Wk 2 Fundamentals: CH 7, Maternal Child Nursing Care- Chapter 28, Ch 8 Fund/Review Questions- Caring for Patients w/ Chronic Illness Wk 2, Ch 11 Fund-Review Questions/ Developmental Theories Wk 3, Ch 11 Fund- Developmental Theories Wk 3, week 2 Mater...

The six essential elements of the Chronic Care Model

- Health system - Delivery system design - Decision support -Clinical information systems - Self-management support - Community

Prevention of Chronic Disease

- increase health behavior through education - screening for early disease - genetic testing and family history assessment - support public policy to improve health at the local, state and national levels

Storytelling

-One way to begin to understand a patient's cultural perspective -conveys culture, combining personal experience with the commonalities of all human experiences -engages a nurse and patient in a way that broadens their relational understanding

The divorce process: Transitional phase:

-adults and children assume unfamiliar roles and relationships within new family structure -phase is often accompanied by change of residence, reduced standard of living and lifestyle, larger share of responsibility, radical altered parent-child relationships.

LEARN mnemonic

-cultural desire requires respect and acceptance of all human beings Listen Explain Acknowledge Recommend Negotiate

iceberg analogy

-is a tool that helps you visualize the visible and invisible aspects of your own world view -most aspects of a person's world view lie outside his or her awareness and are invisible to those around the person

What are the components of cultural humility?

-lifelong commitment to self-reflection and critique. -addresses power imbalances in nurse-pt relationship. -develops mutual beneficial and nonpaternalistic partnerships w/ community in which one is working

ecologic framework

-offers perspective on families within context of various circles of influence. -individuals adapt in response to life changes

The divorce process: stabilizing phase:

-post-divorce family re-establishes stable, functioning family unit. -Remarriage, changes in all areas of family life.

Influences in the Surrounding Environment

-schools -peer cultures/groups -Social roles (self-concept outlined by cultural views) -Co-cultural/subcultural influences -Communities

The divorce process: Acute Phase:

-the married couple makes decision to separate -includes legal steps of filing, usually father departs -lasts for months-1 yr+, stressful for family

Toddler

1 to 3 years of age

Infancy

1 to approximately 12 months of age

During a home visit, a patient states, "I am really upset about my heart failure. I can't go out to eat anymore with my friends, I have no energy, and I don't even want to talk on the phone. All I do is focus on how this disease has changed my life and how much time I have left to live." How should the nurse respond? (Select all that apply.) 1. "Let's talk about going out to lunch. What is making you hesitant about eating with your friends?" 2. "Tell me about what types of activities you were doing before you knew you had heart failure." 3. "Eventually you will get used to all of the changes. You are doing OK." 4. "My mother has heart failure, and she has adjusted to diet, activity, and medication changes." 5. "How has your heart failure affected your energy level?"

1. "Let's talk about going out to lunch. What is making you hesitant about eating with your friends?" 2. "Tell me about what types of activities you were doing before you knew you had heart failure." 5. "How has your heart failure affected your energy level?"

Anal stage

(1-3 years) Interest centers in the anal region as sphincter muscles develop

Autonomy versus shame and doubt

(1-3 years) The development of autonomy during the toddler period is centered on children's increasing ability to control their bodies, themselves and their environment.

Formal operations

(11-15 years) Formal operational thought is characterized by adaptability and flexibility. Can think in abstract terms and draw logical conclusions.

Genital stage

(12 years of age and older) Begins at puberty with maturation of the reproductive system and production of sex hormones

Identity versus role confusion

(12-18 years) Characterized by rapid and marked physical changes

Preoperational

(2-7 years) Intellectual development is egocentrism, inability to put oneself in the place of another. Children interpret objects and events not in terms of general properties but in terms of their relationships or their use to them.

Initiative versus guilt

(3-6 years) Characterized by vigorous, intrusive behavior; enterprise; and a strong imagination. Children explore the world and develop a conscience

Phallic stage

(3-6 years) The genitalia become an interesting and sensitive area of the body; begin to recognize differences in sexes

Latency period

(6-12 years) Children elaborate on previous acquired traits and skills

industry versus inferiority

(6-12 years) Having achieved the more crucial stages in personality development, children want to engage in tasks and activities they can carry out through completion.

Concrete operations

(7-11 years) Thought becomes increasingly logical and coherent. Reasoning is inductive. Thinking becomes socialized.

Trust versus mistrust

(Birth to 1 year) Develop the most important attribute to develop a healthy personality, trust. The result is faith and optimism

Oral stage

(Birth to 1 year) During infancy, the major source of pleasure seeking is centered on oral activities

Sensorimotor

(Birth to 2 years) Six substages that are governed by sensations in which simple learning take place.

Which of the following are examples of the conventional reasoning form of cognitive development? (Select all that apply.) 1. A 35-year-old woman is speaking with you about her recent diagnosis of a chronic illness. She is concerned about her treatment options in relation to her ability to continue to care for her family. As she considers the options and alternatives, she incorporates information, her values, and emotions to decide which plan will be the best fit for her. 2. A young father is considering whether or not to return to school for a graduate degree. He considers the impact the time commitment may have on the needs of his wife and infant son. 3. A teenage girl is encouraged by her peers to engage in shoplifting. She decides not to join her peers in this activity because she is afraid of getting caught in the act. 4. A single mother of two children is unhappy with her employer. She has been unable to secure alternate employment but decides to quit her current job. 5. A young man drives over the speed limit regularly because he thinks he is an excellent driver and will not get into a car accident.

1. A 35-year-old woman is speaking with you about her recent diagnosis of a chronic illness. She is concerned about her treatment options in relation to her ability to continue to care for her family. As she considers the options and alternatives, she incorporates information, her values, and emotions to decide which plan will be the best fit for her. 2. A young father is considering whether or not to return to school for a graduate degree. He considers the impact the time commitment may have on the needs of his wife and infant son.

4 components of cultural competence

1. Cultural awareness 2. Cultural knowledge 3. Cultural skill 4. Cultural encounter

A nurse is caring for a man who is recently retired and who appears withdrawn. He says he is "bored with life." The nurse helps this individual find meaning in life by: 1. Encouraging him to reflect on his relationships with others. 2. Encouraging relocation to a new city. 3. Explaining the need to simplify life. 4. Encouraging him to adopt a new pet.

1. Encouraging him to reflect on his relationships with others.

A 9-year-old child has a difficult time making friends at school and being chosen to play on the team. He also has trouble completing his homework and, as a result, receives little positive feedback from his parents or teacher. According to Erikson's theory, failure at this stage of development results in: (Select all that apply.) 1. Feelings of inadequacy. 2. A sense of guilt. 3. A poor sense of self. 4. Feelings of inferiority. 5. Mistrust.

1. Feelings of inadequacy 4. Feelings of inferiority

Two nurses are revising a self-management education program to help patients better manage their asthma. What strategies are most important for them to include in the program? (select all that apply) 1. Have patients list the medications they are prescribed to take and describe any problems they are having with their medications. 2. Create a common set of patient goals that the patients will work toward as a group. 3. Look for group leaders who are health care providers that are respected by the community. 4. Provide information on how to balance activities during the day. 5. Ask patients to discuss how other people in their family react to them now that they have asthma.

1. Have patients list the medications they are prescribed to take and describe any problems they are having with their medications. 4. Provide information on how to balance activities during the day. 5. Ask patients to discuss how other people in their family react to them now that they have asthma.

A nurse is caring for a patient newly diagnosed with testicular cancer. He asked the nurse to help him find the meaning of cancer by supporting beliefs about life. This is an example of: 1. Instilling hope and faith. 2. Forming a human-altruistic value system. 3. Cultural caring. 4. Being with.

1. Instilling hope and faith.

When Ryan was 3 months old, he had a toy train; when his view of the train was blocked, he did not search for it. Now that he is 9 months old, he looks for it, reflecting the presence of: 1. Object permanence. 2. Sensorimotor play. 3. Schemata. 4. Magical thinking.

