EXAM 3 - Topics 9, 10, 11

(1) Mild (2) Severe (3) Acute (4) Chronic

*Levels of Stress: (1) ______ = Eustress - positive response with protective and adaptive functions. (2) _______ = Distress - negative stress level, creates a level of anxiety exceeding a person's normal coping abilities. (3) _______ = Intense anxiety - untreated, can become chronic -> Ex: PTSD (4) _______ = Harmful to physical and emotional health -> development and exacerbation of cardiac conditions, migraine, and digestive disorders.

(1) Emotional (2) Cognitive (3) Physical (4) Spiritual

*Resilience training - focuses on strengthening 4 areas of function: (1) _______: focusing on a sense of purpose & cultivating an attitude of acceptance of what cannot be changed (2) ________: adopting the mindset that an illness can become an opportunity/time for new learning (3) ________: using exercise as a way to relieve stress (4) _______: renewing faith, placing yourself in a higher power

(1) problem (2) meaning (3) emotion *problem-focused: purposeful active, task-oriented methods to reduce stress. -> Ex: confronting a problem directly, negotiating for a different solution, seeking social support, constructive problem-solving, and taking action. -> found to be the most effective in reducing stress. *meaning-focused: reframes the significance of the stressor so it becomes less powerful/overwhelming and turns into a change in focus level *emotion-focused: effective when the stressor is perceived as an overwhelming irreversible situation or from overthinking about a stressful situation. -> Ex: meditation, yoga, or spirituality

3 purposes of coping strategies: (1) To change the stressful situation (________-focused) (2) To change the meaning of the stressor (________-focused) (3) To help the person relax enough to take the stress in stride (_______-focused)

crisis

A _______ occurs when a stressful life event overwhelms an individual's ability to cope effectively in the face of a perceived challenge or threat.

behavioral **A behavioral emergency is always an emotionally charged, unpredictable situation

A ________ emergency occurs when a crisis escalates to the point that the situation requires immediate intervention to avoid injury or death. -> Ex: any type of violent interpersonal behavior, psychotic crisis, suicide, or homicide. -> describes any type of thinking or behavior that places an individual in an immediate potentially injurious or lethal situation

speech; language

A _________ disorder involves impaired articulation, whereas a ________ disorder is impaired comprehension or use of spoken sounds. Problems can include deficits in talking or reading.

stressor

A _________ is any demand, situation, internal stimulus, or circumstance that threatens the individual

b. hearing c. vision d. speech e. language f. cognitive processing

A communication deficit is an impairment in the ability to receive, send, process, and comprehend concepts or verbal, nonverbal, and graphic symbol systems, which include deficits in? (select all that apply) a. mobility b. hearing c. vision d. speech e. language f. cognitive processing g. pain

psychological first aid

Adapting ______ _____ _____ (PFA) to rape and sexual assault victims is a helpful comprehensive action-oriented intervention. PFA consists of eight core actions: 1. Contact and engagement 2. Safety and comfort 3. Stabilization 4. Information gathering 5. Practical assistance 6. Connection with social supports 7. Information on coping support 8. Linkage with collaborative services

Expressive; Receptive; Global **Use of touch may help communicate **patient may have feelings of loss and social isolation imposed by the communication impairment

Aphasia is a neurological linguistic deficit, such as that occurs after a stroke: -> _________ aphasia = can understand what is being said but cannot express thoughts or feelings in words. -> _________ aphasia = creates difficulties in receiving and processing written and oral messages. -> _________ aphasia = difficulty with both expressive language and reception of messages.

