Lecture Exam 3
Auscultation (pic)
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Breast (pic1)
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Breast (pic2)
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Breat Quadrants (pic)
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Clubbed Fingers (pic)
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ROM (pic)
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Family Care
A nurse discusses a patient's health care needs with his family.
Neuman 1974 Stress Systems Model
Based on stress and the patient's reaction to the stressor Role of nursing is to stabilize the patient or situation.
Deontology
Defines actions as right or wrong
Grade 2
Full ROM with gravity Eliminated (PROM) 25% Assessment: Poor
Grade 5
Full ROM/against gravity Full resistance 100% Assessment: Normal
Grade 4
Full ROM/against gravity Some resistance 75% Assessment: Good
Grading Scale
Have patient perform AROM while you provide resistance 5 Full ROM/against gravity Full resistance 4 Full ROM/against gravity Some resistance 3 Full ROM With gravity/No resistance 2 Full ROM with gravity Eliminated (PROM) 1 Slight contraction 0 No contraction
Explain conditions that promote the transmission of health care-associated infections.
Health care-associated infections result from delivery of health services in a health care facility.
Utilitarianism
Proposes that the value of something is determined by its usefulness Aka consequentialism - main emphasis is on the outcome or consequence of action
Anterior Lungs (pic)
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Comparison of OA and RA table
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Describe the six steps of evidence-based practice.
1. Ask the clinical question (PICOT). 2. Collect the best evidence. (peer reviewed) 3. Critique the evidence. 4. Integrate the evidence. 5. Evaluate the practice decision or change. 6. Share the outcomes of EBP changes with others.
Nursing Research
A way to identify new knowledge, improve professional education and practice, and use resources effectively
Use cultural assessment to identify significant values, beliefs, and practices critical to nursing care of individuals through life transformations.
Census Data/Demographics Asking Questions What is your ethnic identity? or Which culture or ethnicity do you identify with? or Describe a cultural group(s) to which you belong and What values, beliefs, or practices are important for us to know during your care? Establishing Relationships
Results and/or conclusion
Clinical implications
Watson 1979 Transpersonal Caring
Defines the outcome of nursing activity with regard to the humanistic aspects of life Purpose is to understand the interrelationships among health, illness, and human behavior
Feminist Ethics
Focuses on the inequality between people
Ronchi
Low-pitched, snore-like Due to airway narrowing and secretions
Identify patients most at risk for infection.
Patients at greater risk for health-care associated infections (HAIs) Multiple illnesses Older adults Poorly nourished Lowered resistance to infection
Abnormal Respiratory Condition: COPD
People with COPD often sit in a tripod position, leaning forward with arms braced against their Bronchitis, emphysema
Narrative (clinical or research)
Purpose Methods or design Clinical implication Make a difference or not Further research? - Research is part of EBP -helps and supports EBP
#3 Tissue Repair
When there is injury to tissue cells, healing involves the defensive, reconstructive, and maturative stages Damaged cells are replaced with healthy new cells.
Ethnocentrism
a tendency to hold one's own life as superior to others.
Definitions
define the general meaning of concepts. -Define so others know what you mean
Justice
refers to fairness
Concepts
related ideas, mental images; help to describe or label phenomena.
Cultural Imposition
use of one's own values & lifestyles as the absolute guide in dealing with patients and interpreting their behaviors; exhibited by health care providers who have cultural ignorance or cultural blindness about differences.
Muscle Testing
•Inspection •Palpation •ROM •Muscle Testing -Repeat same motions used to test ROM flex & hold as you apply opposing force Measures strength •Grade 0-5
Osteoporosis (pic)
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Rheumatoid Arthritis (hand pic)
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Tactile Fremitus (pic)
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Describe the surface landmarks of the thorax.
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Henderson 1955 14 Basic Needs
14 basic needs of the whole person Framing nursing care are the needs of the individual.