1. Object permanence

Before implementing touch, what does a nurse need to know about touch? (Select all that apply.) 1. Some cultures may have specific restrictions about non- skill-based touch. 2. Touch is a type of verbal communication. 3. Touch can successfully influence a patient's level of comfort. 4. There is never a problem with using touch at any time. 5. Touch only reduces physical pain.

1. Some cultures may have specific restrictions about non- skill-based touch. 3. Touch can successfully influence a patient's level of comfort.

A nurse is taking care of a patient who has decided to stop smoking cigarettes. Which online resource would provide evidence-based information about smoking cessation? 1. The American Lung Association online toolkit for smoking cessation 2. An online blog led by a nurse for people discussing smoking cessation 3. A self-help website maintained by a hospital focusing on general wellness behaviors 4. A CDC website that discusses addictive behavior and risk factors

1. The American Lung Association online toolkit for smoking cessation

A nurse is providing education to a patient with type 2 diabetes. Which characteristics does the nurse include in her teaching to explain why type 2 diabetes is considered a chronic disease? (Select all that apply.) 1. Type 2 diabetes lasts throughout a person's life. 2. Genetic mutations drive the treatment for type 2 diabetes. 3. People with type 2 diabetes have to modify some of their daily activities. 4. Type 2 diabetes occurs in elderly people. 5. People with type 2 diabetes require ongoing medical care.

1. Type 2 diabetes lasts throughout a person's life. 3. People with type 2 diabetes have to modify some of their daily activities. 5. People with type 2 diabetes require ongoing medical care.

Prepubertal

10 to 13 years of age

Adolescence

13 to approximately 18 years of age

A nurse demonstrates caring by helping family members to: (Select all that apply.) 1. Become active participants in care. 2. Remove themselves from personal care. 3. Make health care decisions for the patient. 4. Plan uninterrupted time for family and patient to be together. 5. Discuss their concerns.

1: Become active participants in care 4. Plan uninterrupted time for family and patient to be together. 5. Discuss their concerns.

A hospice nurse sits at the bedside of a male patient in the final stages of cancer. He and his parents made the decision that he would move home and they would help him in the final stages of his disease. The family participates in his care, but lately the nurse has increased the amount of time she spends with the family. Whenever she enters the room or approaches the patient to give care, she touches his shoulder and tells him that she is present. This is an example of what type of touch? 1. Caring touch 2. Protective touch 3. Task-oriented touch 4. Interpersonal touch

1: caring touch

Match the following caring behaviors with their definitions. (separate your answers with commas, if doing long-hand testing) 1. knowing 2. being with 3. doing for 4. maintaining belief a. sustaining faith in the other's capacity to get through an event or transition and face a future with meaning b. Striving to understand an event as it has meaning in the life of the other c. being emotionally present to the other d. doing for the other as he or she would do for self if it were at all possible

1b, 2c, 3d, 4a

Embryonic

2 to 8 weeks of age

The nurse is caring for a family where there is a strong family history of breast cancer. One of the family members says, "I am afraid of having genetic testing. If it is positive, I know I have cancer." What is the nurse's best response? 1. "It will help diagnose the cancer early if you have it." 2. "If the results are positive, it means you have a higher risk for breast cancer, not that you have cancer." 3. "If it is going to cause you to worry, don't have the screening done." 4. "I am sure you will be fine. You are a healthy woman."

2. "If the results are positive, it means you have a higher risk for breast cancer, not that you have cancer."

Which of the following are strategies for creating work environments that support nurse caring interventions? (Select all that apply.) 1. Increasing technological support 2. Improving flexibility for scheduling 3. Providing opportunities to discuss care 4. Promoting autonomy of practice 5. Encouraging increased input concerning nursing functions from health care providers

2. Improving flexibility for scheduling 3. Providing opportunities to discuss care 4. Promoting autonomy of practice

A nurse is providing health promotion information at a health fair for female patients who are diagnosed with cancer. What information should the nurse include? (Select all that apply.) 1. Recommending that they avoid drinking alcohol to prevent alcohol misuse 2. Information from the local health department about smoking-cessation classes 3. The need to avoid physical activity while receiving cancer treatment to lessen fatigue 4. Strategies to talk with family and friends about the cancer diagnosis and the side effects from their treatment 5. How nutritional needs may change based on the diagnosis of cancer and its treatment

2. Information from the local health department about smoking-cessation classes 4. Strategies to talk with family and friends about the cancer diagnosis and the side effects from their treatment 5. How nutritional needs may change based on the diagnosis of cancer and its treatment

The nurse teaches parents how to have their children learn impulse control and cooperative behaviors. This would be during which of Erikson's stages of development? 1. Trust versus mistrust 2. Initiative versus guilt 3. Industry versus inferiority 4. Autonomy versus sense of shame and doubt

2. Initiative versus guilt

A school nurse is planning a health fair for children in first, second, and third grade to promote healthy behaviors. The most 104appropriate health screening for this age-group would be: (Select all that apply.) 1. Providing information about eating fruits and vegetables 2. Taking the children's blood pressure 3. Recording the children's height and weight on a growth chart 4. Asking the students about their family history of cancer 5. Teaching the students about the risks of secondhand smoke

2. Taking the children's blood pressure 3. Recording the children's height and weight on a growth chart

Which of the family caregivers listed below will the nurse expect to be most at risk for experiencing poor health outcomes? 1. A 20-year-old daughter caring for a mother who needs help setting up her medications weekly 2. The 68-year-old spouse of a patient who is experiencing worsening dementia 3. A 32-year-old parent of a child who has an ear infection 4. A married couple who is sharing the caregiving responsibilities for a parent who was recently diagnosed with hypertension and coronary artery disease

2. The 68-year-old spouse of a patient who is experiencing worsening dementia

According to Piaget's cognitive theory, a 12-year-old child is most likely to engage in which of the following activities? (Select all that apply.) 1. Using building blocks to determine how houses are constructed 2. Writing a story about a clown who wants to leave the circus 3. Drawing pictures of a family using stick figures 4. Writing an essay about patriotism 5. Hanging out with a best friend

2. Writing a story about a clown who wants to leave the circus 5. Hanging out with a best friend

Preschool

3 to 6 years of age

A patient tells the nurse, "My doctor told me to lose weight, exercise, stop smoking, and eat better. I am not sick at all. Why would he tell me that?" The nurse's best response would be: 1. "Since I was not there to hear the conversation, I am not exactly sure." 2. "All of these things are behaviors that are good for you and your family. Why not just give it a try?" 3. "I believe he is trying to get you to think about ways that you can be healthier. All these things help to prevent future health problems." 4. "Eating a balanced, healthy diet and exercising regularly will help you lose weight. I know stopping smoking is really hard to do."

3. "I believe he is trying to get you to think about ways that you can be healthier. All these things help to prevent future health problems."

A health system upgraded its electronic health record across all its practice settings to enhance patient care and communication among health care providers. This is an example of which component of the Chronic Care Model? 1. Health systems 2. Decision support 3. Clinical information systems 4. Community

3. Clinical information systems

A young woman comes to a clinic for the first time for a gynecological examination. Which nursing behavior applies Swanson's caring process of "knowing" the patient? 1. Sharing feelings about the importance of having regular gynecological examinations 2. Explaining risk factors for cervical cancer 3. Recognizing that the patient is modest and maintaining her privacy during the examination 4. Asking the patient what it means to have a vaginal examination

3. Recognizing that the patient is modest and maintaining her privacy during the examination

A patient is fearful of upcoming surgery and a possible cancer diagnosis. He discusses his love for the Bible with his nurse, who recommends a favorite Bible verse. Another nurse tells the patient's nurse that there is no place in nursing for spiritual caring. The patient's nurse replies: 1. "You're correct; spiritual care should be left to a pastoral care professional." 2. "You're correct; religion is a personal decision." 3. "Nurses should explain their own religious beliefs to patients." 4. "Spiritual, mind, and body connections can affect health."

4. "Spiritual, mind, and body connections can affect health."

The nurse is aware that preschoolers often display a developmental characteristic that makes them treat dolls or stuffed animals as if they have thoughts and feelings. This is an example of: 1. Logical reasoning. 2. Egocentrism. 3. Concrete thinking. 4. Animism.

