Chamberlain College of Nursing - NURSING NR 222H+W exam 2 Study Guide

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Chamberlain College of Nursing - NURSING NR 222H+W exam 2 Study Guide Make sure we’re not unconsciously biased  Evaluate our own values Therapeutic communication  Purposeful use of comm... unication  Build+ maintain helping relationships with patients, families, significant others  Purpose to our conversation  Patient-centered/ planned/ goal directed  Factors o Rapport  Harmony + affinity between people in relationships o Empathy  Understand another’s feeling without losing personal identity + perspective o Trust o Reliance on pt to carry out responsibilities + prmises o Proxemics  Personal space  Intimate: 0-1.5 ft  Personal: 1.5-4 ft  Social: 4-12 ft  Public: 12 – 25< ft  techniques o active listening o sharing o touch o silence o clarifying o reflecting o focus o paraphrase o summarize o humorhealth promotion/ sensitivity to each pt. goals + values  goals to have pt adopt health promoting behaviors o info not enough therapeutic effectiveness  self-awareness + self-reflection  openness  self-confidence + strength  genuineness  concern for individual  respect for individual  knowledge  ability to empathize  sensitivity  acceptance  creativity  ability to focus + confront Emotional/ spiritual/ physical care  Listening o Shows pt you care o Get info  Silence o Nonverbal response  Open ended questions  Listen/ silence/ touch/ convey acceptance Health people 2020  Improve health literacy o Health promotion requires effective communication o Read, comprehend, + follow through on health info.Values clarification  Method discovering 1’s values + importance of these values  Own values + biases  Helps people recognize what values they hold + evaluate how those values influence their actions  Pt values lead to behaviors that conflict with RN value of promoting health o Ethical dilemmas o RN examine conflicting values o Possible outcomes to promote health interventions Steps in self-awareness  Listening to oneself o Self-concept  Mental picture of self o Self-esteem  How people feel about way they see themself o Judgement + attitudes about self  Listening to + learning from others o feedback  Self-disclosure o Share aspects of self o Disclosure in 1 triggers disclosure in another  Practical reflection o Understand 1’s own thoughts + actions to take action in future  Need self awareness + clarifications of values o Therapeutic use of self impaired Relationship stages  Orientation/ introductory phase/ RN + pt meet o RN structure interaction o Establishing a connection  Consistency  Sensitive pacing of communication  Active listening  Conveying concern + warmth Pay attention to comfort + control  Working phase o RN + pt work together to promote pt’s health  Termination phase o Ending relationship  For therapeutic relationships Ethical communication  How receiver getting message  Treat people with respect  Barriers o Sender o Message o Receiver o Anxiety/ attitudes/ noise/ activity/ distance/ language/ beliefs/ touch/ eye contact/ appearance/ emotion/ body language/ gestures/ interruptions/ distractions/ illness/ medications o 90% communication nonverbal o Did they just receive news  Effective communication o Listening  Reciprocity  RN matches nuances of pt style + behavior, pt interpret RN as active listening increase, misinterpretations decrease o Flexibility o Silence o Humor o Touch o space Forms of communication  Verbal o Using words/ spoken, written o Vocabulary o Word meaning o Pacingo Intonation o Clarity+brevity o Timing+relevance  Non-verbal o Messages not spoken, written o Transmit info about another’s thought + feeling o silence o Posture+gait o Facial expressions o Eye contact o Gestures o Sounds o Territoriality + personal space o Personal appearance Non-therapeutic communication  T o Is it true  H o Is it helpful  I o Is it inspiring  N o Is it necessary  K o Is it kind Communication techniques  Open-ended ? o Describe the problem o Tell me how I can help you o When did the pain start o How have you been feeling since your last appointment o You mentioned abdominal pain. Tell me more about that  Closed-ended ? o Do you eat healthy food o Do you exerciseo Do you follow a particular diet o When do you shop for food o Do you sleep well o Very specific  Special needs o Can’t speak clearly o Are cognitively impaired o Hearing +/or visually impaired o Unresponsive o Don’t speak English  C o Connect with pt  A o Appreciate pt situation  R o Respond to pt  E o Empower pt Holistic health: taking care of whole person Complementary  Using healing practices  Products that work in conjunction with traditional western medicine Alternative  No western medicine  Healing practices