IRSC ADN Module 4
Biofeedback
a method for learning control of involuntary physiologic responses by using electronic devices to monitor bodily changes and feeding this information back to a person
agnostic
a person who believes nothing can be known about the existence of a god
Ayurveda (Ayurvedic medicine)
a science of life that delineates the diet, medicines, and behaviors that are beneficial or harmful for life and considers that balance among people, the environment, and the larger cosmos is integral to human health
Hospice
a type of end-of-life care for persons who are terminally ill, characterized by the following: (1) patients are kept as free of pain as possible so that they may die comfortably and with dignity; (2) patients receive continuity of care, are not abandoned, and do not lose personal identity; (3) patients retain as much control as possible over decisions regarding their care and are allowed to refuse further life-prolonging technologic interventions; and (4) patients are viewed as individuals with personal fears, thoughts, feelings, values, and hopes
A nurse cares for patients in a chiropractic office. What patient education might this nurse perform? Select all that apply. a) Applying heat or ice to an extremity b) Explaining the use of electrical stimulation c)Teaching a patient relaxation techniques d) Teaching a patient about a prescription e) Explaining an invasive procedure to a patient f)Teaching about dietary supplements
a, b, c, f. Chiropractors may combine the use of spinal adjustments and other manual therapies with several other treatments and approaches including heat and ice, electrical stimulation, relaxation techniques, rehabilitative and general exercise, counseling about weight and diet, and using dietary supplements. Chiropractors do NOT prescribe medication or perform invasive procedures.
A nurse midwife is assisting a patient who is firmly committed to natural childbirth to deliver a full-term baby. A cesarean delivery becomes necessary when the fetus displays signs of distress. Inconsolable, the patient cries and calls herself a failure as a mother. The nurse notes that the patient is experiencing what type of loss? Select all that apply. a) Actual b) Perceived c)Psychological d) Anticipatory e) Physical f) Maturational
a, b, c. The losses experienced by the woman are actual, perceived, and psychological. Actual loss can be recognized by others as well as by the person sustaining the loss; perceived loss is experienced by the person but is intangible to others; and psychological loss is a loss that is felt mentally as opposed to physically. Anticipatory loss occurs when one grieves prior to the actual loss; physical loss is loss that is tangible and perceived by others; and maturational loss is experienced as a result of natural developmental processes.
A nurse is caring for patients admitted to a long-term care facility. Which nursing actions are appropriate based on the religious beliefs of the individual patients? Select all that apply. a) The nurse dietitian asks a Buddhist if he has any diet restrictions related to the observance of holy days. b) A nurse asks a Christian Scientist who is in traction if she would like to try nonpharmacologic pain measures. c) A nurse administering medications to a Muslim patient avoids touching the patient's lips d) A nurse asks a Roman Catholic woman if she would like to attend the local Mass on Sunday. e) The nurse is careful not to schedule treatment and procedures on Saturday for a Hindu patient. f) The nurse consults with the medicine man of a Native American patient and incorporates his suggestions into the care plan.
a, b, d, f. The nurse dietitian should ask a Buddhist if he has any diet restrictions related to the observance of holy days. Since Catholic Scientists avoid the use of pain medications, the nurse should ask a Christian Scientist who is in traction if she would like to try nonpharmacologic pain measures. A nurse administering medications to a Hindu *woman* avoids touching the patient's lips. A nurse should ask a Roman Catholic woman if she would like to attend the local Mass on Sunday. The nurse is careful not to schedule treatment and procedures on Saturday for a *Jewish* patient due to observance of the Sabbath. The nurse would appropriately consult with the medicine man of a Native American patient and incorporates his or her suggestions into the care plan.