Basic Human Needs (Maslow)
5 Levels, human needs on a tier with the most basic needs as the foundation of the hierarchy
Providing Presence
Being with, Eye contact, Body language, Tone of voice, Listening, Positive and encouraging attitude
Benner and Wrubel 1989 Primacy of Caring
Caring is central
Describe the normal and adventitious lung sounds.
Crackles, Wheezing, Stridor, Ronchi
Psychosocial Theories
Cultural Diversity Family as Client/Caregiver Grieving
Wheezing
High pitched Due to airway narrowing Heard louder in lungs than trachea
Stridor
High-pitched during inspiration Due to obstruction of upper airway Louder in trachea than lungs
# 1 Vascular/Cellular Responses
Increase local blood flow to injury (vasodilatation & inflammation) Release of body chemicals (histamine, etc.) Edema (↑ permeability) Pain Phagocytosis (WBCs ingest and destroy) the destruction and absorption of bacteria Leukocytosis (systemic response: WBCs leaving blood vessels)
Define key concepts relevant to cultural diversity in nursing and health care.
Knowing the Client -Knowing develops over time. -Avoid assumptions, focus on client, detect changes in client's condition. Spiritual Caring -Client's belief system. Family Care -Involve family in client's care as appropriate. -Being honest, give clear explanations, keep family informed, try to make the client comfortable, showing interest in answering questions.
Grade 0
No contraction 0% Assessment: Zero
Systems Theory
Open and Closed Closed - not able to interact with surroundings Open - ex. Nursing process Patient interact with hospital environment 4 components: input, output, feedback, and content Nursing Process (open system) Figure 4-3; client's interaction with the environment and response to nursing interventions
PICOT
P-Patient population of interest I-Intervention of interest C-Comparison of interest O-Outcome T-Time
Describe ways to convey caring through presence and touch.
Providing Presence -Being there-physically, in communication, and understanding. -Eye contact, body language, voice tone, listening, & having a positive and encouraging attitude. Touch - Comforting approach which communicates support and concern. -Contact/noncontact: task-oriented, caring, protective
Describe the anatomic demarcation of the five lobes of the lungs.
Right lung has 3 lobes: Superior, Middle, and Inferior lobe. Apex is nearest the head, and base is near the stomach (opposite of the heart's base and apex) Left lung has 2 lobes
Abstract
Summary of what's in the paper
Assumptions
Taken for granted or "I believe" statements that describe concepts or connect two concepts that are factual; determine nature of the concepts, definitions, purpose, relationships, and structure of theory. -back up with evidence and research
Explain how nursing research improves nursing practice.
Theories provide direction for nursing research. Nursing theory and nursing research build the knowledge base for nursing, which is then applied to practice. Theory-generating or theory-testing research refines the knowledge base of nursing. Nurses incorporate research-based interventions into theory-based practice.
Abnormal Respiratory Condition: Asthma
accessory muscles used An allergic hypersensitivity to certain inhaled allergens (pollen), irritants (tobacco, ozone), microbes, stress, or exercise that produces a complex response characterized bybronchospasm and inflammation, edema in walls of bronchioles, and secretion of highly viscous mucus into airways. These factors greatly increase airway resistance, especially during expiration, and produce the symptoms of wheezing, dyspnea, and chest tightness.
Acculturation
adapting to and adopting a new culture. Ex. Raised in the Philippines and then move to the US
Emic Worldview
insider/native perspective
Describe the correct sequence of examination technique during abdominal assessment.
(IAPP - only in GI) Inspection Auscultation - before palpation so no false bowel sounds are heard Percussion Palpation
Swanson's Theory of Caring identified five categories:
-Knowing (avoiding assumptions, assessing thoroughly) -Being With (being there, sharing feelings) -Doing For (comforting, anticipating) -Enabling (informing, explaining, supporting, allowing) -Maintaining Belief (maintaining a hope-filled attitude, offering realistic optimism)
AP dm (pic)
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Components of a nursing theory.