only Chiropractor/ primary health provider American holistic rn association  Support pt natural healing  Consider whole person  Consider environment Connect pt spirit/ thoughts/ body Rn healer  Rn presence can contribute to healing  Pt-centered  Facilitative decision-making  Being with instead of being there Holistic principles for rn  Examine own thoughts about healing + rn  Be aware of effect of thoughts, voice, words  Incorporate holistic healing in own life Holistic health  Acupuncture  Cupping  Whole medical systems o Traditional Chinese medicine o Naturopathy  Healing power of nature o Homeopathy  Treats whole person  Symptoms body’s effect to rid itself of disease o Ayruvedic/ india  Biological based o Herbal  Treat of enhance body systems o Probiotics  Live microorganisms in gut o Hydrotherapy  H2O, ice, steam, hot + cold, maintain + restore health o Aromatherapy  Oils, smells  Movemento Qi gong  Relaxed movements  With meditative aspect + controlled breathing  Move qi energy through energy channels + increase vital energy o Tai chi  Physical movement, breath control, meditation/ slow o Yoga  Postures, controlled breathing, medication  Meditation o Transcendental o Mindfulness o Walking o Breathing  Prayer + distance healing  Mind-body o Guided imagery  Access inner pharmacy  Body responses to sensory images o Music therapy  Impact limbic system/ emotions o Hypnosis  Energy-based o Acupuncture/ stimulate mapped points on skin  Manipulates life energy o Acupressure o Reflexology o Therapeutic touch o Healing touch  Touch o Therapeutic touch o Healing touch o Reiki/ japanese Health promotion/ holistic technique  Manipulative/ body based o Chiropractic medicine  Spine + joints  Spinal alignment for optimal nervous system function o Spinal/ bone manipulationo Massage o Cranio-sacral therapy/ originally osteopathy/ skull o Physical therapy  Massage, manipulation, hot+cold, movement, electrical impulses Nurturing self  Environment  Sleep  Exercise  Communication  Nutrition  Herbs  Aromatherapy  Love + healing Accessible therapies  Relaxation  Meditation+breathing  Guided imagery Specific  Need training for  Biofeedback  Massage  Therapeutic touch+touch therapies  Chiropractic therapy  Traditional Chinese medicine  Herbal  Movement Nutrition  Previously on disease of deficiency + inadequate intake  Now with food excess + food intake imbalancesHealth people 2020  Reduce chronic disease + premature death by eating healthy diet  Achieve + maintain healthy body weight/ adults + kids o Obese kids often remain obese into adults  Food safety  Increase access to healthier food o Food security  Increase BMI screening by providers + at work sites o Not only way to tell if pt healthy  Reduce obesity  Increase fruits, vegetables, whole grain  Eliminate food insecurity  Increase overall heart health, reduce CHD, strokes  Reduce # affected by food-borne illness  Increase # of consumers following key food safety practices  Reduce iron deficiency Stats  2/3 adults overweight/ obese  1 in 5 kids overweight/ obese by 6 y  Adults 2x daily Na  15% adults, 10% kids eat recommended fruits, veggies per day BMI  < 18.5 underweight  18.5 – 24.9 normal  25 – 29.9 overweight  30-39.9 obese  >40 extreme, morbid obese Unhealthy diet/ health risks  Coronary heart disease o Hypertension o Blood lipid imbalances  Metabolic syndrome Obesity  Insulin resistance/ diabetes  Osteoporosis/ osteoarthritis  Immune function  Mental health  Cancer risk Dietary reference intakes  Latest understanding about nutrient requirements based on optimizing health in individuals + groups  Replaces RDA ranges  Prevent nutrition deficiency + avoid nutrition access  Estimated average requirements o Estimate nutritional needs ½ of person in particular life stage, group  Recommended dietary allowances o Minimum amount to stay healthy o Average dietary intake level sufficient to meet nutrient requirements of nearly all healthy individuals  Adequate intake o Estimate on observed or experimental mean nutrient intake eaten by group  Tolerable upper intake levels o Highest average daily intake safely eaten Recommendations  Us dietary guidelines for americans  MyPlate o Planning + assessing diets o Establish guidelines for govern sponsored food assistance program  Supplemental nutrition assistance  National school lunch program  Women, infants, + kids/ WIC  Older adults  How many calories can be consumed Dietary guidelines/ recommendations for prevention Increase food variety from all food groups staying within energy intake needs  Control calorie intake to manage body weight  Increase whole foods, lean meats, whole grains  Decreased prepared processed foods  Decreased Na in food o <2300 mg per day all o <1500 mg for blacks, elderly, htn, kidney