created by the nurse outlines steps taken by interdisciplinary staff members to help resident reach his/her goals. Patient MUST be involved.
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Critical Thinking
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Process fo reasoning and analyzing in order to solve problems.
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Nursing Diagnosis
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Used when making care plan. A clinical judgement about responses to actual or potential health problems or life processes.
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Nursing Interventions
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Actions that a nurse is legally able to order or start independently.
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Health Risks: African Americans
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1) Sickle cell anemia 2) HTN 3) Heart Disease 4) Cancer 5) Lactose intoleracen 6) DM 7) Obesity
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ASIANS
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- SILENCE is valued - Eye contact is considered disrespectful and inappropriate - touching during conversations is not usual - touching of opposite sex is not allowed - touching someone's head may be considered disrespectful
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Health Risks: Asians
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1) HTN 2) Heart Disease 3) Cancer 4) Lactose intolerance 5) Thalassemia
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HISPANICS
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- Avoid eye contact for respect - Direct confrontation is disrespectful - Tardiness is usual - Members are very tactile to family, friends and acquaintances
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Health Risks: Hispanics
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1) Hypertension 2) Cardiac Disease 3) DM 4) Obesity 5) Lactose intolerance 6) Parasites
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NATIVE AMERICANS
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- SILENCE indicates respect - Time orientation mainly PRESENT - Massage may be used for newborn to promote bonding - prohibits touching of dead body - Elders are honored - health is considered a state of harmony between the individual, family, and environment
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WHITES
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- Eye contact is usually viewed as indicating trustworthiness - Time is valued - some avoid close physical contact - Handshakes are used as a formal greeting - Health is viewed as the absence of disease and illness - prefers carbohydrates and red meat
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Health Risks: Whites
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1) Cancer 2) Heart Disease 3) DM 4) Obesity 5) HTN
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Homeopathy
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- Focuses on healing and interventions consisting of small doses of specially prepared plant and mineral extracts that assists in the innate healing process
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Naturophathy
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- Focuses on enhancing the natural healing responses of the body
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Concept of Yin and Yang
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- Yin is used to treat hot illnesses - Yang is used to treat cold illnesses
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What Is Communication?
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-Interpersonal communication is a transaction between the sender and the receiver. Both persons participate simultaneously.
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therapeutic communication: Gender
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Masculine and feminine gestures influence messages conveyed in communication with others. Examples: differences in posture and gender roles within various cultures.
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Intimate distance
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the closest distance that individuals will allow between themselves and others. In America, it is 0 to 18 inches.
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Personal distance
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interactions that are personal in nature, such as close conversations with friends. In America, it is 18 to 40 inches.
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Social distance
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conversations with strangers or acquaintances (e.g., at a cocktail party). In America, it is 4 to 12 feet.
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Public distance
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speaking in public or yelling to someone some distance away. In America, the distance exceeds 12 feet.
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Nonverbal Communication
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-Physical appearance and dress. Ways in which individuals dress or wear their hair conveys a message to all who observe their appearance. Example: unkempt appearance may give an impression to some people that the individual is sloppy and irresponsible. -Body movement and posture. The way in which an individual positions his or her body communicates messages regarding self-esteem, gender identity, status, and interpersonal warmth or coldness. Examples: -Slumped posture, head and eyes pointed downward conveys a message of low self-esteem. -Sitting with legs crossed at the thighs sometimes depicts feminine identity -Standing tall with head high and hands on hips indicates a superior status over the person being addressed. -Warmth is conveyed by a smile, direct eye contact, and keeping the hands still.
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therapeutic communication: Touch
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Can elicit both negative and positive reactions, depending on cultural interpretation.
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therapeutic communication: Facial Expressions
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Next to human speech, facial expression is the primary source of communication. The face can give multiple messages, such as happiness, sadness, anger, surprise, doubt, fear, and disgust.
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Therapeutic Communication Techniques: Using silence
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Allows the client to take control of the discussion, if they so desire.
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Therapeutic Communication Techniques: Accepting
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Conveys positive regard.
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Therapeutic Communication Techniques: Giving recognition
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Acknowledging indicating awareness.
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Therapeutic Communication Techniques: Offering self
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Making oneself available.
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Therapeutic Communication Techniques: Giving broad openings
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Allows the client to select the topic.
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Therapeutic Communication Techniques: Offering general leads
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Encourages the client to continue.
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Therapeutic Communication Techniques: Placing the event in time or sequence
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Clarifies the relationship of events in time.
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Therapeutic Communication Techniques: Making observations
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Verbalizing what is observed or perceived.
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Therapeutic Communication Techniques: Encouraging description of perceptions
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Asking the client to verbalize what is being perceived.
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Therapeutic Communication Techniques: Encouraging comparison
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Asking the client to compare similarities and differences in ideas, experiences, or interpersonal relationships.
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Therapeutic Communication Techniques: Restating
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Lets the client know whether an expressed statement has been understood or not.
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Therapeutic Communication Techniques: Reflecting
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Questions or feelings are referred back to the client so that they may be recognized and accepted.
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Therapeutic Communication Techniques: Focusing
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Taking notice of a single idea or even a single word.
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Therapeutic Communication Techniques: Exploring
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Delving further into a subject, idea, experience, or relationship
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Therapeutic Communication Techniques: Seeking clarification and validation
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Striving to explain that which is vague and searching for mutual understanding.
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Therapeutic Communication Techniques: Presenting reality
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Clarifying misperceptions that the client may be expressing.
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Therapeutic Communication Techniques: Verbalizing the implied
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Putting into words what the client has only implied.
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Therapeutic Communication Techniques: Attempting to translate words into feelings
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Putting into words the feelings that client has expressed only indirectly.