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Digestive Organs (pic)
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Evidenced Based Practice (pic)
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Grading Muscle Strength Chart
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Herberden's and Bouchard's node (pic)
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Inspection of Stomach Size/Shape (pic)
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Kyphosis (pic)
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Lobes on Lungs (pic)
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Location of Bruits on Stomach (pic)
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Location of Lobes on Anterior body (pic)
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Location of Lobes on Posterior body (pic)
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Lung Sounds (pic)
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Nursing Process as a System
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Nursing Theories
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Organs in Stomach (pic)
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Pectus Carinatum & Pectus Excuvatum (pic)
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Percussion (pic)
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Posterior Lungs (pic)
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Quadrants in Stomach (pic)
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ROM 1 of 6 (pic)
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ROM 2 of 6 (pic)
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ROM 3 of 6 (pic)
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ROM 4 of 6 (pic)
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ROM 5 of 6 (pic)
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ROM 6 of 6 (pic)
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Identify the events in the inflammatory response.
3 Steps of the Inflammatory Response # 1 Vascular/Cellular Responses #2 Formation of Exudate #3 Tissue Repair
Discuss the benefits of evidence-based practice.
A response to societal forces. A problem-solving approach to practice. Can be a challenge to obtain the very best and most current information at the right time for patient care Integrates the conscientious use of best evidence +clinician's expertise + patient preferences & values in making decisions about patient care
Identify major components of cultural assessment.
A systematic and comprehensive examination of the cultural care values, beliefs, and practices of individuals, families, and communities Gathers information that will enable the nurse to provide culturally competent care
Discuss the role of values in the study of ethics.
A value is a personal belief about the worth of a given idea, attitude, custom, or object that sets standards that influence behavior.
#2 Formation of Exudate/Inflammatory Exudate
Accumulation of fluid & dead tissue cells and WBCs at the site of inflammation. Types: serous - clear, like plasma sanguineous - containing red blood cells serosanguineous purulent - containing WBCs and bacteria
Abnormal Respiratory Condition: Acute Respiratory Distress Syndrome (ARDS)
An acute pulmonary insult (trauma, gastric acid aspiration, shock, sepsis) damages alveolar capillary membrane, leading to increased permeability of pulmonary capillaries and alveolar epithelium and to pulmonary edema. Gross examination (autopsy) would show dark red, firm, airless tissue, with some alveoli collapsed, and hyaline membranes lining the distended alveoli
Describe the legal responsibilities and obligations of nurses.
As a professional nurse you need to understand the legal limits influencing your practice. This, along with good judgment and sound decision making, ensures that your patients receive safe and appropriate nursing care.
Explain the difference between medical and surgical asepsis.
Asepsis is the absence of pathogenic (disease-producing) microorganisms. Medical asepsis, or clean technique, includes procedures for reducing the number of organisms present and preventing the transfer of organisms.
Intentional Torts
Assault: Any intentional threat to bring about harmful or offensive contact. No actual contact is necessary. any action that places a person in apprehension of a harmful or offensive contact without consent Battery: Intentional touching without consent. Contact harmful or offensive to personal dignity. Consent key component. False Imprisonment: Unjustified restraining of a person without legal warrant.
Compare and contrast theories on caring.
Caring is a universal phenomenon that influences the way in which people think, feel, and behave in relation to one another. Florence Nightingale studied caring. In the 1980s, Patricia Benner and Benner with Judith Wrubel offered another definition of caring. Determines what matters to a person and has a wide range of interactions.
Define the role that caring plays in building a nurse-patient relationship.
Caring is an inherent feature of nursing practice, whereby nurses help clients recover from illness, give meaning to that illness, and maintain or reestablish a connection. Caring facilitates a nurse's ability to know a client, allowing the nurse to recognize a client's problems and to find and implement individualized solutions.
Identify the potential implications when nurses' and patients' perceptions of caring might differ.
Clients have valued nurses' effectiveness in performing tasks, but clients also value the affective dimension of nursing care. The identification of behaviors that clients perceive as caring helps to emphasize what clients expect from their caregivers. Clients' satisfaction with nursing care is an important factor in their decision to return to a hospital.
