Basic Concepts Test 5

Lakukan tugas rumah & ujian kamu dengan baik sekarang menggunakan Quizwiz!

what ate the fat soluble vitamins?

A, D, E, and K

when is the apgar score done on an infant?

1 and 5 minutes after birth

when does the anterior fontanel usually close?

12-18 months

how long does the stomach hold food?

3 hours

how long food to pass through the small intestine?

5 hours

for the adult, what size are feeding tubes?

8-12 FR

absence or deficiency of a substance, usually an enzyme, essential to cellular metabolism that results in abnormal protein, carbohydrates, or fat metabolism

IEM

what are the most commonly communicable disease among adolescents?

STDs

when is cow's milk okay for infants to drink?

after 12 months

what amino acids are synthesized in the body?

alanine, asparagine, and glutamic acid

what are common labs for nutritional status?

albimin, transferrin, prealbumin, retinol binding protein, total iron binding capacity, and hemoglobin

what are two substances absorbed directly through the lining of the stomach?

alcohol and aspirin

how should a nurse care for a young adult who is in the intimacy versus isolation stage of development?

all them to be with their significant other or partner as much as possible

cohabitation, single parents, and lesbian, gay, bisexual, and transgender parents are considered what type of family structure?

alternative

what is the simplest form of a protein called?

amino acide

what enzymes does pancreatic secretions contain?

amylase, lipase, trypsin, elastase, chymotrypsin, and carboxypeptidase

small, round, red or brown cherry spot that occur on the trunk are called?

angiomas

pursuit of thinness through starvation; intense fear of gaining weight; refuse to maintain normal body weight describes what disease process

anorexia

measurement system of the size and the makeup of the body?

anthropometry

what medications can influence sexuality during middle adulthood?

antihypertensives, beta blockers, and diuretics

beta-carotene, vitamins A, C, and E are what type of vitamins?

antioxidant vitamins

change, conflict, or perceived lack of control of the environment can cause what in the middle adult?

anxiety

how should a nurse communicate with adolescents?

ask open ended questions, look for the meaning behind their words or actions, be alter to clues to their emotional state, involve other individuals and resources when necessary

what is serious complication of enteral feedings?

aspiration of formula leading to infection

how do preschool age children play?

associative play

what colors to older adults have trouble distinguishing between?

blue and green

what is the most widely ingested stimulant in north america?

caffeine

carbohydrates are composed of?

carbon, hydrogen, and oxygen

which nutrient provides the main sours of energy for the body?

carbs

what are sources of stress for the preschool age group?

changes in caregiving arrangements, starting school, the birth of a sibling, parents martial distress, relocation to a new home, or illness

what can be indicators of acute illness in older adults?

changes in mental status, falls, dehydration, decrease in appetite, loss of function, dizziness, and incontinence

what sexual changes do men go through in middle adulthood?

changes in the strength of erection and a decrease in ability to experience repeated orgasm

what foods do patients with altered taste usually prefer?

chilled foods or foods that are spicy

what is a risk factor for the most common causes of death in older adults?

cigarette smoking

what are the warning signs of dysphagia?

cough during eating, change in voice tone or quality after swallowing, abnormal movements of the mouth, tongue, or lips, and slow weak, imprecise, or uncoordinated speech

A nurse who has recently graduated has been assigned to be a primary nurse on a geriatric unit. After completing a review of development and aging, the nurse recalls that changes for the older adult include: a. a transition from young adulthood b. the ability of the older adult to achieve sexual arousal c. a time when cognitive performance begins to peak d. adjusting to decreasing health and physical strength

d

According to Kholberg, moral development is a component of psychosocial development. Moral development depends on the child's ability to integrate: a. modeling of others b. faith and optimism c. self control and independence d. decisions of right and wrong

d

characterized by a gradual, progressive, irreversible cerebral dysfunction

dementia

what is used to distinguish between normal and abnormal infants in Gesell's theory?

development quotient

stage-crisis theory focuses on?

developmental tasks

these things propose ways to account for how and why people grow as they do; they provide a framework for examining, describing and appreciating human development; they also help nurses assess and treat a patient's response to illness

developmental theories

what two interventions can stimulate peristalsis?

exercise and fiber

what are all adolescents at risk for?

experimental or recreational substance use

true or false. Older adults are not interested in sex or sexual activities

false

true or false. Older adults are unable to learn and understand new information

false

true or false. hypertension is a normal sign of aging

false

true or false. older adults are forgetful, confused, rigid, boring, unfriendly, and poort

false

true or false. older adults are ill, disabled, or unattractive

false

what is the major form of body reserve energy?

fat

what is the most calorie dense nutrient?

fat

what should older adults limit in their diet?

fat, salt, refined sugars, and alcohol

Composed of chains of carbon and hydrogen atoms with an acid group on one end of the chain and a methyl group on the other

fatty acids

what does the placenta function as for the baby?

fetal lungs, kidneys, GI tract, and endocrine organ

what nutrient is important for DNA synthesis and the growth of red blood cells

folic acid

gesell's theory of development proposed that growth is directed by?

gene activity

name this stage by erikson: The adult focuses on supporting future generations. the ability to expand one's social and personal involvement is critical to this stage. They contribute to future generations through parenthood, teaching, mentoring, and community involvement. Achieving generativity results in caring for others as a basic strength.

gernativity versus self-absorption and stagnation

what provides energy during brief periods of fasting?

glycogen

what hormone does the hypothalamus release to stimulate ovarian cells for produce estrogen and testicular cells to produce testosterone?

gonadotropin-releasing hormones

what are the five food groups?

grains, vegetables, fruits, dairy products, and meats

what are the most visible changes in middle adulthood?

graying of hair, wrinkling of the skin, and thickening of the waist, decreases in hearing and eyesight

encompasses the physical changes that occur form the prenatal period through older adulthood and also demonstrates both advancement and deterioration

growth

what doe macrominerals do for the body?

help balance pH

why is play important?

help to develop cognitive, social, and motor skills

what is a nursing priority in the care of older adults?

helping older adults maintain their quality of life

contains all essential amino acids in sufficient quantity

high quality proteins

why is kholberg's moral development theory criticized?

his studies were done on males raised with western philosophies

what regulates the flow of digestive secretions need for enzyme supply

hormones

the recruitment, transport, transfer, harboring, or receipt of a person by threat or the use of force for the purpose of exploitation

human trafficking

what turns pepsinogen into pepsin

hydrochloric acid

what is an amino acid composed of?