(1) Mental status (2) Motor behavior (3) Body language (4) Speech patterns (5) Affect

Behavioral Indicators of Potential Violence: (1) ______ status: Confused, Paranoid, Disorganized, Angry (2) ______ behavior: Agitated, Pacing, Fists Clenched, Rapid breathing (3) _____ _______: Prolonged staring or lack of eye contact, Spitting, Pale, or red face (4) ______ patterns: Rapid, pressured, Incoherent, mumbling, Raised voice, Use of profanity (5) ________: Belligerent, Labile, Angry

(1) shock (2) recoil (3) restoration (or reconstruction)

Caplan's Crisis Response Pattern - 3 phases: (1) ________: person's initial response to a crisis state -> varied emotions, ranging from anger, laughing, hysterics, crying, and acute anxiety to social withdrawal. (2) _______: extended period of adjustment following the initial state, which can last from 2 to 3 weeks. -> behavior appears normal to outsiders, but patients describe nightmares, phobic reactions, and flashbacks of the crisis event. (3) ______: final phase of crisis intervention - involves developing a plan and taking constructive actions to resolve the crisis situation. -> success = person returns to a precrisis functional level (desired clinical outcome) -> fails = maladaptive coping strategies (drug or alcohol use, violence, or avoidance)

sorrow

Chronic ________: defined as a normal grief response associated with an ongoing living loss that is permanent, progressive, recurring, and cyclic in nature. -> Many parents of children with a physical, developmental, emotional, or chronic disorder experience this

Nonverbal; Verbal

Communication Deescalation Tips for Mental Health Emergencies: -> _________: • Give the person your undivided attention. • Respect personal space: stand 3 feet away • Use a nonthreatening, nonverbal stance • Make eye contact • Movement: avoid sudden movements, announce actions when possible, keep hands where they can be seen. • Have a clear escape route -> _________: • Communication: focus on feelings. • Be brief, slow, with simple vocabulary, moderate tone • Attitude: calm, interested, firm, patient, reassuring, respectful, truthful, empathetic, and nonjudgmental. • Acknowledge legitimacy of feelings, delusions, hallucinations as being real to the patient • Allow verbal venting within reason. • Set limits if necessary. • Avoid rushing: slow things down.

vision

Communication-enhancing equipment for the ______ impaired includes: -> electronic magnifier machines, auditory teaching materials, and computer screen readers with voice synthesizers, Braille keypads or cards, and video magnifying machines.

4-6 weeks

Crisis intervention is a time-limited treatment. What is considered the standard time frame for crisis resolution?

present; action

Crisis intervention represents a systematic application of theory-based problem-solving strategies designed to help individuals and families resolve situation quickly and successfully. -> desired clinical outcome = return to an individual's precrisis functional level. -> strategies should be adapted to fit each patient's preferences, beliefs, values, and individual circumstances -> interventions should be ______-focused and ______-oriented.

humility **results = mutual empowerment, respect, partnerships, optimal care, and lifelong learning **pinpoints an attitude that is characterized by openness and a willingness to learn from patients about their beliefs

Cultural _______ is defined as a process of openness, self-awareness, being egoless, and incorporating self-reflection and critique after willingly interacting with diverse individuals.

relativism

Cultural _______: describes how each culture is unique should be judged only on its values and standards (i.e., something that seems strange to one culture makes sense in cultural context)

(1) Process (2) Act (3) Reflect

Describe the 3 Levels of Nursing Communication Behavior: (1) _________ = Gathers data & Accepts -> Becomes aware of goals and patient care plan -> Uses patient's correct name -> Maintains eye contact & adopts open posture (2) ________ = Listens (Responds to cues, Nods head, Smiles); Clarifies (Asks open-ended questions, Restates the problem); and Informs (Provides honest, complete answers) (3) _______ = Analyzes -> Identifies unknown emotions -> Interprets underlying meanings

(1) Perception (2) Intrapersonal (3) Interpersonal (4) Environmental

Describe the 4 Stress Assessment Topics to Discuss: (1) _______ of stressors: - Major stress area or health concern - Present circumstances related to usual pattern - Anticipation of future consequences - Expectations of self and caregivers (2) _________ factors: - Physical (mobility, body function) - Psychosociocultural (attitudes, values, coping patterns) - Developmental (age, factors related to present situation) - Spiritual belief system (hope and sustaining factors) (3) ________ factors: - Resources and relationship of family or significant others (4) ________ factors: - Resources and relationships of community

