N480 Exam Study Guide PDF

1 Study Guide for Exam 1 N480 Robinson Chapters: 1-5, 7-9 Denham Chapters: 1, 2, 5, 6, 7 There are twenty (30) questions and you will have 40 minutes to complete the exam. ​ Definitions of family, family focused care, family health ★​ Family: Family refers to two or more individuals w...

1 Study Guide for Exam 1 N480 Robinson Chapters: 1-5, 7-9 Denham Chapters: 1, 2, 5, 6, 7 There are twenty (30) questions and you will have 40 minutes to complete the exam. ​ Definitions of family, family focused care, family health ★​ Family: Family refers to two or more individuals who depend on one another for emotional, physical, and economic support. The members of the family are self-defined. ★​ Family Health: Family health is a dynamic, changing state of well-being which includes the biological, psychological, spiritual, sociological, and cultural factors of individual members and the whole family system. ⇒ Assessment of family health involves collecting data on the health and functional status of each individual as well as the whole family system. ★​ Family focused care: Families influence the process and outcome of health care. Knowledge of family structure, function, and process informs the nurse in how to: optimize nursing care, and provide individualized care in families. Therefore, this approach focuses on the assessment and care of the individual client in which the family is the context. ​ Influence of family on health/illness – consider education, resources, support a.​ ​ Traits of a healthy (well-functioning) family ★​ Communicates and listens ★​ Fosters table time ★​ Affirms and supports each other ★​ develops trust ★​ laughs and plays ★​ balance of interaction ★​ teaches right and wrong ★​ has rituals and traditions ★​ shares religious core ★​ Respects the privacy of each member ★​ Values service to others ★​ Admits to problems and seeks help ★​ Manages conflict and crisis when they occur ★​ Offers forgiveness, comfort and support ​ ​ Family functions, family processes, family dynamics a.​ ​ Definition/understanding of “theory” and “framework” - how/why do we use them? ​ ​ Theoretical foundations a.​ Family systems theory ⇒ is an approach that allows nurses to understand and assess families as an organized whole and / or as individuals within family units who form an interactive and interdependent system.  2 ⇒ this theory is constructed of concepts and propositions that provide a framework for thinking about the family as a system. (Family nursing looks at three-generational family systems). ⇒ family system features are designed to maintain stability weather they are adaptive or maladaptive. ⇒ family systems increase in complexity over time and increase their ability to adapt and to change. ⇒ Family systems theoretical perspective encourages nurses to see individual clients as participating members of a larger family system. ⇒ any change in one family member affects all members of the family. ⇒ the goal of nurses is to help maintain or restore the stability of the family in order to help family members achieve the highest level of functioning that they can. Emphasis is on the whole, rather than the individual. Concept 1: All Parts of the System are Interconnected → When one family member experiences a health event, it impacts the entire family system.For example, one parent takes on more parenting duties, while the other parent sacrifices activities to help another child, and that child misses his mother's care.Another child struggles to focus on college work. Each family member's roles shift, showing how one person’s illness influences the whole family. Concept 2: The whole is More than the sum of its parts → A family is more than just its individual members; it is an interconnected system where each person’s experiences impact the whole.one family member's chronic illness affects everyone, creating stress and uncertainty about their future. The disruption of their traditions and day to day highlights how the family's sense of unity and identity is challenged by her illness, making the loss greater than just an individual experience. Concept 3: All systems have some form of boundaries or borders between the system and its environment. → Families manage the flow of information and people into their system through boundaries, which can be closed, flexible, or too open. Closed boundaries limit outside help, while flexible boundaries allow selective support, like the Jones family accepting a pastor’s visit but declining others. Too open boundaries can lead to chaos if not managed carefully. Each family’s boundary permeability varies, influencing how they handle stress and external support. b.​ Developmental & life cycle theory ⇒ Is a framework for nurses to understand normal family changes and experiences over a member's lifetimes. ⇒ the theory assesses and evaluates both individuals and families as a whole because individual family members and family as a whole develop and change over time. ⇒ this approach views the evolving needs and priorities of family members and the family. ⇒ Family developmental theories are specifically geared to understanding families and not individuals.  