hydrogen, oxygen, carbon, and nitrogen

what are ways nurses can prevent accidents and death in adolescents?

identify adolescents at risk, counsel and provide education to prevent accidents, and provide counseling to those in rehab for drug use

name this stage by erikson: dramatic physciological changes associated sexual maturation mark this stage. There is a marked preoccupation with body image. identity development begins with the goal of achieving some perspective or direction, and answers the question "who am I?" Acquiring a sense of identity is essential for making adult decisions; Successful mastery of this stage results in devotion and fidelity to others and their own needs; perceived invulnerability results in risk taking behaviors

identity versus role confusion

when are adolescents much more likely to use health care services?

if they encounter providers who are caring and respectful

if a nursing assessment suggests suicide in an adolescent, what should the nurse do?

immediately refer them to a mental health professionals

what are IEM?

inborn errors of metabolism

a prolonged time to conceive

infertility

name this stage by erikson: children like to pretend and try out new roles. Also at this time they are developing their superego. conflicts occur between the child's desire to explore and the limits placed on the child's behavior. These conflicts sometimes lead to feelings of frustration and guilt. Guilt also occurs if the caregiver's responses are to harsh. Successful resolution of this stage results in direction and purpose. Teaching the child impulse control and cooperative behaviors helps the family avoid the risks of altered growth and development

initiative versus guilt

name this stage by erikson: older adults often engage in a retrospective appraisal of their lives. They interpret their lives as meaningful as a whole or experience regret because of goals not achieved. Because the aging process creates physical and social losses, some adults also suffer from loss of status and function. These external struggles are met with internal struggles such as the search for meaning in life. Meeting these challenges creates the potential for growth and the basic strength of wisdom

integrity versus despair

name this stage by erikson: young adults, having developed sense of identity, deepen their capacity to love others and care for them. if the young adults does not find companionship and intimacy, isolation results because the young adult fears rejection and disappointment.

intimacy versus isolation

necessary for the absorption of vitamin B12 in the ileum

intrinsic factor

why is breastfeeding recommended?

it contains essential nutrients of protein, fats, carbs, and immunoglobulins for the infant to resist infection

how does middle adulthood affect recovering from an illness or injury?

it may take longer

if there is a risk for gastric reflux (leads to aspiration) is present what type of feeding is preferred?

jejunal feeding

the flow of milk for breastfeeding

lactation

drinks milk but avoids eggs

lactovegetarian

what are normal physical characteristics of the neonate?

languo on the back, cyanosis of the hands and feed for the first 24 hours and a soft abdomen

when does young adulthood begin?

late teens -mid to late 30s

what are ways a nurse can educate parents on how they should put their baby to bed to reduce SIDS?

lay them on their backs, remove stuffed animals, soft bedding, and pillows, avoid overheating the infant

name this level of kholberg's moral development moral decision making at this level moves from, "What's in it for me?" to "How will it affect my relationships with others?" Emphasis now is on social rules and a community-centered approach.

level (conventional reasoning)

name this level of kholberg's moral development cognitive thinking is limited, and the individual's thinking is primarily egocentric. Thinking is mostly based on likes and pleasures. This stage progresses toward having punishment guide behavior.

level 1 (preconventional reasoning)

what level of moral development do nurses observe when family members make end of life decisions for their loved ones

level 2

research has proven successful aging to be much more consistent with which approach?

life span

what is thinning of the face in the elderly caused by?

loss of subcutaneous fat and skin elasticity

what may impact the ability to understand basic health information or read a prescription bottle correctly

lower health literacy

minerals are classified as __________________ when the daily requirement is 100 mg or more

macrominerals

what is the key in diabetes management?

maintaining a prescribed carbohydrate intake

when do girls attain 90-95% of the height by?

menarche

disruption of the monthly cycle; usually happens between 45-60 years of age

menopause

all biochemical reactions within the cells of the body?

metabolism

when does the middle adult portion of life begin?

mid 30s- late 60s

what developmental group is the sandwich generation?

middle adult

inorganic elements essential to the body as catalysts in biochemical reactions

minerals

what is the nutritional treatment for diverticulitis?

moderate or low residue until the infection subsides and then a high fiber diet

what categories did Gesell's theory include?

motor, language, adaptive, and personal-social

how can parents and nurse promote language development in the infant?

name objects the infant is focused on

if the patient needs a tube for short term placement, what should the nurse put in?

nasogastric or nasojejunal tube

what are common physical concerns of pregnancy?

nausea and vomiting, breast tenderness, urinary frequency, heartburn, constipation, ankle edema, and backache

what maltreatment do children suffer from the most?

neglect

means that the intake and output of nitrogen are equal

nitrogen balance

can a developmental stage be skipped?

no

energy necessary for the normal function of numerous body processes

nutrients

this type of growth starts at the center of the body and moves toward the extremities

proximodistal

what is the newborn's physical functioning during the neonatal period?

reflexive

what 3 things does the return of nutrition depend on after surgery?

return of bowel function, extent of surgical procedure, and the presence of any complications

what reflexes that were present in the newborn start to disappear in the infant?

rooting, sucking, and the moro (startle) reflex

carbohydrate units are called?

saccharides

an enzymes that acts on cooked starch to being its conversion to maltose

salivary amylase (ptyalin)

each carbon in the chain has two attached hydrogen atoms

saturated

animals fats have high proportions of?

saturated fatty acids

6-12 years old is known as?

school age

what age is crucial for the acquisition of behaviors and health practices for an adult healthy life?

school age period

when is the time for children to have sex education?

school age years

what is the major task of adolescence?

search for personal identity

name this type of formula designed to meet specific nutritional needs in certain illnesses

specialty formulas

what is the primary task of the body during the neonatal period?

stabilization of major organs

true or false. diet has significant effect on fetal development

true

true or false. drop side rail cribs are illegal

true

consumes only plant foods

vegan

should a sexually active adolescent be screened for STIs even when they don't have symptoms

yes

consumes only brown rice, other grains, and herbal teas

zen macrobiotic

when do girls have prepubescent changes?

1-2 years before boys

what age should parents begin discussions about puberty changes?

10 years old

what age does the young adult complete growth?

20

how many kilocalories does carbs provide?

4

how many kilocalories does protein provide?

4

how long does a full term pregnancy last?