disease, diabetes o 5% or less low o 20% of more high Supplements  Billion $ us market  Not regulated by FDA o No approval by FDA  Vitamin toxicity o Fat-soluble A,D,E,K o Too much o Not through food  Pregnancy/ folic acid o Reduce neural tube defects/ spinal bifidia o Anemia, osteoporosis, bone health Safety  Food-borne illness/ 1 in 6 sick  Practices o Clean  Wash hands, utensils, cutting boards before + after contact with raw meat, poultry, seafood, eggs o Separate  Raw meat + poultry  Separate from foods that don’t need to be cooked o Cook  Use food thermometer o Chill  Refrigerate within 2 hrDisorders  Risks o Poverty o Knowledge deficit o Emotion/ stress-related o Eating disorders o Underlying medical conditions  Binge eating  Bulimia  Anorexia nervosa Diets  Ask if pt following specific diet for weight loss/ taking pills  Be aware of side effects of some diet pills  Low carb  Liquid  Grapefruit  Low fat  Detox  Juice  Cabbage soup  Macrobiotic ADPIE  Assessment/ screening o Identify risk factors associated with dietary/ nutrition problems o Older adults disproportionate risk  Involuntary decrease >10% weight in 6 months  Problems complying with special diet  Dependent for eating/ not able to feed self  Diagnosis o Identify nutrition-related RN diagnosis  Imbalances nutrition/ less than body requirements, more than body requirements  Self-care deficit/ eating  Knowledge deficit/ nutritionAssess impact of problems/ recognize risk from factors/ interventions D  disease E  eating poorly T  tooth loss/ mouth pain E  economic hardship R  reduced social contact M  multiple medications I  involuntary weight loss, gain N  needs assistance in self care E  elderly/ 80 fitness  physical activity  exercise  cardiorespiratory fitness  flexibility  muscular strength, endurancehealthy people 2020  increase in activity increase with education level  aerobic o use large muscle groups in repetitive rhythmic fashion over extended period to improve body  increase leisure time physical activity f  frequency/ 3-5x week i  intensity t  time/ 20 min t  type of training/ resistance NFL play 60 / Let’s Move Exercise impact  aging o keeps balance o keeps independent o prevent disability/ hospitalization  cardiovascular system o correlation between decrease in physical activity + coronary heart disease o decrease chd, increased activity  triglyceride levels o increase hdl, decrease chd  duration + frequency of exercise  hypertension o resistance training hyperinsulinemia/ glucose intolerance o exercise + diet 1st line of prevention + intervention of diabetes o increase glucose into cells  obesity o decrease fat mass  low back pain o increase muscular +aerobic fitness decrease risk  immune function o decrease probability of becoming ill  mental health o fell better/ increase self-esteem  osteoporosis o porous bone  low bone mass which leads to bone fragility + increased risk of fractures o weight-bearing activity increases bone density impact  arthritis o upsets balance of joint health o restore health to synovium + cartilage, improve strength + flexibility, decreased joint vulnerability, delay dysfunction o reduce pain + joint stiffness, reduce fatigue, improve function considerations  coronary heart disease o dr consult/ specific exercise needs  diabetes o dr consult/ special exercise needs  chronic conditions/ injury/ age o dr consult/ special exercise needs adpie  assessment  diagnosis o potential, actual activity intolerance related to o potential, actual impaired physical mobility related to o readiness for enhanced info  planningo smart goals o determine proposed course of action  implementation o implement interventions  evaluation o ongoing  focus on outcomes + goals stress management  intervention o health promotion o disease prevention o symptom management  increase quality of life  increase effectiveness coping  smart goals/ pt. monitor how they are doing  reduce unhealthy consequence of distress sources  stress o state of threatened homeostasis triggers adaptive responses  stressor o what triggers stress o requires change, adaption  stress o eustress  challenging + useful stress o distress  chronic, excessive stress  body unable to adapt + maintain homeostasis o post traumatic stress responses  physiological o increased mental activity o dilated pupilso bronchiolar dilation o increased respiratory rate o increased heart rate o increase glucose o increased cardiac output o increased arterial blood pressure o increased fatty acids o increased blood flow to skeletal muscles o sympathetic nervous system  triggers  fight, flight  psychological  behavioral  spiritual  chronic/ more risk + more frequent infections  revert to old behaviors assessing stress  primary o perceived actual, potential positive, negative