3 Duvall used normative families (two-parent, white, heterosexual parents with two or more biological children). Carter and McGoldrick (2005) expanded this view to include diverse families. They replaced the term nuclear family with immediate family. Instead of legal marriage as the time stone for the beginning formation of families, they suggested using commitment of a couple as the beginning of the family. Identifiable transition: parent takes kid to school, then kid drives themselves to school Systematic and predictable transitions→ adolescence kids wanted more autonomy there will be stress during these transitions → when parents get older they move back in with you. Move from being cared for to being cared for. This is expected and disruptive. Family life cycle theory identifies this as a typical phase. As nurses, if we know…its actually expected and you can give them some coping strategies. You can assess where they are in the life cycle phase, anticipate changes, provide interventions, and validate their feelings within their phase. Help them adjust in a healthy manner. Concept 1: Families Develop and Change Over time → Families evolve over time through predictable stages, as outlined in the Developmental and Family Life Cycle Theory. These changes affect family structure, roles, and interactions, creating stresses that vary depending on the stage of development. One perspective on family development focuses on expected life transitions, such as marriage, child-rearing, and aging, aligning with societal norms. Another perspective considers how long a family remains in a particular stage, influencing the stresses experienced, such as the decision to remain childless. Overall, families follow a natural trajectory, becoming more complex with new members and adjusting as members leave or pass away.  4 Concept 2: Families Experience Transitions from One Stage to Another. c.​ Bioecological systems theory ​ Microsystem vs Mesosystem vs Exosystem vs Macrosystem ​ → Microsystems: immediate / direct environment that affects the child such as family, school, and friends where direct interactions occur. ​ Mesosystems: Interactions: relationship between family and school / teacher. If teachers and parents communicate well then the kid will have a positive experience. ​ Exosystem: External environments that indirectly affect a person, like a parent’s job or government policies. ​ Macrosystems: The broader cultural and societal beliefs that shape a person’s life, such as religion or political systems. ​ Chronosystem: The influence of time, life events, and historical changes on development, live divorce or economic shifts. ​ ​ This theory emphasizes that people don’t develop in isolation but are influenced  5 by multiple layers of their environment interaction over time. d.​ Family Nursing Assessment & Intervention Model ​ Jones Levels of Racism ​ Roles nurses play in family health nursing ​ Culturally-sensitive family centered care ​ Cultural factors that contribute to health status ​ Health policy, family policy – implicit, explicit ​ Social determinants of health ​ Health literacy, consequences of low health literacy ​ Gene, genome ​ Nurses use of genetic knowledge ​ Types of genetic testing  6 Diagnostic s/s of a genetic condition are present. Confirms whether or not an individual has the suspected condition. Carrier Detects whether a person is a carrier of either an autosomal recessive or an x-linked disorder Carriers of autosomal recessive condition usually have no s/s of the condition, and are at risk of having an affected child if the other parent is also a carrier. 1 normal copy, 1 mutated copy of gene. Female carriers of X-linked condition have one normal copy of the gene on the X chromosome and one mutated copy of the gene on the other X chromosome, usually w/out s/s (or very mild signs) of the condition. Her sons have a 50% chance of having the condition, and daughters have a 50% chance of being carriers. Predictive or presymptomatic Performed on healthy individuals. Detects whether they inherited a mutation in a gene and therefore whether they will or may develop a condition in the future. Prenatal Dx Genetic test performed on the fetus–indicates whether fetus has inherited the gene mutation that causes a specific condition and if the child will develop that condition Pharmacogenetic testing (PGx) Analyzes a person’s genes to understand how drugs may move through the body and be broken down. Purpose is to select drug tx that best suite each person DTC genetic testing Marketed directly to the general public via the internet. DTC genetic testing provides access to an individual’s genetic information, usually without involving a healthcare provider.  7 ​ Ethical considerations with genetic disease ★​ PTs have the right to disclosure and privacy unless there is reasonable threat to the patient. ★​ Nurses must maintain the confidentiality of each family member’s generic testing information ★​ It is completely up to the individual to determine whether or not to reveal info about genetic risks, testing, disease or management. ★​ Consent must be given by tested patient to share information with other family members (HIPAA) ★​ Reasons for family not sharing include: avoid disagreements, protect others in the family from sadness or worry, or prevent discrimination or bias. Example a patient with Huntington’s disease may be reluctance to talk about it with their provider as they fear it will be documented in the medical history and shared with future employers. ★​ Nurses must become aware of cultural values that differ from their own family cultural values–it is unethical for nurses to try to influence the decisions of the family / family members because of their own views. ★​ When obtaining a family genetic history, any information shared by the patient is personal, private and considered to be part of their personal health record.