Self-Concept- NURS 111
Following a bilateral mastectomy, a 50-year-old patient refuses to eat, discourages visitors, and pays little attention to her appearance. One morning the nurse enters the room to see the patient with her hair combed and makeup applied. What is the best response from the nurse?
"I see that you've combed your hair and put on makeup."
Identity versus role confusion is what age group?
12-20 years
Role conflict results when a what?
A person has to assume two or more roles that are inconsistent, contradictory, or mutually exclusive.
When setting priorities focus on what in the nursing plan?
Adaptations to stressors.
When caring for an 87-year-old patient, the nurse needs to understand that what most directly influences the patient's current self-concept?
Adjustment to role change, loss of loved ones, and physical energy.
What is the most important factor in determining one's response?
An individual's perception of the stressor is the most important factor in determining his or her response.
Identity stressors can occur when?
At any time during the life span, but particularly during adolescence.
What does body image involve?
Attitudes related to physical appearance, structure or function.
What are some nursing implications for practice in older adults?
Clarify what the life changes mean and the effect on self-concept. Be alert to preoccupation with physical complaints. Communicate that the older adult is worthwhile by actively listening to and accepting the person's feelings, being respectful and praising healthy behaviors. Allow additional time for tasks.
Self esteem stressors can vary within what?
Developmental stages
An appropriate nursing diagnosis for an individual who experiences confusion in the mental picture of his physical appearance is:
Disturbed body image
Based on knowledge of Erikson's stages of growth and development, the nurse plans her nursing care with the knowledge that old age is primarily focused on what?
Ego integrity versus despair
A patient diagnosed with major depressive disorder has a nursing diagnosis of chronic low self-esteem related to negative view of self. What would be the most appropriate cognitive intervention by the nurse?
Focus on identifying strengths and accomplishments to minimize the emphasis on failures assists the patient to alter distorted and negative thinking.
When developing an appropriate outcome for a 15-year-old girl, the nurse considers that a primary developmental task of adolescence is to?
Form a sense of identity.
Self esteem comes from what?
From self-concept- self esteem influences self-concept.
The nurse can increase a patient's self-awareness through what?
Helping the patient define her problems clearly. Allowing the patient to openly explore thoughts and feelings. Reframing the patient's thoughts and feelings in a more positive way.
What is the pattern of self esteem?
Highest in childhood drops during adolescence rises gradually throughout adulthood declines again in old age
What is role performance?
How individuals carry out their significant roles, such as parent, supervisor or close friend.
What can help older adults with their self concept?
Identify positive and negative coping mechanisms. Encourage the use of storytelling and review of old photos.
What are some adolescent self-concept issues?
Identity confusion, disturbed body image, self esteem and role conflict
Role performance stressors can occur where?
In relationship to situational transitions that occur when parents, children, spouses, family members, or close friends die, or when people move, marry, divorce, or change jobs. They can also occur when one moves from a place of wellness to illness.
Based on knowledge of the developmental tasks of Erikson's Industry versus Inferiority, the nurse emphasizes proper technique for use of an inhaler with a 10-year-old boy so he will do what?
Increase his self-esteem with mastery of a new skill.
Development of self concept ends when?
NEVER
A 20-year-old patient diagnosed with an eating disorder has a nursing diagnosis of situational low self-esteem. What nursing interventions would be best to address self-esteem?
Offering opportunities for decision making promotes a sense of control, which is essential for promoting independence and enhancing self-esteem. Reviewing successful coping strategies is a priority intervention for the nursing diagnosis of ineffective coping.
Early in growth and development, an individual develops this identity of culture within the context of what?
One's family.
What are some factors that influence self concept?
Parents and primary care givers. Ethnicity and cultural influences. Job satisfaction and job performance. Peers and friends. Media and advertisements.
Parents should respond to their kids how? How will their kids respond?
Parents should respond in a firm, consistent and warm manner. Children will have good self esteem and develop low risk behaviors because of this.
An adult woman is recovering from a mastectomy for breast cancer and is frequently tearful when left alone. The nurse's approach should be based on an understanding of what?
Patients need support in dealing with the loss of a body part.
A person's self concept is strengthened or questioned through what?
Political, social, or cultural influences experiences in school and workplace environments.
What can foster self esteem, especially in adolescents?
Positive communication and positive social support.
In planning nursing care for an 85-year-old male, the most important basic need that must be met is:
Preservation of self-esteem
A depressed patient is crying and verbalizes feelings of low self-esteem and self-worth such as "I'm such a failure...I can't do anything right." The best nursing response would be to do what?
Remain with the patient until he or she stops crying. Demonstrating acceptance of the patient by supportively sitting with him or her builds a therapeutic nurse-patient relationship. The nurse's presence signals value and allows the patient to explore issues of self-concept and self-esteem.
The home health nurse is visiting a 90-year-old man who lives with his 89-year-old wife. He is legally blind and is 3 weeks' post right hip replacement. He ambulates with difficulty with a walker. He comments that he is saddened now that his wife has to do more for him and he is doing less for her. Which of the following is the priority nursing diagnosis?
Risk for situational low self-esteem
Role strain combines what?
Role conflict and role ambiguity
Positive or negative cultural role modeling or past experiences influence what?
Self concept
Self concept is closely related to what?
Self esteem
The nurse asks the patient, "How do you feel about yourself?" The nurse is assessing the patient's what?
Self-esteem
What does identity involve?
The internal sense of individuality, wholeness, and consistency of self.
Body image stressors include those that what?
Those that occur in appearance, structure, or function of a body part.
Role ambiguity involves what?
Unclear role expectations, which makes people unsure about what to do or how to do it
Define self concept
a subjective sense of self and a complex mixture of unconscious and conscious thoughts, attitudes and perceptions.
Self concept is an individual's what?
conceptualization of himself.
When planning care for the patient who is experiencing problems with self-concept, you will use what two things?
critical thinking and the nursing process.
Self esteem is an individuals overall feeling of self-worth or the what?
emotional appraisal of self concept
When the nurse uses a matter-of-fact approach and acknowledges a change in the patient's behavior or appearance, it allows the patient to do what?
establish its meaning.
Role overload involves what?
having roles or responsibilities that are unmanageable. This can occur when a person is ill.
Erikson's stages are helpful in understanding what?
key tasks
Ego integrity versus despair is what age group?
late 60s to death
A positive self concept gives a sense of what?
meaning, wholeness and consistency to a person
Intimacy versus isolation is what age group?
mid 20s to mid 40s
Generativity verses self absorption is what age group?
mid 40s to mid 60s
Children develop a basic sense from family. Gains from family are what?
norms for thinking, feelings and behaving.
The ability to re-establish balance following a stressor is related to what?
numerous factors including the number of stressors, the duration of the stressors and health status.
What can affect self concept?
physical changes, spiritual, emotional, sexual, familial and sociocultural health affect self-concept.
Strong parental support and parental monitoring create what?
positive effects.
Inability to make decisions reflects a what kind of issue?
self-concept issue.
Successful mastery of Erickson's psychosocial stages leads to a sense of what?
self.
A healthy self concept has a high degree of what?
stability and generates positive feelings toward the self.
Define body image
the mental picture of one's body and is not necessarily consistent with a person's actual body structure or physical appearance.