40 weeks

when can infants differentiate a stranger from a familiar person and respond differently to each?

8 months

consumes fruit, nuts, honey, and olive oil

Fruitarian

because the young adult has the physical ability and emotional maturity to establish intimacy, what should the nurse educate them about?

STIs

what is a way to prevent childhood obesity in the school aged child?

allow them to plan, select, and prepare healthy meals and snacks

a developmental characteristic that makes children treat dolls or stuffed animals as if they have thoughts and feelings

animism

when does puberty begin?

at around 12

name 3 insoluble fibers?

cellulose, hemicellulose, adn lignin

what is a common symptom of the onset of pneumonia, heart failure, and urinary tract infection

decrease in appetite

what are signs that occur at least one month before suicide?

decrease in school performance, withdrawal, loss of initiative, loneliness, sadness, crying, appetite and sleep disturbances, verbalization of suicidal thought

why is dehydration common in older adults?

decreased thirst response, don't wanna get up to go to the bathroom and less free water because of less muscle mass

what are good nursing interventions for most children who can learn?

deep-breathing techniques, positive imagery, progressive relaxation of muscle groups

a potentially reversible cognitive impairment that often has a physiological cause and is considered a medical emergency; it is an acute confursional state

delirium

what is usually the presenting sign of pneumonia or UTI

delirium

name this type of formula predigested nutrients, easier for partially dysfucntional GI tract to absorb

elemental formulas

day 15 through week 8 of gestation is known as?

embryonic stage

what is the most vulnerable stage of gestation and why?

embryonic stage because all body organ are formed by the 8th week

the term used to describe the sadness and loneliness that accompany children leaving home

empty nest syndrome

these feedings are for patients who are unable to ingest food but are able to digest and absorb good in the gastrointestinal tract

enteral feedings

what is the preferred method of meeting nutritional needs if a patient is unable to swallow or take nutrients orally, yet has a functioning GI tract

enteral nutrition

genes direct the sequence of devleopment, but ____________________ _______________________ also influence development

environmental factors

what time period if breastfeeding recommended

first 6 months of life

how long should human milk be consumed?

first year of life

the reasoning and processing component of learning are called?

fluid intelligence

before beginning a tube feeding, what should you do to make sure the tube is patent?

flush the line with a small amount of waterq

a hormone that triggers parietal cells to secrete hydrochloric acid

gastrin

how does reading to toddlers affect them?

increases their vocabulary

when does the most period of growth and development occur?

infancy

what two fatty acids are important for metabolic processes?

linoleic acid and arachidonic acid

what does nutrition management of a patient with cancer focus on?

maximizing intake of nutrients and fluids

should a parent avoid discussing sensitive issues with an adolescent?

no

an understanding that objects continue to exist even when they cannot be seen, heard, or touched

object permanence

what is a major task for the young adult?

occupational direction

in what position should infants sleep?

on their backs

what score on the MNA requires the health care provided finish the assessment?

11

how much sleep do preschoolers need?

12 hours a night and will take infrequent naps

when do girls reach their full height?

16-17 years old

what score on the MNA indicated protein-energy malnutrition?

17

when do boy reach their full height?

18-20 years old

how much breast milk will an average 1 month old consume?

18-21 ounces

what age is emerging adults?

18-25

how hot should meat, poultry, fish, and eggs be cooked at?

180 degrees

what trimester is the most important period of pregnancy?

1st

when does the posterior fontanel close?

2-3 months

what is the recommended weight gain in pregnancy?

25-35 pounds

what should the head of the bed be elevated to when a patient is receiving a tube feeding?

30 degrees

what is the average weight at 3 years old?

32 pounds

what is the average weight at 4 years old?

37 pounds

when does placenta development begin?

3rd week

how far away from menarche can pregnancy place a mother and baby at risk because of physical immaturity?

4 years

what is the average weight at 5 years old?

41 pounds

how many calories above usual allowance does lactation require?

500

how much fluid equals 1 pound?

500 mL

when are infants ready for solid food?

6 months

how long is a food bag for enteral nutrition good?

6-8 hours

how much does water make up of body weight?

60-70%

when do infants begins to demonstrate object permanence?

7-9 months

what are the water soluble vitamins?

C and B complex

A pregnant teenager asks the clinic nurse why she should not smoke during the first trimester. The nurse's best response should be: a. the distribution of body hair can be altered b. the organ systems are beginning to develop c. development of fingers and toes can be affected d. the sex of the baby is determined in the first 3 months

b

what are the american heart association dietary guidelines

balance caloric intake and exercise maintain a healthy body weight eat a diet rich in fruits, vegetables, and complex carbs eat fish twice per week limit foods and beverages high in sugar and salt limit trans-saturated fat to less than 1%

name 4 soluble fibers

barley, cereal grains, cornmeal, and oats

energy needed to rest to maintain life-sustaining activities for a specific amount of time

basal metabolic rate

how should a nurse care for a child in the autonomy versus shame and doubt developmental stage?

be empathetic and keep choices sage and simple

why do poisonings occur frequently in toddlerhood?

because 2 year olds like to put things in their mouths to learn about them

why can't patients go to rehab with a feeding tube?

because they are not considered to be medically stable

when does the american academy of pediatrics recommend administering hearing screenings?

before discharge

what developmental thing is important in the development of identity in adolescents?

being able to solve problems that require manipulation of several concepts

acts a detergent because it emulsifies fat to permit enzyme action while suspending fatty acids in a solution

bile

this describes how our bodies grow and change

biophysical development

what does exercise decrease?

blood pressure, heart rate, fatigue, insomnia, stress

what is the fear for the preschool age group

bodily harm

measure weight corrected for height and serves as an alternative to traditional height-weight relationships

body mass index

contractions that are irregular, short, contractions in the third trimester of pregnancy

braxton-hicks contractions

most identified with binge eating behaviors and behaviors to prevent weight gain; self-induced vomiting, misuse of laxatives; excessive exercise; occurs within normal weight ranges describes what disease process

bulimia

Maria is working with one of the neonatal nurses during volunteer shift. Maria assists with an assessment of a newborn girl. Maria palpates the newborn's head and feels fontanels. What should Maria do next? a. alert the neonatal nurse that there is a problem with the newborn's head b. palpate harder to see if a dent can be made in the fontanels c. proceed with the assessment because palpable fontanels are a normal finding d. try to adjust the skull bones to move the fontanel

c

patients with peptic ulcers are encouraged to avoid what foods?

