NRS 221A, Exam 1
Maslow's hierarchy of needs – answer physiological, safety, love/belonging, esteem,
self-actualization
Goal to self-actualization
Mental illness definition (Townsend) - answer “maladaptive responses to stressors from
the internal or external environment, evidenced by thoughts, feelings, and behaviors
that are incongruent with the local and cultural norms, and interfere with the individual's
social, occupational, and/or physical functioning"
Mental illness immediate stress response to chronic state: - answer physiologic
changes produce chronic negative effects
Autonomy - answer personal right to self-determination
Beneficence - answerdo good to others
Nonmaleficence - answerdo no harm
Advocacy - answeracting on other's behalf
Justice - answerduty to treat all individuals equally and fairly
Veracity - answeralways be truthful
Informed consent requires: - answerCompetency, knowledge, free will
Informed consent: competency - answerRequires patient to have capacity to understand
and be able to make decisions about their care
Informed consent: knowledge - answerPatient should be educated by LIP about
risks/benefits and outcomes of procedure, including alternate options or no treatment
option
Informed consent: free will - answerPatient should not be subject to coercion by the LIP
Informed consent: nurse's responsibility - answer-Witness patient giving consent
-Advocate for patient
(legal liability for consent lies with LIP, not the nurse)
, Potential legal conditions/reasons for involuntary commitment - answer- Imminent
danger to self (suicidal)
- Imminent danger to others (aggressive, violent, homicidal)
- Unable to take care of basic needs ("gravely disabled")
Trajectories of serious illness - answer- Sudden Death
- Terminal Illness
- Major Organ Failure
- Debility/Frailty
- Catastrophic Event
Sudden death - answer- 10% of deaths in the US (MI, CVA, embolism)
-No time to treat, plan for or utilize palliative care due to suddenness of event
Terminal illness - answer-Cancer
-Slow disease progression with treatments, but patient will eventually die
Major Organ failure - answer- CHF, renal disease, COPD
-Intermittent crises or flares, exacerbations, usually require acute interventions or
hospitalization
Debility/Frailty (Failure to thrive) - answer-Seen in neurodegenerative diseases
(Alzheimer's, dementia)
-Slow onset, subtle signs of decline often present years before
Catastrophic event - answer-Combines parts of sudden death and frailty trajectories
-Sudden health event occurs that patients survives but negatively affects their functional
status
Tasks of Chronic illness - answer1. Prevent and manage a crisis - recognize how and
why crises occur, signs/symptoms and make a plan to manage/prevent
2. Carry out prescribed treatment plan - so crises are prevented
3. Control symptoms - to allow normal activities
4. Reorder time - planning ahead! Changing lifestyle or routines
5. Adjust to changes in course of disease - some things you can't do any longer
6. Prevent social isolation - try not to withdraw from social interaction
7. Attempt to normalize interactions with others - manage symptoms or appearance
to hide disease or pass as normal
ACE effects - answerrepeated/ongoing episodes of "toxic stress" during development
has been shown to have lifelong impact on mental and physical health
Trauma informed care: - answeran approach that recognizes that many individuals have
experienced or are experiencing trauma that may terrify, overwhelm, and violate the
individual
Maslow's hierarchy of needs – answer physiological, safety, love/belonging, esteem,
self-actualization
Goal to self-actualization
Mental illness definition (Townsend) - answer “maladaptive responses to stressors from
the internal or external environment, evidenced by thoughts, feelings, and behaviors
that are incongruent with the local and cultural norms, and interfere with the individual's
social, occupational, and/or physical functioning"
Mental illness immediate stress response to chronic state: - answer physiologic
changes produce chronic negative effects
Autonomy - answer personal right to self-determination
Beneficence - answerdo good to others
Nonmaleficence - answerdo no harm
Advocacy - answeracting on other's behalf
Justice - answerduty to treat all individuals equally and fairly
Veracity - answeralways be truthful
Informed consent requires: - answerCompetency, knowledge, free will
Informed consent: competency - answerRequires patient to have capacity to understand
and be able to make decisions about their care
Informed consent: knowledge - answerPatient should be educated by LIP about
risks/benefits and outcomes of procedure, including alternate options or no treatment
option
Informed consent: free will - answerPatient should not be subject to coercion by the LIP
Informed consent: nurse's responsibility - answer-Witness patient giving consent
-Advocate for patient
(legal liability for consent lies with LIP, not the nurse)
, Potential legal conditions/reasons for involuntary commitment - answer- Imminent
danger to self (suicidal)
- Imminent danger to others (aggressive, violent, homicidal)
- Unable to take care of basic needs ("gravely disabled")
Trajectories of serious illness - answer- Sudden Death
- Terminal Illness
- Major Organ Failure
- Debility/Frailty
- Catastrophic Event
Sudden death - answer- 10% of deaths in the US (MI, CVA, embolism)
-No time to treat, plan for or utilize palliative care due to suddenness of event
Terminal illness - answer-Cancer
-Slow disease progression with treatments, but patient will eventually die
Major Organ failure - answer- CHF, renal disease, COPD
-Intermittent crises or flares, exacerbations, usually require acute interventions or
hospitalization
Debility/Frailty (Failure to thrive) - answer-Seen in neurodegenerative diseases
(Alzheimer's, dementia)
-Slow onset, subtle signs of decline often present years before
Catastrophic event - answer-Combines parts of sudden death and frailty trajectories
-Sudden health event occurs that patients survives but negatively affects their functional
status
Tasks of Chronic illness - answer1. Prevent and manage a crisis - recognize how and
why crises occur, signs/symptoms and make a plan to manage/prevent
2. Carry out prescribed treatment plan - so crises are prevented
3. Control symptoms - to allow normal activities
4. Reorder time - planning ahead! Changing lifestyle or routines
5. Adjust to changes in course of disease - some things you can't do any longer
6. Prevent social isolation - try not to withdraw from social interaction
7. Attempt to normalize interactions with others - manage symptoms or appearance
to hide disease or pass as normal
ACE effects - answerrepeated/ongoing episodes of "toxic stress" during development
has been shown to have lifelong impact on mental and physical health
Trauma informed care: - answeran approach that recognizes that many individuals have
experienced or are experiencing trauma that may terrify, overwhelm, and violate the
individual
