312 final exam
what is homeopathic medicine?
"like cures like" belief that small oses of that whcihc asues disease or illness can cure the disease or illness
what ethnic group considers eye contract as disrespectful?
Japan/korean
what is the code of ethics?
set of ethical principles that are accepted by all members of a profession, standards of behavior, professional duty of every nurse to be familiar to these
what is an advacned directive?
statement that outlines the medical treatment one would want or designate a person to make healthcare deicions for that person, in the event they can no longer express wishes
what is genomics?
study of all the genes in the human genome together, including their interactions with eachtoher, with the environment, and the influence of other psychosocial and cultural factors
what is genetics?
study of individual genes and thier impact on relatively rare single gene disorders
what are side effects of ginkgo biloba
suppresses coagulation (dont use in patients with bleeding disorders), seizures (dont use with seizure disorder, drugs lower seizure threshold)
what is nonmaleficence?
the avoidance of hurt, do not harm, weight benefits and risks vs doing nothing
what is cabler-ross's 5 stages of dying
denial, anger, bargaining, depression, and acceptance
a moral theory that claims that right action is determined by whether an act is consistent with a persons moral duties and obligations
deontology
an ethical principle that requires that reasonable care be exercised in a given situation to ensure that one does not harm another person
due diligence
difference between emic and etic worldview
emic: insiders perspective, native view (must seek to try and gain understanding) etic: outsiders perspective, not apart of the culture
a way of thinking and a way of breaking down concepts and examining them in a contect and from various perspectives
ethical analysis
who should have an advance directive?
everyone
what are 4 concepts correlated with spiritual health?
faith, religion, hope, and fear
T/F: Kava Kava is the natural alternative to Valium
false
T/F: grief and mourning are both inner feelings.
false
T/F: it is okay for an immunocomprimsed individual to use Echinacea for thier cold
false (compromise immunosuppressant drugs)
T/F: individuals with diabetes do not have to worry about using ginseng
false (increases hypoglycemiz effect - interacts with insulin)
T/F: religion and spirituality are the same?
false (one can practice religion with out being spiritual or one can be spiritual and not belong to any religion)
should a family member be used as an interpreter?
family members may need to be present and with limited access to interpreters it may be needed - cautions used: information not conveyed completely (dont know medical terms), may be inappropriate for family o talk about certain personal issues
T/F: advance directives deal with finanical decision-mkaing as well
fasle - general power of attorney deal with finances and property
an ethical pinricple that requires one to honor matters of trust and other expectations in a clinician patient relationship
fidelity
are grief and mounring inner or outward feelings?
grief - inner feelings mounring - outward reactions
what is traditonial chinese medicine?
herbal/nutritional therapy, restorative physcial exercises, meditation, acupuncture, remedial massage (ancient chinese medicine, concept of "qi" or vital life energy)
what is used if a patient doesnt have advance directive and they lack decisions-making capacity?
hierarchy of surrogate decision-makers: legal guardian, spouse, adult children, parents, adult siblings, friend (complicated if disagreement amoung children) -dispute amoung equally ranked surrogates is referred to facillity ethics committee
what is Ayurveda?
hindu medicine practiced in india, diet and herbal remedies
how does ginkgo biloba help with hearing loss?
imporve hearing in cases where hearing loss secondary to circulatory problem (increase blood flow to brain - hearing processes)
what is ginkgo biloba used for?
improve cerebral circulation, dementia, PVD, vertigo, tinnitus, hearing loss, sexual dysfunction
interactions of saw palmetto
increased risk of bleeding with surgery, avoid use with antiandrogenic (finasteride)
2 categories of advance directives
instruction: dictate in writing how to be cared for proxy: designate persons to execute HC decisions
a fundamental ethical prinicple that requires that all people be treated fairly
justice
what is one of the final steps after making an advanced directive?
keep individual copy and distribute other copies (primary physician, family member, healthcare POA)
name the 3 categories of treatment choices
life supporting: maintain vital functions (CPR, ventilation) life sustaining: prolonglife when condition cannot be reversed (tube feedings, IV fluids, kindye dialysis life enhancing: maintain comfort until death (O2, pain meds)
what is a major problem with a living will?