A nurse mentor is teaching a new nurse about the underlying beliefs of CHAs versus allopathic therapies. Which statements by the new nurse indicate that teaching was effective? Select all that apply. a) "CHA proponents believe the mind, body, and spirit are integrated and together influence health and illness." b) "CHA proponents believe that health is a balance of body systems: mental, social, and spiritual, as well as physical." c) "Allopathy proponents believe that the main cause of illness is an imbalance or disharmony in the body systems." d) "Curing according to CHA proponents seeks to destroy the invading organism or repair the affected part." e) "The emphasis is on disease for allopathic proponents and drugs, surgery, and radiation are key tools for curing." f) "According to CHA proponents, health is the absence of disease."
a, b, e. With CHA, mind, body, and spirit are integrated and together influence health and illness, and illness is a manifestation of imbalance or disharmony. Allopathic beliefs include: The main causes of illness are considered to be pathogens (bacteria or viruses) or biochemical imbalances, curing seeks to destroy the invading organism or repair the affected part, and emphasis is on disease and high technology. Drugs, surgery, and radiation are among the key tools for dealing with medical problems. According to *allopathic* beliefs, health is the absence of disease.
A nurse who cared for a dying patient and his family documents that the family is experiencing a period of mourning. Which behaviors would the nurse expect to see at this stage? Select all that apply. a) The family arranges for a funeral for their loved one. b) The family arranges for a memorial scholarship for their loved one. c) The coroner pronounces the patient's death. d) The family arranges for hospice for their loved one. e) The patient is diagnosed with terminal cancer. f) The patient's daughter writes a poem expressing her sorrow.
a, b, f.
A nurse caring for culturally diverse patients in a health care provider's office is aware that patients of certain cultures are more prone to specific disease states than the general population. Which patients would the nurse screen for diabetes mellitus based on the patient's race? Select all that apply. a) A Native American patient b) An African-American patient c) An Alaska Native d) An Asian patient e)A White patient f) A Hispanic patient
a, c, e, f. Native Americans, Alaska Natives, Hispanics, and Whites are more prone to developing diabetes mellitus. African Americans are prone to hypertension, stroke, sickle cell anemia, lactose intolerance, and keloids. Asians are prone to hypertension, liver cancer, thalassemia, and lactose intolerance.
In order to provide culturally competent care, nurses must be alert to factors inhibiting sensitivity to diversity in the health care system. Which nursing actions are examples of cultural imposition? Select all that apply. a) A hospital nurse tells a nurse's aide that patients should not be given a choice whether or not to shower or bathe daily. b) A nurse treats all patients the same whether or not they come from a different culture. c) A nurse tells another nurse that Jewish diet restrictions are just a way for them to get a special tray of their favorite foods. d) A Catholic nurse insists that a patient diagnosed with terminal bladder cancer see the chaplain in residence. e) A nurse directs interview questions to an older adult's daughter even though the patient is capable of answering them. f) A nurse refuses to care for a married gay man who is HIV positive because she is against same-sex marriage.
a, d. Cultural imposition occurs when a hospital nurse tells a nurse's aide that patients should not be given a choice whether or not to shower or bathe daily, and when a Catholic nurse insists that a patient diagnosed with terminal bladder cancer see the chaplain in residence. Cultural blindness occurs when a nurse treats all patients the same whether or not they come from a different culture. Culture conflict occurs when a nurse ridicules a patient by telling another nurse that Jewish diet restrictions are just a way for Jewish patients to get a special tray of their favorite foods. When a nurse refuses to respect an older adult's ability to speak for himself or herself, or if the nurse refuses to treat a patient based on that patient's sexual orientation, the nurse is engaging in stereotyping.
A nurse is caring for a patient who has crippling rheumatoid arthritis. Which nursing intervention best represents the use of integrative care? a) The nurse administers naproxen and uses guided imagery to take the patient's mind off the pain. b) The nurse prepares the patient's health care provider-approved herbal tea and uses meditation to relax the patient prior to bed. c) The nurse administers naproxen and performs prescribed range-of-motion exercises. d) The nurse arranges for acupuncture for the patient and designs a menu high in omega-3 fatty acids.
a. Adding guided imagery (CHA) to the administration of pain medications (allopathy) is an example of integrative care. A person who uses integrative care uses some combination of allopathic medicine and CHA.
A nurse is providing postmortem care. Which nursing action violates the standards of caring for the body after a patient has been pronounced dead and is not scheduled for an autopsy? a) The nurse leaves the patient in a sitting position while the family visits. b) The nurse places identification tags on both the shroud and the ankle. c) The nurse removes soiled dressings and tubes. d) The nurse makes sure a death certificate is issued and signed.
a. Because the body should be placed in normal anatomic position to avoid pooling of blood, leaving the body in a sitting position is contraindicated. The other actions are appropriate nursing responsibilities related to postmortem care.