caffeine, decaffeinated coffee, frequent milk intake, citric acid juices, spicy foods, aspirin, NSAIDs,

what is an essential component of discharge teaching to new born parents that involves the ride home?

car seat use

what nutrients help us meet our energy needs?

carbs, proteins, fats, water, vitamins and minerals

breakdown of chemical substances into simpler substances; occurs during physiological states of negative nitrogen balance

catabolism

what are the 3 main processes of nutrient metabolism?

catabolism of glycogen into glucose, carbon dioxide, and water; anabolism of glucose into glycogen for storage, catabolism of amino acids and glycerol into glucose

if there sluggish or no flow through the catheter of a CVC, what is present

catheter occlusion

if a patient with a CVC or PICC develops fever, chills, or glucose intolerance and has a positive blood culture, what should the nurse suspect?

catheter sepsis

what does feces contain?

cellulose, sloughed epithelial cells, digestive secretions, water, and microbes

what direction foes development proceed if it is described as proximal-distal?

central to peripheral

this type of growth is fastest at the top and goes from head down

cephalocaudal

what are tetrogens?

chemicals, viruses, or drugs that can cross the placenta and affect the health of the mother, baby, or both

What cells of the stomach secrete pepsinogen?

chief cells

how should a nurse care for an adult in the gernativity versus self-absorption and stagnation stage?

choose creative ways to foster social development

an acidic, liquefied mass of food

chyme

how should you speak to a patient that has a hearing impairment?

clear, low pitched tones and move to a quiet area to reduce background noise

what does the parent-child interaction involve

close body contact, including breastfeeding

what things have been reported to increase the risk of SIDS?

co-sleeping, bed sharing, avoid smoking during pregnancy or around the infant

these theories examine how people learn to think and make sense of their world. focus is on the rational thinking processes

cognitive developmental theories

where are electrolytes and minerals synthesized?

colon

are pairs of incomplete proteins that when combined supply the total amount of protein provided by complete protein sources

complementary proteins

forgetfulness is an expected outcome of aging, but _____________ is not

confusion

the ability to see objects or quantities as remaining the same despite a change in their physical appearance

conservation

what should the nurse do if an adolescent discloses to them that they are gay, lesbian, or bisexual?

construct a safety plan before telling the family

Building of more complex biochemical substances by synthesis of nutrients: A. Glycogenesis B. Chyme C. Glycogenolysis D. Anabolism E. Catabolism

d

Results from megadoses of supplemental vitamins, fortified food, and large intake of fish oils. A. Unsaturated fatty acids B. Saturated fatty acids C. Indispensable amino acids D. Hypervitaminosis

d

which of the following might be a cause of stress for the middle adult? a. financial security b. planned retirement c. arrival of grandchildren d. caring for children and aging parents

d

the second set on the food label that consists of nutrients such as total fat, saturated fat, cholesterol, carbohydrates, fiber, sodium, and potassium based on a 2000 calorie diet

daily references values (DRVs)

Needed protein, vitamins, fats, cholesterol, carbohydrates, fiber, sodium, and potassium

daily values

acute care setting pose risk for what types of adverse events?

delirium, dehydration, malnutrition, HAIs, urinary incontinence, falls

______________ is a risk factor for delirium

dementa

what is the most common and also most undetected, untreated, impairment in older adulthood

depression

what two things commonly precede a suicide attempt?

depression and social isolation

refers to the biological, cognitive, and socioemtional changes that being at conception and continue throughout out a lifetime

development

what did erikson believe about development?

development occurred throughout the lifespan and it focused on psychosocial changes

what is the major psychosocial task of the school aged child?

development of a sense of industry or competency

acceptable range of quantities of vitamins and minerals for each gender and age group

dietary reference intakes (DRIs)

name this temperament: highly active, irritable, and irregular in habits negative withdrawal towards others is typical, and the child requires a more structured environment adapts slowly to new routines, people, or situations, mood expression are usually intense and primarily negative

difficult child

mechanical breakdown that results from chewing, churning, and mixing with fluid and chemical reactions in which food reduces to its simplest form

digestion

what does the young adult do between ages 29-34?

direct energy toward achievement and mastery of the world

sucrose, lactose, and maltose are why type of saccharide?

disaccharide

what type of amino acid does the body synthesize?

dispensable amino acids

how can parents limit tantrums in toddlerhood?

do not give them the option to say no. tell them what is about to happen and give them simple choices about the situation

when does the greatest risk of intimate partner violence occur?

during the reproductive years

difficulty swallowing is called?

dysphagia

what did frued believe about development?

each stage is characterized by sexual pleasure in the mouth, anus, and genitals

name this temperament: easy going and even tempered regular and predictable in his or her habits open and adaptable to change and displays a mild to moderately intense mood that is typically positive

easy child

how should patients with peptic ulcers eat their meals throughout the day?

eat 3 regular meals without snacks

how can nurses contribute to the general health of children?

educate them about safety and encourage them to take responsibility for their safety

what nursing activities promote healthy development in the adolescent?

education

what is the part of the personality that mediates conflicts between the environment and the forces of the id; it helps people judge reality accurately, regulates impulses, and make good decisions; often referred to as one's sense of self

ego

intentional actions that cause harm or create serious risk of harm to a vulnerable elder by a caregiver or other person who is in a trust relationship to the elder

elder mistreatment

formula with nutrients in their simplest form ready for absorption

elemental diets

protein-like substances that act as catalysts to speed up chemical reactions

enzymes

a flap of skin that closes over the trachea as a person swallows to prevent aspiraton

epiglottis

A nursing student is learning that psychoanalytical theorists varied greatly in their perceptions related to development. One of them believed that development occurred throughout the life span and focused on psychosocial stages, but the nursing student cant remember if it was piaget, freud, erikson, or chess. which one is it?

erikson

what is the most well known stage theory?

erikson's psychosocial theory

amount of nutrient that appears sufficient to maintain a specific body function for 50% of the population based on age and gender

estimated average requirement (EAR)

how often should gastric residual volume be checked?

every 4 hours

how often should the nurse check the placement of the feeding tube?

every 4-6 hours

when should you increase the hourly rate of tube feedings?

every 8-12 hours

what does the young adult do between ages 35-43?