limitmed - only applies if pt is certified by doctor as terminal, end-stage condition, persistent vegetative state -can be difficult, cannot anticipate every possible clincial situation
what are probiotics? give examples
live microorganisms which, when administered adquate amounts, conder a health benefit on the host (balance between normal flora vs. disease causing bacteria) -yogurt (active), miso, soy beverages, dietary supplements
what is the difference between a living will and a durable power of attorney for healthcare?
living will - specifies what person would want at end of life, can be intervention specific (CPR, ventilator) Durable POA - another person named by client to make medical decisions only in even individual unable to state wishes
ways that spirituality can impact recovery from illness
lower metabolism, lower heart rate, lower respiraotry rate, slower brainn waves
what is genetic counseling
masters trained genetic counselors, physicians, nurses who interpret family and medical histories (assessment of chance of disease occurance or reoccurrence)
how could an advanced directive conflict with end of life care in different cultures?
may not fit with cultures where family decisions of health are highly regarded
what are some holistic nursing practices a genreal practicing nurse can use with their patients?
meditation, relaxation, imagery, music therapy, massage, touch, laughter/humor
Is an attorney or notarization required for these documents?
no, not required
what is naturopathic medicine?
nutrition counseling, dietary supplments, medicinal plants, exercise, treatments from traditionl chinese medicine (healing power within the body that establishes, maintains, and restores health)
When are DNRs addressed and how?
only in hospital or long-term care facility - must be addressed by physician (even if they have advanced directive) and dopcumented specifically
what is kava kava used for?
oral beverage decrease anxiety, imporves sleep/mood/cognitive performance
what is st johns wort used for and how?
oral, antidepressant, supresses anxiety and OCD symptoms
what is echinacea used for? (oral/topical)
oral-immune function, suppress inflammation, treat flu topical-wounds, burns, eczema, psoriasis, herpes complex
What should you not take Kava Kava with?
other herbs/medications known to cause hepatotoxicity, sedatives
How to tell if patient who is at home or receiving paramedic treatment has a DNR or not?
out-of-hospital DNRs special EMT form on fridge in home so EMTs know they dont want CPR/emergency treatment
an ethical principle derived from beneficence that obliges one to act for the good of another without consulting or heeding the expressed wishes of the other, which results in overriding another's preferences or freedoms
paternalism
what other patients need to use caution with Echinacea
patients who have TB, HIV, SLE, and cancer
what are the 4 dimentions in the quality of life model?
physical well being, psychological well-being, social well-being, spiritual well-being
what are some examples from the Jarel tool?
prayer is an important part of my life, i beleive i have spiritual well-being, as I grow older I am more tolerant of others beliefs, there is a close relationship between my beleifs and what I do
what patients should not take st johns wort?
pregnancy, lactation, exposure to strong sunlight
who should not use herbals?
pregnant/breastfeeding, having surgery (stop using 2 weeks before), younger than 18 or older than 65
how is the nurse a liaison role?
primary communication line between client and physician, link between family and physician
what is one benefit of states particiapting in the MOLST program?
promotes adherence of clients wishes even when they are not in the hospital
what is the goal of diversity and health?
provide culturally-sensitivve care to increasily diverse population
what are ethical issues that oftne arise in healthcare?
quality of life, genetic screening, futile care, allocation of medical technologies, allocation of nursing shortage
side effects of saw palmetto
rare, mild stomach upset, headache, reduces PSA (cause false negative)
What are some examples of energy therapies?
reiki therpay, theraopeutic touch, magnetic fields
an ethical principle that requires that one act in condisderate ways and in such a way as to perserve the dignity of others
respect
Is the fear of dying alone common?
yes
can ginkgo biloba imporve blood flow?
yes
can you take st johns wart with perscription antidepressants? what syndrome should be monitored and what side effects are associated?
yes, monitor for serotonin syndroms (agitation, panic, hyperthermia, rigidity, coma, death)
what are some techniques that are designed to enhanc the minds capacity to affect bodily function and symptoms?
yoga, imagery, meditation, prayer, mental healing, hypnotherapy, art/music/dance therapies
alternative therapy
-not allopathoc medicine -primary source of treatment
what is one of the nurses primary role regarding patient use of CAPP therapies
-advocate for the patient and their wishes -encourage client to share CAPP they are utilizaing w their PCP
4 symptoms of normal grief reactions
-feelings/emotion (sadness, anger, guilt) -cognition (disbelief, confusion, hallucinations) -physical sensations (upset stomach, tightness in chest/throat, heart palpitations) -behaviors (sleep/appetite disturbances, absent mindedness, withdrawl)
who needs to sign these documents?
