NR 222 Chamberlain College of Nursing - NURSING exam 2 Study Guide - $15.49   Add to cart

Case

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

NR 222 Chamberlain College of Nursing - NURSING exam 2 Study Guide Make sure we’re not unconsciously biased • Evaluate our own values Therapeutic communication • Purposeful use of communication • 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 humor health 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 Pacing o 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 exercise o 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 • Movement o 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 manipulation o 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 imbalances Health 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 hr Disorders • 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/ nutrition Assess 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, endurance healthy 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 • planning o 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 pupils o 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 pt coping • 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 + thinking melting 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 Stroke o 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 covered Homeless • 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 needed Maslow’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-beliefs

Preview 3 out of 25  pages

adampicker

The benefits of buying summaries with Stuvia:

Guaranteed quality through customer reviews

Guaranteed quality through customer reviews

Stuvia customers have reviewed more than 450,000 summaries. This how you know that you are buying the best documents.

Quick and easy check-out

Quick and easy check-out

You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.

Focus on what matters

Focus on what matters

Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!

$ 15.49
  • (0)
  Add to cart