Displacement; Intellectualization; Reaction; Sublimation; Undoing

Ego Defense Mechanisms (cont.): *______: Redirecting feelings onto object or person considered less of a threat than original object or person *_______: Unconscious focusing on only the intellectual and not the emotional aspects of a situation or circumstance *______ formation: Unconscious assumption of traits that are the opposite of undesirable behaviors *________: Redirecting socially unacceptable unconscious thoughts and feelings into socially approved outlets *_______: Verbal expression or actions representing one feeling, followed by expression of the direct opposite

Regression; Repression; Denial; Rationalization; Projection

Ego Defense Mechanisms: *________: Returning to an earlier, more primitive form of behavior in the face of a threat to self-esteem *_______: Unconscious forgetting of parts or all of an experience *_______: Unconscious refusal to allow painful facts, feelings, or perceptions into awareness *_______: Offering a plausible excuse or explanation for unacceptable behavior *_______: Attributing unacceptable feelings, facts, behaviors, or attitudes to others; usually expressed as blame

(1) Physical (2) Psychological (3) Spiritual

Examples of Personal Sources of Stress: (1) _______ Stressors: • Acute or chronic illness • Trauma, injury, or pain • Insomnia • Mental disorder (2) ________ Stressors: • Loss of job or job security or loss of role • Loss of a significant person or pet • Significant change in residence, relationship, work • Personal finances • Work relationships / High-stress work environment • Caretaking (frail elderly, children) (3) _______ Stressors: • Loss of purpose or hope • Questioning of values or meaning

b. macular degeneration *Macular degeneration patients often still have some peripheral vision. Enhanced lighting and use of light filters to reduce glare may help you to communicate with those who have reduced vision. *hearing loss patients- face directly when speaking

For which type of patients is it acceptable and more helpful to stand to their side when communicating, an exception to the usual "face them directly" rule? a. presbyopia b. macular degeneration c. presbycusis d. blind persons

d. socioeconomic status **Health disparities: -> influence a person's capacity to achieve positive health outcomes, experience satisfaction with treatment, and achieve healthy well-being through normal channels. -> create an increased health burden on certain populations *Bioecology - assesses genetics, hereditary factors, ethnic physical characteristics, drug metabolism

Healthy People 2030, says health disparity is closely linked with a person's? a. bioecology b. educational status c. spirituality d. socioeconomic status

presbycusis; 20/200 **age-associated vision changes: -> accommodation shifts from far to near vision; known as presbyopia. -> macular degeneration has also become a major cause of vision loss in older adults, as do conditions such as cataracts, diabetic retinopathy, or glaucoma

Hearing Loss: -> Aging increases the likelihood for ________: defined as the degeneration of ear structures, which is a sensorineural dysfunction that normally occurs with aging Vision Loss: -> In addition to total loss blindness, visual impairment is defined as vision ___/____ or worse or having less than a 20-degree visual field.

c. subculture

Hippies, bikers, or goths, described as a smaller group of people within a dominant culture, would be known as a: a. societal group b. diverse group c. subculture d. coexisting culture

knowledge, skill, attitudes *Nurses need cultural ~knowledge~; ability to select appropriate communication ~skills~; and ability to have an ~attitude~ of acceptance of differences.

Intercultural care requires effective communication within what 3 specific areas?

DABDA: (1) Denial (2) Anger (3) Bargaining (4) Depression (5) Acceptance

Kübler-Ross's 5 Stages of Death and Dying: (1) _______ = "This can't be happening" (2) _______ = "Why me?" (3) ________ = "I need more time" (4) ________ = Reality sets in - sadness (5) ________ = Acknowledges & comes to terms

Interpreter; Translator

Language Services for Communication: *__________ = a professional who is fluent in two or more languages. *________ = a professional who works with written documents moving words from and meaning from one document to another. *CyraCom interpreter-phone service where a language is chosen through an automated IVR process

Transactional

Lazarus and Folkman's _______ Model of Stress: a psychological model that considers stress as a 2-way interactive process between- (1) the stressor (2) the individual's response to the stressor

men = "fight or flight" women = "tend and befriend" *Women use nurturing activities to reduce stress and promote safety for self and others as priority interventions - seek social support from others *Children express stress through behavior, usually corresponding with their developmental stage and family patterns. Acting-out behaviors and psychosomatic illness can mask a child's distress.