Explain how an ethic of care influences nurses' decision making.
Concerned with the relationship between the patient and the nurse and the attitude of each toward the other Places the nurse as the patient's advocate who solves ethical dilemmas by creating a relationship Gives priority to each patient as a unique being Ethics refers to the ideals of right and wrong behavior. In any client encounter, a nurse must know what behavior is ethically appropriate. An ethic of care is concerned with relationships between people and with a nurse's character and attitude toward others. Places the nurse as the client's advocate, solving ethical dilemmas by attending to relationships and by giving priority to each client's unique personhood.
Jean Watson's Theory of Caring (1988, 1979)
Conscious intention to care promotes healing and wholeness Rejects the disease orientation to health care and places care before cure Looks beyond disease and treatment by conventional means to deeper sources of inner healing Emphasizes the nurse-patient relationship and forming a connection Dying at peace
Listening
Creates trust Opens lines of communication Creates a mutual relationship
Describe steps toward developing cultural competence.
Cultural Competence: the process of acquiring specific knowledge, skills, and attitudes that ensure delivery of culturally congruent care (5 components...). Cultural awareness Cultural knowledge Cultural skills Cultural encounters Cultural desire
Differentiate culturally congruent from culturally competent care.
Culturally congruent care Goal of transcultural nursing Fits the person's valued life patterns and set of meanings Requires specific knowledge, skills, and attitudes in the delivery of care Culturally competent care Is the process of acquiring specific knowledge, skills, and attitudes to provide culturally congruent care the ability of the practioner to bridge cultural gaps in caring, work with cultural differences, and enable clients and families to achieve meaningful and supportive care.
Describe social and cultural influences in health, illness, and caring patterns.
Culture affects how people value, evaluate, and categorize life experiences The members of a cultural group share values and ways of thinking and acting. These values and ways of thinking and acting are different from those of people who are outside the group.
Developmental Theories
Describe and predict behavior and development at various phases of the life continuum. Maslow's Hierarchy of Needs
Describe the historical development of nursing theory.
Development of nursing theories and models is relatively recent. The nursing profession relied on theories from other disciplines such as medicine, psychology, and sociology, as a basis for practice. In the mid-1950's Teachers College, Columbia University, NY City, began offering master's and doctoral programs in nursing education and administration, resulting in student participation in theory development and testing.
Crackles
Due to fluid, mucus or pus; Non-musical, popping sound
Ethics of Care
Emphasizes the importance of understanding relationships, especially as they are revealed in personal narratives
Nightingale mid 1800s (1860) Environmental Theory
Environment as the focus of nursing care Descriptive theory Manipulate the environment to promote healing. Gave clean sheets
Describe the steps in processing an ethical dilemma.
Ethical dilemmas almost always occur in the presence of conflicting values. To resolve ethical dilemmas, one needs to distinguish among values, facts, and opinion. Sometimes people have such strong values that they consider them to be facts, not just opinions. Sometimes people are so passionate about their values that they provoke judgmental attitudes during conflict.
Discuss the role of ethics in professional nursing.
Ethics refers to the study of conduct & character; philosophical ideals of right and wrong behavior. concerned with determining what is good or valuable for individuals, for groups of individuals, and for society at large. Bioethics refers specifically to ethical issues that affect health and delivery of health care. A code of ethics is a set of guiding principles that all members of a profession accept
Ethnicity
Ethnic identity is based on the language, geographic area, racial characteristics, and values of the group's heritage (Irish, Polish, Vietnamese, Mexican). Differs from race.
Peplau 1952 Interpersonal Relationships
Focus on interpersonal relations between nurse, patient, and patient's family Development of nurse-patient relationship
Grade 3
Full ROM With gravity/No resistance 50% Assessment: Fair
Describe the IPPA of pulmonary assessment.