examine life goals and relationships (midlife crisis)

a nursing student is studying gesell's theory of development with a friend. His friend says, "According to Gesell's theory of development, each child's pattern of growth is a result of the environmental influences." true or false?

false

end of week 8 until birth is known as?

fetal stage

the structural part of plants that is not broken down by our digestive system?

fiber

what are important things to assess in a woman with an unplanned pregnancy?

financial, career, and living accommodations, family support systems, potential parenting disorder, depression, and coping mechanisms

what does erikson define as intimacy?

finding oneself to lose it in another

what is the best food to offer toddlers to allow them to feed themselves and explore different food groups?

finger foods

how long does attachment evolve in a newborn/infant?

first 24 months

the term that describes when all members of a household have access to sufficient, safe, and nutritious food to maintain a healthy lifestyle on a consistent basis and have the resources to obtain appropriate food for a nutritious diet

food security

what is the best way to evaluate the quality of a nursing center in a community?

for the patient and family to visit that facility and inspect it personally

which stage does piaget believe marks the end of cognitive development?

formal operations

what are the most common injuries in older adults?

fractures of the spine, hip, forearm, leg, ankle, pelvis, upper arm, and hand

produce oxidative damage to body cells and tissues

free radicals

in what foods is vitamin content usually the highest?

fresh foods that have minimal exposure to heat, air, or water prior to use

where does the brain continue to develop the most in preschoolers

frontal lobe

what are examples of high nutrient dense foods?

fruits and vegetables

where does the american dietetic association recommend that carbohydrates comes from?

fruits, veggies, whole grains, legumes, and low-fat milk

what group of adolescents has a increased vulnerability to depression and suicide?

gay, lesbian, or bisexual adolescents

enlarged breasts in men

gynecomastia

what is the most important factor in protecting the newborn from infection?

handwashing

what is a helpful intervention to help the patient on enteral feedings feel less bloated?

have them turn on their left side to empty the stomach

what direction does development proceed if it is described as cephalocaudal?

head to toe

the cognitive and social skills that determine the motivation and ability of individuals to gain access, to, understand, and use information in ways that promote and maintain good health

health literacy

what is the number 1 leading cause of death in older adults?

heart disease

what are the 4 most common causes of death in older adults?

heart disease, cancer, chronic lung disease, and stroke

since infants can see objects 8-10 inches form their fact, how should the parents hold the baby to improve bonding?

holding the baby where the can see the parent's face and have the parent talk to them

what is most likely the cause of death for African american teenagers?

homicide

what are causes of chronic illness in the young adult?

hypertension, coronary artery disease, accidents, rheumatoid arthritis,, AIDS, and cancer

what part of the brain begins to release hormones to signal puberty changes?

hypothalamus

what is the most primitive part of the personality and is the basic instinctual impulses driven to achieve pleasure

id

what 3 things did freud believe regulated behavior?

id, ego, superego

an estimate of what a person should weight

ideal body weight

what is the prime danger of adolscence as seen by erikson?

identity or role confusion

what factors can affect metabolism?

illness, pregnancy, lactation, and activity

what is the most important health promotion during infancy?

immunizations

how can physical changes impact the middle adult?

impact self concept and body image

how should all infants and toddlers be place in a car seayt?

in a rear facing car seat in the back seat until they are 2 years old or until they have reached the highest weight and height for the carseat

missing one or more of the nine indespensable amino acids. this includes cereal, legumes and vegetables

incomplete proteins

how should patients manage irritable bowel syndrome?

increase fiber, reduce fat, avoid eating large meals, and avoid lactose or sorbital containing foods

how does hypothermia affect oxygen needs in the infant?

increases

what type of amino acids do we need to gain through our diet?

indispensable amino acids

what did piaget believe about development?

individuals move from one stage to another seeking cognitive equilibrium

what stage did erikson believe could explain feelings towards work in the older adult?

industry versus inferiority

1 month old to 1 year old is known as what time period?

infant

what developmental stage has the greatest percentage of total body water?

infants

what can make the body go into negative nitrogen balance?

infection, burns, fever, starvation, head injury, and trauma

what accounts for the majority of all childhood illness?

infections

why are vegans are risk for vitamin B12 deficiency?

it is found only in animal sources

this approach considered how the person views and adjusts to changes, and the current social and historical context in which the individual is living

life span approach

what is the only essential fatty acids in humans?

linoleic acid

formed by the combination of a lipid and a simple protein

lipoprotein

where is bile manufactured

liver

where is glycogen stored?

liver and muscle tissue

what should the interventions for older adults be focused on?

maintaining and promoting patients' function and quality of life

what are the top 3 nursing interventions for a newborn?

maintaining open airway, stabilizing and maintaining body temp, and protecting the newborn from infection

what is the focus of nutritional care for AIDS and HIV patients?

maximizing kilocalories and nutrients

what is the best way to ensure the enteral feeding tube is in place?

measurement of the pH of secretions withdrawn from the feeding tube

this nutrient is a catalyst for enzymatic reactions

minerals

what are interventions the nurse can do to minimize stress in the middle adult?

minimize the frequency of stress producing situations, increase stress resistance, avoid the physiological response to stress

name this type of formula single-macronutrient (protein, glucose, polymers, or lipids) formulas are added to other foods to meet patient's need

modular

what theory attempts to define how moral reasoning matures for an individual; refers to changes in a person's thoughts, emotions, and behaviors that influence the perception of right or wrong; it also encompasses both interpersonal and intrapersonal dimensions as it governs how we interact with other

moral development theory

how will school age children define themselves?

more on an internal basis than an external basis

what is the leading cause of death in adolescents?

motor vehicle accidents

what is the most common form of injury in the school age time period?

motor vehicle injuries and bicycle injuries

do strategies that worked well with the first child work well with the second child?

no

a basic component of health and is essential for normal growth and development, tissue repair and maintenance, cellular metabolism, and organ function

nutrition

what type of screening should be regular part of assessment of the adolescent?