A nurse manager who works in a hospital setting is researching the use of energy healing to use as an integrative care practice. Which patient would be the best candidate for this type of CHA? a) A patient who is anxious about residual pain from cervical spinal surgery b) A patient who is experiencing abdominal discomfort c) A patient who has chronic pain from diabetes d) A patient who has frequent cluster headaches
a. Energy healing is focused on pain that lingers after an injury heals, as well as pain complicated by trauma, anxiety, or depression. Nutritional and herbal remedies treat all chronic pain, but especially abdominal discomfort, headaches, and inflammatory conditions, such as rheumatoid arthritis.
A nurse performing a spiritual assessment collects assessment data from a patient who is homebound and unable to participate in religious activities. Which type of spiritual distress is this patient most likely experiencing? a) Spiritual Alienation b) Spiritual Despair c) Spiritual Anxiety d) Spiritual Pain
a. Spiritual Alienation occurs when there is a "separation from the faith community." Spiritual Despair occurs when the patient is feeling that no one (not even God) cares. Spiritual Anxiety is manifested by a challenged belief and value system, and Spiritual Pain may occur when a patient is unable to accept the death of a loved one.
A hospice nurse is caring for a patient who is terminally ill and who is on a ventilator. After a restless night, the patient hands the nurse a note with the request: "Please help me end my suffering." Which response by a nurse would best reflect adherence to the position of the American Nurses Association (ANA) regarding assisted suicide? a) The nurse promises the patient that he or she will do everything possible to keep the patient comfortable but cannot administer an injection or overdose to cause the patient's death. b) The nurse tells the patient that under no condition can he be removed from the ventilator because this is active euthanasia and is expressly forbidden by the Code for Nurses. c) After exhausting every intervention to keep a dying patient comfortable, the nurse says, "I think you are now at a point where I'm prepared to do what you've been asking me. Let's talk about when and how you want to die." d) The nurse responds: "I'm personally opposed to assisted suicide, but I'll find you a colleague who can help you."
a. The ANA Code of Ethics states that the nurse "should provide interventions to relieve pain and other symptoms in the dying patient consistent with palliative care practice standards and may NOT act with the sole intent to end life" (2015, p. 3).
A patient diagnosed with breast cancer who is in the end stages of her illness has been in the medical intensive care unit for 3 weeks. Her husband tells the nurse that he and his wife often talked about the end of her life and that she was very clear about not wanting aggressive treatment that would merely prolong her dying. The nurse could suggest that the husband speak to his wife's health care provider about which type of order? a) Comfort Measures Only b) Do Not Hospitalize c) Do Not Resuscitate d) Slow Code Only
a. The nurse could suggest that the husband speak to the health care provider about a Comfort Measures Only order. The wife would want all aggressive treatment to be stopped at this point, and all care to be directed to a comfortable, dignified death. A Do Not Hospitalize order is often used for patients in long-term care and other residential settings who have elected not to be hospitalized for further aggressive treatment. A Do Not Resuscitate order means that no attempts are to be made to resuscitate a patient whose breathing or heart stops. A Slow Code means that calling a code and resuscitating the patient are to be delayed until these measures will be ineffectual. Many health care institutions have policies forbidding this, and a nurse could be charged with negligence in the event of a Slow Code and resulting patient death.
The nurse practitioner sees patients in a community clinic that is located in a predominately White neighborhood. After performing assessments on the majority of the patients visiting the clinic, the nurse notes that many of the minority groups living within the neighborhood have lost the cultural characteristics that made them different. What is the term for this process? a) Cultural assimilation b) Cultural imposition c) Culture shock d) Ethnocentrism
a. When minority groups live within a dominant group, many members lose the cultural characteristics that once made them different in a process called assimilation. Cultural imposition occurs when one person believes that everyone should conform to his or her own belief system. Culture shock occurs when a person is placed in a different culture perceived as strange. Ethnocentrism is the belief that the ideas, beliefs, and practices of one's own cultural group are best, superior, or most preferred to those of other groups.