4. Animism

An example of a nurse caring behavior that families of acutely ill patients perceive as important to patients' well-being is: 1. Making health care decisions for patients. 2. Having family members provide a patient's total personal hygiene. 3. Injecting the nurse's perceptions about the level of care provided. 4. Asking permission before performing a procedure on a patient.

4. Asking permission before performing a procedure on a patient.

Dave reports being happy and satisfied with his life. What do we know about him? 1. He is in one of the later developmental periods, concerned with reviewing his life. 2. He is atypical, since most people in any of the developmental stages report significant dissatisfaction with their lives. 3. He is in one of the earlier developmental periods, concerned with establishing a career and satisfying long-term relationships. 4. It is difficult to determine Dave's developmental stage since most people report overall satisfaction with their lives in all stages.

4. It is difficult to determine Dave's developmental stage since most people report overall satisfaction with their lives in all stages.

When preparing a 4-year-old child for a procedure, which method is developmentally most appropriate for the nurse to use? 1. Allowing the child to watch another child undergoing the same procedure 2. Showing the child pictures of what he or she will experience 3. Talking to the child in simple terms about what will happen 4. Preparing the child through play with a doll and toy medical equipment

4. Preparing the child through play with a doll and toy medical equipment

Elizabeth, who is having unprotected sex with her boyfriend, comments to her friends, "Did you hear about Kathy? You know, she fools around so much; I heard she was pregnant. That would never happen to me!" This is an example of adolescent: 1. Imaginary audience. 2. False-belief syndrome. 3. Personal fable. 4. Sense of invulnerability.

4. Sense of invulnerability.

An experienced nurse is explaining the use of touch from a caring perspective. What information does the nurse include in the discussion with the student about touch? 1. Nurses touch patients only while performing procedures or doing assessments. 2. Touch is a type of verbal communication. 3. Nurses use touch only when a patient is in pain. 4. Touch forms a connection between nurse and patient.

4. Touch forms a connection between nurse and patient.

Middle Childhood

6 to 11 or 12 years of age

Fetal

8 to 40 weeks of age (birth)

1, 4, 5

A 35-year-old woman has Medicaid coverage for herself and two young children. She missed an appointment at the local health clinic to get an annual mammogram because she has no transportation. She gets the annual screening because her mother had breast cancer. Which of the following are social determinants of this woman's health? (Select all that apply.) 1. Medicaid insurance 2. Annual screening 3. Mother's history of breast cancer 4. Lack of transportation 5. Woman's age

stereotype

A _______is an assumed belief regarding a particular group

reconstituted family

A blended family in which one or both partners have a child or children from a previous relationship.

Perspectives on Adult Development

A life span approach accounts for the multiple life events occurring in adulthood. This view considers an individual's personal circumstances (health and family support), how a person views and adjusts to changes, and the current social and historical context in which an individual is living. Life span development is lifelong, multidimensional, multidirectional, and contextual.

4

A mother is concerned about her child's flu-like symptoms. You learn from the health assessment that the mother practices use of "hot" and "cold" foods to treat ailments. Which of the following foods do you expect the mother to use to treat her child? 1. Chicken 2. Yogurt 3. Fresh fruits 4. Eggs

3

A nurse working in a large occupational health clinic knows that many of the workers at her company are marginalized and at risk for poor health outcomes. Which of the following individuals are most likely to be marginalized? 1. Wives of the employees 2. The head supervisors of the company 3. Workers who have a high school education 4. Workers employed for less than a year at the company

Family Systems Theory

A perspective on family functioning that emphasizes interconnections among different family relationships (such as marital, parent-child, sibling).

Ages and stages

A term used to broadly outline key periods in the human development timeline

which statement most accurately describes cultural factors that may affect health? a. Diabetes and cancer rates differ by cultural/ethnic groups b. There are limited ethnic variations in physiological responses to drugs c. Most patients find that religious rituals help them d. silence during a nurse-patient interaction means the patient understands the instructions

A. Diabetes and cancer rates differ by cultural/ethnic groups.

A cultural assessment should include the folllowing:

A.Brief history of the cultural group with which person identifies B.Communication C. Cultural sanctions and restrictions D. Educational background E. Health-related beliefs and practices F. Nutrition G. Organizations providing cultural support H. Religious affiliation I. Socioeconomic considerations J. Spiritual considerations K. Values orientation

___________ is the lifelong process of incorporating cultural aspects of the contexts in which a person grows, lives, works, and ages.

Acculturation

Nine characteristics of temperment

Activity; Rhythmicity; Approach-Withdrawal; Adaptability; Threshold of responsiveness (sensory threshold); Intensity of reaction; Mood; Distractibility; Attention span and persistence

Skill play

After infants develop the ability to grasp and manipulate, they persistently demonstrate and exercise their newly acquired abilities through skill play repeating an action over and over again.

Duvall's developmental theory stage 8 is:

Aging families: -shift from work role to leisure and semiretirement or full retirement. -Maintain couple and individual functioning while adapting to aging process. -prepare for own death and dealing with loss of spouse or siblings and other peers.

Physchosexual Development (Freud)

All human behavior is energized by psychodynamic forces, and this psychic energy is divided among three components of personality: the id, ego, and superego.

Reduced or incomplete penetrance

Allele does not express the phenotype

maturation

An increase in competence and adaptability; aging; usually used to describe a qualitative change; a change in the complexity of a structure that makes it possible for that structure to begin functioning; to function at a higher level

Neonatal

Birth to 27 or 28 days of age

Psychosocial Development (Erikson)

Built on Freudian theory and emphasizes a healthy personality as opposed to a pathological approach. Each psychosocial stage has two components- favorable and the unfavorable.

_________ ____________ provide pratical guidance for care of people with limited English proficiency and of cultural backgrounds

CLAS Standards (Culturally and Linguistically Appropriate Services)

______________ is a universal phenomenon influencing the ways in which people think, feel, and behave in relation to one another.

Caring

__________ theories are valuable when assessing patient perceptions of being cared for in a multicultural environment.

Caring theories

Single-gene disorder

Caused by an abnormality within a gen or in a gene's regulatory region. Can affect all body systems and may have mild to severe expressions.

Moral development (Kohlberg)

Children acquire moral reasoning in a developmental sequence. Based on cognitive developmental theory and consists of three major levels, each which has two stages.

Conventional level

Children are concerned with conformity and loyalty.

Period III: Concrete Operations (7 to 11 Years)

Children are now able to describe a process without actually doing it. At this time they are able to coordinate two concrete perspectives in social and scientific thinking, so they are able to appreciate the difference between their perspective and that of a friend. Reversibility is one of the primary characteristics of concrete operational thought. Another major accomplishment of this stage is conservation, or the ability to see objects or quantities as remaining the same despite a change in their physical appearance

Initiative vs. Guilt (3 to 6 Years)

Children like to pretend and try out new roles. Fantasy and imagination allow them to further explore their environment. Also at this time they are developing their superego, or conscience. Conflicts often occur between a child's desire to explore and the limits placed on his or her behavior. Conflicts sometimes lead to feelings of frustration and guilt. Guilt also occurs if a caregiver's responses are too harsh.

Solitary play

Children play alone with toys different from those used by other children in the same way

Parallel play

Children play independently but among other children

Associative play

Children play together and are engaged in a similar or even identical activity, but there is no organization, division of labor, leadership assignment, or mutual goal.

Onlooker play

Children watch what other children are doing but make no attempt to enter into the play activity

Hot Treatments

Chinese Heritage Beef Cereals Chili peppers Chocolate Eggs Liquor Onions Medicines and Herbs Anise Aspirin Castor oil Cinnamon Garlic Ginger root Iron Penicillin

cold treatments

Chinese heritage Barley water Chicken Dairy products Fresh vegetables Fruits Honey Bicarbonate of soda Milk of Magnesia Sage

Hot Conditions

Chinese heritage Constipation Diarrhea Fever Infection Kidney problems Rash Sore throat

Cold Conditions

Chinese heritage Cancer Cold, flu Earaches Headaches Joint pain Menses Pneumonia Stomach cramps

What are the four categories of internal assets?

