Final Review S.V. PDF

Final Review Ch. 8  What Is Stress? Any disturbance in a person’s normal balanced state Unique response by each person to a stressor Can be harmful or motivating Categories of Stress Distress Developmental Can threaten health (e.g., Associated with li...

Final Review Ch. 8  What Is Stress? Any disturbance in a person’s normal balanced state Unique response by each person to a stressor Can be harmful or motivating Categories of Stress Distress Developmental Can threaten health (e.g., Associated with life stages continual financial worries) (e.g., college graduation) Eustress Good stress (e.g., passionate kiss) Categories of Stress Situational Anticipatory Random, unpredictable (e.g., The future (e.g., upcoming hurricane, accident) exam) Time Unable to meet demands (e.g., multiple demands, rushing) Categories of Stress Physiological Psychosocial Affect body: structure/function Arise from life event or (e.g., diseases, mobility relationships (e.g., work problems) pressure, family arguments)  Styles of Coping Strategies Adaptive Healthy choices Directly reduce negative effects of stress Examples: Change in lifestyle; problem-solving  Styles of Coping Strategies Maladaptive Unhealthy style, temporary fix Possible other harmful effects Examples: Substance abuse; overeating  Dealing With Stress: Coping Strategies Three general approaches for coping, depending on situation Alter the stressor: Change jobs Adapt to the stressor: Changing thoughts about nursing clinicals Avoid the stressor: Ending a relationship  Physical Responses to Stressors General adaptation syndrome (GAS) Selye’s theoretical model of physiological responses to stress Nonspecific bodily responses shared by all people Response to distress as well as eustress Involves three stages General Adaptation Syndrome  General Adaptation Syndrome: Stages Alarm stage Fight or flight Involves involuntary body responses Endocrine system: CRH, ACTH, ADH Sympathetic nervous system: Epinephrine, norepinephrine  General Adaptation Syndrome: Stages Alarm stage (continued) Cardiovascular system: Vasoconstriction, elevated blood pressure Respiratory system: Dilated bronchioles Metabolic system: Increased availability of glucose Urinary system: Sodium and water retention Gastrointestinal system: Decreased peristalsis Musculoskeletal system: Increased blood flow to muscles  General Adaptation Syndrome: Stages Resistance stage Goal: Maintenance of homeostasis Involves use of coping mechanisms Psychological Physical  return of vital signs to normal Failure to adapt to or contain stress leads to third phase  General Adaptation Syndrome: Stages Exhaustion If adaptive mechanisms become ineffective/nonexistent Decrease in blood pressure, elevated pulse, respiration Usually ends in disease or death Recovery Third stage, if adaptation is successful  Psychological Responses to Stress Include feelings, thoughts, and behaviors Anxiety and fear Ego defense mechanisms (e.g., denial, rationalization, projection) Anger Depression  Table 12- 1 ➤ Psychological Denial Defense Mechanisms Displacement—“Kick the dog.” Rationalization Repression  Consequences of Failed Adaptation Stress-induced organic responses Continual stress Repeated central nervous system stimulation Elevation of certain hormones Results in long-term changes in body systems  Consequences of Failed Adaptation (continued) Somatoform disorders Hypochondriasis Somatization Somatoform pain disorder Malingering Stress-induced psychological responses Crisis Burnout Post-traumatic stress disorder (PTSD)  Assessment Stressors, risk factors, and coping and adaptation Responses to stress Support systems Ch. 12  What Is Religion? A “map” that outlines essential beliefs, values, and codes of conduct into a manner of living Many of the world’s religions hold common beliefs.  What Is Spirituality? A “journey” that takes place over time and involves the accumulation of life experiences and understanding. An attempt to find meaning, value, and purpose in life.  Major Religions Judaism Orthodox Conservative Reform Reconstructionist  Major Religions Christianity Roman Catholicism Christian Science Jehovah’s Witness Mormonism Nursing Diagnoses Related to Spirituality Moral Distress Impaired Religiosity* Risk for Impaired Religiosity* Risk for Spiritual Distress* Spiritual Distress Spiritual Pain *In order to make safe and effective judgments using NANDA-I nursing diagnoses, it is essential that nurses refer to the definitions and defining characteristics of the diagnoses listed in this work. Ch. 13  What Is Grief? Grief: Physical, psychological, and spiritual responses to a loss Mourning: Action associated with grief Bereavement: Mourning and adjustment time following a loss Theoretical Foundations of Grief Major theorists Engel Bowlby Rando Worden Kubler-Ross  Factors Affecting Grief Significance of the loss Support system Unresolved conflict Circumstances of the loss  Factors Affecting Grief Previous loss Spiritual/cultural beliefs and practices Timeliness of death Developmental stage of the bereaved  Types of Grief Uncomplicated Dysfunctional/Complicated Chronic Masked Delayed Disenfranchised Anticipatory  End-of-Life Care Palliative care: Holistic comfort care Hospice care: Holistic care of dying clients  Legal and Ethical Considerations Advance directives Do not resuscitate (DNR)/allow natural death (AND) Assisted suicide Euthanasia Autopsy Organ donation Therapeutic Communication Perfect your listening skills. Encourage and accept expression of feelings. Reassure it is not wrong to feel anger, relief, or other “unacceptable” feelings. Respond to nonverbal cues with touch and eye contact. Increase your self-awareness. Continue to communicate, even in case of coma. Helping Families of Dying Clients Have family help with care, if able. Encourage questions. Provide follow-up for referrals