dysfunctional grief
abnormal or distorted grief that may be either unresolved or inhibited
spiritual distress
an alteration in spiritual health (e.g., spiritual pain, alienation, anxiety, guilt, anger, loss, despair)
therapeutic touch
an alternative therapy that involves using one's hands to consciously direct an energy exchange from the practitioner to the patient to facilitate healing or pain relief
DNR (do not resuscitate)
an order that tells medical professionals not to perform CPR Must be yellow Must be a physical paper Must have physical paper on person at time of emergency
Spirituality
anything that pertains to a person's relationship with a nonmaterial life force or higher power
Sterotyping
assigning characteristics to a group of people without considering specific individuality
A nurse works for a health care provider who practices the naturopathic system of medicine. What is the focus of nursing actions based on this type of medical practice? Select all that apply. a) Treating the symptoms of the disease b) Providing patient education c) Focusing on treating individual body systems d) Making appropriate interventions to prevent illness e) Believing in the healing power of nature f) Encouraging patients to take responsibility for their own health
b, d, e, f. Naturopathic medicine is not only a system of medicine, but also a way of life, with emphasis on patient responsibility, patient education, health maintenance, and disease prevention. Its principles include: - minimizing harmful side effects and avoiding suppression of symptoms, - educating patients and encouraging them to take responsibility for their own health, - treating the whole person, - preventing illness, -believing in the healing power of nature, and -treating the cause of a disease or condition rather than its symptoms.
A nurse is using the ESFT model to understand a patient's conception of a diagnosis of chronic obstructive pulmonary disease (COPD). Which interview question would be MOST appropriate to assess the E aspect of this model—Explanatory model of health and illness? a) How do you get your medications? b) How does having COPD affect your lifestyle? c) Are you concerned about the side effects of your medications? d) Can you describe how you will take your medications?
b. The ESFT model guides providers in understanding a patient's explanatory model (a patient's conception of her or his illness), social and environmental factors, and fears and concerns, and also guides providers in contracting for therapeutic approaches. Asking the questions: "How does having COPD affect your lifestyle?" explores the explanatory model. "How do you get your medications?" refers to the social and environmental factor, "Are you concerned about the side effects of your medications?" addresses fears and concerns, and "Can you describe how you will take your medications?" involves therapeutic contracting.
A patient tells a nurse that he would like to appoint his daughter to make decisions for him should he become incapacitated. What should the nurse suggest he prepare? a) POLST form b) Durable power of attorney for health care c) Living will d) Allow Natural Death (AND) form
b. A durable power of attorney for health care appoints an agent the person trusts to make decisions in the event of subsequent incapacity. Living wills provide specific instructions about the kinds of health care that should be provided or foregone in particular situations. A Physician Order for Life-Sustaining Treatment form, or POLST form, is a medical order indicating a patient's wishes regarding treatments commonly used in a medical crisis. The living will is a document whose precise purpose is to allow people to record specific instructions about the type of health care they would like to receive in particular end-of-life situations. Allow natural death on the medical record of a patient indicates the patient or surrogate has expressed a wish that there be no attempts to resuscitate the patient.
A nurse working in a long-term care facility incorporates aromatherapy into her practice. For which patient would this nurse use the herb ginger? a) A patient who has insomnia b) A patient who has nausea c) A patient who has dementia d) A patient who has migraine headaches
b. Commonly used essential oils in a health care setting are ginger or peppermint for nausea and lavender or chamomile for insomnia.
A nurse who is comfortable with spirituality is caring for patients who need spiritual counseling. Which nursing action would be most appropriate for these patients? a) Calling the patient's own spiritual adviser first b) Asking whether the patient has a spiritual adviser the patient wishes to consult c) Attempting to counsel the patient and, if unsuccessful, making a referral to a spiritual adviser d) Advising the patient and spiritual adviser concerning health options and the best choices for the patient
b. Even when a nurse feels comfortable discussing spiritual concerns, the nurse should always check first with patients to determine whether they have a spiritual adviser they would like to consult. Calling the patient's own spiritual adviser may be premature if it is a matter the nurse can handle. The other two options deny patients the right to speak privately with their spiritual adviser from the outset, if this is what they prefer.