nutritional screening

name this stage of kholberg's moral development the individual wants to win approval and maintain the expectations of one's immediate group. "Being good" is important and defined as having positive motives, showing concern for others, and keeping mutual relationships through trust, loyalty, respect, and gratitude. One earns approval by "being nice"

stage 3 (good boy nice girl orientation)

name this level of kholberg's moral development individuals move away from moral decisions based on authority or conformity to groups to define their own moral values and principles. Individuals at this stage start to loos at what an ideal society would be like. Moral principles and ideals come into prominence

stage 3 (postconventional reasoning)

name this stage by erikson children are now able to perform mental operations, and can coordinate two concrete perspectives in social and scientific thinking; able to appreciate the difference between their perspective and that of a friend. they can mentally picture a series of steps and reverse the steps to get back to the starting point. seriation is achieved, able to correctly order objects by length, weight, or other characterisitics; conservation is accomplished

stage 3 concrete operations

name this stage by freud: the genital organs are the focus of pleasure in this stage; the boy becomes interested in the penis; the girl becomes aware of the absence of the penis, known as penis envy; the child fantasizes about the parent of the opposite sex as their first love interest, known as the Oedipus or electra complex; at the end the child identifies with the parent of the same sex as a way to win recognition and acceptance

stage 3 phallic

name this stage of kholberg's moral development individuals expand their focus from a relationship with others to societal concerns. Moral decisions take into account societal perspectives. Right behavior is doing one's duty, showing respect for authority, and maintaining the social order

stage 4 (society-maintaining orientation)

name this stage by piaget egocentricity leads adolescents to demonstrate feelings and behaviors characterized by self consciousness: a belief that their actions and appearance are constantly being scrutinized (an imaginary audience), that their thoughts and feelings are unique (the personal fable), and that they are invulnerable; feelings of being invulnerable lead to risk taking behaviors. they learn that many of their thoughts are shared by almost everyone. they thinking moves to abstract and theoritical subjects and they have the capacity to reason with respect to possibilities

stage 4 formal operations

name this stage by freud: sexual urges from the earlier stage are repressed and channeled into productive activities that are socially acceptable; there is much to learn and accomplish by the child

stage 4 latency

name this stage of kholberg's moral development an individuals follows the societal law but recognizes the possibility of changing the law to improve society. The individual also recognizes that different social groups have different values but believes that all rational people would agree on basic rights such as liberty and life. Individuals at this stage make more of an independent effort to determine what society as a group should value rather than what society as a group would value. The US constitution is based on this morality

stage 5 (social contract orientation)

name this stage by freud: sexual urges are reawakened and redirected to individuals outside the family circle; unresolved prior conflicts surface at this time; once the individual resolves conflicts they are capable of having a mature adult sexual relationship

stage 5 genital

name this stage of kholberg's moral development defines "right" by the decision of conscience in accord with self-chosen ethical principles. These principles are abstract, like the Golden Rule, and appeal to logical comprehensives, uviversality, and consistency

stage 6 (universal ethical principle in orientation)

name this period by piaget infants develop a schema or action pattern for dealing with the environment, which are self initiated. Successful achievement leads to greater exploration. this child learns object permanence, which is one of the child's most important accomplishment

stage one sensorimotor

what emotional changes can a members of a sandwich family experience?

stress and depression

the involuntary release of urine that occurs when they cough, laugh, sneeze, or lift an object

stress incontinence

what is often a sign of onset of an acute illness or worsening of a chronic illness

sudden change in function with ADLs

what are examples of low nutrient dense foods?

sugar and alcohol

what is the part of the personality that regulates, restrains, and prohibits actions; its also known as the conscience; it is influenced by the standards of outside social forces (ex: parent and teacher)

superego

what is the best way to help language development in toddlers?

talking to them

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

temperament

what are "food jags"?

the desire to eat one food repeatedly

when does the transitions from intrauterine life to extrauterine life occur?

the first 24 hours of life

when in a good time for the parent-child interaction begin?

the first half hour after birth when the baby is awake and alert

the first 28 days of life are known as?

the neonatal period

how does the patient need to be weighed?

the the same time each day, on the same scale, with the same clothing

what happens if there are repeated developmental failures in the life span

there are inadequacies

why is parental example extremely important for the preschool age child?

they are great imitators

why are tetrogens dangerous for the baby?

they can cause abnormal development of structures in the embryo

how do 3 year old children play?

they can play with one other child where they make something or they play the mother baby roll

why do older adults learn at a slower rate?

they have less fluid intelligence

how do preschoolers interpret language and see another's point of view?

they interpret language literally and cannot see another's point of view

what happens to preschool age children when they are under a lot of stress?

they make revert to bed-wetting or thumb-sucking

how do peer groups help the adolescent?

they provide a sense of belonging, approval, and the opportunity to learn acceptable behavior

why is assessment of reflexes vital in newborns?

they survive by their reflexes

what is associative play?

they will play together, play in groups, and pretend play

what adolescents are more at risk for chronic use and physical dependency of substances?

those with dysfunctional families

how should intravenous fat emulsions be administered?

through a separate peripheral line or through the central line by using a Y connector tubing

why should solid foods only be offered on at a time?

to identify allergies

what is the key factor in the development and progression of COPD?

tobacco smoke

highest level that poses no risk of adverse health effents

tolerable upper intake level (UL)

minerals are classified as ____________________ when the daily requirement is below 100 mg

trace elements

circulate in the blood and are composed of 3 fatty acids attached to a glycerol

triglycerides

true or false. disorientation, loss of language skills, loss of the ability to calculate, and poor judgement are not normal changes of aging and require you to further asses

true

true or false. it is possible for dementia and delirium to occur at the same time

true

true or false. most girls exceed boys in height and weight by the end of the school years

true

name this developmental stage by eriskson: establishing a basic sense of trust is essential for the development of a healthy personality; the infants resolution of this stage requires a consistent caregiver who is available to meet the infant's needs; the formation of trust results in faith and optimism

trust versus mistrust

obesity has been linked to what other conditions?

type 2 diabetes, hypertension, high cholesterol, asthma, joint problems, psoriatic arthritis

what can cause the need for a nutritional consultation?

unintentional weight loss, presence of a modified diet, or presence of altered nutritional symptoms

what can cause stress in the life of a young adult?

unplanned pregnancies, insecurity with home, work, and life

an unequal number of hydrogen atoms are attached and the carbon atoms attach to each other with a double bone

unsaturated

vegetable fats have high proportions of?

unsaturated and polyunsaturated fats

what types of changes do menopausal women experience in middle adulthood?

vaginal dryness and pain during sex

communication technique used with confused older adults. This therapy accepts the description of time and place as stated by the confused older adult

validation therapy

what is the greatest cause of mortality and morbidity in the young adult?

violence

along with PN therapy, what else should patient's receive throughout nutritional therapy?

vitamin K

what do bacteria in the colon synthesize?

