question

World Health Organization's International Goal for Health

answer

eliminate the threat of pathogen transmission across international boundaries and attain the highest level of health for all people

question

WHO 6 principles

answer

1) Essential services that should be available to all citizens 2) Equitable access for all members of society 3) Individual and community involvement w/in the planning and operation of health will result it 4) Health of society will improve w/emphasis that includes prevention and promotion services 5) Technology should be used appropriately 6) Health development should be integrated

question

Healthy People 2010/2020 Goals: 2 National Health Goals

answer

1) Increase the quality and years of healthy life 2) Eliminate health disparities among Americans

question

Healthy People 2010/2020 Goals: 10 Leading Health Indicators

answer

Each are measurable and can be used for comparing in the future: 1) Physical Activity; 2) Nutrition and Overweight and Obesity; 3) Tobacco Use; 4) Substance Abuse; 5) Responsible Sexual Behavior; 6) Mental Health; 7) Injury and Violence; 8) Environmental Quality; 9) Immunization; 10) Access to Health Care

question

Center for Disease Control and Prevention Roles:

answer

1) Registers all communicable diseases 2) Investigates and sets guidelines form prevention/spread of communicable diseases 3) Implementing Standard Precautions: set of actions designed to reduce transmission

question

World Health Organization (WHO) Goals for preventing spread of disease

answer

monitors disease outbreak; assesses the performance of health systems around the globe; beyond individual, local, or community perspectives: looking at the entire world- THE BIG PICTURE; the treat of pathogen transmission across international boundaries: People to People, Other Vertebrates to People, and this potential threat is much greater than most realize- a recent example is the concern over bird flu

question

Health Maintenance is...

answer

health seeking behaviors, ineffective health maintenance, noncompliance, deficient knowledge, decisional conflict and ineffective therapeutic regimen management

question

Factors Affecting Health- 5 Determinants of Health

answer

Biology- heredity; Social Environment- social networks, socioeconomic status, knowledge; Public Policy & Interventions- what is socially acceptable at the time; Behaviors- personal habits, cultural factors, relationships w/others; Physical Environment- work, ecosystem, safety

question

Factors that Affect Change: (7)

answer

1) communication; 2) cognition and perception; 3) age and developmental level; 4) lifestyle and habits- economic resources; 5) cultural values and beliefs- environment; 6) roles and relationships; 7) coping and stress tolerance

question

define primary preventative care and provide an example

answer

Actions that focus on the prevention of health problems; exercise and/or eat well to stay healthy, identify high risk groups and intervene, immunizations, public health nurse informing teen girls on STDs, community wide exercise program

question

define secondary care and provide an example

answer

actions that focus on early diagnosis and prompt treatment of health problems; screening programs, emergency response/care, illness or injury has occurred but there are no complications, newly diagnosed pt w/high blood pressure that does not have any damage to his heart or cardiovascular system, diagnosed as hypertensive and now prescribed BP meds, pap smears, testicular examinations, elderly client recovering form hip surgery

question

Has an injury or illness occurred with secondary preventive care?

answer

yes, but no complications

question

define tertiary prevention and provide an example

answer

actions to minimize the effects of the effects of a permanent, irreversible disease or disability, prevent complications and deterioration; rehab for a stroke, medications, medical therapy, surgical treatment, PT, teaching a class of pregnant teens on future birth control

question

Health perception

answer

the knowledge and experience of one's state of wellness and well being

question

Health promotion

answer

the advancement of health through the encouragement of activities that enhance the wellness of individuals, families, and communities

question

health disparity

answer

refer to gaps in the quality of health and health care across racial, ethnic, sexual orientation and socioeconomic groups; wellness- state of optimal health or optimal physical and social functioning

question

disease

answer

specific disorder characterized by a recognizable set of signs and symptoms and attribute to heredity, infection, diet, or environment

question

illness (acute)

answer

sudden onset and short duration

question

illness (chronic)

answer

extended time, often the person's lifetime

question

morbidity

answer

a state of wellness, disease, or abnormal condition which examines the number of people who develop a certain condition per year

question

mortality

answer

the state of being mortal; this identifies the number of people who die from various causes each year

question

lifestyle

answer

a behavior/group of behaviors chosen by a person that may have influence on health

question

health

answer

state of complete physical, mental, and social well being, and not merely as the absence of illness (WHO definition)

question

Primary Health care

answer

ALL care necessary to people's lives and health (Health care for ALL)

question

Health disparities r/t Healthy People 2010 goals

answer

race or ethnicity, sex, sexual identity, age, disability, socioeconomic status, and geographic location; a particular type of health difference that is closely linked with social, economic, and/or environmental disadvantage

question

ineffective therapeutic regimen- contributing factors: Assessments

answer

pt. reports difficulty in carrying out proposed activities on in making choices to incorporate these activities of the regimen into daily living, or the pt may report making no attempt to incorporate these activities into patterns of daily living

question

ineffective therapeutic regimen- contributing factors: Interventions

answer

increasing knowledge level, clarifying values, engaging participation, anticipating problems, providing reinforcing factors

question

ineffective therapeutic regimen- contributing factors: Evaluations

answer

pt agrees to participate in therapeutic regimen

question

ineffective therapeutic regimen- contributing factors

answer

Acceleration of illness symptoms, inappropriate activities for meeting health goals, failure to take actions to reduce risk factors, lack of attention to illness, verbalizes desire to manage the illness, verbalizes difficulty with therapeutic regimen; R/T: mistrust of traditional healthcare personnel, complexity of health care system, complexity of therapeutic regimen decisional conflicts, economic difficulties, excessive demands, family conflict

question

Professional boundaries

answer

what the client-nurse relationship is characterized by. The nurse should be accessible to the client, while maintaining awareness that the therapeutic relationship is not a friendship or other social relationship

question

professional boundaries of the Nurse/client relationship

answer

relationship does not occur spontaneously; helping relationship characterized by an unequal sharing of information; patient shares info related to personal health problems, nurse shares info in terms of a professional role; built on patient's needs, not on those of the helping person; rudeness, sloppiness, inattention to professionalism undermines image of nursing professionalism and the effectiveness of individual nurses

question

3 elements of a therapeutic relationship

answer

nurse, client, communication b/t the nurse and client

question

encoder

answer

the sender, the person initiates the transaction to exchange, to convey thoughts or feelings, or engage another person

question

message

answer

content thee sender wishes to relay. Must be encoded in language/cues that are both understood by sender and receiver

question

sensory channel

answer

how we send it: visual, auditory, kinesthetic

question

decoder

answer

person must be able to decode the message sent

question

content

answer

condition under which communication occurs

question

feedback

answer

process of which the effectiveness of communication is determined

question

phases of therapeutic relationship

answer

pre-orientation: nurse anticipates what the client needs to maximize the impending meeting (gathering supplies, prepping room, etc.); orientation: trying to est. trust, honest from the start, est. goals and set limits; working: nurse analyzes results, help the pt. express feelings, working together towards goals, looking at community resources, doing the care, giving meds; termination: discharge planning begins at the very start, acknowledging early what to expect

question

termination of the nurse-client relationship

answer

occurs when the conclusion of the initial agreement is acknowledged; patient will participate in identifying the goals accomplished or the progress made towards goals; patient will verbalize feelings about the termination of the relationship

question

working phase of the therapeutic relationship- definition and example

answer

working phase: usually the longest phase of the helping relationship. You will work together with the patient to meet physical and psychological needs; interaction is the essence of the working phase, patient will actively participate in the relationship, doing the care, giving the meds

question

confidentiality

answer

the legal and ethical responsibility to keep information about a client private; indicate with whom the information that the patient gives will be shared, patient should know about right to specify who might have access to the information

question

breach of confidentiality

answer

discussing pt information in any public area where those who have no need to know the information can overhear; leaving pt medical info in a public area; leaving a computer unattended in an accessible area with medical record info unsecured; failing to log off a computer terminal; sharing or exposing passwords; copying or providing data, either in hard copy or machine-readable form, for one's self, coworkers, or any other party, except as requiring to fulfill job responsibilities