Inspection: inspect shape and configuration of chest, position of pt., LOC, use of accessory muscles, location of trachea, skin color and condition, resp. rate, AP/Lateral diameter, barrel chest Palpation: symmetric expansion, tactile fremitus (vibration), tender areas, lumps or masses Percussion: should have tympany (hollow) sound Auscultation: 5 areas in front, 9 areas in back
Unintentional
Negligence, malpractice Negligence is conduct that falls below the standard of care. Compared to what a careful and prudent nurse would do in the same situation. Malpractice is one type of negligence; "professional negligence." Occurs when: The nurse owed a duty to a patient; The nurse did not carry out that duty; The patient was injured; The nurse's failure to carry out the duty caused the injury.
Define selected nursing theories.
Nightingale, Peplau, Henderson, Roy, Orem & King, Neuman, Leininger, Watson, Benner & Wrubel
The Challenge of Caring
Nurses are given less time to spend with clients, making it much harder to know who they are; nursing shortage. Modern technology provides advances, but is often detrimental to providing "nursing care." Clients have multiple illnesses/diseases that require immediate treatment.
Describe the relationship between theory, the nursing process, and patient needs.
Nurses need a theoretical base to demonstrate the science and art of the profession when they promote health and wellness for their clients, families and communities.
Describe the relationship between theory and knowledge development in nursing.
Nursing knowledge is theoretical and practical. The goals of theoretical knowledge are to stimulate thinking and create a broad understanding of the "science" and practices of the nursing discipline. Experiential knowledge, or the "art" of nursing, is based on nurses' experiences in providing care to patients.
Define nursing theory.
Nursing theory is a conceptualization of some aspect of nursing Communicated for the purpose of describing, explaining, predicting, and/or prescribing nursing care Describes, explains, predicts, and/or prescribes nursing care A theory contains a set of concepts, definitions, and assumptions or propositions that explain a phenomenon. Describes and links concepts Theories guide the design of nursing interventions.
Orem 1971 King 1971 Self-Care Deficit Goal Attainment
Orem (2001) Self-Care Deficit Theory of Nursing Focuses on patient's self-care needs Goal is for patient to manage his or her health problems Help client attain total self-care; nursing care is necessary when the client is unable to fulfill biological, psychological, developmental, or social needs. King (1971) Theory of Goal Attainment 3 dynamic/interacting systems: personal, interpersonal, and social. Nurse/client relationship is vehicle for delivery of nursing care.
Touch
Provides comfort Creates a connection Contact touch Noncontact touch Protective touch - prevent harm from an incident Nurse - remove self from situation Task-oriented touch - ex. shower
Describe the types of contemporary ethical issues.
Quality of life: Central to discussions about end-of-life care, cancer therapy, physician-assisted suicide, and DNR - Oregon, Washington, Montana are 3 states with physician assisted suicides Genetic screening: What are the risks and benefits to individuals and to society of learning about the presence of a disease that has not yet caused symptoms, or for which a cure is not yet available? Care at the end of life: Interventions unlikely to produce benefit for the patient Access to care: As a nurse, you will certainly deal with ethical issues related to access to care.
Explain legal concepts that apply to nurses.
Safe nursing practice includes an understanding of the legal boundaries within which nurses must function. Nurses must understand the law to protect themselves from liability and to protect their patient's rights.
Grade 1
Slight contraction 10% Assessment: Trace
Spiritual Care
Spiritual health is achieved when a person can find a balance between his life values, goals, and belief symptoms and those of others. Spirituality offers a sense of interpersonal and transpersonal connectedness. Can be related to religion
Swanson's Theory of Caring
Swanson (1991) identified five categories/processes of caring following 3 studies performed in a perinatal unit: Knowing; Being with; Doing for; Enabling; Maintaining belief Defines caring as a nurturing way of relating to a valued other, toward whom one feels a personal sense of commitment and responsibility
After critiquing all articles for a PICOT question,
Synthesize or combine the findings Consider the scientific rigor of the evidence and Whether it has application in practice
Define selected theories from other disciplines.