At a follow-up visit, a patient recovering from a myocardial infarction tells the nurse: "I feel like my life is out of control ever since I had the heart attack. I would like to sign up for yoga, but I don't think I'm strong enough to hold poses for long." What would be the nurse's best response? a) "Right now you should concentrate on relaxing and taking your blood pressure medicine regularly, instead of worrying about doing yoga." b) "There is a slower-paced yoga called Kripalu that focuses on coming into balance and relaxation that you could look into." c) "Ashtanga yoga is a gentle paced yoga that would help with your breathing and blood pressure." d) "Yoga is contraindicated for patients who have had a heart attack."
b. Kripalu, or "gentle yoga," focuses on relaxation and coming into balance. Ashtanga focuses on synchronizing breath with a fast-paced series of postures. The nurse should not discourage the use of yoga in patients who are healthy enough to participate. Yoga is not contraindicated in patients with controlled high blood pressure.
A young Hispanic mother comes to the local clinic because her baby is sick. She speaks only Spanish and the nurse speaks only English. What is the appropriate nursing intervention? a) Use short words and talk more loudly. b) Ask an interpreter for help. c) Explain why care can't be provided. d) Provide instructions in writing.
b. The nurse should ask an interpreter for help. Many facilities have a qualified interpreter who understands the health care system and can reliably provide assistance. Using short words, talking loudly, and providing instructions in writing will not help the nurse communicate with this patient. Explaining why care can't be provided is not an acceptable choice because the nurse is required to provide care; also, since the patient doesn't speak English, she won't understand what the nurse is saying.
A nurse is visiting a patient with pancreatic cancer who is dying at home. During the visit, he breaks down and cries, and tells the nurse that it is unfair that he should have to die now when he's finally made peace with his family. Which response by the nurse would be most appropriate? a) "You can't be feeling this way. You know you are going to die." b) "It does seem unfair. Tell me more about how you are feeling." c) "You'll be all right; who knows how much time any of us has." d) "Tell me about your pain. Did it keep you awake last night?"
b. This response by the nurse validates that what the patient is saying has been heard and invites him to share more of his feelings, concerns, and fears. The other responses either deny the patient's feelings or change the subject.
A nurse is performing spirituality assessments of patients living in a long-term care facility. What is the best question the nurse might use to **assess for spiritual needs**? a) Can you describe your usual spiritual practices and how you maintain them daily? b) Are your spiritual beliefs causing you any concern? c) How can I and the other nurses help you maintain your spiritual practices? d) How do your religious beliefs help you to feel at peace?
c) How can I and the other nurses help you maintain your spiritual practices? Questioning how the staff can meet patients' spiritual practices **assesses spiritual needs**. Asking the patient to describe spiritual practices **assesses spiritual practices**. Asking about concerns **assesses spiritual distress**. asking about feeling at peace **assesses the need for forgiveness**.
A nurse is interviewing a newly admitted patient. Which question is considered culturally sensitive? a) "Do you think you will be able to eat the food we have here?" b) "Do you understand that we can't prepare special meals?" c) "What types of food do you eat for meals?" d) "Why can't you just eat our food while you are here?"
c. Asking patients what types of foods they eat for meals is culturally sensitive. The other questions are culturally insensitive.
A nurse who is caring for patients on a pediatric ward is assessing the children for their spiritual needs. Which is the most important source of learning for a child's own spirituality? a) The child's church or religious organization b) What parents say about God and religion c) How parents behave in relationship to one another, their children, others, and to God d) The spiritual adviser for the family
c. Children learn most about their own spirituality from how their parents behave in relationship to one another, their children, others, and God (or a higher being). What parents say about God and religion, the family's spiritual advisor, and the child's church or religious organization are less important sources of learning.