question

assertive

answer

stands up for themselves but does not infringe on the rights of others- expresses feelings honestly and directly- can communicate both positive and negative feedback; uses "I" statements when sharing information. this respects the other person's viewpoint

question

aggressive

answer

angry, dominating, puts others down, superior attitude, manipulative, demanding

question

passive

answer

lets others push them but feels hurt and anxious about the communication- unable to share their feelings or needs and has difficulty asking for help

question

passive aggressive

answer

sometimes they will do something, but never actually do it; usually cannot share direct feelings and unable to say "no" upfront, but then will undermine other's efforts to complete the project or tasks

question

purpose of therapeutic communication

answer

encourages clients to open up and speak more freely

question

enhancing therapeutic communication

answer

beginning the interaction- provide broad openings; continuing the interaction- providing silence, generally leads to convo going forward; concluding the interaction- summarizing the convo, encouraging the formulation of a plan of action

question

therapeutic techniques: beginning the interaction

answer

offering self, providing broad openings, making observations, suggesting collaboration

question

therapeutic techniques: continuing the interaction

answer

providing silence, accepting messages, providing general leads, exploring, focusing, active listening, passive listening

question

therapeutic techniques: concluding the interaction

answer

encouraging formulation of a plan of action, summarizing

question

ways to promote effective communication

answer

awareness; acceptance, respect, and unconditional positive regard; respect; you avoid being critical; empathy; relatedness; caring; objectivity; protectiveness; genuineness; openness; professional closeness or distance; sense of humor

question

awareness

answer

acknowledge the presence of the client; attending behaviors shows that you are paying attention and listening to what the client is saying; facing the client, leaning toward the client, using appropriate eye contact, keeping your eyes open with eyebrows raised, maintaining an open body posture and body position in which the arms and legs are uncrossed

question

acceptance, respect, and unconditional positive regard

answer

acceptance is openness to the unique qualities and attributes of individual clients; accept clients for who they are, even if their behavior is undesirable, does not mean condoning inappropriate client behaviors

question

respect

answer

an attitude of acceptance; includes: valuing, highly regarding, or esteeming clients or who they are; unconditional positive regard; respect for the client does not depend on the client's behavior, you learn to value and care for clients simply b/c their humanity warrants your care

question

empathy

answer

ability to "be in the other person's shoes" w/out taking on the client's feelings or thoughts; accurate perception of the client's feelings; not sympathy, wherein you feel pity or compassion for the client; sense of understanding or "being with" the client

question

relatedness

answer

recognition of similarities b/t you and the client and the forging of emotional connections based on those similarities

question

caring

answer

taking an emotional risk to feel a personal interest in the client's welfare

question

objectivity

answer

an unbiased, reality-based stance that allows you to assess the facts of a client's situation w/out being emotionally pulled into the client's difficulties

question

protectiveness

answer

leads you to shield the fragile and vulnerable client during the person's recovery from illness; protectiveness is a caring attitude that should be used judiciously while you continue to evaluate the client's capacity to defend the self

question

genuineness

answer

ability to be honest, open and sincere in self-presentation; the phrase, "what you see is what you get" describes the demeanor of a genuine person

question

openness

answer

being open w/a client reflects your ability and willingness to be real, genuine, and emotionally accessible

question

professional closeness or distance

answer

delicate balance b/t maintaining objectivity and professional distance, and the warmth, openness, and availability associated w/professional closeness; care about your clients and allow yourself to know their concerns, but it does not mean taking their thoughts, feelings or attitudes as your own

question

offering self

answer

techniques in which you offer to stay with the client and either talk or just sit quietly; I have 30 min available to talk with you at 10 o'clock today; I will stay with you while you wait for your family

question

seeking clarification

answer

clients say things that are unclear, or may have more than one specific meaning, or that are simply vague; ask client for clarification; let the client know that you are not certain about what was said and, if necessary, request that the client clarify anything that is obscure; "I'm not sure I follow what you mean"; may have to clarify by stating what the client said and what you take it to mean

question

restating/clarifying

answer

another way to clarify is to use therapeutic technique of restating, or paraphrasing what the client has said; you alter the client's words to express your understanding of the client's meaning; you send this back to the client in the form of a statesmen or question, and you provide the client the opportunity to agree or disagree that this was the intended message and, if necessary, to clarify further

question

barriers to effective communication

answer

belittling, offering false reassurance, parroting, disapproving, disagreeing, rationalizing, interpreting, advising, blaming, patronizing, making stereotypical comments, introduction unrelated topic, using jargon, giving literal responses, requesting explanation and proving

question

vitamins

answer

most are active in the form of coenzymes, which, together with enzymes, facilitate thousands of chemical reactions in the body; don't provide energy (calories), they are needed for metabolism of CARBS, PRO, and FAT; essential in diet b/c most are not synthesized in the body or are made in insufficient quantaties- not a replacement supplement, but rather an addition to an already healthy diet; increases necessary nutrients that are diminished during the everyday wear and tear of the body

question

phytochemicals

answer

compounds in food that seem to prevent disease (increase consumption of fruits and vegetables in the diet); flavonoids, carotenoids, antioxidants

question

flavonoids

answer

fruits and vegetables

question

carotenoids

answer

vegetables

question

antioxidants

answer

selenium, Vitamin E, Vitamin C

question

aerobic exercise

answer

cardio exercise that promotes cardiovascular fitness; it increases blood flow, heart rate, and the metabolic demand for oxygen over a period of time: jogging, swimming, cycling, etc.

question

anaerobic exercise

answer

exercise in which supply of oxygen is less than the demand created by contracting mm; oxygen debt results: power lifting, sprinting, etc.

question

basic behavior modification techniques

answer

self-monitoring: show what and when foods are eaten; stimulus control: separate events that trigger eating from the act of eating- incentives for weight loss

question

goal of overeating modification programs

answer

deemphasize diet and focus on how and when a person eats; overeating is a learned disorder; critical difference b/t an obese person and a non-obese person are cues that regulate eating behavior

question

Sibutramine (Meridia)

answer

promote weight loss; dry mouth, increased appetite, nausea, strange taste in the mouth, upset stomach, constipation, trouble sleeping, dizziness, drowsiness, menstrual cramps/pain, headache, flushing, or joint/mm pain may occur

question

illness effect on sleep

answer

impinges on sleep cycle and leaves familiy caregivers exhausted, sleep deprived, and enable to cope as well

question

tryptophan

answer

precursors to serotonin r/t sleep and found in many foods like turkey, milk, banana, and most protein-based foods

question

parasomnias

answer

bruxism, enuresis

question

enuresis

answer

bedwetting during sleep caused by insufficient baldder size and hormonal imbalance; children nad mentally disabled suffer more often; tx may be low doeses of tricylcic antidepressants, behavioral techniques (bladder traingin or using a pad) and fluid restriciton in the evening; tx might include low doses of tofranil (tryicyclic) pt shoudl stay away from sunlight b/c of sunbrns

question

dyssomnia

answer

narcolepsy

question

narcolepsy

answer

striking hypersomnia characterized by abnormal sleep tendencies as well as pathological REM sleep AEB excessive daytime sleepiness, disturbed nighttime sleep, cataplexy, sleep paralysis, and hypagogic hallucinations, CNS loses control of REM sleep

question

cataplexy

answer

results from abrupt bilateral loss of mm tone and paralysis of voluntary mm

question

hypnagogic hallucinations

answer

vivid, bizarre, dreamlike experiences lasting 1-15 min

question

sleep paralysis

answer

inability to move during onset of sleep or awakening

question

most obvious symptom of narcolepsy

answer

daytime sleep attacks lasting 20-30 minutes, episodes of REM sleep

question

lifestyle changes suggested for narcolepsy

answer

healthy diet, restriction of alcohol consumption and sedatives, additional daytime sleep AEB 10-60 min. naps throughout the day

question

bruxism

answer

teeth grinding characterized by violent, repetitive grinding of teeth occurring during lighter sleep stages and partial arousals: lasts 4-5 sec or longer, damage to teeth and jaw pain may result, tx is rubber mouth guard, can cause TMJ problems; symptoms: anxiety, stress, tension, depression, earache, eating disorders, headache, sore or painful jaw

question

interuppted sleep

answer

awakening at night and unable to go back to sleep, excessively rumpled bedding r/t increased restlessness, partner description of frequent leg twitching, jerks or kicks, sleep apnea (snorts, loud snoring, gasping, or choking)

question

Why do babies need to sleep on their backs and not side or stomach?