Men and women respond to stress differently: -> men respond with patterns of "_____ or ____" -> women use a "______ and _____" approach.

(1) recognition (2) attending (3) empathetic **attending behaviors = attentive, open posture; responding to verbal and nonverbal cues through appropriate gestures and facial expressions; using eye contact; and allowing patient self-expression.

Nursing actions that facilitate empathy can be classified into 3 major skills: (1) _________ and classification of requests, (2) ________ behaviors (3) _________ responses.

Acute; Anticipatory

Patterns of Grieving: *______ Grief: -> feelings are intense, and emotional pain is beyond imagining. -> feelings can somaticized in the form of physical symptoms such as fatigue, SOB, or chest pain. *_______ Grief: -> may begin to experience emotions associated with grief even before the patient dies. -> ambivalent feelings are common

Tertiary

Prevention as Intervention - would this be classified as a primary, secondary, or tertiary intervention? 1. Attain/maintain wellness 2. Educate or reeducate as needed 3. Coordinate resources 4. Provide information about primary and secondary interventions

Primary

Prevention as Intervention - would this be classified as a primary, secondary, or tertiary intervention? 1. Identify and classify stressor 2. Provide information to maintain or strengthen strengths 3. Support positive coping mechanisms 4. Educate patient and family

Secondary

Prevention as Intervention - would this be classified as a primary, secondary, or tertiary intervention? 1. Mobilize resources 2. Motivate, educate, involve patient in healthcare goals 3. Facilitate appropriate interventions; refer to external resources as needed 4. Provide information on primary prevention or intervention as needed

(1) alarm (2) resistance (3) exhaustion

Selye described a 3-stage progressive pattern of nonspecific physiological responses: (1) ________: acute stress response (2) ________: occurs as the body tries to accommodate for the stressor (3) _______: body fails to adapt or is unable to resist the continued stress -> At this point, the person becomes higher risk for a stress-related illness, or mental disorder.

general adaptation

Selye described stress as a physiological whole-body response to stress, primarily through the endocrine and autonomic nervous systems: **Referred to as the _______ _______ syndrome

validation

Since word meanings are not the same even within a culture, _________ is an important communication strategy to use with culturally diverse patients

hormones; mediators

Stress _______ protect the body against short-term acute stress (allostasis). Stress _______, such as social support, can provide protective effects.

C = Communicate - with the family O = Orient - yourself to family functioning M= Mindfully - be there (presence) F = Familiarize - yourself with family O = Open - yourself R= Relate - to patient and family goals T= Team building - communication skills

The COMFORT Communication Model stands for:

suicide **Identifying risk factors is KEY to prevention

The Joint Commission (2021) identifies ______ as a "sentinel event" and calls for appropriate screening in behavioral care units, medical surgical units, and the emergency department to avert a death.

(1) primary (2) secondary

The Transactional Model of Stress and Coping states: -> stress occurs, creating a significant adaptive demand requiring a response from the individual. -> is not the objective stressor that accounts for how a person responds to a stressor - it is the primary response mediators: (1) _______ appraisal = a person's interpretation of the severity of a stressor -> The stronger the perceived threat to self-integrity, the greater the stress response (2) _______ appraisal = a person's perception of his or her personal ability to resolve the stressful situation

empathy **An empathetic nurse perceives and understands the patient's emotions accurately

The ability to place oneself into the client's situation and be sensitive and communicate understanding of the client's feelings is crucial in clinical setting is known as?

complicated

Three of Lindeman's concepts of interest for nursing communication interventions are as follows: 1. use of open, empathetic communication; 2. honesty in communication; 3. tolerance of emotions being expressed. -> If the grief work is exaggerated and persists over time, it is termed " _______ grief."

b. Discrimination

Treatment or consideration of, or making a distinction in favor of or against, a person or thing based on the group, class, or category to which that person or thing belongs rather than on individual merit is known as: a. Racism b. Discrimination c. Stereotype d. Ethnocentrism

TRUE *A crisis state creates a temporary disconnect from attachment to others, loss of meaning, and disruption of previous mastery skills. -> feeling of vulnerability

True or False: A crisis state as an acute but normal human response to severely abnormal circumstances. It is not a mental illness, although individuals with mental illness can experience a crisis state associated with their disorder.