Commitment to learning, positive values, social competencies, positive identity

Case study: 1. When reviewing your assignment for the day, you notice that you will be conducting a family interview with a family from Saudi Arabia. This is your first interaction with a family from this country. The three children, ages 3, 6, and 11, are accompanied by their parents. No one in the family speaks English. When caring for a family from a different culture, which option would not be included? a. To provide culturally sensitive care to children and their families, one must be aware of his or her own cultural values and beliefs. b. Generalizations made about an ethnic group apply to all groups and individuals. c. Beliefs related to the cause of illness and health maintenance influence the way families cope with health problems. d. A behavior may be characteristic of a culture rather than an abnormal behavior.

Correct Answer: B

Case Study: 1. A mother brings her three children to the clinic for their annual physical examinations. The children are 13 months and 2 and 5 years of age. The two younger children are cared for at the local day care, and the 5 year old attends kindergarten. The grandmother cares for the children for 2 hours in the early evening until the mother finishes work. The grandmother lives in a two-story house on a busy road located in the city. The mother reports a recent divorce, and the children have no contact with their father. The 5 year old recently started kindergarten, and the mother reports that the teacher has concerns because he is quiet and withdrawn but has become aggressive with peers. Which of the following is not appropriate to discuss with the mother? a. Marital factors in the home have an effect on children of all ages. b. Attention to the child's emotional and developmental needs is important. c. Aggression is a normal behavior that can be related to divorce. d. Positive outcomes of divorce rarely occur.

Correct Answer: D

Case Study: 1. A mother brings her three children to the clinic for their annual physical examinations. The children are 13 months and 2 and 5 years of age. The two younger children are cared for at the local day care, and the 5 year old attends kindergarten. The grandmother cares for the children for 2 hours in the early evening until the mother finishes work. The grandmother lives in a two-story house on a busy road located in the city. The mother reports a recent divorce, and the children have no contact with their father. The mother expresses concerns related to the children's safety. When providing anticipatory guidance to the mother, what do you say? a. Injuries cause no more deaths or disabilities in children than all types of diseases combined. b. Injuries cannot be prevented, even when safety measures are applied. c. Car restraints, bicycle helmets, and smoke detectors have not resulted in a significant decrease in fatalities. d. The developmental stage of the child helps determine the types of injuries that are most likely to occur at a specific age.

Correct Answer: D

______________ occurs when we impose our own cultural beliefs and practices on another person or group of people. In health care, it can result in disregarding or trivializing a patient's healthcare beliefs or practices.

Cultural Imposition

______________ is the ability to understand, appreciate, and work with people from cultures other than your own. It involves an awareness and acceptance of cultural differences, knowledge of the patient's needs, and adaptation of skills to meet the patient's needs.

Cultural competence

Preconventional level

Culturally oriented to the labels of good/bad and right/wrong. Children integrate these in terms of the physical or pleasurable consequences of their actions.

_________ is a way of life for a group of people. It includes the behaviors, beliefs, values, traditions, and symbols that the group accepts, generally without thinking about them.

Culture

__________ are illnesses or afflictions that are recognized only within a cultural group. These are expressed through psychologic or physical symptoms.

Culture-Bound Syndromes

Forcing one's own cultural beliefs and practices on another person is an example of: a. stereotyping b. ethnocentrism c. cultural relativity d. cultural imposition.

D. Cultural Imposition

The difficult child

Difficult children are highly active, irritable, and irregular in their habits. Negative withdrawal responses are typical and they require a more structured environment. These children are usually intense and primarily negative. They exhibit frequent periods of crying, and frustration often produces violent tantrums. This group represents about 10% of children.

Identity vs. Role Confusion (Puberty)

Dramatic physiological changes associated with sexual maturation mark this stage. There is a marked preoccupation with appearance and body image. This stage, in which identity development begins with the goal of achieving some perspective or direction, answers the question "Who am I?" Acquiring a sense of identity is essential for making adult decisions such as choice of a vocation or marriage partner.

1

During a nursing assessment a patient displayed several behaviors. Which behavior suggests the patient may have a health literacy problem? 1. Patient has difficulty completing a registration form at a medical office 2. Patient asks for written information about a health topic 3. Patient speaks Spanish as primary language 4. Patient states unfamiliarity with a newly ordered medicine

Period II: Preoperational (2 to 7 Years)

During this time children learn to think with the use of symbols and mental images. They exhibit 139"egocentrism" in that they see objects and people from only one point of view, their own. They believe that everyone experiences the world exactly as they do. Their thinking is influenced greatly by fantasy and magical thinking. Children at this stage have difficulty conceptualizing time.

Individual differences

Each child grows in his or her own unique way

The Easy Child

Easygoing and even-tempered. This child is regular and predictable in his or her habits. An easy child is open and adaptable to change and displays a mild to moderately intense mood that is typically positive.

The easy child

Easygoing children are even tempered, are regular and predicable in their habits, and have a positive approach to new stimuli. They are open and adaptable to change and display a mild to moderately intense mood that is typically positive. Approximately 40% of children fall into this category.

Games

Engage in games alone or with others. Small children participate in repetitive activities and progress to more complicated games and challenge their independent skills

Trust vs. Mistrust (Birth to 12 to 18 months)

Establishing a basic sense of trust is essential for the development of a healthy personality. An infant's successful resolution of this stage requires a consistent caregiver who is available to meet his needs. The formation of trust results in faith and optimism.

Multifactorial Inheritance

Explains why a person who carriers genetic material for developing a chronic illness may or may not eventually be diagnosed with the disease.

Duvalls developmental theory stage 6 is:

Families as launching centers: -parents and young adults establish independent identities -parents renegotiate marital relationship

Duvalls developmental theory stage 2 is:

Families with infants: -integrate infants into family unit -accommodate to new parenting and grandparenting roles -maintain marital bond

Duvalls developmental theory stage 3 is:

Families with preschoolers: -social children -parents and children adjust to separation

Duvalls developmental theory stage 4 is:

Families with schoolchildren: -children develop peer relations -parents adjust to their childrens peer and school influences

Duvalls developmental theory stage 5 is:

Families with teenagers: -Adolescents develop increasing autonomy -parents refocus on midlife marital and career issues -parents begin a shift toward concern for the older generation

Family Stress Theory

Family response to & coping with stressful events

___________________ ___________________ can affect how the body processes a drug and the overall effect of selected drugs on the body.

Genetic Variations

Cultural practices the Dominant culture may consider abusive: traditional remedies that contain lead:

Greta and azarcon (mexico; used for digestive problems), paylooah (southest asia; used for rash or fever), surma (india; used as cosmetic to improve eyesight).

1, 2, 4, 5

Health care organizations must provide which of the following based on federal civil rights laws? (Select all that apply.) 1. Provide language assistance services at all points of contact free of charge. 2. Provide auxiliary aids and services, such as interpreters, note takers, and computer-aided transcription services. 3. Use patients' family members to interpret difficult topics. 4. Ensure that interpreters are competent in medical terminology. 5. Provide language assistance to all patients who speak limited English or are deaf.

Community

Help develop partnerships to enhance the effectiveness of chronic disease management programs. Community partnerships between health systems and local, state, and national agencies help fill in the gaps that exist in different services and improve patient care.

The Difficult Child

Highly distracted, active, irritable, and irregular in habits. This child may benefit from "practice" or role playing to be successful with new skills, situations, or environments.

Watson's Transpersonal Caring

Holistic model that supports that supports a nurse's conscious intention to care to promote healing and wholeness. It integrates the human caring processes with healing environments, incorporating the life-generating and life-receiving processes of human caring and healing for nurses and their patients.

Self-concept

How an individual descries himself or herself.

Sequential Trends

In all dimensions of growth and development, there is a definite, predictable sequence, with each child passing through every stage

Postconventional, autonomous or princible level

Individual has reached the cognitive stage of formal operations.

Period I: Sensorimotor (Birth to 2 Years)

Infants develop a schema or action pattern for dealing with the environment; include hitting, looking, grasping, or kicking. Schemas become self-initiated activities. Successful achievement leads to greater exploration.