answer

reduce likelihood of suffocation and SIDs

question

DASH (Dietary Approach to Stop HTN) diet

answer

milk, cheese, bread, cereal, canned soups and veges may be severely restricted; low-fat, low-cal diet; less red meats, salts, sweets, added sugars, and sugar-containing beverages

question

heart healthy foods

answer

fish, almonds, garlic, produce, fruits and veges, wine, dark chocolate

question

restrict sodium to less than ___ grams a day b/c...

answer

6; it can increase bld volume and CO

question

decreasing amount of saturated fat and increasing poly-saturated fat can...

answer

decrease BP and improve cholesterol levels

question

obesity

answer

associated w/abnormalities of glucose, insulin and lipoprotein metabolism (common in primary hypertension), also increases workload of the heart, causing an enlarged heart and increasing myocardial oxygen consumption

question

angiogram

answer

a radiographic image of a bld vessel after injection of a radiopaque contrast medium

question

cardiac catheterization involves...

answer

insertion of catheter into heart to botain information about oxygen levels and pressure readings within the heart chambers

question

angiograms are used to

answer

evaluae patency of coronary arteries and collateral circulation

question

what is pseudo-hypertension?

answer

false HTN due to sclerosis of large arteries; sclerotic AA don't collapse under the cuff and therefore present a much higher cuff pressure than is actually present with/in the vessels; only way to get an accurate bp is with the intra-arterial catheter (angiogram)

question

post care after angiogram

answer

keep affected extremity immobilized for 6-8 hours after removal of sheath to allow time for body's natural hemostatic mechanisms to form stable initial repair at the insertion site, use orthopedic bedpan for female pt as needed while on bed rest; emphasize the need to lay flat for 6-12 hours and possibly overnight if sheath is left in the groin to prevent disruption of hemostasis; encourage pt to drink 1-2 L of fluid after procedure to facilitate elimination of contrast material and prevent renal damage

question

Nursing intervention for Ineffective tissue perfusion (assessment, interventions, and evaluations)

answer

assessments: edema, DVT, confusion, unequal pulses; interventions: modifying risk factors- diet, exercise, concurrent health problems; preventing vasoconstriction- positioning, cold temperatures, nicotine, emotional stress; evaluations: BP WNL of pt, palpable peripheral pulses of equal strength and quality, skin warm and dry, capillary refill in less than 3 seconds, absence of pain, mental status WNL for pt

question

Ineffective tissue perfusion

answer

CO is decreased b/c of poor circulation

question

Nursing interventions for decreased CO

answer

discourage smoking, discourage excessive intake of beverages high in caffeine such as coffee, tea, and colas, implement measures to reduce fluid volume excess. Administer meds if ordered such as diuretics, angioplasty-converting enzyme inhibitors, positive inotropic agents, and beta-adrenergic blocking agents

question

Aerobic, resistance exercise can help obese client lose weight, improve circulation, improve cardiovascular conditioning, and assist with BP reduction, true of false?

answer

true

question

brisk walking, jogging, swimming can reduce SBP in HTN client by 10 mm Hg, True or false?

answer

true

question

goals of vasodilator drugs in treatment of HF include:

answer

increasing venous capacity; improving EF through improved ventricular contraction; slow the process of ventricular dysfunction; decreasing heart size

question

How do vasodilating drugs decrease BP?

answer

by relaxing vaxcular smooth mm and reducing SVR

question

side effects of vasodilating drugs?

answer

tachycardia, angina, headache, nausea, flushing

question

Vasodilating drugs include:

answer

Fenoldopam (Corlopam), Hydralazine (Apresoline), Minoxidil (Loniten), Nitroflycerin (Tridil), Sodium Nitroprusside (Nipride)

question

Examples of Statins

answer

Lipitor, Toryast, Lescol, Meyacor, Altrocar, Crestor, and Lipostat

question

most common S/E of statins

answer

raised liver enzymes and muscular cramps

question

what do statins do?

answer

lower cholesterol level by inhibiting the enzyme HMG-CoA reductase, which plays a central role in the production of cholesterol in the liver

question

increased levels of cholesterol are associated with?

answer

cardiovascular disease

question

non-modifiable risk factors of cardiac disease?

answer

age, gender, ethnicity

question

modifiable risk factors of cardiac disease?

answer

elevated serum lipids, HTN, tobacco use, physical inactivity, obesity, and stress; diabetes mellitus, metabolic syndrome, psychological states, homocysteine

question

HTN emergency

answer

used to indicate either a hypertensive urgency or emergency and is determined by the degree of target organ damage how quickly the BP must be lowered. Develops over hours or days and is a situation when the patient's BP is severely elevated often above 220/140 with evidence of acute target organ damage, esp. to the CNS

question

HTN Urgency

answer

develops over days to weeks and is a situation in which a patient's BP is severely elevated but there is no clinical evidence of target organ damage

question

With HTN emergency and urgency, is the absolute value of the BP more important than the rate and rise of BP in determining the severity of the emergency?

answer

no, rise and rate b/c pts who suffer from chronic HTN can tolerate a much higher BP than previously normotensive pts

question

Why do HTN emergency and urgency occur?

answer

when pts with a history of HTN failed to comply with their prescribed medication or have been under medicated

question

common reasons for lack of medication compliance:

answer

inadequate pt teaching; unpleasant side effects of durgs; return of BP to normal range while on medication; lack of motivation; high cost of drugs (socioeconomic); lack of insurance; important for pt to understand that HTN is a chronic illness that cannot be cured but controlled w/drug therapy, diet changes, physical activity

question

What do ACE inhibitors do?

answer

inhibits angiotensin-converting enzyme, reduces conversion of angiotensin I to angiotensin II, and prevent angiotensin II medicated vasoconstriciton and sodium and water retention

question

Common ACE Inhibitors:

answer

Benzepril (Lotensin); Captopril (Capoten); Enalapril (Vasotec); Fosinopril (Monopril); Lisinopril (Prinivil); Moesipril (Univasc), Peridorpil (aceon); Quinapril (Accupril); Ramipril (Altace); Trandolapril (Mavik)

question

side effects of ACE Inhibitors

answer

hypotension, dizziness, loss of taste, COUGH, hyperkalemia, acute renal failure, skin rash, angioedema

question

Accupril actions and side effects

answer

actions: ACE Inhibitor- HTN, HF, acute MI, L ventricular dysfunction, and diabetic and nondiabetic nephropathy; S/E: first-dose hypotension, dry persistent cough, hyperkalemia, renal failure, fetal injury, angioedema

question

if BP cuff is too narrow, reading will be ___; if BP cuff is too wide, reading will be ___

answer

high; low

question

systolic is the ___ sound and diastolic is the ___ sound

answer

first, absence

question

cyanosis

answer

bluish tint to the skin, seen as ash gray in dark skin; best seen in lips, buccal mucosa, and tongue; peripheral cyanosis is best observed in the nail beds and in the skin of the arms and legs

question

Ventilation

answer

the cycle of inspiration and expiration of air into and out of the lungs; air moves into the lungs when the atmospheric pressure is greater than the pressure in the air passages

question

What two things happen simultaneously to create pressure gradient in the lungs?

answer

1) elevation of ribs and mvt of diaphragm enlarges (expands) the chest cavity. The diaphragm moves down as it contracts, thus creating more intrathoracic space 2) as the chest wall expands, it pulls away from the lungs, creating negative pressure, which draws the lungs open. As the lungs are pulled down, negative pressure is created in the airways inside the lungs and the air is drawn into the lungs

question

Gas Exchange is made possible by:

answer

respiration and perfusion

question

diffusion

answer

movement of CO2 and O2 b/t air and blood

question

Major risk factors for pulmonary system problems in premature newborns

answer

surfactant deficiency RDS (respiratory distress syndrome)- treat with exogenous surfactant at birth and thereafter; persistence or reversion to fetal circulatory system (PFC)- treat with indomethacin, surgery; Apnea of Prematurity and Infancy- treat with stimulation, low pressure CPAP, caffeine, theophylline

question

Major risk factors for pulmonary system problems in infants and toddlers

answer

URI (upper respiratory infection); airway obstruction- asthma, "choking episodes"; accidental poisoning; common airway infections: nasopharyngitis, pharyngitis, tonsillitis, haemophilus influenza

question

Most children develop six to eight colds a year and the number increases for children who attend daycare, true or false?