FALSE Advance directives are NOT a permanently binding; if the patient chooses to later revoke the document, the patient can do so. **nurses role = provide the patient with full information about risks and benefits of prolonging life and to serve as patient advocate in support of the person's right to make decisions about treatment and care

True or false: Advance directive are permanently, legal bindings that the patient, patient's family, caregivers, and health care providers must abide to

organic

Violence = mental health emergency - creates a critical challenge to the safety, well-being, and health of the patients and others in their environment. **Nurses should always assume an _______ component (drugs, alcohol, psychosis, or delirium) underlying the aggression in patients presenting with disorganized impulsive or violent behaviors, until proven otherwise.

(1) Mild: -> heightened state of alertness; increased acuity of senses -> Enhanced learning, problem-solving -> Walking, singing, eating, drinking, mild restlessness (2) Moderate: -> Decreased sensory perceptions -> Loss of concentration; decreased cognitive ability -> Increased muscle tone, pulse, respirations; rapid speech (3) Severe: -> Greatly diminished perceptions; decreased sensitivity to pain -> Limited thought processes & functioning; confused mental state -> Purposeless behaviors; rapid pulse, respirations; high BP (4) Panic: -> No response to sensory perceptions; possible chest pain -> No cognitive or coping abilities; without intervention = death -> Immobilization

What are the 4 Levels of Anxiety - With Degree of Sensory Perceptions, Cognitive and Coping Abilities, and Manifest Behaviors

C- "Connect" - Offer your attention to the client. Avoid terms of endearment, such as 'sweetie' or 'honey.' A- "Appreciate" - the patient's situation, point of view, and express concern R- "Respond" - Know your client's priorities and expectations in health care. E- "Empower" the client through education. They gain strength and confidence from having the ability to interact with providers.

What are the 4 steps involved in helping to communicate C.A.R.E with clients?

b. empowerment c. creativity

What are the characteristics of resilience? (select all that apply) a. avoidance b. empowerment c. creativity d. realism e. sensitivity

• Listen (carefully to the patient's perceptions & words & descriptions) • Explain (what the patient needs to understand) • Acknowledge (cultural differences between nurse-patient; without devaluing the patient's viewpoint -respect, ask, & incorporate) • Recommend (what patient should do - suggest using a culturally acceptable care process) • Negotiate (with patient to culturally adapt constructive self-management strategies based on patient input - fundamental to patient compliance)

What does the LEARN model stand for? -> is used to frame clinical teaching and coaching encounters with culturally diverse patients

c. FACES scale

When assessing pain in patients with communication disabilities, it is difficult to be exact with "yes/no" nodding. Critical care nurses have validated use of a number of pain assessment graphic assessment scales such as? a. numeric rating scale b. COMFORT scale c. FACES scale d. visual analogue scale

b. Hispanic c. Asian

When assessing patient preferences when the patient is from a different culture about truth-telling and level of disclosure, it is important to ask the family about cultural ways of talking about serious illness. In which cultures, does the family knows the diagnosis/prognosis, but it is not told to the ill person? (select all that apply) a. Indian b. Hispanic c. Asian d. Muslim e. Arabian

Maladaptive

When short-term methods fail and a person resorts to using harmful strategies, such as use of street drugs, alcohol, or uncontrolled anger, this is known as ________ coping

adventitious

When the crisis impacts a large number of people simultaneously, for example, a disaster or pandemic, it is referred to as an _________ crisis.