Systems Theory Maslow's Basic Human Needs Developmental Theories Psychosocial Theories
Describe the composition of breast granular tissue.
The glandular tissue contains 15 to 20 lobes radiating from the nipple, and these are composed of lobules. Within each lobule are clusters of alveoli that produce milk. Each lobe empties into a lactiferous duct. The 15 to 20 lactiferous ducts form a collecting duct system converging toward the nipple. There, the ducts form ampullae, or lactiferous sinuses, behind the nipple, which are reservoirs for storing milk.
Explain the relationship of the chain of infection to transmission of infection.
The presence of a pathogen does not mean that an infection will occur. Infection occurs in a cycle that depends on the presence of all of the following elements: Infectious Agent or pathogen Reservoir or source for pathogen growth Portal of Exit from the reservoir Mode of Transmission Portal of Entry to a host Susceptible Host Infection can develop if this chain remains uninterrupted . Preventing infections involves breaking the chain of infection.
When you decide to apply evidence, consider:
The setting Whether support is provided from staff and available resources Evaluate the change. Share the information.
Define the value of nursing theory in nursing practice.
Theories guide the design of nursing interventions. A theory offers a well-grounded rationale or reason for how and why nurses perform specific actions. Common nursing theories enhance communication and increase autonomy and accountability for patient care
Leininger 1978 Culture Care/Sunrise
Theory of cultural care diversity and universality Considers social structure factors
Identify the need for values clarification in nursing.
Values clarification is a process of self-discovery that helps a person gain insight into values. A person clarifying values learns to make choices when alternatives are presented and determines whether choices are carefully made. The result is greater self-awareness and personal insight. Know and understand own point of view, accept that others will have different views
Roy 1970 Adaptation Model
Views the patient as an adaptive system When patient cannot adapt to stressors, nursing is needed Client is adaptive system, nurses help client adapt to changes. Need for nursing arises when client unable to adapt to environmental demands.
Identify auscultatory sites for lung sounds.
While standing behind the person, listen to the following lung areas—posterior from the apices at C7 to the bases (around T10), and laterally from the axilla down to the seventh or eighth rib. While standing behind the person, listen to the following lung areas—posterior from the apices at C7 to the bases (around T10), and laterally from the axilla down to the seventh or eighth rib.
Introduction
Why they wrote what they wrote
Quasi-intentional
acts in which intent is lacking but volitional action and direct causation occur such as in invasion of privacy and defamation of character Defamation of Character: The publication of false statements that results in damage to a person's reputation. Malice - person publishing information knows it is false & publishes it anyway or it is published with reckless regard as to the truth or falsity of the statement. Slander - oral statement; speaks falsely Libel - written statement; charting false entries
Culture
affects how people value, evaluate, and categorize life experiences thoughts, communications, actions, customs, beliefs and institutions of racial, ethnic, religious or social groups.
Fidelity
agreement to keep promises
Phenomenon (of nursing and nursing care)
aspect of reality that can be sensed or experienced; caring, self-care, client's responses to stress. Reflects the domain of nursing practice.
Cultural Skills
assessment of social, cultural, and biophysical factors influencing treatment and care of clients.
Nonmaleficence
avoidance of harm or hurt.
Abnormal Respiratory Condition: Tuberculosis
blood in sputum ◦Rust colored sputum, fever, night sweats ◦If pt comes in with signs of TB, are isolated until cultures comes back Inhalation of tubercle bacilli into the alveolar wall starts: (1) Initial complex is acute inflammatory response—macrophages engulf bacilli but do not kill them. Tubercle forms around bacilli. (2) Scar tissue forms, lesion calcifies and shows on x-ray. (3) Reactivation of previously healed lesion. Dormant bacilli now multiply, producing necrosis, cavitation, and caseous lung tissue (cheeselike). (4) Extensive destruction as lesion erodes into bronchus, forming air-filled cavity. Apex usually has the most damage.