answer

true

question

Major risk factors for pulmonary system problems in school-aged children and adolescents

answer

exposed to respiratory infections; respiratory risk factors: increased incidence of SIDS if parent smokes; increased incidence of asthma, bronchitis, colds if parent smokes; smoking and second-hand smoke; inhaling dangerous substances or huffing

question

Pregnant women who smoke are more likely to have babies with low birth weights, true or false?

answer

true

question

Smoking by one or more parents has no correlation with SIDS.

answer

false, smoking does

question

Do children who live with one or more smoking parents have higher incidences of asthma, bronchitis, emphysema, pneumonia, influenza, colds and respiratory infections?

answer

yes

question

Major risk factors for pulmonary system problems in young and middle-age adults

answer

unhealthy diet; lack of exercise; stress; drugs; smoking

question

Cannabis (marijuana)

answer

a synthetic form of the active ingredient in marijuana (Marinol/dronabinol) for prescription to cancer pts suffering from anorexia, N/V caused by chemotherapy

question

immediate effects of cannabis

answer

increased heart rate, low BP, faintness and reddened eyes, "hangover" effect like drowsiness and poor co-ordination that lasts for several hours after the initial effects

question

Marijuana cigarettes have more tar than tobacco and burn at a higher temperature and therefore are more dangerous airways, true or false?

answer

true, more likely to cause lung cancer and chronic bronchitis

question

alcohol will eventually lead to R-sided heart failure and pulmonary hypertension

answer

true

question

Major risk factors for pulmonary system problems in elderly adults

answer

decrease in response to hypoxemia and hypercapnia, immunity and specific antibodies, cilia function, cough force, avelolar macrophage function; chest wall- decrease in elastic recoil, decrease compliance and elasticity, and increase in anteroposterior diameter; alveoli- decrease in surfactant, decrease in diffusion of gases

question

Changes occurring that affect the respiratory system as people age:

answer

ribs don't move as freely with inspiration as a result of kyphosis, costal cartilage calcification and arthritis of costovertebral joints; loss of elasticity of pleural tissue; weakening of the intercostal mm and possibly the diaphragm, lungs become more rigid; diminished strength of the thoracic muscles in inspiration and expiration; above changes decrease forcefulness of the cough which is needed to expel things

question

elastic recoil

answer

tendency of the lung to contract

question

compliance

answer

ability of the lung to expand/distend (distensibility) in response to intraalverolar pressure

question

Related factors to ineffective breathing pattern

answer

anxious about results of cardiac catheterization and possible cardiac surgery

question

position to maximize air exchange in pts with dyspena and orthopnea

answer

high Fowler's position

question

effects of smoking on respiratory system

answer

hyperplasia of cells, including goblet cells, which subsequently results in increased production of mucus; lung disease and respiratory distress

question

packs per year =

answer

packs/day x # of years smoking

question

Traditional Chinese Medicine (TCM)

answer

interaction of people w/environment creates health; central concept is qi or chi, yin/yang; uses acupuncture, diet herbs, massage,and energy exercises

question

Acupuncture

answer

qi lows through body through meridians; places thin needles at particular acupoints to change flow of energy; reduces pain, promotes adherence to substance abuse, minimizes N/V

question

Qi gong

answer

system of posture; exercise-gentle and dynamic; breathing techniques; visualization that regulates the qi gong

question

Yin and Yang

answer

dynamic, interacting, and interdependent energies, neither of which can exist without the other, each containing some part of the other within it. These energies are a part of everything in nature and must be maintained n a harmonious state of balance to achieve optimal health. Yin- cold, heavy, moist, negative; Yang- hot, dry, light, positive

question

Herbal medicine

answer

the use of herbs for therapeutic benefit, viewed as natural and often safer

question

issues with herbal products

answer

can alter the effects of prescribed, conventional drugs; herbs ACT LIKE drugs; not regulated by FDA, considered dietary supplements in U.S.; ALWAYS ASK if they are taking any vitamins, herbs, etc. during assessment

question

Dangerous herbs:

answer

liver disease: chaparral, comfrey; death: comfrey, ephedra, Yohimbe (comfrey and ephedra removed from market)

question

Most common herbs

answer

echinacea- prevention and treatment of URI; garlic- lowers cholesterol; gingko- used to dilate cerebral bld vessels; St. John's Wort- everything from cancer to ___.

question

Advantages of Conventional drugs

answer

standardized; regulated by FDA; tested for safety and efficacy

question

Ayuryedic Medicine

answer

originated in Vedic civilization of India; balance among people, environment, and larger cosmos integral to health; central is pts basic constitution- dosha, vata- changeable, pitta-intense, Kapha- relaxed; uses nutrition, exercise, herbs, breathing, medication, massage, aromatherapy, and purification

question

Garlic

answer

lowers cholesterol; use with caution in pt w/bleeding disorders; HTN- do not use in large amounts

question

Gingko

answer

used to dilate cerebral vlood vessels; cluadication (peripheral basculature disease)- generally well tolerated in recommended dosages for pu to 6 months; dementia treatment

question

St. Johns Wort

answer

depressive disorder (mild to moderate)- generally well tolerated 1-3 months; anxiety- interacts with many herbs, supplements, medications

question

Echinacea

answer

prevention and treatment of upper respiratory infection

question

Risk factors for Nurses

answer

back injuries: 1/3 of all nursing personnel have back-related injuries; shoulder strains; needle stick injuries: eliminating needle-bearing devices to increase safety

question

Environmental Hazard

answer

a biological, physical, chemical or psychosocial threat to health that arises form the environment

question

ergonomics

answer

the study of people at work in order to understand the complex relationships associated with work, such as human anatomy and psychology

question

ergonomic agent

answer

agents that cause mechanical strain on the body resulting in illness

question

exposure pathway

answer

the process by which an individual is exposed to contaminants that originates from some source: air- inhalation of fumes or dust, soil- direct skin contact, water- dermal absorption, food- ingestion (pesticide)

question

sentinel health event

answer

an unusual, or atypical, pattern of illness for which an environmental cause is suspected

question

Food and Drug Administration (FDA)

answer

enforces federal laws on the purity of foods, drugs, and cosmetics and on the advertising claims of their manufacturers

question

Centers for Disease Control (CDC)

answer

registers all communicable disease

question

Environmental Protection Agency (EPA)

answer

implements federal laws designed to promote public health by protecting our Nation's air, water, and soil from harmful pollution

question

Consumer Product Safety Commission

answer

tests products for safety

question

occupational safety and health administration (OHSA)

answer

sets standard for occupational safety

question

national center of environmental health

answer

work to prevent illness, disability, and death form interactions b/t people and the environment

question

sanitation:

answer

health measures r/t hygiene, such as waste disposal, water quality, sewage regulations, food-handling regulations

question

toxicology

answer

the scientific study of harmful effects of chemicals on humans and their ecosystems

question

RACE acronym for fire

answer

R- Rescue anyone in immediate danger, A- activate the fire code and notify appropriate person, C- confine the fire by closing doors and windows, E- evacuate patients and other people to safe area

question

Prevention of falls in hospitalized clients

answer

orient person to surroundings (avoid falls); restraints- prevents patient from falling and sustaining injury, removing excess furniture, clutter, or debris form the room, assessment/recognition of fall risks

question

Risk factors for falls

answer

age >65; history of falls; impaired vision or balance; altered gait or posture, impaired mobility; medication regimen; postural hypotension; slowed reaction time, weakness, frailty; confusion or disorientation; unfamiliar environment