as needed. Encourage visit to chapel or to talk with clergy. Provide anticipatory guidance. Acknowledge feelings of family. Providing Postmortem Care Care of the body: Follow agency policies and respect cultural and spiritual preferences. Ch. 2 The Phases of the Nursing Process/ Clinical Judgment-Defined Assessment/ Assess / Gather data / Filter Recognize Cues information Diagnosis Identify client’s health needs Analyze Cues/ (patient response to health Prioritize problem). Identify what is important & in what order. Hypothesis Decide with your patient the health Planning / outcomes you both want to achieve Generate with your nursing actions. Choose Solutions nursing interventions to help the client achieve chosen outcomes. Implementation/ Carry out or delegate interventions you Take Action previously planned. Evaluation/ Determine if your planned interventions achieved the planned Evaluate patient outcomes, then revise or Outcomes resolve. What Is Critical Thinking? A combinatio n of A desire Reasoned to seek thinking truth Openness Ability to to reflect alternativ es The most correct definition of “critical thinking” is A. A problem-solving process that enables one to show others they are wrong B. An examination of one’s own beliefs in order to defend them intelligently C. Purposeful, analytical thinking that results in a reasoned decision D. Rational thinking that results in obtaining the one correct answer Correct Answer: C Most definitions of critical thinking include the concept of it being purposeful and deliberate. It is more than just problem-solving and is not used exclusively to defend one’s beliefs. Critical thinking enables a person to see that there may be more than one correct answer.  Why Is Critical Thinking Important for Nurses? Patients Nurses Nurses are Nursing apply Nursing care for unique uses knowledg is an Nursing patients and have knowledg e to applied is fast with individual e from provide discipline paced. multiple needs other holistic. health and fields. care. problems differenc es Ch. 3 KEY CONCEPTS: ADPIE ▪ Assessment: involves gathering data about the patient and their health status. ▪ Diagnosis: using critical-thinking skills, the nurse analyzes the assessment data to identify patterns in the data and draw conclusions about the client’s health status, including strengths, problems, and factors contributing to the problems. ▪ Planning: encompasses identifying goals and outcomes, choosing interventions, and creating nursing care plans. ▪ Implementation: involves performing or delegating planned interventions; this is the step in which you carry out the care plan. ▪ Evaluation: occurs as the last step of the process and involves making judgments about the client’s progress toward desired health outcomes, the effectiveness of the nursing care plan, and the quality of nursing care in the healthcare setting. Can I Delegate Assessments? ▪ A professional nurse must perform the assessment portion of the nursing process. ▪ Nurse aides or other unlicensed assistive personnel (UAP) and licensed practical nurses (LPNs) collect information such as vital signs, pain reports, and fingerstick blood glucose levels. However, it is the responsibility of the professional nurse to assign those tasks, validate After collecting data on a client, the nurse reviews and sorts the information. Which example includes both objective and subjective data? 1. The client’s blood pressure reading is 132/68 mm Hg, and their heart rate is 88 beats/min. 2. The client’s cholesterol is elevated, and they admit to liking and eating fried food. 3. The client reports having trouble sleeping and admits drinking coffee in the evening. 4. The client verbally reports having frequent headaches and taking aspirin for the pain. The nurse is obtaining the health history of a client. Which question is an example of the nurse using an open-ended question? 1. “Have you had surgery before?” 2. “When was your last menstrual period?” 3. “What happens when you have a headache?” 4. “Do you have a family history of heart disease?” The nurse is interviewing a patient being admitted for gastrointestinal issues. The patient informs the nurse that they have persistent vomiting and diarrhea. Which type of assessment is the nurse performing by asking, “When did you first begin to have the vomiting and diarrhea?” 1. Comprehensive assessment 2. Ongoing focused assessment 3. Special needs assessment 4. Initial focus assessment The nurse is aware that when a patient becomes alarmed, the body will release a substance to promote a sense of well-being. Which substance is released? 1. Aldosterone 2. Thyroid-stimulating hormone 3. Endorphins 4. Adrenocorticotropic hormone The nurse is aware that which function of antidiuretic hormone occurs when the hormone is released in the alarm stage of the general adaptation syndrome? 1. Promotes fluid retention by increasing the reabsorption of water by kidney tubules 2. Increases efficiency of cellular metabolism and fat conversion to energy for cells and muscle 3. Increases the use of fats and proteins for energy and conserves glucose for use by the brain 4. Promotes fluid excretion by causing the kidneys to reabsorb more sodium The nurse is providing care for a patient who sustains a laceration of the thigh in an industrial accident. Which step in the inflammatory process does the nurse expect the patient to experience first? 1. Cellular inflammation 2. Exudate formation 3. Tissue regeneration 4. Vascular response In which situation would using standard precautions be adequate? Select all that apply. 1. While interviewing a client with a contagious productive cough 2. While helping a client perform their own hygiene care 3. While taking vital signs for a client who has smallpox 4. While inserting a peripheral intravenous catheter 5. While assessing sutures in an abdominal incision