Torts
civil wrong made against a person or property Intentional - willful acts that violate another's rights such as assault, battery, and false imprisonment Assault, battery, false imprisonment
Abnormal Respiratory Condition: Atelectasis
collapse of alveoli Collapsed shrunken section of alveoli or an entire lung as a result of (1) airway obstruction (e.g., the bronchus is completely blocked by thick exudate, aspirated foreign body, or tumor), the alveolar air beyond it is gradually absorbed by the pulmonary capillaries, and the alveolar walls cave in; (2) compression on the lung; and (3) lack of surfactant (hyaline membrane disease).
Transcultural Perspective
describes the concept of care as the essence and central, unifying, and dominant domain that distinguishes nursing from other health disciplines. -Care is an essential human need, necessary for health and survival of all individuals. -Care, unlike cure, assists an individual or group in improving a human condition.
How to Process an Ethical Dilemma
differs from the nursing process in that it requires negotiation of differences of opinion Step 1: Ask if this is an ethical dilemma. Step 2: Gather all relevant information. Patient, family, institutional, and social perspectives are important sources of relevant information Step 3: Clarify values. Distinguish among fact, opinion, and values. Step 4: Verbalize the problem. Step 5: Identify possible courses of action. Step 6: Negotiate a plan. Step 7: Evaluate the plan.
Autonomy
freedom from external control refers to the commitment to include patients in decisions about all aspects of care as a way of acknowledging and protecting a patient's independence.
Literature review or background
how, purpose, design
Cultural Awareness
in-depth, self-examination of one's own background, recognizing biases and prejudices and assumptions about others.
Cultural Encounters
involve the engagement in cross-cultural interactions that can provide learning of other cultures and opportunities for effective intercultural communication development (researching).
Cultural Knowledge
obtaining sufficient comparative knowledge of diverse groups, including their indigenous values, health beliefs, care practices, worldview, and biocultural ecology.
Biculturalism
occurs when an individual identifies equally with 2 or more cultures. Cultural Backlash: occurs when an individual rejects a new culture because experience with a new or different culture is extremely negative.
Etic Worldview
outsider perspective
Subcultures
represent various ethnic, religious, and other groups with distinct characteristics from the dominant culture (Appalachian, Missouri Ozark, Amish).
Assimilation (process)
results when an individual gradually adopts and incorporates the characteristics of the dominant culture.
Enculturation
socialization into one's primary culture as a child.
Madeleine Leininger (1991)
studied caring from a transcultural perspective.
International Council of Nurses (ICN)
supports the need for nursing research as a means of improving the health and welfare of people.
Beneficence
taking positive actions to help others.
Cultural Desire
the motivation and commitment to caring that moves an individual to learn from others, accept the role of learner, be open and accepting of cultural differences, and build upon cultural similarities.
Abnormal Respiratory Condition: Pneumocystis Carinii Pneumonia (PCP)
◦Pneumocysits Jiroveci fungus - doesn't affect healthy individuals ◦Affects HIV pts. Because immunocompromised ◦If pt comes in with PCP, assume they have HIV This virulent form of pneumonia is a protozoal infection associated with AIDS. The parasite P. jiroveci (P. carinii) is common in the United States and harmless to most people, except to the immunocompromised, in whom a diffuse interstitial pneumonitis ensues. Cysts containing the organism and macrophages form in alveolar spaces, alveolar walls thicken, and the disease spreads to bilateral interstitial infiltrates of foamy, protein-rich fluid.
Abnormal Respiratory Condition: Pleural Effusion
◦Pneumonia ◦Heart Failure ◦Hemothorax ◦Pneumothorax Collection of excess fluid in the intrapleural space, with compression of overlying lung tissue. Effusion may contain watery capillary fluid (transudative), protein (exudative), purulent matter (empyemic), blood (hemothorax), or milky lymphatic fluid (chylothorax). Gravity settles fluid in dependent areas of thorax. Presence of fluid subdues all lung sounds.