2 "imparital" adults witnesses and person it applies to
what is the Jarel tool?
21 questions with strongly disagree to strongly agree that score on value/beleif assessment questions
what is decisional capacity?
ability to understnad nature/consequences of treatment decision, rationally evaluate benefits/burdens, and communicate decisions
what ethical principle requires health care providers to ensure that the needs, concerns, and wishes of patients or profession are heard and respected?
advocacy
what ethnic group suffers from high blood pressure, kidney disease and stroke?
african american
an unselfish concern for the welfare of others
altruism
what signs and symptoms might suggest spiritual distress and risk for spiritual distress?
anger behvaiors, crying, feeling unloved, questions meaning of life, excessive guilt
what ethnic group values silence?
asian
what cultures make decision by goroups or heads of the group?
asian and african
what do ethics committees do?
assist with resolving dilemmas, case review, policy recommendations, education
a fundamental ethical principle based on respect for persons that requires one to accept the free and informed choices of competent patients or thier designated decision-makers
autonomy
what are the 5 constructs of teh Campinhea-Bacote model?
awareness, knowledge, skill, encounters, desire
a fundamental ethical principle that requires that one first fo no harm, and then seek to do or produce good for others
beneficence
what is it called when an individual identifies with 2 or more cultures?
biculturalism (multicultureaslim)
during the end of life, what ritual do buddhists follow?
cannot move body until its cold as it symbolizes the spirit has left
what is cultural senstivity?
capacity to feel, convey, or react to ideas, habits, customs or traditions unqiue to a group of people
what are 4 types of complicated grief
chronic - continues over long period of time delayed - when normal grief reactions suppressed/postponed exaggerated - overwhelming grief, interferes with function masked - survivor is unaware of grief reaction (loss of pet)
a professions ideal ethical standards and expectations as endorsed by its professional associations
code of ethics
what is garlic used for?
controls dysentery (stomach infection, diarrhea - settles stomach), fights parasites, lower fever, relieves abdominal cramping
what are methods a nurse can use to cope?
crying with family, attending funeral, write letter of sympathy to family, discuss feelings with other health care professionals, support system, stress management techniques to restore energy
what is cultural imposition?
cultural ignorance - using ones own values and beliefs as an absolute guide in dealing with others
complementary therapy
therapies used in addition to conventional treatment/allopathic medicine
T/F: advocacy for client access to desired genomic services, resources, and support groups is a professional nursing responsibility
true
T/F: bereavement includes grief and mourning
true
T/F: culture is comprised of both visible and invisible components
true
T/F: ginko biloba causes decreased platelet formation
true
T/F: grief affects survivors physical, psychologically, socially, and spiritually.
true
T/F: nurses grieve and should have support systems
true
T/F: one emphasis of hospice care is on comfort and symptom management at the end of life
true
T/F: palliative care can be provided for longer periods of time than hospice care
true
constructing a pedigree from a family health history is an appropriate nursing function related to addressing genetics and genomics in healthcare
true
T/F: garlic can casue increased INR and PT intervals
true (elevates prothrombin times used with anticoagulants)
T/F: cultural backlash is when an experience with a new or different culture is negative
true (nurses avoid stereotypes)
T/F: individuals with BPH might be more inclined to try Saw Palmetto
true (used to decrease BPH symptoms)
T/F: some elderly patients are touch deprived
true - lack of human interaction, simple touch can be used to calm patients
the unrestricted certainty that another (person, agency, or even inanimate object) will always perform as expected
trust
accuray or conforming to truth
veracity
what are the visible and invisible components of culture?
visible: hair, clothing, jewelry invisible: beleifs, values
what is ethnocentrism?
when cultural groups transmit their own values, beliefs, morals, and norms onto others, feeling superior