Stage 1: Oral (Birth to 12 to 18 Months)

Initially sucking and oral satisfaction are not only vital to life but also extremely pleasurable in their own rights.

Clinical Information Systems

Maintain and share patient health information among providers and patients to ensure effective communication and quality patient care.

Integrity vs. Despair (Old Age)

Many older adults review their lives with a sense of satisfaction, even with their inevitable mistakes. Others see themselves as failures, with their lives marked by despair and regret. They interpret their lives as a meaningful whole or experience regret because of goals not achieved

Duvall's developmental theory stage 1 is:

Marriage and an independent Home: the joining of families. -re-establish couple identity -realign relationships with extended family -make decisions regarding parenthood

Duvall's developmental theory stage 7 is:

Middle-aged families: -reinvent in couple identity with concurrent development of independent interests -realign relationships to include in-laws and grandchildren -deal with disabilities and death of older generation

Cultural practices the Dominant culture may consider abusive: Cupping

Old World practice; also vietnamese: placing container containing steam against skin to draw out poison or other evil element. bruiselike blemish

Domains of Culture

Overview- country of origin and current residence Communication- verbal language skills Family roles and organization Workforce issues Biocultural ecology-skin color, genetics High-risk behaviors Nutrition Pregnancy and childbearing practices Death rituals Spirituality Health care practices Health care providers- perceptions of providers

Depression

Patients living with chronic illnesses are at a higher risk of experiencing ________________

Growth and Development considerations

Patients who became chronically ill as children often experience depression and anxiety in adulthood.

These types of zones are the variable and subjective distance at which 1 person feels comfortable talking to another.

Personal space zones

Developmental milestones

Physical or behavioral signs through development

Self- Management Support

Places the patient in the center of disease management. Self-management support requires providers to collaborate with patients, which ultimately empowers patients to take responsibility for and manage their chronic diseases.

Cooperative play

Play is organized and children play in a group with other children

Developmental Theory

Provides a framework for explaining the patterns and problems of development. An outgrowth of several theories of development

Syndrome

Recognized pattern of anomalies resulting from a single specific cause

what greatly influences health promotion beliefs in families?

Religious practices

Disruptions

Result from the breakdown of previously normal tissue

Dysplasia

Results from abnormal organization of cells into a particular tissue type

Industry vs. Inferiority (6 to 12 Years)

School-age children are eager to apply themselves to learning socially productive skills and tools. They thrive on their accomplishments and praise. Without proper support for learning new skills or if skills are too difficult, they develop a sense of inadequacy and inferiority.

Functions of play

Sensorimotor development Intellectual development Socialization Creativity Self-awareness Therapeutic value Morality

The slow-to-warm-up child

Slow-to-warm-up children typically react negatively and with mild intensity to new stimuli and, unless pressured, adapt slowly with repeated contact. They respond with only mild but passive resistance to novelty or change in routine. They are interactive and moody but show only moderate irregularity in functions. 15% of children demonstrate this temperament pattern.

Cognitive development (Piaget)

Stage theory to better understand the way children think

What are the four categories of external assets?

Support, empowerment, boundaries and expectations, constructive use of time

This theory of caring was developed from three perinatal studies involving interviews with women who miscarried, parents and health care professionals in a newborn intensive care unit, and mothers who were socially at risk and received long-term public health intervention. This theory of caring includes 5 caring processes.

Swanson's Theory of Caring

TRUE OR FALSE: Recent immigrants are at high risk for health problem s when arriving in new area.

TRUE: Relocation is associated with many losses and can cause economic hardship, physical stress, and mental distress.

What theory rejects the disease orientation to healthcare and places care before cure.

The Transpersonal Caring Theory

Seriation

The ability to mentally classify objects according to their quantitative dimensions.

social determinants of health

The conditions in which people are born, grow, live, work, and age, shaped by the distribution of money, power, and resources at global, national, and local levels

Loneliness

The degree of ____________ a person experiences is negatively related to illness and emotional perception of the chronic disease as well as the person's opinion about the usefulness of the treatment.

Stage 2: Anal (12 to 18 Months to 3 Years)

The focus of pleasure changes to the anal zone. Children become increasingly aware of the pleasurable sensations of this body region with interest in the products of their effort.

Stage 3: Phallic or Oedipal (3 to 6 Years)

The genital organs are the focus of pleasure during this stage. The boy becomes interested in the penis; the girl becomes aware of the absence of the penis, known as penis envy. a time of exploration and imagination as a child fantasizes about the parent of the opposite sex as his or her first love interest, known as the Oedipus or Electra complex.

cephalocaudal or head-to-tail

The head end of the organism develops first and is large and complex, whereas the lower end is small and simple

Temperament

The manner of thinking, behaving or reacting characteristics of an individual

Postconventional Reasoning

The person finds a balance between basic human rights and obligations and societal rules and regulations; individuals move away from moral decisions based on authority or conformity to groups to define their own moral values and principles.

Basal metabolic rate (BMR)

The rate of metabolism when the body is at rest

Period IV: Formal Operations (11 Years to Adulthood)

The transition from concrete to formal operational thinking occurs in stages during which there is a prevalence of egocentric thought; egocentricity leads adolescents to demonstrate feelings and behaviors characterized by self-consciousness: a belief that their actions and appearance are constantly being scrutinized, that their thoughts and feelings are unique, and that they are invulnerable. These feelings of invulnerability frequently lead to risk-taking behaviors, especially in early adolescence.

Proximodistal or near-to-far

The trend applies to the midline-to-peripheral concept

Self-esteem

The value that an individual places on oneself and refers to an overall evaluation of oneself

Contact touch involves skin-to-skin contact and is referred to as

Therapeutic touch

Leininger's Transcultural Caring

This form of caring offers a trancultural view of caring. It describes the concept of care as the domain that sets nursing apart from other health care disciplines.

Cultural Assessment

Thus the nurse needs to conduct a comprehensive _______ to understand how the patient's religious values will affect her willingness to receive care

Sensitive periods

Times during the process of growth when the organism is more susceptible to positive or negative influences

Watsons model is _____________ because the relationship influences both the nurse and the patient for better or for worse.

Transformative

True or False Caring improves a nurse's ability to know a patient, recognize a patients problems, and find and implement individualized solutions.

True

The Slow-to-Warm Up Child

Typically displays discomfort when introduced to new situations and needs time to adjust to new environment, authority figures, and expectations. These children respond with tears, somatic complaints, or other maneuvers to avoid the situation (e.g., complaining of a stomachache to avoid going to school).

Decision Support

Used by health care providers to implement evidence-based guidelines, guide patient education, and encourage patients to participate in their care.

Delivery System Design

Uses evidence-based care that is patient-centered, preventive in nature, and occurs in a variety of acute, outpatient, and community settings.

_________ are the sets of rules by which persons, families, groups, and communities live. They are the principles and standards that serve as the basis for beliefs, attitudes, and behaviors.

Values

family

What an individual considers it to be. No universal definition; Biologically: fulfilling biologic function of perpetuation of species. Psychologically: emphasizes interpersonal aspects of family and responsibility for personality development. Economically: family is a productive unit providing material needs. Sociologically: depicts family as social unit interacting with larger society; creates context within cultural values and identity.

Three dimensions: Health traditions that differ from Western, modern health care system:

What are physical aspects of caring for the body (eg. are there specific clothes, foods, medicines)? What are the mental parts of caring for health (eg. feelings, attitudes, rituals, actions)? What are the spiritual aspects of health (eg who I am, spiritual customs, prayers, healers)?

Cultural health-related influences and differences to ask:

What do you think caused your child's health problem? Why do you think it started when it did? How severe is your child's sickness? Will it have short or long course? How do you think your child's sickness affects your family? What are the chief problems your child's sickness has caused? What kind of treatment do you think your child should receive? What are the most important results you hope to receive from your child's treatment? What do you fear most about your child's sickness?

1.

Which explanation provided by the nurse is the most accurate meaning for "providing culturally congruent care"? 1. It fits the patient's valued life patterns and set of meanings. 2. It is the same set of values as those of the health care team member providing daily care. 3. It holds one's own way of life as superior to those of others. 4. It redirects the patient to a more socially expected set of values.