vitamin K

organic substances present in small amounts in foods that are essential to normal metabolism. they can act as catalysts in biochemical reactions

vitamins

this nutrient is essential for metabolism and is water soluble or fat soluble

vitamins

what is the preferred exercise for older adults?

walking

school age children think about _______________ ________, whereas adolescents are able to imagine _____________ _______________ __________

what is, what might be

when does the risk for delirium increase?

when patients experience immobilization, sleep deprivation, infection, dehydration, pain, sensory impairment, drug interactions, anesthesia, and hypoxia

what is the most extreme physiological change that happens in an infant?

when the infant leaves utero circulation and develops independent circulatory and respiratory functioning

what does gastric residual volume indicate?

whether gastric emptying is delayed

who have the highest suicide rate in the US?

white men, age 85 and older

when do changes in cognitive function happen in a middle adult?

with illness or trauma

_____________ of the lens of the eye occurs with age

yellowing

what diets frequently results in malnutrition?

zen macrobiotic and fruitarian

this type of feeding supplies essential nutrients in appropriate amounts to support life through the administration of a concentrated nutrient solution into the superior vena cava near the right atrium of the heart

TPN

you are caring for a 5 year old who is hospitalized for stabilization of asthma. To render age-specific care, an action you can take would be to; a. allow the child to handle medical equipment b. respond immediately to the child's every need c. tell the child to be good d. rationalize the child's complaint as part of the developmental stage

a

after a CVC line is placed, how does the nurse confirm placement before use?

a chest xray

what is a lay doula?

a person to provide support during labor

which of the following is a normal reflex found in newborns? (select all that apply). a. blinking in response to bright lights b. startling in response to sudden loud noises c. performing sucking, rooting, and grasping movements d. touching the nose on verbal command

a, b, c

which of the following might be a cause of stress for young adults? (Select all that apply.) a. being single b. career c. sexuality d. activity

a, b, c

Which of the following might be a cause of stress for the older adult? (select all that apply) a. financial security b. planned retirement c. housing d. adjusting to decreasing health and physical strength

a, b, c, d

what are signs of feeding intolerance?

abdominal pain, large volume gastric residuals, and diarrhea

what factors influence nutritional intake in the acutely ill patient?

ability to swallow, energy, nausea, dexterity of fingers

what are major causes of death in infants 6-12 months?

accidents, aspirations, suffocation, fallse, and poisoning

how do adolescents evaluate their health?

according to feelings of well-being, ability to function normally, and absence of symptoms

this theory states that continuing an active, involved lifestyle results in greater satisfaction and well-being in aging

activity theory

suggested intake for individuals based on observed or experimentally determined estimates of nutrient intakes used when not enough evidence to set RDA

adequate intake (AI)

13-20 years old is known as?

adolescence

in what time period do individuals gain their final 20-25% of the height and 50% of their weight

adolescence

psychological maturation describes?

adolescence

what developmental age group is a high risk for complications of pregnancy and labor, and are also at an increased risk for prematurity, low birth weight, and exposure to alcohol, drugs, or tobacco

adolescents

gradual progression of dietary intake of therapeutic diet to manage illness

advancing diets

when is an infertility assessment performed?

after 12 months of unprotected sex and the couple still cannot conceive

smooth, brown irregularly shaped spots that appear on the backs of hands and forearms are called?

age spots of senile lentigo

discrimination against people because of increasing age

ageism

what is an important nursing intervention for school aged children?

allow them to participate in care and maintain as much independence as possible

name this stage by erikson: the toddler develops sense of autonomy by making choices. Limiting choices and/or enacting harsh punishment leads to feelings of shame and doubt. The toddler who successfully masters this stage achieves self control and willpower

autonomy versus sense of shame and doubt

the time period of 3-5 years is known as?

preschooler

what patients require lifetime feeding with elemental enteral feedings or PN?

short bowel syndrome

disaccharides and monosaccharides are what type of carbohydrate?

simple

what type of proteins are albumin and insulin?

simple proteins

how should you speak to someone who has visual impairments?

sit or stand at eye level and face them, encourage use of assistive devices

what is an example of catabolism?

starvation

12-36 months is known as?

toddlerhood

true or false. neonates lose up to 10% of birth weight withing their first few days of life

true

name this stage by erikson: school aged children are eager to apply themselves to learn socially productive skills and tools. they learn to work and play with their peers. 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 or inferiority. They need to be able to experience real achievement to develop a sense of competency

Industry versus inferiority

what is the most common HAI?

UTIs from catheters

what should nurses be aware of in adolescence and provide screening questions for it, no matter the setting?

potential for school violence

what is a factor that can impact all aspects of an adolescent's life who lives in a high-risk environment?

poverty

the first 14 days after conception is known as?

preembryonic stage

affects the ability to hear high pitched sounds and conversational speech and is typically bilateral, affecting more men than women is called?

presbycusis

the progressive decline in the ability of they eyes to accommodate from near to far vision

presbyopia

what is one of the most important screening tests in preschool age children?

presence of nonbinocular vision or strabismus

why should infants sleep on their backs?

prevent SIDS

what is one of the most important responsibilities of the nurse when administering enteral feedings?

prevent the patient from aspirating the feeding

what type of things often create barriers for older adults?

previous health experiences, personal motivation, health beliefs, culture, health literacy, transportation, and finances

discussions with adolescents need to be?

private and confidential

what is the second leading cause of death in american men?

prostate cancer

the nutrient that is essential for the growth, maintenance and repair of body tissue

protein

what nutrient is necessary for nitrogen balance

protein

when a patient has an infection, what nutrient do they need more of?

protein

what is the priority of care when providing nutrition to a patient who is malnourished?

provide optimal preoperative nutrition support

how should a nurse care for an adolescent in the identity versus role confusion stage of development?

provide them with enough information to allow them to make decisions about their treatment plan

these theories describe development form personality, cognitive, and behavioral perspectives; they explain development as primarily unconscious and influenced by emotion

psychoanalytical/psychosocial theory

reproduction becomes possible during?

puberty

what glands secrete gastrin?

pyloric cells

a communication technique that makes an older adult more aware of time, place, and person. This type of therapy restores a sense of reality

reality orientation

describe the language development of a 1 year old

recognize their name, say 3-5 words, and understand almost 100 words

what is crucial in determining the child's readiness to toilet train?