question

A1C

answer

Glycosylated Hemoglobin Level

question

Normal Blood sugar values

answer

A1C: 4.0-6.0%; fasting blood glucose (FBG): 70-99 mg/dL; 2 hours after meals FSBS (Finger stick blood sugar): < 140 mg/dL

question

Pre-Diabetes blood sugar values

answer

A1C: 5.7- 6.4%; FBG: 100-125 mg/dL; 2 hours after meal: 140-199 mg/dL

question

diabetic blood sugar values

answer

A1C: >/= 6.5%; FBG: >/= 126 mg/dL; 2 hours after meal: >/= 200 mg/dL

question

3 P's of diabetes

answer

pulyuria- frequent urination; polydipsia- excessive thirst; polyphagia- excessive hunger

question

5-10% of all diabetics are

answer

type I (insulin dependent)

question

diabetes associated with lack of insulin, genetic component, abrupt onset, weight loss, autoimmune, and with younger persons

answer

type I (insulin dependent)

question

diabetes associated with insufficent or poorly utlized insulin (impaired insulin secretion and action, tissue cells are less sensitive, metabolic syndrome, nonspecific and gradual onset, can be controlled with diet and exercise, sedentary lifestyle, blurred vision, family history

answer

type 2 (non-insulin dependent)

question

complications form diabetes resulting from poor vascular circulation

answer

cardiovascular disease, kidney failure, retinopathy, neuropahty, stroke

question

long term goal for diabetic pt regarding exercise

answer

150 minutes of exercise per week

question

RDA allowance for CARBS for diabetic

answer

130 g/day

question

Men base self-esteem on ___; women base self-esteem on ___

answer

achievements; realtionships

question

self-esteem

answer

person's perception of his or her total being, including self-worth and body image

question

interventions for chronic low self-esteem

answer

promote feelings of acceptance/worthiness- est. a trusting relationship with them; allow them to freely express themselves without you making judgement about their feelings or behaviors; promote a sense of competence/mastery- learn how to draw or do something to gain confidence to approach others, learn how to perform self-care skills; promote a sense of power/control- reminiscing of life experiences is a form of therapy in older adults and may contribute to a sense of power and control; promote a sense of moral worth/virtue- value clarification is a useful tool in gaining a sense of moral worth of virtue

question

evaluations of chronic low self-esteem

answer

identify negative self-talk or reduce the incidence of negative self-talk; name the feelings associated with negative self-talk and tell how it affects behavior; appraise the situation in a realistic manner without distortions; identify personal strengths and positive attributes; replace negative self-talk with positive self-talk; engage in positive behaviors; demonstrates healthy coping behaviors

question

disturbed body image

answer

the state in which one experiences confusion in the mental picture of one's physical self

question

related factors to disturbed body image

answer

irreversible changes in body image such as amputation, mastectomy, hysterectomy, colostomy, scars, burns, disfiguring skin disorder, effects of treatment (braces, casts); difficulty accepting development of secondary sx characteristics or delayed development of same; extreme thinness or obesity

question

disturbed body image assessments

answer

statements that indicate a changed view of body appearance, structure, or function; assess for statements that focus on past strength, function, or appearance

question

disturbed body image interventions

answer

Express interest in and acceptance of the patient through verbal and nonverbal expression; Explore with the patient his or her feelings about altered body image and his or her perceptions about the meaning and consequences of such alteration; Support the patient through the various stages of loss, grief, and mourning (shock, disbelief, denial, anger, guilt, acceptance), remembering that there is no one right way to proceed through these stages; Use play therapy with children so that they can describe their feelings and work through their grief using the non- threatening medium of dolls or animals.; Use self-reflection to gain awareness of your attitudes and feelings toward the patient. Be careful that facial expressions, words, or body positioning do not communicate to the patient disgust, fear, or rejection.; While communicating support to the patient who is slow to develop and use appropriate self-care behaviors, firmly insist that the patient participate in his or her care to the extent that the patient is able; Reinforce the patient's personal strengths and help the patient and family to identify all possible resources; Assess the response of the patient's significant others and intervene if they negatively influence the patient

question

disturbed body image evaluations

answer

o Verbalize and demonstrate acceptance of the pt. appearance (grooming, dressing, posture, eating patterns, presentation of self) o Demonstrate an interest in, and willingness to resume, self-care or responsibilities o Discuss the impact or meaning of the change o Initiate new or re-establish existing support

question

role ambiguity

answer

does not clearly understand the expected role behaviors.

question

role conflict

answer

incompatible expectations for a role or 2 roles that conflict or a role that is incongruent with the person's beliefs or values o Have to be in two places at once—class and pick up kid

question

role strain

answer

feels unable or inadequate to accomplish the tasks required in a role o May express frustration or tension (be a housekeeper and a student)

question

role mastery

answer

full understanding and competence in role performance

question

role failure

answer

Inability to fulfill conflicting role expectations; Failure to accept role responsibility o Parenting responsibilities

question

acquired role

answer

a one-step event whereby individuals assume new social positions & conform immediately to the expectations consequently directed at them o Wife becomes bread-winner or oldest son becomes man of the house when dad gets sick

question

Coopersmith Four components of self-esteem

answer

significance, competence, virtue, power

question

significance

answer

The way a person feels he or she is loved and approved of by the people important to that person.

question

competence

answer

the way tasks that are considered important are performed

question

virtue

answer

attainment of moral-ethical standards

question

power

answer

extent to which a person influences his or her own and others' lives

question

coping mechanism

answer

patterns of behavior used to neutralize, deny, or counteract anxiety

question

adaptive coping

answer

process that fosters problem solving, growth and development, and the ability to perceive reality and respond in a way that supports emotional and physical well-being. o Listening to music o Talking with a supportive person o Praying or meditating o Playing with pets o Creative activities, such as drawing

question

maladaptive coping

answer

the use of methods or efforts directed toward management of dangerous, threatening, or challenging situations and producing feelings and behaviors that decrease the quality of life and lead to unhealthy outcomes. o Use of drugs and alcohol o Violence directed at self, others, animals, or property o Withdrawal from family and friends o Excessive risk taking o Increased compulsive behavior (overeating, gambling, promiscuity)

question

defense mechanisms

answer

methods used to protect oneself from stress and maintain psychological homeostasis. Lessen uncomfortable feelings of anxiety, prevent pain, and protect individuals by allowing them to deny, distort, or restrict full awareness of unpleasant thoughts, feelings, and feared impulses

question

types of stressors

answer

physiologic (chemical agents, physical agents, infectious agents, nutritional imbalances, hypoxia, genetic or immune disorders) and psychosocial (includes real and perceived threats)

question

ways to deal with stress

answer

Exercise, rest and sleep, nutrition, use of support systems, use of stress management techniques (relaxation, meditation, anticipatory guidance, guided imagery, biofeedback).

question

relaxation

answer

Most involve rhythmic breathing, reduced muscle tension, and an altered state of consciousness

question

meditation

answer

Four components: quiet surroundings, a passive attitude, a comfortable position, and a word or mental image on which to focus. A person practicing meditation sits comfortably with closed eyes, relaxes the major muscle groups, and repeats the selected word silently with each exhalation -This exercise should be performed for 20 to 30 minutes twice a day.

question

anticipatory guidance

answer

Focuses on psychologically preparing a person for an unfamiliar or painful event.; Nurses use this technique to teach patients about procedures and the surgical experience. When patients know what to expect, their anxiety is reduced and their coping mechanisms are more effective

question

guided imagery

answer

A person creates a mental image, concentrates on the image, and becomes less responsive to stimuli (including pain).

question

biofeedback

answer

A method of gaining mental control of the autonomic nervous system and thus regulating body responses, such as blood pressure, heart rate, and headaches; A measurement device (e.g., skin temperature sensors) is used, and the patient tries to control the readings through relaxation and conscious thought.