2, 3, 5

Which of the following is an example of a patient with a health disparity? (Select all that apply.) 1. A patient who has a homosexual sexual preference 2. A patient unable to access primary care services 3. A patient living with a chronic disease 4. A family who relies on public transportation 5. A patient who has had a history of smoking for 10 years

1-

Which statement made by a new graduate nurse about the teach-back technique requires intervention and further instruction by the nurse's preceptor? 1. "After teaching a patient how to use an inhaler, I need to use the teach-back technique to test my patient's technique." 2. "The teach-back technique is an ongoing process of asking patients for feedback." 3. "Using teach-back will help me identify explanations and communication strategies that my patients will most commonly understand." 4. "Using pictures, drawings, and models can enhance the effectiveness of the teach-back technique."

Cultural practices the Dominant culture may consider abusive: topical garlic application:

Yemenite jew practice: crushed garlic cloves or garlic-petroleum jelly applied to wrists to treat infectious disease, can result in blisters or garlic burns.

Intimacy vs. Isolation (Young Adult)

Young adults, having developed a sense of identity, deepen their capacity to love others and care for them. They search for meaningful friendships and an intimate relationship with another person.

marginalized groups

______ are more likely to have poor health outcomes and die at an earlier age because of a complex interaction between individual genetics and behaviors; public and health policy; community and environmental factors; and quality of health care -gay, lesbian, bisexual, or transgender; people of color; people who are physically or mentally challenged; and people who are not college-educated.

Oppression

_______ is formal and informal system of advantages and disadvantages tied to membership in social groups, reinforced by societal norms, biases, interactions, and beliefs

implicit bias

__________ are attitudes or stereotypes that affect our understanding, actions, and decisions. -we are aware of the bias that is present.

Unconscious bias

____________ refers to a bias we are unaware of and that happens outside our control, which is influenced by our personal background, cultural environment, and personal experiences. -quick judgments and assessments of people and situations

cultural competence

_____________professional health care must be culturally sensitive, culturally appropriate, and culturally competent to meet the multifaceted health care needs of each person, family, and community

culturally congruent care

___________emphasizes the need to provide care based on an individual's cultural beliefs, practices, and values

Culture

___________refers to the learned and shared beliefs, values, norms, and traditions of a particular group, which guide our thinking, decisions, and actions

cultural respect

________is critical to reducing health disparities and improving access to high-quality health care that is respectful and responsive to the needs of the diverse patient.

Cultural skill

________is the ability to conduct a cultural assessment of a patient to collect relevant cultural data about a patient's presenting problem, as well as accurately conducting a culturally based physical assessment.

Assimilation

________is the process in which the individual adapts to the host's cultural values and no longer prefers the components of the origin culture

acculturation

________occurs when an individual or group transitions from one culture and develops traits of another culture -In this transition, there will be adaptation to the new cultures, traditions, customs, and language.

cultural identity

_______is "the frame in which individuals identify consciously or unconsciously with those with whom they feel a common bond because of similar traditions, behaviors, values, and beliefs"

Intersectionality

_______looks at how being marginalized affects people's health and access to care. It serves to describe the forces, factors, and power structures that shape and influence life.

core measures

_____key quality indicators that help health care institutions improve performance, increase accountability, and reduce costs -are a set of evidence-based, scientifically researched standards of care -regulated by Medicare, Medicaid, and Joint Commission

Temperament

a behavioral style that affects an individual's emotional interactions with others.

Polygamous family

a family consisting of one man, several wives, or vice versa and the biological children of the man and his wives

Chronic Care Model

a framework to guide health care delivery for patients living with chronic illness; considers the complex nature of factors that affect the care delivery needs of a person with chronic illnesses.

development

a gradual change and expansion; advancement from lower to more advanced stages of complexity; the emerging and expanding of the individual's capacity through growth, maturation and learning

Autonomy vs. Sense of Shame and Doubt (18 Months to 3 Years)

a growing child is more accomplished in some basic self-care activities, including walking, feeding, and toileting, This newfound independence is the result of maturation and imitation. A toddler who successfully masters this stage achieves self-control and willpower.

health disparity

a particular type of health difference that is closely linked with social, economic, and/or environmental disadvantage

Chronic Disease

a pathophysiologic condition that lasts more than 1 year, requires ongoing medical care, and often limits a person's ADL's due to symptoms of the disease or self-care activities required to manage the disease.

developmental task

a set of skills and competencies specific to each developmental stage that children must accomplish or master to function effectively within their environment

Binuclear family

a type of family consisting of divorced parents living in two separate households but remaining one family in spirit for the sake of the children

What are leading determinants of a patient's health? (select all that apply) a. Genetics b. Health Behaviors c. Family History of Disease d. Social and Physical Environment e. Type and quality of medical care received

a, b, and d

Case Study: 1. When reviewing your assignment for the day, you notice that you will be conducting a family interview with a family from Saudi Arabia. This is your first interaction with a family from this country. The three children, ages 3, 6, and 11, are accompanied by their parents. No one in the family speaks English. When entering the room, you notice that the father is kneeling, facing the wall. You review the child's chart and notice that the family is Muslim. You think that the father may be praying. What is the best action to take? a. Give him a few more minutes to complete the prayer because it is part of the Muslim belief system. b. Interrupt him because prayer is not a part of the Muslim belief system and you need to take the child's physiologic measurements. c. Realize that he did not hear you enter the room and introduce yourself in a loud manner. d. Explain to him that you understand that religion and spirituality are important but that you must take the child's physiologic measurements at this time.

a. Give him a few more minutes to complete the prayer because it is part of the Muslim belief system.

The nurse is caring for a vietnamese child and observes various marks on the childs body. When completing a thorough assessment, the nurse should keep which applicable cultural practices in mind? (select all that apply.) a. coining b. cupping c. forced kneeling d. topical garlic application e. burning

a. coining b. cupping e. burning

The practice of cultural humility is continual and an important concept in the nursing process. Nurses can facilitate this process by: (select all that apply). a. integrating cultural knowledge b. recognizing cultural differences c. acting in a culturally appropriate manner d. being aware of their own beliefs and practices. e. helping the family adapt to the health care practices.

a. integrating cultural knowledge b. recognizing cultural differences c. acting in a culturally appropriate manner d. being aware of their own beliefs and practices.

While caring for hospitalized adolescents, the nurse observes that sometimes they are skeptical of their parents religious beliefs/practices. The nurse should recognize that this is: a. normal in spiritual development b. abnormal in spiritual development c. related to illness and ocurs only at times of crisis d. related to the inability of parents to explain adequately their beliefs/practices.

a. normal in spiritual development

The parent of a hospitalized child tells the nurse, "We do not eat meat. We are practicing Buddhists and strict vegetarians." The most appropriate intervention by the nurse is to: a. order the child a meatless tray. b. tell the parents to take any meat off the child's meal tray. c. ask the parent if they would like to have Buddhist priest visit. d. explain to the parent that meat provides protein needed to heal their child.

a. order the child a meatless tray.

Which statement is true concerning folk remedies? a. they may be used to reinforce the treatment plan b. they are incompatible with modern medical regimens. c. they are a leading cause of death in some cultural groups d. they are not a part of the culture in large, developed countries.

a. they may be used to reinforce the treatment plan

Malformation

abnormal formations of organs or body parts resulting from an abnormal developmental process

Genetic Mutation

abnormality in inherited genetic material; causes autosomal genetic disorders.

Generativity vs. Self-Absorption and Stagnation (Middle Age)

an adult focuses on supporting future generations. The ability to expand one's personal and social involvement is critical to this stage of development. Middle-age adults achieve success in this stage by contributing to future generations through parenthood, teaching, mentoring, and community involvement.