A nurse interviews an 82-year-old resident of a long-term care facility who says that she has never gotten over the death of her son 20 years ago. She reports that her life fell apart after that and she never again felt like herself or was able to enjoy life. What type of grief is this woman experiencing? a) Somatic grief b) Anticipatory grief c) Unresolved grief d) Inhibited grief
c. Dysfunctional grief is abnormal or distorted; it may be either unresolved or inhibited. In unresolved grief, a person may have trouble expressing feelings of loss or may deny them; unresolved grief also describes a state of bereavement that extends over a lengthy period. With inhibited grief, a person suppresses feelings of grief and may instead manifest somatic (body) symptoms, such as abdominal pain or heart palpitations. Somatic grief is not a classification of grief, rather somatic symptoms are the expression of grief that may occur with inhibited grief. Anticipatory loss or grief occurs when a person displays loss and grief behaviors for a loss that has yet to take place.
A nurse is teaching a novice nurse how to provide care for patients in a culturally diverse community health clinic. Although all these actions are recommended, which one is MOST basic to providing culturally competent care? a) Learning the predominant language of the community b) Obtaining significant information about the community c) Treating each patient at the clinic as an individual d) Recognizing the importance of the patient's family
c. In all aspects of nursing, it is important to treat each patient as an individual. This is also true in providing culturally competent care. This basic objective can be accomplished by learning the predominant language in the community, researching the patient's culture, and recognizing the influence of family on the patient's life.
A nurse is guiding a patient in the practice of meditation. Which teaching point is *most* useful in helping the patient to achieve a state of calmness, physical relaxation, and psychological balance? a) Teach the patient to always lie down in a comfortable position during meditation. b) Teach the patient to focus on multiple problems that the patient feels demand attention. c) Teach the patient to let distractions come and go naturally without judging them. d) Teach the patient to suppress distracting or wandering thoughts to maintain focus.
c. Meditators should have an open attitude by letting distractions come and go naturally without judging them. They should also maintain a specific, comfortable posture lying down, sitting, standing, walking, etc.; focus attention on a mantra, object, or breathing; and NOT suppress distracting or wandering thoughts; instead they should gently bring attention back to focus.
A nurse working in an emergency department assesses how patients' religious beliefs affect their treatment plan. With which patient would the nurse be most likely to encounter resistance to emergency lifesaving surgery? a) A patient of the Adventist faith b) A patient who practices Buddhism c) A patient who is a Jehovah's Witness d) A patient who is an Orthodox Jew
c. Patients who practice the Jehovah's Witness faith believe blood transfusions violate God's laws and do not allow them. The other religious groups do not restrict modern lifesaving treatment for their members.
A nurse who was raised as a strict Roman Catholic but who is no longer a practicing Catholic stated she couldn't assist patients with their spiritual distress because she recognizes only a "field power" in each person. She said, "My parents and I hardly talk because I've deserted my faith. Sometimes I feel real isolated from them and also from God—if there is a God." Analysis of these data reveals which unmet spiritual need? a) Need for meaning and purpose b) Need for forgiveness c) Need for love and relatedness d) Need for strength for everyday living
c. The data point to an unmet spiritual need to experience love and belonging, given the nurse's estrangement from her family and God after leaving the church.
Cultural Comeptence
care delivered with an awareness of the aspects of the patient's culture
postmortem care
care of the body after death
Intergrative Health Care
combination of complementary health and conventional health approaches in a coordinated way
anticipatory loss
condition in which a person displays loss and grief behaviors for a loss that has yet to take place
spiritual health
condition that exists when the universal spiritual needs for meaning and purpose, love and belonging, and forgiveness are met
A patient whose last name is Goldstein was served a kosher meal ordered from a restaurant on a paper plate because the hospital made no provision for kosher food or dishes. Mr. Goldstein became angry and accused the nurse of insulting him: "I want to eat what everyone else does—and give me decent dishes." Analysis of these data reveals what finding? a) The nurse should have ordered kosher dishes also. b) The staff must have behaved condescendingly or critically. c) Mr. Goldstein is a problem patient and difficult to satisfy. d) Mr. Goldstein was stereotyped and not consulted about his dietary preferences.