Patient Self-Determination

Which act became a law that requires all adult patients be given information about advance directives?

b. social customs c. expected behaviors d. cultural beliefs e. values f. language *Cultural patterns and beliefs can dictate personal preferences on information is interpreted.

Which components are described as cultural patterns and are passed down from generation to generation? (select all that apply) a. food traditions b. social customs c. expected behaviors d. cultural beliefs e. values f. language

a. stabilization of distress symptoms b. reduction of distress symptoms d. restoration of functional capabilities to precrisis levels e. referrals for follow-up support care, if indicated

Which of the following accurately describe and are evidenced by the goal of crisis intervention, which is to return patients to their previous level of functioning: (select all that apply) a. stabilization of distress symptoms b. reduction of distress symptoms c. enhanced awareness to maladaptive coping d. restoration of functional capabilities to precrisis levels e. referrals for follow-up support care, if indicated

a. prejudice b. xenophobia d. racism

Which of the following are examples of ethnocentrism, or the inclination to view one's own cultural group as the standard and judge value of another cultural group? (select all that apply) a. prejudice b. xenophobia c. relativism d. racism e. assimilation

b. deep breathing c. guided imagery d. meditation e. progressive relaxation *Biofeedback - referral to an expert who teaches this technique is needed.

Which of the following describe easily learned and applied self-management techniques patients can use to decrease stress? (select all that apply) a. biofeedback b. deep breathing c. guided imagery d. meditation e. progressive relaxation

b. Developing desirable goals * would want to developing realistic goals - not goals that are unachievable and desirable

Which of the following is NOT an effective strategy to reducing stress? a. Promoting education b. Developing desirable goals c. Set priorities d. Anticipatory guidance e. Promote a healthy lifestyle

a. Identify a family spokesperson and support persons involved in decision-making b. Call the family about any changes in patient condition or treatment. c. Provide complete data in easily understandable terms. e. Ensure collaborative rapport and support among healthcare team members. **it is important to actively involve the patient and family in all clinical decisions.

Which of the following would be appropriate nursing interventions to include in decreasing family anxiety? (select all that apply) a. Identify a family spokesperson and support persons involved in decision-making b. Call the family about any changes in patient condition or treatment. c. Provide complete data in easily understandable terms. d. Do not discuss clinical decisions with the family to respect the relationship of the family e. Ensure collaborative rapport and support among healthcare team members.

developmental crisis **Normative psychosocial crises are used as benchmarks for assessing S/S of developmental crisis.

Which type of crisis is based on Erikson's model of psychosocial development? -> can occur as individuals negotiate developmental age-related milestones in their lives -> Ex: becoming a parent or retiring from long-term employment.

situational crisis **A situational crisis is not defined by the life event itself, but by the individual's personal response to it.

Which type of crisis refers to an unusually stressful life event, which exceeds a person's resources and coping skills? -> Ex: unexpected illness or injury, rape, a car accident, the loss of a home or spouse, or being laid off from a job.

George Engel

Who developed the 3 sequential phases of grief work: (1) shock and disbelief: -> detached from normal everyday life events (2) developing awareness: -> phase occurs slowly as the void created by the loss fully enters consciousness. Patients experience a loss of energy. (3) restitution/resolution: -> becomes accustomed to life without the deceased and begins to rebuild a new life (while not forgetting) -> characterized by adaptation

Aguilera

Whose nursing model approaches crisis intervention from a balancing perspective between a crisis situation and a patient's capacity to resolve it? -> proposes that a crisis state develops because of a distorted perception of a situation or because the patient lacks the resources to cope successfully with it. -> balancing factors include: 1. a realistic perception of the event 2. the patient's internal resources (beliefs or attitudes), 3. the patient's external (environmental) supports. -> These factors can minimize or reduce the impact of the stressor, leading to resolution of the crisis.

c. Lindemann *findings suggest that psychiatric management of grief reactions may prevent prolonged and serious alterations in the patient's social adjustment, as well as potential medical disease.