question

crisis intervention

answer

Five-step problem-solving technique designed to promote a more adaptive outcome, including improved abilities to cope with future crises. -Identify the problem -List alternatives -Choose from alternatives -Implement the plan -Evaluate the outcome

question

adaptation

answer

adjustment of living with other living things and environmental conditions; change that occurs as result of accommodation aka coping -Going out & getting drunk b/c upset - maladaptive -Going shopping - adaptive -Cleaning when stressed -adaptive

question

local adaptation syndrome (LAS)

answer

localized response of the body to stress, precipitated by trauma or pathology; reflex pain response and inflammatory response

question

local adaptation syndrome (LAS) reflex pain response

answer

Response of the central nervous system to pain. It is rapid and automatic, serving as a protective mechanism to prevent injury.; Example: Putting your foot/leg into a hot bath and then automatically pulling it out b/c it's too hot.

question

local adaptation syndrome (LAS) inflammatory response

answer

A local response to injury or infection. It serves to localize and prevent the spread of infection and promote wound healing.; Example: When you cut your finger you often develop symptoms such as - pain, swelling, heat, redness, and changes in function

question

General Adaptation Syndrome (GAS)

answer

biochemical model of stress (Hans Selye); alarm reaction, stage of resistance, stage of exhaustion

question

General Adaptation Syndrome (GAS) alarm reaction

answer

- Initiated when a person perceives a specific stressor and various defense mechanisms are activated. - Conscious or unconscious reaction - The autonomic nervous system initiates the fight-or-flight response, preparing the body to either fight off the stressor or to run away from it. - Increase hormone levels, increase in energy, oxygen, cardiac output, blood pressure, and mental alertness. - Shock and counter-shock phases

question

General Adaptation Syndrome (GAS) stage of resistance

answer

- Adaptation to the stressor - Vitals, hormone levels and energy production levels return to normal - If the stress can be managed or confined to a small area (LAS), the body regains homeostasis. If the damage to the body is too great (e.g., with severe injury and bleeding or a major illness such as cancer or a heart attack), the adaptive mechanisms fail. • Body regains homeostasis or adaptive mechanisms fail

question

General Adaptation Syndrome (GAS) stage of exhaustion

answer

- Results when the adaptive mechanisms are exhausted - Without defense against the stressor, the body may either rest and mobilize its defenses to return to normal, or reach total exhaustion and die.

question

anxiety

answer

vague sense of impending doom or apprehension precipitated by new and UNKNOWN experiences

question

fear

answer

a feeling of dread, a cognitive response to a KNOWN threat

question

Anxiety characteristics

answer

o Behavioral characteristics such as diminished productivity, poor eye contact, insomnia, and fidgeting o Affective characteristics such as being distressed, anxious, worried, overexcited, and scared o Physiological characteristics such as sleep disturbance, abdominal pain, increased pulse, reflexes, and respirations o Cognitive characteristics such as blocking of thought, impaired attention, decreased perceptual field, and confusion.

question

related factors of anxiety

answer

Situational or maturational crises, substance abuse, threat of death, and threat to or change in health status, self-concept, environment, economic status, or stress.

question

characteristics of fear

answer

o The client's ability to identify the specific source of the fear. o Separation from sources of support in a potentially threatening situation (hospitalization), surgery, and treatments or procedures can evoke fear. o Refusal to leave home, refusal to risk coming into contact with the feared object or situation, symptoms of apprehension or even panic or a tendency for fight-or-flight when exposed to the feared object or situation.

question

related factors of fear

answer

Specific phobias or other mental illnesses, learned responses, sensory or cognitive impairment, threat to self-esteem or ego integrity, loss of a body part or function, and threat of death (actual or perceived)

question

Nursing interventions of fear and anxiety

answer

Use a calm, reassuring approach; Explain all procedures, including sensations likely to be experienced during the procedure; Stay with the patient to promote safety and reduce fear; Listen attentively; Encourage verbalization of feelings, perceptions, and fears; Instruct patient on the use of relaxation techniques; Assess for verbal and nonverbal signs of anxiety

question

4 levels of anxiety

answer

mild, moderate anxiety, severe anxiety, panic

question

mild anxiety

answer

- Present day-to-day living - It increases alertness and perceptual fields (e.g., vision and hearing) and motivates learning and growth. Although mild anxiety may interfere with sleep, it also facilitates problem solving. Mild anxiety is often manifested by restlessness and increased questioning.

question

moderate anxiety

answer

Moderate anxiety narrows a person's perceptual fields so that the focus is on immediate concerns, with inattention to other communications and details. Moderate anxiety is manifested by a quavering voice, tremors, increased muscle tension, a complaint of "butterflies in the stomach," and slight increases in respirations and pulse.

question

severe anxiety

answer

- Very narrow focus on specific details, with all behavior geared towards getting relief. - Impaired learning ability and is easily distracted - Characterized by extreme fear of a danger that is not real, by emotional distress that interferes with everyday life, and by avoiding situations that cause anxiety - Manifested by difficulty verbally communicating, increased motor activity, a fearful facial expression, headache, nausea, dizziness, tachycardia, and hyperventilation

question

panic

answer

- Loss of control and experience dread and terror - Disorganized state is characterized by increased physical activity, distorted perception of events, and loss of rational thought - Manifested by difficulty communicating verbally, agitation, trembling, poor motor control, sensory changes, sweating, tachycardia, hyper- ventilation, dyspnea, palpitations, a choking sensation, and sensations of chest pain or pressure. - Unable to learn, concentrates only on the present situation, and often experiences feelings of impending doom. - Can lead to exhaustion and death

question

eustress

answer

a positive form of stress. A balance between selfishness and altruism through which an individual develops the drive and energy to care for others; Will improve and could shorten course of illness, Is an adaptive response to illness, Positive outlook can provide hope even in life's bleakest moments

question

ineffective coping

answer

pt. experience anxiety when they are unable to meet basic needs, the demands of life, or role expectations.; Characteristics: Pt. response to stress and anxiety with maladaptive or regressive behaviors such as manipulation or inappropriate anger

question

assessments of ineffective coping

answer

inability to form valid appraisal of stressors, make adequate choices, use available resources

question

interventions of ineffective coping

answer

therapeutic relationship, enhancing social support, protecting a vulnerable self, practicing adaptive thinking, gaining control through knowledge.

question

evaluations of ineffective coping

answer

ability to perceive reality and respond in a way that supports emotional and physical well-being.

question

regression

answer

A person returns to an earlier method of behaving; Children soiling diapers or demanding a bottle when they are ill; 2-3 year old starts peeing pants again

question

projection

answer

A person's thoughts or impulses are attributed to someone else/attributing unacceptable thoughts & feelings to others; Person who denies any sexual feelings for a coworker accuses him of sexual harassment; A guy proposes and gets rejected, then he says "I'm sorry you are feeling so angry" but really he is the angry one

question

denial

answer

A person refuses to acknowledge the presence of a condition that is disturbing/person really isn't in control, simply don't admit it exists; Despite finding a lump in her breast a woman does not seek medical treatment; I'm not an alcoholic - but drinks 3 bottles of wine every night; I swear I didn't know I was pregnant until I had the baby

question

repression

answer

A person voluntarily excludes an anxiety-producing event from conscious awareness/placing a traumatic situations out of awareness so they cannot be consciously remembered; Different than suppression = deciding consciously to exclude unacceptable thoughts & feelings; Father may not remember shaking his crying baby

question

attributes of culturally competent practitioners

answer

• Awareness of values and beliefs • Sensitivity to different meanings of behavior • Recognition of customs and behaviors • Respect worth, uniqueness, rights, privileges • Compromise

question

culturally competent care

answer

• The use of culturally based knowledge in creative, congruent, and meaningful ways to provide beneficial and satisfying health care to diverse cultures • The nursing interventions must fit cultural values, beliefs and practices to be effective and acceptable to the client/family/community • Use teaching material consistent with the client's vocabulary. (Use interpreter when needed - do not use family members as interpreters this breaks confidentiality). • Attend to dietary and spiritual needs • Focus on the capabilities, rather than the losses, w/in the client's sociocultural environment • Know about the interrelationships of all clients' personal dimensions when making health care decisions.

question

female Islamic preference for female healthcare provider

answer

o Male doctors may be able to relay information through a female nurse or physician's assistant o Male nurses should try to allow nursing duties that can be appropriately handed off to a female nurse technician to be handled by the tech o In extremely strict Islamic families males should never speak directly to a female, but instead to a male relative. If this is the case respect that wish. o Even in extremely strict Islamic families Healthcare can be provided by a male if it absolutely necessary. If this is the case explain the necessity and expect that a male from the patient's family will want to be present during all of your interactions with her.