d) Mr. Goldstein was stereotyped and not consulted about his dietary preferences
A nurse is caring for patients of diverse cultures in a community health care facility. Which characteristics of cultural diversity that exist in the United States should the nurse consider when planning culturally competent care? Select all that apply. a) The United States has become less inclusive of same-sex couples. b) Cultural diversity is limited to people of varying cultures and races. c) Cultural diversity is separate and distinct from health and illness. d) People may be members of multiple cultural groups at one time. e) Culture guides what is acceptable behavior for people in a specific group. f) Cultural practices may evolve over time but mainly remain constant.
d, e, f. A person may be a member of multiple cultural, ethnic, and racial groups at one time. Culture guides what is acceptable behavior for people in a specific group. Cultural practices and beliefs may evolve over time, but they mainly remain constant as long as they satisfy a group's needs. The United States has become more (not less) inclusive of same-sex couples. The definition of cultural diversity includes, but is not limited to, people of varying cultures, racial and ethnic origin, religion, language, physical size, biological sex, sexual orientation, age, disability, socioeconomic status, occupational status, and geographic location. Cultural diversity, including culture, ethnicity, and race, is an integral component of both health and illness.
A nurse is caring for a postoperative patient who is experiencing pain. Which CHA might the nurse use to ensure *active participation* by the patient to achieve effective pre- or postoperative pain control? a) Acupuncture b) TT c) Botanical supplements d) Guided imagery
d. Imagery involves using all five senses to imagine an event or body process unfolding according to a plan. A patient can be encouraged to "go to a favorite place." With the other modalities, the patient is more passive.
A nurse states, "That patient is 78 years old—too old to learn how to change a dressing." What is the nurse demonstrating? a) Cultural imposition b) Clustering c) Cultural competency d) Stereotyping
d. Stereotyping is assuming that all members of a group are alike. This is not an example of cultural competence nor is the nurse imposing her culture on the patient. Clustering is not an applicable concept
race
division of human beings based on distinct physical characteristics
grief
emotional response to loss. Dysfunctional grief: distorted or abnormal grief response, including inhibited grief (suppression of grief reaction) and unresolved grief (lengthy or denied grief reaction). Abbreviated grief: short but genuine grief reaction. Anticipatory grief: grief reaction before actual loss.
personal space
external environment surrounding a person that is regarded as being part of that person
Palliative care
hospice care; taking care of the whole person—body, mind, spirit, heart and soul—with the goal of giving patients with life-threatening illnesses the best quality of life they can have through the aggressive management of symptoms
loss
inaccessibility or change in a valued person, object, or situation. Actual loss: loss tangible to both the person sustaining the loss and to others. Perceived loss: loss tangible only to the person sustaining it. Physical loss: loss of life, limb, an object, person, pet, or job. Psychological loss: loss that affects a person's self-image. Anticipatory loss: loss behaviors displayed before the actual loss occurs.
hope
ingredient in life responsible for a positive outlook, even in life's bleakest moments
guided imagery
intentional visualization of images that are calming, relaxing, or beneficial in other ways
complementary health approaches
interventions that can be used with conventional medical interventions
Spiritual needs
lack of anything necessary for spiritual health (e.g., meaning and purpose, love and relatedness, forgiveness) -Need for meaning and purpose -Need for love and relatedness -Need for forgiveness
perceived loss
loss of youth, of financial independence, and of a valued environment experienced by a person, but intangible to others
euthanasia
mercy killing; the deliberate termination of the life of a person
spiritual healing
movement toward integration, from brokenness to wholeness
holistic nursing/care
nursing practice built on a holistic philosophy/Thewholesumisgreaterthansum.Holistoccareseekstounitethebody,mind,andspirit
Religion
organized system of beliefs about a higher power; often includes set forms of worship, spiritual practices, and codes of conduct
Mourning
period during which a person learns to accept grief
spiritual beliefs
practices associated with all aspects of a person's life, including health and illness, that address the invisible "spirit"—a creative, mysterious, guiding power
Accupuncture
procedure consisting of placing very thin, short, sterile needles at particular acupoints, believed to be centers of nerve and vascular tissue, along a meridian to either increase or decrease the flow of chi along the meridian, restoring the balance of yin and yang, and thereby contributing to healing