outcome o how pt perceived it  secondary o pt identifies choices to cope with actual, potential harm, threat, challenge effects  depression  psychocutaneous disease o psoriasis o hives  increased risk for heart disease + other illness  effects on immune system management  what does it mean to ptcoping  take care of physical health + well-being  accept  use distraction  reduce emotional arousal  harmful effects of stress minimized o stress challenged instead of threat crisis intervention  specific to pt/ internal  sink or swim from it  safety 1st priority adpie  diagnosis o ineffective coping o anxiety o feat o insomnia o spiritual distress culture  language  beliefs  custom  music  food  traditions  values  ethnicity values  beliefs o worth something to someone  standards that influence behavior + thinkingmelting pot  voluntary migration o immigrants  going from 1 country to another  + o Refugee  Escaping  Treat of being hurts  -  Still choosing to leave o Sojourner  Temporary  Studying for school  Involuntary migration o Fleeing, being forced out of homeland o Natural disaster/ war Cultural competence  Disregard personal biases + treat every person with respect o Reduce disparities in healthcare o No judgement Health people 2020  Achieve health equality  Eliminate disparities  Improve health of all groups Race  Caucasian  Asian  American Indian  Physical/ biological characteristics Ethnicity  Individuals who identify with common traits Language  History  Religion  Customs Minority group  Group with disadvantages in relation to power/ control  Blacks  Women Ethnic group  Location  Religion Madeleine Leininger  Transcultural rn  Care/ helps with recovery, growth, development Cultural iceberg  See + hear  Going deeper to understand culture Asian americans/ pacific islanders  Issues o Heart disease o Cancer o Highest rate of tuberculosis  Family network/ rely on family to support sick member Blacks  Issues o Hypertension o High bp o Strokeo Inadequate/ unsafe envir o Poverty o No health insurance o Limited access to receive health care  Religion/ church  Screenings at church o More likely to go Latino/ Hispanic American  Issues o Cardiovascular disease o Diabetes o Stomach cancer/ may be due to diet o Family o Spiritual strength o Folk remedies to cure  Natural o Highest # of uninsured o Rely on natural/ folk remedies only Native americans  issues o Alcoholism o Cirrhosis/ liver disease o Smoking o Substance abuse  Sharing resources  Peace+harmony with nature/ health Arab americans  Issues o Diabetes o Smoking/ kids o Heart disease  Males dominate  Woman care from woman only  Woman coveredHomeless  Issues o Hygiene o Nutrition o Mental health o Drug/ alcohol abuse o Infectious diseases o Instability of living + connections o Access to healthcare  Place to stay  Food o Poverty HIV/AIDS  Black/ most affected  50+/ faster growing RN role  Showing pt we care o Actively listening o Speaking up for pt Rn cultural assessment  Systematic + comprehensive examination of cultural care values, beliefs, practices of individuals, families, communities  Strategy o Assess pt beliefs o Plan care around what was being communicated  Questions o General cultural patterns/ lifestyle o Values, norms, expressions o Taboos, myths o Worldviews  Ethnocentrism 1’s own cultural belief + way of life are better than another’s  Medio centrism  Professional health care methods are better than popular, folk methods Acculturation  Process of adapting to + adopting parts of a new culture Assimilation  Process of acquiring social, psychological characteristics of dominant culture Life points  Rites of passage  Pregnancy  Childbirth  Newborn  Postpartum period  Grief, loss Adpie  Diagnosis o Impaired communication result of cultural differences  Throughout hospitalization pt will communicate accurately with others  Throughout hospitalization pt will communicate needs to staff with minimal frustration  End of teaching session, pt will demonstrate effective communication as evidenced by acknowledgment of message received Interventions  Assess language needs  Assess ability to establish communication with staff + family  Demonstrate active listening  Use interpreter  Use assistive devices as neededMaslow’s Hierarchy  physiological needs basic needs  safety needs basic needs  belongingness and love needs psychological needs  esteem needs physiological needs  self-actualization self-fulfillment functional health pattern framework  health perception - health management  nutritional-metabolic  Elimination  activity-exercise  sleep-rest  cognitive-perceptual  self-perception/ self-concept  roles-relationship  sexuality-reproductive  coping-stress tolerance  values-belief [Show More]

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