question

5 pillars of Islam

answer

• Recite the creed, "there is not God but Allah, and Muhammad is the messenger of Allah" • Observe the 5 prayer times each day (sunrise, noon, midafternoon, sunset, and bedtime) • Give at least 2.5% of one's income to help the poor • Fast during the day in the month of Ramadan • Go once during one's lifetime on a pilgrimage to Mecca

question

Jewish beliefs about seeking health care

answer

May resist surgical procedures during Sabbath: begins sundown Friday, ends sundown Saturday; Illness is grounds for violating dietary laws.; Spiritual items while praying: Men may wear prayer shawl, yarmulka (cap) while; Family, friends, and rabbi are supportive visitors.

question

Christian Scientist beliefs about seeking health care

answer

Oppose human intervention with drugs or other therapies, however, accept legally required immunizations; Accept physical and moral healing; Family, friends, and members of spiritual community may visit

question

Hindu beliefs about seeking health care

answer

With an amputation, loss of a limb is believed to represent sins committed in previous life.; Accept most modern medical practices, some belief in faith healing.; Spiritual item: Person may wear a thread around wrist or body, do not remove it; Family, community members, and priest are supportive visitors.

question

Buddhist beliefs about seeking health care

answer

Illness is believed to be a trial to aid development of soul, illness results from Karmic causes; Surgery is permitted, but extremes must be avoided; Cleanliness is of great importance; Family, community, and Buddhist priest are supportive visitors

question

Assimilation

answer

process by which a person interprets information to fit the current level of cognition

question

Cultural assimilation

answer

process that occurs when a minority group, living as part of a dominant group within a culture, loses the cultural characteristics that made it different

question

acculturation

answer

the process of adopting the cultural traits of social patterns of a different population group; Russian immigrants celebrating Thanksgiving, for example

question

ethnocentrism

answer

one's own culture is correct or superior; Feeling as though immigrants to this country should only speak English in public

question

cultural sensitivity

answer

the quality of being aware and accepting of other cultures; An American company that manufactures golf balls in packs of four. They were successful and began selling internationally. However they were not so successful in Japan, where the number four holds the meaning of death.

question

Hindu burial rituals

answer

• Priest may tie thread around neck or wrist to signify blessing • Family will wash the body • Particular about who touches their dead • Bodies are to be cremated

question

Muslim burial rituals

answer

• Specific rituals (e.g., bathing, wrapping the body in cloth) • Must be done by same-sex Muslim.; Before moving and handling the body contact someone to perform these rituals: Someone from the person's mosque or Local Islamic Society; Must be buried within 24 hours

question

Mormons burial rituals

answer

• Believe that it is proper to bury the dead in the ground • Cremation is discouraged

question

Native American

answer

• Each tribe will have its own rituals • Rites among Native Americans tend to focus on aiding the deceased in their afterlife: Some tribes bring food and/or personal possessions to the deceased; Among many tribes, mourners, especially widows, cut their hair; Some Native Americans discard personal ornaments (jewelry) or black their faces to honor the dead; Some tribes gash their arms and legs to express their grief; California tribes: Engage in wailing, Stage long funeral ceremonies, hold an anniversary mourning rituals after one or two years

question

Jewish faith rituals surrounding circumcision

answer

• Occurs on 8th day of child's life • Performed by Mohel (ritual circumciser familiar w/ Jewish Law and aseptic technique)

question

awareness

answer

recognizing the values and beliefs of both the pt. and yourself

question

sensitivity

answer

recognizing the possibility of different meanings of behavior and looking objectively for cues that suggest the meaning. It requires validating your interpretation with the pt.

question

recognition

answer

have desire to explore why they are seeing, hearing, and experiencing the behaviors

question

respect

answer

dictates that the nurse refrain from interfering with the beliefs and values of another. Must believe that there is value in diversity and then actively look for the value in life-ways that are different from your own.

question

compromise

answer

you may need to compromise when a pt.'s values and beliefs about health care, life, family, and responsibility differ from yours

question

universality

answer

common mode or value of caring or a prevailing pattern of care across cultures

question

diversity

answer

the differences in modes or patterns of care between cultures and includes specific patterns of care between cultures and includes specific patterns of care within cultural groups.

question

3 Major Modalities

answer

Cultural care preservation/maintenance; cultural care accommodation/negotiation; cultural care repatterning/ restructuring

question

cultural care preservation/maintenance

answer

helping the pt. to continue cultural practices that have importance to them. This may include using folk medicine, practicing religious rites, eating traditional cultural foods, or providing interpreters when the client's primary language is not the dominant language.

question

cultural care accommodation/ negotiation

answer

changing your behaviors or actions to be more fully understood and accepted by the pt. (examples: modifying your manner of addressing the pt., extending visiting hours, or ensuring that the pt. is not interrupted during prayers or meditation

question

cultural care repatterning/ restructuring

answer

helping the pt. change patterns of living that are not beneficial to healthy life patterns. (Teaching the pt. different methods of food preparation—steaming or baking instead of frying)

question

culture

answer

sum total of human behavior or social characteristics peculiar to a specific group and passed from generation to generation or from one to another within the group

question

Hindu dietary restrictions

answer

vegetarianism is commonly associated with Hindu diet; majority of Hindus consume animal products such as dairy, fish and shellfish, poultry (even consumed in regions where wild boar has historically provided ready food source in lean times), NO BEEF b/c cows are seen as the "Mother", beef is consumed in small pockets of Hindu populations

question

Sattyic foods- hindu diet

answer

considered ideal, and are the only foods eaten in certain customs; Fruits, vegetables, whole grains and nuts are considered Sattvic; Thought to cleanse the mind and body, increasing inner tranquility

question

Rajasic foods- hindu diet

answer

thought to heighten intense emotion and promote restlessness; Animal products and pungent or spicy foods like chili peppers

question

Tamasic foods

answer

thought to promote negative emotions; foods that are stale, spoiled, overripe or otherwise inedible

question

The hindu diet is the same

answer

false, it varies by region: some are strict vegetarians, others eat meat hunted locally

question

spiritual well-being

answer

most simply, spiritual health or well being is the condition that exists when the universal spiritual needs for meaning and purpose, love and belonging, and forgiveness are met

question

O'Brien's conceptual model of spiritual well being

answer

personal faith, spiritual contentment, religiosu practice

question

spiritual healing

answer

mvt toward integration from brokenness to wholeness

question

spiritual distress

answer

Spiritual distress may be further specified as spiritual pain, alienation, anxiety, guilt, anger, loss, or despair

question

HOPE

answer

H- source of hope, meaning, comfort, strength, peace, love, and connection; O- Organized religion; P- personal spirituality and practice; E- Effects of medical care and end-of-life issues

question

Readiness for Enhanced Religiosity defining characteristics:

answer

• Acknowledges need for participation in religious ceremonies, rituals, or services • Asks for clergy, rabbi, or religious leader • Expresses need for forgiveness or reconciliation with others

question

Christian Scientist Beliefs associated with health care

answer

• Oppose human intervention with drugs or other therapies; however, accept legally required immunizations • Accept physical and moral healing • Family, friends, and members of spiritual community may visit

question

Ways to meet a hospitalized client's spiritual needs

answer

• Identifying the patient's spiritual beliefs aids in meeting the patient's spiritual needs • These needs can be met through: Acceptance, Participation in prayer or other rituals, Referral to a spiritual leader

question

Birth rate has at least doubled by month ___

answer

5

question

average weight at 6 months is ___

answer

16 lbs

question

infants increase in weight by ___ lbs per month until age 5 months

answer

1.5

question

weight gain ___ during second 6 months of infants life

answer

slows down by half

question

by ___ weight has tripled from birth rate to average of ___ lbs

answer

tripled; 21.5

question

during initial 6 months, growth is about ___ inch/month

answer

1

question

during months 6-12, growth is about ___ inch/month

answer

half

question

growth in height for infants occur in sudden spurts or slow and steady?