cultural assimilation
process that occurs when a minority group, living as part of a dominant group within a culture, loses the cultural characteristics that made it different
transcultural nursing
providing nursing care that is planned and implemented in a way that is sensitive to the needs of individuals, families, and groups representing the diverse cultural populations within our society
relaxation
reduce the effects of stress
parasympathetic response
rest and digest
ethnicity
sense of identification that a cultural group collectively has; the sharing of common and unique cultural and social beliefs and behavior patterns, including language and dialect, religious practices, literature, folklore, music, political interests, food preferences, and employment patterns
culture conflict
situation that occurs when people become aware of cultural differences, feel threatened, and respond by ridiculing the beliefs and traditions of others to make themselves feel more secure about their own values
Presencing
standing in the presence of another consciously believing in—and affirming—his or her capacity for wholeness
POLST form
stands for Physician Order for Life-Sustaining Treatment, a medical order indicating a patient's wishes regarding treatments commonly used in a medical crisis; must be completed and signed by a health care professional, NOT the patient (gives patient more options than a DNR)
culture
sum total of human behavior or social characteristics particular to a specific group and passed from generation to generation or from one to another within the group
cultural imposition
tendency of some to impose their beliefs, practices, and values on another culture because they believe that their ideas are superior to those of another person or group
Ethnocentrism
the belief that one's own culture or group is superior to others and the tendency to view all other cultures from the perspective of one's own
Meditation
the focusing of the mind on spiritual ideas
cultural blindness
the process of ignoring differences in people and proceeding as though the differences do not exist
allopathic medicine
the term generally used to describe "traditional" medical care (biomedicine), dominant for about 100 years, which spearheaded remarkable advances in biotechnology, surgical interventions, pharmaceutical approaches, and diagnostic tools
Aromatherapy
the use of essential oils of plants to treat symptoms
holism
theory and philosophy that focuses on connections and interactions between parts of the whole
culture shock
those feelings, usually negative, a person experiences when placed in a different culture
When caring for a patient who is in spiritual distress, the nurse should:
- *First* Listen to the patient, by asking if they would like to talk about their feelings. -*THEN* ask whether the patient would like to visit with a spiritual adviser if appropriate.
cultural diversity
1) coexistence of different ethnic, biological sex, racial, and socioeconomic groups within one social unit; 2) diverse groups in society, with varying racial classifications and national origins, religious affiliations, languages, physical size, biological sex, sexual orientation, age, disability, socioeconomic status, occupational status, and geographic location
death
1) irreversible cessation of all functions of circulatory and respiratory functions; (2) irreversible cessation of all functions of the entire brain, including the brainstem; (3) termination of life
faith
1) spiritual dimensions of a persons life regardless of religious affiliation; 2) confident belief in something for which there is no proof or material evidence
Kubler-Ross Stages of Grief
1. Denial 2. Anger 3. Bargaining 4. Depression 5. Acceptance can fluctuate
Engel's Six Stages of Grief
1. Shock and disbelief 2. Developing awareness 3. Restitution 4. Resolving the loss 5. Idealization 6. Outcome
atheist
A person who denies the existence of God
impending death
Caring for dying clients makes us painfully aware of our own frailty and is one of the most difficult experiences you will face as a nurse.
CAT / CHA
Complementary And Integrative health
HOPE acronym
H - sources of Hope, meaning, comfort, strength, peace, love & connection O - organized religion P - personal spirituality & practice E - effects on medical care & end of life issues
Types of Spiritual Distress
Spiritual Pain: ex: inability to accept death of son : " If he could allow this I dont want to know him (God)" Spiritual Alienation: Separated from "faith community" Spiritual Anxiety: Challenged belief and value system Ex: stopped going to church, "I wonder what God thinks of me now" Spiritual Guilt: Failure to live according to religious rules. Spiritual Anger: Inability to accept illness. Ex: "Does HE love me so much that He gave me AIDS and now no one comes near me?" Spiritual Loss: Terminal illness; anticipatory grieving; inability to find comfort in religion. Ex: "I do everything right, why is all this happening to me?"/ "No one can help me now" Spiritual Despair: Feeling that no one (not even God) cares. Ex: "I guess even God doesn't want me" / giving up.
stress response
The response to a demand or stressor. Has three phases: alarm, resistance, and recovery.