Whose theoretical framework and study of bereavement provides a reference for understanding the stages involved in resolving emotional crisis and bereavement? a. Caplan b. Aguilera c. Lindemann d. Engel

Madeleine Leininger -> this depiction of the many interrelated dimensions of culture and care is useful for exploring important meanings and patterns of care.

Whose theoretical framework for transcultural nursing emphasizes the commonalities and differences among worldviews of diverse health systems?

a. Caplan

Whose theoretical framework introduced practical crisis intervention strategies- for example, crisis telephone lines, training for community workers, and early response strategies, and viewed nurses as key service providers in crisis intervention? a. Caplan b. Aguilera c. Lindemann d. Engel

Ego defense **Persistent use of the ego defense mechanisms is considered pathological. -> as a primary stress reducer, defense mechanisms are ineffective because avoidant behavior typically delays action and compromises trust in relationships. -> Some defense mechanisms—humor, anticipation, affiliation (asking for help), and sublimation—can be adaptive.

_____ ______ mechanisms: a coping style people use to protect self from full awareness of challenging conflict situations. -> designed to protect the ego from anxiety and loss of self-esteem by denying, avoiding, or projecting responsibility for a challenging conflict to an external source.

Cognitive behavioral therapy (CBT)

______ ______ therapy model: helps a patient reframe the meaning of difficult situations. -> through cognitive restructuring people can become aware of and change negative or dysfunctional thoughts, beliefs, and perceptions.

Advance directives

______ _______ = written instructions detailing the process by which patient, together with their families and HCPs, specify preferences for future care. -> specify a person's healthcare decisions should they become incapacitated. -> includes "do not resuscitate (DNR) directives." -> information should be documented and made available to caregivers directly involved in the patient's care.

Distress

______ often presents through behavior rather than through words. -> Ex: anxiety can present in the form of heart palpations, SOB, sweating, and muscle tension. -> Other physical and mental symptoms of stress include the following: • Significant changes in eating or sleeping habits • Headaches, gastric problems, muscular tension, aches and pains, tightness in the throat • Restlessness and irritability • Inability to cope with everyday concerns/obligations • Inability to concentrate

Coping

_______ = the constantly changing cognitive and behavioral efforts to manage specific external or internal demands that are appraised as taxing or exceeding the resources of the person.

Palliative; Hospice **An interdisciplinary palliative care team usually consists of nurses, physicians, social workers, and clergy specially trained in palliative care

_______ care: patient-centered care, with an emphasis on care of patients with diagnosed, progressive, life-limiting health conditions -> can still receive curative treatment components -> goal = optimize QofL and prevent or mitigate suffering among individuals with serious, complex illnesses _______ care: patient has stopped all curative treatments and is near end-of-life period -> differentiation is driven partially by regulations for Medicare reimbursement

Somatic; Psychological

_______ symptoms of stress: -> GI upsets, headaches, changes in weight, and many more reflecting the increased release of cortisol. _________ symptoms of stress: -> sleep disturbances, worry, anxiety, increased irritability

Ethnicity

________ = "social construct" -> A common identity shared based on national, cultural or ancestral values

Burnout

________ = fatigue or frustration brought about by devotion to a cause, way of life, or relationship that failed to produce an expected reward -> Examples: •Occupational stress •Compromises performance

Cultural Humility *Developing competence begins with cultural humility. -> involves self-awareness of your own cultural values, attitudes and perspectives followed by developing knowledge and acceptance of cultural differences in others

________ _______ is the beginning of developing competence which is a process of openness, self-awareness, being egoless and incorporating self reflection, critique after willingly interacting with diverse individuals.

cultural competence

________ ________ is the integration of knowledge ,attitudes and skills that enhances cross-cultural communication and appropriate interactions with others

Cultural Sensitivity

________ _________ is the ability to appropriately respond to the attitudes, feelings, or circumstances of groups of people that share a common and distinct racial, national, religious, linguistic or cultural heritage

Culture **Cultural competence is a legal and ethical standard, an essential skill of nursing care

________ is a complex social concept consisting of family customs, health beliefs, values, and ethnic identities held by individuals and groups. Communication is more than language and nonverbal behaviors. -> the way we view other people, family expectations, and cultural norms. -> has its own beliefs about health and illness and treatment. -> designate professional and organizational system values

Culture

________ plays a role in determining a person's stress and coping behaviors by 1. shaping the types of stressors a person is likely to experience; 2. influencing the patient's appraisal of stress; 3. affecting the choice of coping strategies; and 4. providing different resources and institutional mechanism as coping options.