Growth

an increase in number and size of cells as they divide and synthesize new proteins,; results in increased size and weight of the whole or any of its parts

National Culturally and Linguistically Appropriate Services

are intended to advance health equity, improve quality, and help eliminate health care disparities by establishing a blueprint to help individuals and health care organizations implement culturally and linguistically appropriate services

Absolute standard of poverty

attempts to delimit a basic set of resources needed for adequate existence

A mexican American adolescent states to the nurse, " I have cancer because it is God's will. It will make me stronger." The MOST appropriate response by the nurse is: a. " You are too young to think that way. You still have many years to live" b. "Tell me how you feel about the treatment plan." c. " I will move your family into the waiting area to give you some quiet time." d. " I will contact the hospital chaplain for you."

b. "Tell me how you feel about the treatment plan."

In identifying patients at the greatest risk for health disparities, the nurse would note that a. patients who live in urban areas have readily available access to health care services. b. Cultural differences exist in patients' ability to communicate with their health care provider. c. a patient receiving care from a health care provider of a different culture will have decreased quality of care. d. men are more likely than women to have their cardiovascular disease symptoms ignored by a health care provider.

b. Cultural differences exist in patients' ability to communicate with their health care provider.

What is the first step in developing cultural competence? a. Create opportunities to interact with a variety of cultural groups. b. Examine the nurse's own cultural background, values, and beliefs about health and health care. c. Learn about a multitude of folk medicines and herbal substances that different cultures use for self-care. d. Learn assessment skills for different cultural groups, including cultural beliefs and practices and physical assessments..

b. Examine the nurse's own cultural background, values, and beliefs about health and health care.

A camp nurse is assessing a group of children attending summer camp. Based on the nurses knowledge of special parenting situations, which group of children is a t risk for a sense of belonging? a. children adopted as infants b. children recently placed in foster care c. children whose parents recently divorced d. children who recently gained a stepparent

b. children recently placed in foster care

The nurse is caring for a dying boy whose religion is islam (muslim/Moslem). An important nursing consideration related to his impending death and religion is that: a. there are no special rites b. there are specific practices to be followed. c. the family is expected to "wait" awat from the dying person d. baptism should be performed if it has not been done previously.

b. there are specific practices to be followed.

When communicating with a patient who speaks a language that the nurse does not understand, it is important to first attempt to a. have a family member interpret. b. use a trained medical interpreter. c. use specific medical terminology so there will be no mistakes. d. focus on the translation rather than nonverbal communication.

b. use a trained medical interpreter.

As part of the nursing process, cultural assessment is best accomplished by a. judging the patient's cultural values based on observations. b. using a cultural assessment guide as part of the nursing process. c. seeking guidance from a nurse from the patient's cultural background. d. relying on the nurse's previous experience with patients from that cultural group.

b. using a cultural assessment guide as part of the nursing process.

Stage 4: Latency (6 to 12 Years)

believed that children repress and channel sexual urges from the earlier Oedipal stage into productive activities that are socially acceptable.

Before transporting a 16-year-old american indian female for a mangetic resonance imaging (MRI) scan, the nurse notices the girl is wearing a decorated amulet necklace. The nurses next BEST action is to: a. remove the necklace and place it at the nurses station b. explain the risks of wearing the necklace during the MRI c. Ask the patient if there is a special reason for wearing the necklace d. place tape around the neck covering the necklace.

c. Ask the patient if there is a special reason for wearing the necklace

What is appropriate advice for parents who are preparing to tell their children about their decision to divorce? a. avoid crying in front of the children b. avoid discussing the reason for the divorce c. Give reassurance that the divorce is not the childrens fault. d. give reassurance that the divorce will not affect most aspects of the childrens lives.

c. Give reassurance that the divorce is not the childrens fault.

The nurse should expect to possibly incorporate which religous and cultural practices into the plan of care when caring for a 35-yr-old jewish mother who just gave birth to a healthy baby boy? (Select all that apply) a. Circumcision in hospital b. Ordering house diet lunch tray of roasted pork with mashed potatoes c. allowing family, friends, and rabbi to visit patient often d. Ask males to remove shawl and yarmulke while visiting e. ordering house diet with the exception of shellfish

c. allowing family, friends, and rabbi to visit patient often e. ordering house diet with the exception of shellfish

The MOST overwhelming adverse influence on health is: a. race b. customs. c. socioeconomic status d. genetic constitution

c. socioeconomic status

Parents of a 10 yr old child are concerned that their child has recently been showing signs of lineliness and abondonment. What should the nurse consider when discussing this issue with the parents? a. Changing self-esteem is difficult after about age 5. b. self-esteem is the objective judgement of ones worthiness. c. transitory periods of loneliness and abandonment are expected developmentally d. high self-esteem develops when parents show adequate love for the child.

c. transitory periods of loneliness and abandonment are expected developmentally

________ is an essential human need. This helps an individual or group improve a human condition.

care

The impact of divorce on a child depends on:

child's age, the outcome, and the quality of the parent-child relationship and parental care following the divorce.

Unoccupied behavior

children are not playful but focusing their attention momentarily on anything that strikes their interest

Dramatic, or pretend play

children incorporate dolls/action figures, role-play or make-believe through pretending.

Genetic Counseling

clarifies the risk of disease development based on family history when there is a strong disease pattern.

The use of touch is one ________________ approach that reaches out to patients to communicate concern and support.

comforting

Newer concepts of family include:

communal families, single-parent families, and homosexual families. (referred to as household).

Caring and _________________ interventions need to be taught and practiced early in nursing education and emphasized in all clinical practice settings.

compassion

Germinal

conception to approximately 2 weeks of age

Culturally competent care includes __________________ and __________________.

continual learning and self-reflection

The nurse is planning care for a patient with cultural background different from that of the nurse. An appropriate goal is to: a. strive to keep cultural background from influencing health needs. b. encourage continuation of cultural practices in the hospital setting. c. attempt in a nonjudgemental way to change cultural beliefs. d. adapt as necessary cultural practices to health needs.

d. adapt as necessary cultural practices to health needs.

Nurses play a key role in promoting health equity. An important mechanism to do this is to a. discourage use of evidence-based practice guidelines. b. insist that patients adhere to established clinical guidelines. c. teach patients to use the Internet to find resources related to their health. d. engage in active listening and establish relationships with patients and families.

d. engage in active listening and establish relationships with patients and families.

Congenital defects

defects present at birth, birth defects

Contiguous gene syndrome

disorders characterized by a microdeletion or microduplication of smaller chromosome segments

spirituality

dynamic and personal experiential process, concerned w/ deepest levels of human experiencing, the places of deepest meaning in and for our lives

Psychoanalytical/Psychosocial Theory

explains development as primarily unconscious and influenced by emotion and that these unconscious conflicts influence development through universal stages experienced by all individuals.

Adoptive parents have _____ sources of support and preparation for the new addition to their family.

fewer

Self-Management

focus on the life changes that a person with chronic illness must make to live well with his or her illness.

The nurse should consider _____________ cultural beliefs, practices, and habits when discussing nutrition with a patient and planning their diet.

food-related

Caring touch

form of nonverbal communication, which successfully influences a patient's comfort and security, enhances self-esteem, increases confidence of the caregivers, and improves mental well-being

Linear growth

height; occurs almost entirely as a result of skeletal growth

Theories of caring

help nurses understand the behaviors and processes that characterize caring.

Biophysical Developmental

how our physical bodies grow and change.

