Chapter 4

The nurse in the adolescent in-patient psychiatric unit is interviewing the family of a 16-year-old client admitted for depression and threatened suicide. What assessment information is most essential for the nurse in determining the affective and coping function of the family?

Family patterns of communication explaination The five major areas of family function are physical, economic, reproductive, affective and coping, and socialization. When assessing the family of a depressed client for affect and coping function, it is helpful for the nurse to be aware of the family's communication style. This information can help identify family difficulties and teaching points that could benefit the client and the family.

A nurse is caring for a client newly diagnosed with diabetes mellitus and developing a holistic plan of care. For this plan of care to be successful, it must what?

Address the disease but also incorporate the mind, body, and spirit. explaination A holistic plan of care seeks to balance and integrate the use of crisis medicine, advanced technology, and the mind, body, and spirit, which are incorporated though the use of the nursing process. Taking into account the cost of care is only one facet of a holistic picture. Connecting families, friends, and the environment is important, but mind, body, and spirit define holism. A holistic plan of care may provide a connection between medicine and nursing, but it does not define it.

A nurse is reading a journal article about families and the typical structures commonly seen. The nurse demonstrates understanding of the article by identifying which type as a family structure? Select all that apply.

Nuclear Single adult Blended Extended Explanation: Types of family structures include nuclear, blended, extended, single-parent, cohabitated, and single adults.

Which client requires priority intervention by a nurse providing care on a medical-surgical unit?

A postsurgical client who is feeling dizzy and has a heart rate of 45 beats/min explaination According to Maslow, the first-level physiologic needs are the most important. They are the activities necessary to sustain life, such as breathing, circulation, and eating. Using Maslow's theory and the ABCs (airway, breathing, circulation) to help prioritize care of clients, the nurse needs to see the client experiencing acute problems with circulation and a heart rate of 45 beats/min. All other client problems are not the priority at this time.

Nursing, as a profession, has long held the belief that providing nursing care to an individual patient means providing nursing care to the entire family. What does this mean when put into a holistic framework of patient care?

Active participation by individuals and families in health promotion is integral to this framework of patient care. explaination Active participation by individuals and families in health promotion supports the self-care model historically embraced by the nursing profession. This model is congruent with the philosophy that seeks to balance and integrate the use of traditional medicine and advanced technology with the influence of the mind and spirit on healing. Families are not always caretakers when the patient is not acutely ill; it is not necessary for the nurse, patient and the patient's family to integrate the physical and emotional environment of the patient. It is necessary for the patient to integrate their physical and emotional environment. The holistic framework of patient care is not a model that is congruent with the philosophy of traditional patriarchal medicine.

The home health nurse is making an initial visit to a client's home. During the visit the nurse observes the mother cooking dinner, the father watching television with a child on the lap, and the grandmother in a rocking chair reading the Bible. The nurse recognizes this family structure as which of the following?

Extended family explaination The extended family is composed of two parents, their children, and relatives (such as aunts or grandparents) living in the same household. The blended family is a family formed when parents bring unrelated children from previous relationships together. Single-parent families have only one parent, and the nuclear family consists of two parents and their children.

The nurse is assessing a family parented by a 60-year-old grandmother and three school-age grandchildren. The nurse is aware that which problem may occur in a single-parent family at a greater level than in other types of families?

Increased financial concerns explaination Many single-parent families are headed by women. Single parents often have special problems and needs, including financial concerns and role shifts (i.e., having the roles of both parents). Single-parent families are not less knowledgeable about child safety than other family types, nor is there a higher incidence of child abuse, neglect, or conflict among family members.

The nurse is assessing the communication style of the client. Communication is an example of which dimension of the individual?

Sociocultural dimension explaination Communication is essential for interaction with others and is an example of the sociocultural dimension. The physical dimension incudes physiological health and nutrition. Housing and community are examples of the environmental dimension. The emotional dimension includes fear, sadness, loneliness, and acceptance of self.

When providing care to a client, the nurse prioritizes the client's needs. Which intervention would the nurse employ to meet the client's physiologic needs? Select all that apply.

Assessing the client's skin color Promoting a high-fiber diet Weighing the client

The nurse is conducting a family assessment of a traditional family. Which assessment data cue describes the socioeconomic status of the family?

The father is an engineer and the mother is an elementary school teacher. explaination The occupations of the parents provide financial support for the family and contribute to the socioeconomic status of the family. Affiliation with a religious organization can be a source of social support during stressful times, which can promote adaptive coping for the family. Cultural and religious activities of the family define values and beliefs important to family members. Recreational activities, such as vacationing together, promote interaction of family members.

A home health nurse is visiting a family after the recent death of their matriarch. The nurse observes that the family is dressed in black, all of the mirrors are covered, and that the immediate family is sitting on square wooden boxes instead of chairs. The nurse asks what is happening, and is told, "We are Jewish, and the family is 'Sitting Shiva'." This family is fulfilling which family function?

affective and coping functions explaination This family exhibits the function of affective and coping by observing the ritual of "Sitting Shiva." By observing this Jewish, seven-day period of mourning for first-degree relatives (husband, wife, parent, or child) the family provides emotional comfort to family members, helps to establish their identity, and maintains it in times of stress. Economical function provides financial aid to family members. Physical function provides a safe, comfortable environment necessary for growth and development. Through socialization the family teaches values, attitudes, and provides feedback, and with the function of reproduction the family produces and raises children.