recognizing the urge to urinate or defecate

The average needs of 98% of the population, not the exact needs of the individual

recommended dietary allowance (RDA)

what body cells do not oxidize fatty acids into ketones when dietary carbs are not adequate

red blood cells and neurons

why is prenatal care important?

reduces maternal and fetal mortality and morbidity

the first set on the food label that compromises protein, vitamins, and minerals based on the RDA

referenced daily intakes (RDIs)

what does the young adult do between ages 23-28?

refine self perception and ability for intamcy

how should a nurse care for a patient that is in level 1 of moral development?

reinforce that the child does not become ill because of wrongdoing

this therapy uses the recollection of the past to bring meaning and understanding to the present and to resolve current conflicts. It helps with coping

reminiscence

how do neonates lose the 10% of their weight in the first few days of life?

respiration, urination, defecation, and low fluid intake

what is the most prevalent infection in childhood?

respiratory infections

amount of energy needed to consume over 24 hour period for the body to maintain internal working activities while at rest

resting energy expenditure

what is amblyopia?

resulting blindness from disuse

what are 3 things that older adults have to cope with?

retirement, residence change, death

what should the nurse assess for in school age children, especially girls, that relates to skeletal growth?

scoliosis

lesions that appear as irregular, round, or oval, brown, watery lesions are called?

seborrheic or keratoses

toddlers who are ill and require hospitalization are stressed mainly by?

separation from their parents

the ability to mentally classify objects according to their quantitative deminsions

seriation

name this temperament: typically reacts negatively and with mild intensity to new stimuli adapts slowly with repeated contact unless pressured and responds with mild but passive resistance to novelty or changes in routine

slow-to-warm up child

Where does digestion and absorption mainly occur?

small intestine

where is 85-90% of water absorbed?

small intestine

how should the nurse encourage patients who have HIV or AIDS to eat their meals?

small, frequent, nutrient-dense meals with fluid in between

why should you administer enteral feedings slowly at the beginning?

so feedings are not coming out both ways

name this stage of kholberg's moral development avoiding punishment or the unquestioning deference to authority is characteristic motivation to behave. Physical consequences guide right and wrong choices. If the child is caught, it must be wrong; if the child escapes, is must be right

stage 1 (punishment and obedience orientation)

name the stage by Freud: initially sucking and oral satisfaction are not only vital to life but also extremely pleasurable; late in this stage the infant begins to realize that the mother/parent is something separate from self; inadequate bonding or chronic illness could affect an infant's development

stage 1 oral

name this stage of kholberg's moral development the child recognizes that there is more than one right view. The decisions to do something morally right is based on satisfying one's own needs and occasionally the needs of others. The child perceives punishment not as proof of being wrong but as something one wants to avoid

stage 2 (instrumental relativist orientation)

name this stage by Freud: the focus of please changes to the anal zone; children become increasingly aware of the pleasurable sensations of this body region with interests in the products of the effort; through the toilet training process the child delays gratification to meet parental and societal expectations

stage 2 anal

name this stage by paiget children learn to think with the use of symbols and mental images; they exhibit egocentricsm and believe everyone experiences the world as they do; demonstrate animism and their thinking is influenced greatly by fantasy and magical thinking; play is importnat

stage 2 preoperational

is necessary to help the body metabolize certain nutrients, correct nutritional deficiencies related to the disease, and eliminate foods that may exacerbate disease symptoms

MNT

a form of nutrition provided intravenously that is a combination of crystalline amino acids, hypertonic dextrose, electrolytes, vitamins, and trace elements

PN formula

what are the 5 stages of development freud identified?

oral, anal, phallic, latency, genital

what flavor food and drinks should be used for cancer patients because they can actually taste it?

orange and cherry flavored food

what happens when a mother introduces foreign chemicals to the baby?

organ development can be altered

this diet avoids meat, fish, and poultry, but eats eggs and milk

ovolactovegetarian

what type of play do toddlers participate in?

parallel play

stimulation from what system increases GI tract action?

parasympathetic (vagus nerve)

what areas do school age children experience stress?

parental expectations, peer expectation, the school environment, or violence in the family, school, or community

patients who cannot tolerate nutrition through the GI tract receive this type of nutrition which is a solution of glucose, amino acids, lipids, minerals, electrolytes, trace elements, and vitamins, through an indwelling peripheral or central venous catheter

parental nutrition

how does the body absorb nutrients?

passive diffusion, osmosis, active transport, and pinocytosis

what types of patients are good candidates for PN?

patients in highly stressed physiological states like sepsis, head injury, or burns

how do peer relationships look in the school age children?

peer relationships tend more toward groups

the time during which ovarian function declines, resulting in diminishing numbers of ova and irregular menstrual cycles. Generally lasts 1-3 years

perimenopause

life span approach considers?

personal circumstances

_____________ and temperament are closely linked

personality

a period of approximately 6 weeks after devlivery

peurperium

what is one of the most important aspects of the nutritional assessment?

physical assessment

who's work did lawrence kholberg expand upon

piaget

where do you mainly obtain carbs from?

plant foods

what is important to a child's development?

play

what is the primary means by which children foster cognitive development and learn about the world, and is also a nursing intervention during hospitalization

play

how do 4 year old children play?

play in groups of 2 or 3

how do 5 year old children play?

play in groups that have a temporary leader for each activity

what type of therapy is instrumental in helping the child successfully deal with the inherent threats related to hospitalization or chronic illness

play therapy

what is parallel play?

playing alongside one another but not with each others

what are adults more susceptible to because of decreased lung expansion?

pneumonia and bacterial or viral infections

what are health risks for the toddler?

poisoning, drowning, and motor vehicle accidents

name this type of formula: milk-based, blenderized; the patinet's GI tract need to be able to absorb whole nutrients

polymeric

glycogen is what type of saccharide?

polysaccharide

starches are what type of saccharide?

polysaccharides

what two things can affect growth rate and can actually cause a smaller stature no matter the genetic blueprint

poor nutrition and chronic disease

what type of nitrogen balance is required for growth, normal pregnancy, maintenance of lean muscle mass and vital organs, and wound healing

positive

what is the 5th stage of the cognitive theory?

post formal thought

name this stage of cognitive development: adults change how they use knowledge, and the emphasis shifts from attaining knowledge or skills to using knowledge for goal achievement. Adults demonstrate the ability to recognize that answers vary from situation to situation and the solutions need to be sensible

postformal thought


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