Piaget's Theory of Cognitive Development

includes four periods that are related to age and demonstrate specific categories of knowing and understanding. Period I: Sensorimotor (Birth to 2 Years) Period II: Preoperational (2 to 7 Years) Period III: Concrete Operations (7 to 11 Years) Period IV: Formal Operations (11 Years to Adulthood)

Erikson's Theory of Psychosocial Development

individuals need to accomplish a particular task before successfully mastering the stage and progressing to the next one. -Trust vs. Mistrust (Birth to 12 to 18 months) -Autonomy vs. Sense of Shame and Doubt (18 Months to 3 Years) -Initiative vs. Guilt (3 to 6 Years) -Industry vs. Inferiority (6 to 12 Years) -Identity vs. Role Confusion (Puberty) -Intimacy vs. Isolation (Young Adult) -Generativity vs. Self-Absorption and Stagnation (Middle Age) -Integrity vs. Despair (Old Age)

variable expressivity

individuals possessing the alleles for a trait will display the phenotype for that trait, but to a varying degree of severity

Social-affective play

infants take pleasure in relationships with people

Emic worldview

insider or native perspective in a culture

_______________ is an important first step in providing culturally competent care.

interpersonal skills

Kohlberg's Theory of Moral Development

interviewed children, adolescents, and eventually adults and found that moral reasoning develops in stages. It is important to note that his theory is applicable to age 4 until adulthood. Children younger than 4 do not understand morality. Level I: Preconventional Reasoning -Stage 1: Punishment and Obedience Orientation -Stage 2: Instrumental Relativist Orientation Level II: Conventional Reasoning -Stage 3: Good Boy-Nice Girl Orientation -Stage 4: Society-Maintaining Orientation Level III: Postconventional Reasoning -Stage 5: Social Contract Orientation -Stage 6: Universal Ethical Principle Orientation

protective touch

is a form of touch that protects the nurse and/or patient; can be viewed either positively or negatively

Presence

is a person-to-person encounter conveying a closeness and sense of caring. It is also a interpersonal process that is characterized by sensitivity, wholism, intimacy, vulnerability, and adaptation to unique circumstances.

Cultural encounter

is a process that encourages health care professionals to directly engage in face-to-face cultural interactions and other types of encounters with patients from culturally diverse backgrounds. A cultural encounter aims to modify a health care provider's existing belief about a cultural group and to prevent possible stereotyping.

teach back method

is an ongoing process of asking patients open-ended questions to gather feedback through explanation or demonstration until the health care provider feels confident in the patient's ability to understand and safely apply the new educational content

Ethic of care

is concerned with relationships between people and with a nurse's character and attitude towards others. Nurses who function from this are sensitice to unequal relationships that lead to an abuse of one's power over another- intentional or otherwise.

Listening

is necessary for meaningful interactions with patients. It is a planned and deliberate act in which the person is present and engages the patient in a nonjudgmental and accepting manner.

Touch

is relational and leads to a connection between nurse and patient. It involves contact and noncontact touch.

Linguistic competence

is the ability to communicate effectively and convey information in a manner that is easily understood by diverse audiences

Health literacy

is the degree to which individuals have the capacity to obtain, process, and understand basic health information and the services needed to make appropriate health decisions

Cultural desire

is the motivation of a health care professional to "want to" (and not "have to") engage in the process of becoming culturally aware, culturally knowledgeable, and culturally skillful in seeking cultural encounters.

Cultural knowledge

is the process in which a health care professional seeks and obtains a sound educational base about culturally diverse groups. In acquiring this knowledge, health care professionals must focus on the integration of three specific issues: health-related beliefs and cultural values, care practices, and disease incidence and prevalence.

Cultural awareness

is the process of conducting a self-examination of one's own biases toward other cultures and the in-depth exploration of one's cultural and professional background. It also involves being aware of the existence of documented racism and other "isms" in health care delivery.

Swanson's 5 caring processes:

knowing, being with, doing for, enabling, and maintaining belief

Risk Behaviors

lifestyle choices that contribute to the development of chronic illness.

Cultural beliefs related to cause of illness and maintenance of health may focus on:

natural forces, supernatural forces, or an imbalance of forces.

Health System

needs to constantly attempt to improve the management of chronic illnesses and focus on safety and quality of care.

Sense-pleasure play

nonsocial stimulating experiences that originates from without; Environmental objects attract the children's attention

Deformations

often caused by extrinsic mechanical forces on normally developing tissue

Social Isolation

often occurs as an illness or disability becomes more advanced or severe.

racial identity

one's self-identification with one or more social groups in which a common heritage with a particular racial group is shared

Etic worldview

outsider's perspective (not part of the culture)

religion

particular and culturally influenced representation of human spirituality.

The solutions to reduce health disparities often rest with the _______________.

policymakers

Cultural practices the Dominant culture may consider abusive: Female genital mutilation (female circumcision)

practiced in africa, middle east, latin america, india, asia, North america, australia, western europe: removal of or injury to any part of female genitalia.

Differentiation

process in which early cells and structures are systematically modified and altered to achieve specific and characteristic physical and chemical properties; sometimes used to describe the trend of mass to specific; development from simple to more complex activities and functions

Developmental Theories

provide a framework for examining, describing, and appreciating human development. also important in helping nurses assess and treat a person's response to an illness.

Sociocultural influences upon the child and family include:

race, ethnicity, social class, poverty, religion, and mass media.

Chronic Illness

refers to a patient and family's subjective experience of and response to chronic disease.

Ethnocentrism

refers to the belief that one's own culture and worldview are superior to those of others from different cultural, ethnic, or racial backgrounds.

Moral Development Theory

refers to the changes in a person's thoughts, emotions, and behaviors that influence beliefs about what is right or wrong. It encompasses both interpersonal and intrapersonal dimensions as it governs how we interact with others.

relative standard of poverty

reflects the median standard of living in a society and is the term used in referring to childhood poverty in the United States

Stage 5: Genital (Puberty Through Adulthood)

sexual urges reawaken and are directed to an individual outside the family circle. Unresolved prior conflicts surface during adolescence. Once the individual resolves conflicts, he or she is then capable of having a mature adult sexual relationship.

Cultural practices the Dominant culture may consider abusive: Forcing kneeling

some caribbean groups: child discipline measure, child is forced to kneel for long time.

Cultural practices the Dominant culture may consider abusive: Burning

some southeast asian groups: small areas of skin burned to treat enuresis and temper tantrums

Freud's Psychoanalytical Model of Personality Development

states that individuals go through five stages of psychosexual development and that each stage is characterized by sexual pleasure in parts of the body: the mouth, the anus, and the genitals. Stage 1: Oral (Birth to 12 to 18 Months) Stage 2: Anal (12 to 18 Months to 3 Years) Stage 3: Phallic or Oedipal (3 to 6 Years) Stage 4: Latency (6 to 12 Years) Stage 5: Genital (Puberty Through Adulthood)

Body image

subjective concept and attitudes that individuals have towards their own bodies

Gesell's Theory of Development

that each child's pattern of growth is unique and this pattern is directed by gene activity.

Adherence

the extent to which a person's behavior, taking medication, following a diet, and/or executing lifestyle changes, corresponds with agreed recommendations from a health care provider.

Incidence

the occurrence, rate, or frequency of a disease.

Conventional Reasoning

the person sees moral reasoning based on his or her own personal internalization of societal and others' expectations.

Skeletal or bone age

the radiologic determination of osseous maturation; the most accurate measure of general development

Family function

the way a family works to meet the physical and psychological needs of its members

The US Census Bureau defines family in the following ways:

traditional nuclear family, nuclear family, blended family or household, and extended family or household.

Cultural practices the Dominant culture may consider abusive: Coining

vietnamese practice: weltlike lesions on childs back when edge of coin is rubbed on oiled skin to rid body of disease.

National Health Core Measures

• Accountable care organizations (ACOs), patient-centered medical homes (PCMH), and primary care • Cardiology • Gastroenterology • HIV and hepatitis C • Medical oncology • Obstetrics and gynecology • Orthopedics • Pediatrics

What are the Five A's that support a patient in managing their chronic disease?

• Assess: Determine a patient's beliefs, behaviors, knowledge. • Advise: Provide specific information regarding health risks and the benefits of changing behaviors. • Agree: Collaborate with the patient to set realistic goals. • Assist: Help the patient identify barriers, strategies, problem-solving skills, and available support. • Arrange: Determine a follow-up plan such as return visits, phone calls, and text messages.

Interventions to promote health equity:

• Treat all patients equally. • Be aware of your own biases or prejudices and work toward eliminating them. • Learn about services and programs that focus on specific cultural/ ethnic groups. • Inform patients about health care services available for their specific cultural/ ethnic group. • Make sure the same standards of care are followed for all patients regardless of culture or ethnicity. • Recognize health care practices and cultural practices that are important to cultural and ethnic identity. • Take part in research focused on understanding and improving care to culturally and ethnically diverse populations. • Identify stereotypic attitudes toward a culture/ ethnic group that may interfere with getting appropriate health care. • Support patients who are fearful about traveling outside the accepted neighborhood for health care services.