Purnell's *states that being knowledgeable about other cultures promotes feelings of respect and enhances understanding of attitudes, behaviors, and the impact of illness

________'s Model considers cultural competence from a macro level which includes global society, community, family, down to the micro level of the person. -> uses domains as a framework to understand individual differences & create a comprehensive cultural assessment - leads to culturally congruent, individualized, client-centered approach to care.

disaster

________: defined as a calamitous event of slow or rapid onset that results in large-scale physical destruction of property, social infrastructure, and human life.

Allostasis **Allostatic accommodation = physiological process through which the brain tries to find a new homeostasis, using a range of adaptive functioning.

________: theory of stress response that describes how humans maintain physiological homeostasis through changing circumstances. -> brain serves as a primary mediator between the current exposure, internal regulation of bodily processes, and health outcomes.

Prejudice; Stereotype *Stereotypes based on strong emotions = prejudices.

_________ = Unreasonable feelings, opinions, or attitudes, especially of a hostile nature, regarding a racial, religious, or national group _________ = A simplified and standardized conception or image invested with special meaning and held in common by members of a group

Resilience

_________ = the ability of individuals who are exposed to highly disruptive stressors to remain relatively stable and functional and cope successfully with stress -> a physiologic and psychologic phenomenon. -> linked to well-being and burnout prevention. -> explains why some people seem to weather stress and adversity more easily than others and are able to grow from the experience.

Hardiness

_________ is considered as a protective factor that can minimize the effects of stress. -> consists of 3 basic elements: • Challenge—looking at stressors and characterizing the need for change as an opportunity for personal growth • Commitment—developing a sense of purpose and a strong involvement in directing one's life • Taking control—the belief that one can help to influence one's life's outcomes

Empowerment **Empowered patients feel valued and are more likely to adopt successful coping methods

_________ is defined as assisting patients to take charge of their lives. -> an important aim in every nurse-patient relationship and is addressed by nursing theories such as Orem's view of the patient as an agent of self-care.

Stress; Crisis *Internal stressors: pregnancy, fever, menopause, or emotions *External stressors: social, work, accidents, debt, or exams

_________: represents a natural physiological, psychological, and spiritual response to the presence of a stressor. _________: represents an extreme acute stressor situation for which coping mechanisms fail and the person is unable to function normally. -> usually resolved within 6 weeks.

Anticipatory **should only relate to behaviors that can be changed

__________ guidance: a proactive strategy to help patients cope effectively with stressful situations. -> refers to the process of sharing information about a circumstance, concern, or situation before it occurs.

Ethnocentrism

__________: believes that personal culture is superior when compared to others. -> belief that one's culture has the right to impose its standards of "correct" behavior and values on another culture.

Diversity *Diversity can exist within a culture. -> more differences occur among individuals within a culture than between cultural groups (i.e., differences in educational and socioeconomic status (SES), age, gender, and life experiences)

__________: variations that occur among and across groups in race, ethnicity, gender, cultural background, sexual orientation, physical and mental abilities, socioeconomic status, experiences, and beliefs.

Acculturation; Assimilation

___________: describes how immigrants from a different culture learn and choose to adapt to the behavior and norms of a different or new culture -> may change dress/appearance, new foods, activities, etc. __________: occurs when an individual from a different culture fully adopts the behaviors, customs, and values of the mainstream culture as part of his or her social identity

Conditioning

•Culture _________: means people are culturally bond and are unconscious of their own innate values and beliefs also assumes all people are alike. -> is created by HCPs -> Nurses tend to hold their knowledge and beliefs about health in high regard and may devaluate people who do not posses' similar knowledge and beliefs.