answer

sudden spurts

question

average height at 6 months is ___

answer

25.5"

question

average height at 12 months is

answer

29", almost 50% from birth length

question

growth occurs main in trunk or legs during the first 12 months?

answer

trunk

question

head growth for an infant is rapid and important in determining brain growth, true or false?

answer

true

question

from birth to 3 months, head growth is approximately ___ inch/month

answer

0.75

question

from 4-6 months, head growth is approximately ___ inch/month

answer

0.4

question

during last 6 months of infancy, head growth is approximately ___ inch/month

answer

0.2

question

average head size at 6 months is ___

answer

17"

question

average head size at 12 months is ___, a growth of ___% since birth

answer

18", 33%

question

posterior fontanel fuses by ___

answer

6-8 weeks

question

anterior fontanel fuses by ___

answer

12-18 months, 14 months average

question

crawling (propelling forward with belly on floor) progresses to creeping on hands and knees with belly off the floor by ___

answer

9 months

question

by 36 months, preschoolers can walk, run, climb, and jump well?

answer

yes

question

by 36 months, preschoolers can draw a perfect square

answer

false, they can draw a circle and imitate a cross and vertical and horizontal lines

question

can a 3 year old complete a stick figure?

answer

no

question

3 year olds have refinement in eye-hand and mm coordination in several area, rides tricycle, walks on tiptoe, balances on one foot for a few seconds, place small pellets in narrow-necked bottle

answer

true

question

3 year olds hold writing instrument in fist

answer

no in fingers

question

by 4 years, preschooler can walk downstairs using alternate footing

answer

true

question

by 3 years, preschooler can walk downstairs using alternate footing

answer

no, need both feet on step coming down, but going up they can use alt. footing

question

by 4 years, preschooler can use scissors to cut out picture following outline

answer

true

question

can a 4 year old lace their own shoes? can they tie a bow

answer

yes; no

question

at what age can a preschooler copy a square?

answer

between 4-5 years

question

By 5 years, preschooler can throw and catch a ball well?

answer

yes

question

what can a 4 year old do in terms of locomotion?

answer

skip and hop on one foot, catch a ball reliably, and throw a ball overhead

question

what can a 5 year old do in terms of locomotion?

answer

skip on alternate feet, jump rope, and begin to skate and swim

question

how high can a 5 year old jump and land on toes?

answer

12 inches

question

at what age can a preschooler tie shoe laces?

answer

5

question

can a 4 year old balance on alternate feet with eyes closed and draw several body parts (head, arms, legs, body, and facial features)?

answer

no but a 5 year old can

question

when can a preschooler draw a triangle and diamond?

answer

between 5 and 6 years old

question

do preschoolers (age 2-5) view death as a permanent state?

answer

no, they think death is transient

question

what comes first: bowel training or bladder training?

answer

bowel training

question

by ___ to ___ month, child is able to retain urine for up to 2 hours or longer

answer

14;18

question

what age should toddler be able to control bowel movements?

answer

2 years

question

What are some ways to prevent otitis media in infants?

answer

immunizations w/pneumococcal conjugate vaccine PCV 7 (Prevnar) has reduced incidence of AOM in some infants and children; breast feeding during first 6 months; not propping the bottle; decreasing or discontinuing use of pacifier after 6 months; prevent exposure to tobacco

question

how long can you return to school or daycare after antibiotics are prescribed?

answer

24 hours after the first dose of the antibiotic

question

is grief greatly influence by culture?

answer

yes

question

what are ways to support family of a dying client?

answer

have grieving person identify and express feelings; pay attention to disfranchised grief; provide a presence whether silent or active listening; identify support system and have grieving person think and talk about support systems; normalize the grief process: remind the grieving that this is normal, the anger, sadness, is normal; actualize the loss: finding meaning in loss, allow the grieving to balance the loss with positive memories of the deceased

question

Kubler-Ross 5 stages of grief

answer

Denial and isolation; anger; bargaining; depression; acceptance

question

disenfranchised grief

answer

The grief encountered when a loss is experienced and cannot be openly acknowledged, socially sanctioned or publicly shared: a woman grieving over a miscarriage or stillborn baby or a man not being allowed to attend the funeral by his gay partner's family

question

what are 3 different kinds of complicated grief? what are examples of them?

answer

chronic grief, delayed grief, exaggerated grief; sudden death of a family member in an auto accident, suicide, homicide

question

chronic grief

answer

Normal grief reactions that do not subside and continue over very long periods of time.

question

delayed grief

answer

Normal grief reactions that are suppressed or postponed. The survivor consciously or unconsciously avoids the pain of the loss.

question

exaggerated grief

answer

Survivor resorts to self-destructive behaviors such as suicide.

question

anticipatory grief

answer

Provide time for preparation of loss, real losses associated with diagnosis, acute and chronic illnesses and terminal illness: pt diagnosis with terminal cancer, a woman grieving r/t loss of body image after a mastectomy

question

uncomplicated (normal) grief

answer

Normal feelings, reactions and behaviors to a loss; grief reactions can be physical, psychological, cognitive, behavioral: A family mourning the death of an older family member

question

What is the difference b/t hospice and palliative care

answer

hospice is near end of life, pt typically has 6 months to live; palliative care is not specific to death

question

what kind of vision changes occur with aging?

answer

impaired night vision, reduced accommodation, reduced color discrimination, reduced visual fields

question

presbyopia

answer

impairs close vision, caused by the lens losing elasticity and muscles that focus the lens weaken, ex: reading glasses

question

what hearing changes that occur with aging?

answer

discriminating consonants, speech sounds gurgled, low pitch sounds heard best, trouble hearing conversations over background noise

question

what are early signs in adult of loss of hearing?

answer

decreased social interactions, embarrassed, withdraw from those that they can't hear

question

presbycusis

answer

reduction in hearing, reduction in clarity of speech

question

symptoms of hearing loss

answer

certain sounds seem overly loud; difficulty hearing things in noisy areas; high-itched sounds such as "s" or "th" are hard to distinguish from one another; men's voices are easier to hear than women's; other people's voices sound mumbled or slurred; ringing in the ears

question

ototoxic drugs include:

answer

ASA, alkaloids, quidine, loop diuretics, aminoglycosides (gentamycin, strptomycin, neomycin)

question

shat does disruptive behavior, decreased in school performance, or loss of interest in school indicate for a school age child?

answer

could be visual problems: child can't see board and/or hearing problems: trouble hearing teacher and classmates, both can lead to embarrassment or loss of self-esteem

question

when do you refer a child for hearing tests?

answer

indifferent to loud noises, speech, or sounds; absence of babble by 7 months; use gestures rather than verbalization; lack of intelligible speech by 2 years

question

what are special considerations for adolescents with sensory deficits?

answer

refuses to admit can't hear; irritable; lack of understanding; withdraws from communication with hearing adults; suspicion, insecurity, loss of self esteem

question

Interventions for a hospitalized client with visual impairments:

answer

Make eye contact with partially sighted; Explain activities or unusual sounds; Orient to the area with one object as focal point (ex. bed); Take person for tour around room to orient; Do not move objects in room without telling person or asking; Describe items on food tray using clock face; Ask if help is needed and talk before touching them to prevent startling them

question

Interventions for a hospitalized client with hearing impairments:

answer

use visual aids- written information when possible; face the pt directly and speak distinctly and slowly- stand still; face and talk to pt even when using an interpreter; stand closer to the good ear if one ear is better; don't shout- use simple direct sentences

question

what are some hearing diagnoses?

answer

risk for injury r/t decreased hearing and dizziness; impaired verbal communication r/t hearing loss; social isolation r/t inability to make meaningful contact with others

question

Healthy People 2010 objective r/t vision:

answer

Improve visual and hearing health through prevention, early detection, treatment and rehabilitation: Exams, screening, correcting refractive errors, treatment of blindness, reduction of occupational eye injuries, use of protective eye wear.

question

Healthy People 2010 objective r/t hearing:

answer

Improve visual and hearing health through prevention, early detection, treatment and rehabilitation: Screen newborns for hearing loss by 1 month, hearing exams every 10 years, protective devices used, specific disorders such as infections treated

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