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Therapeutic Communication Techniques: Formulating a plan of action
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Strives to prevent anger or anxiety from escalating to an unmanageable level the next time the stressor occurs.
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Nontherapeutic Communication Techniques: Giving reassurance
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May discourage the client from further expression of feelings if he or she believes they will only be belittled.
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Nontherapeutic Communication Techniques: Rejecting
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Refusing to consider the client's ideas or behavior.
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Nontherapeutic Communication Techniques: Giving approval or disapproval
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Implies that the nurse has the right to pass judgment on the "goodness" or "badness" of the client's behavior.
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Nontherapeutic Communication Techniques: Agreeing/disagreeing
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Implies that the nurse has the right to pass judgment on whether the client's ideas or opinions are "right" or "wrong."
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Nontherapeutic Communication Techniques: Giving advice
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Implies that the nurse knows what is best for the client, and that the client is incapable of any self-direction.
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Nontherapeutic Communication Techniques: Probing
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Pushing for answers to issues the client does not wish to discuss causes the client to feel used and valued only for what is shared with the nurse.
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Nontherapeutic Communication Techniques: Defending
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To defend what the client has criticized implies that he or she has no right to express ideas, opinions, or feelings.
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Nontherapeutic Communication Techniques: Requesting an explanation
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Asking "Why?" implies that the client must defend his or her behavior or feelings.
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Nontherapeutic Communication Techniques: Indicating the existence of an external source of power
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Encourages the client to project blame for his or her thoughts or behaviors upon others.
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Nontherapeutic Communication Techniques: Belittling feelings expressed
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Causes the client to feel insignificant or unimportant.
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Nontherapeutic Communication Techniques: Making stereotyped comments, clichés, and trite expressions:
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These are meaningless in a nurse-client relationship.
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Nontherapeutic Communication Techniques: Using denial
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Blocks discussion with the client and avoids helping the client identify and explore areas of difficulty.
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Nontherapeutic Communication Techniques: Interpreting
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Results in the therapist telling the client the meaning of his or her experience.
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Nontherapeutic Communication Techniques: Introducing an unrelated topic
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Causes the nurse to take over the direction of the discussion.
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Active Listening
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is to be attentive to what the client is saying, both verbally and nonverbally.
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Several nonverbal behaviors have been designed as facilitative skills for attentive listening. They can be identified by the acronym SOLER.
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S—Sit squarely facing the client. O—Observe an open posture. L—Lean forward toward the client. E—Establish eye contact. R—Relax.
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Process recordings
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are written reports of verbal interactions with clients. -They are written by the nurse or student as a tool for improving communication techniques.
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Feedback
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-is useful when it is conveyed in the following manner: -is descriptive rather than evaluative and focuses on the behavior rather than on the client. -should be specific rather than general. -should be directed toward behavior that the client has the capacity to modify. -should impart information rather than offering advice. -should be well timed.
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Erikson's Stages of Development
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Birth to 12-18 Months: Trust vs. Mistrust 18 months to 3 years: Autonomy vs. Shame & Doubt 3 to 6 years: Initiative vs. Guilt 6 to 12 years: Industry vs. Inferiority 12 to 18 years: Identity vs. Role Confusion 18 to 25 years: Intimacy vs. Isolation 25 to 65 years: Generativity vs. Self-absorption 65 years to death: Ego integrity vs. Despair
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Maslow's heirarchy of needs
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Self actualization self-esteem love and belonging needs physical safety, psychological safety (safety and security) oxygen, fluids, nutrition, body temperature, elimination, shelter, sex (physiological)
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Changes in the Elderly
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Integument: Brown age spots, dry, scaly. Perspiration decreased. Wrinkles. Fat re-distributes to the abdomen, facial hair in women, decreased nail growth. Head and neck: <visual acuity. <accommodation, sensitive to glare. difficulty with darkness. <hearing acuity. chest rigidity. >respiratory rate. <lung expansion. Heart: Orthostatic hypotension common. Breasts: diminished breast tissue, pendulous. Gastrointestinal: <saliva, swallowing, peristalsis. Reproductive: Female: <secretions <hormones. Male: <hormones, sperm count, testicular size. Urinary: <renal filtration and renal insufficiency, nocturia. Musculoskeletal: <muscle mass and strength, bone demineralization, intervetebral space narrows. <joint mobility, slowed reactions. Neurological: <reflexes, insomnia, shorter sleeping periods.
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Referent
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The stimulus of why you're communicating
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Sender
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The person communicating
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Receiver
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The person that is receiving the communication
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Message
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The Message..
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Channel
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The means of communication
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Environment
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What is the environment? Could be a disaster situation, patient room with loud tv. Also, what is the age and gender of receiver and communicator? etc.
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Feedback
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Did they receive the message correctly?
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Different levels of communication: Intrapersonal (self talk)
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People talk to themselves by forming thoughts that influence their perceptions feelings, perceptions, behaviors, self concept, and performance.
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Different levels of communication: Interpersonal
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Occurs between two people or groups
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Different levels of communication: Public
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Interaction of one person with a group of people
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Different zones of touch: Social
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Permission generally not needed. Hands, arms, shoulders, back.
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Different zones of touch: Consent
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Permission needed. Mouth, wrists, feet.
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Different zones of touch: Vulnerable Areas
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Permission needed. Face, neck, front of body.
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Different zones of touch: Intimate
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Permission needed. Genitalia, private parts.
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The nurse-patient helping relationship
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Pre-interaction phase: before meeting the patient Orientation phase: when nurse and patient meet for the first time Working phase: When nurse and patient work together to solve problems and achieve goals Termination phase: When the nurse and patient end the relationship
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SBAR
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Situation Background Assessment Recommendation