holistic nursing
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- what is "presencing" and what are 4 features of "presencing"?
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it is being present, of being there for a client
-giving of self in the present moment
-being available with all of the self
-listening, with full awareness of the privilege of doing so
-being there in a way that is meaningful to another person - when a client is helpless, powerless, and vulnerable, what should the nurse focus on?
- rather than worrying about saying or doing "the right thing", nurses should focus on being fully present
- what are 4 ways of being present for a client (according to Osterman and Schwrtz-Barcott)
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-Presence
-Partial presence
-Full Presence
-Transcendent Presence - True or false? Prayer has many health benefits and healing properties.
- True
- the nurse's major responsibility in regards to a client who participates in private or group prayer
- to provide privacy
- if asked to pray with a client, what should the nurse do afterward?
- the nurse needs to spend time with the client following prayer so that the client can express feelings
- before discussing your personal spiritual beliefs with a client, what is needed?
- a request from the client. only discuss spiritual beliefs with the client if the client requests it
- Seventh-Day Adventists observe the Sabbath on which day?
- It begins at sundown on Friday and ends sundown on Saturday
- to implement spiritual care, nurses need what type of skill?
- skill in establishing a trusting nurse-client relationship
- "full presence" refers to what?
- when a nurse is mentally, emotionally, and physically present; intentionally focusing on the client
- what is meant by "partial presence"
- when a nurse is physically present and attending to some task on the client's behalf but not relating to the client on any but the most superficial level
- what are the 3 nursing diagnoses related to spirituality which are approved by NANDA?
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-spiritual distress
-risk for spiritual distress
-readiness for enhanced spiritual well-being - what does the Joint Commission on Accreditation for Healthcare Organizations require in regards to spirituality?
- it mandates that each client admitted to an institution be assessed for spiritual beliefs
- cues to spiritual and religious preferences, concerns, or distress may be revealed by what?
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-environment
-behavior
-verbalization
-affect and attitude
-interpersonal relationships - how does "spiritual health" or "spiritual well-being" manifest itself in a person?
- by a feeling of being "generally alive, purposeful, and fulfilled"
- 10 characteristics indicative of spiritual well-being
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-sense of inner peace
-compassion for others
-reverence for life
-gratitude
-appreciation of both unity and diversity
-humor
-wisdom
-generosity
-ability to transcend the self
-capacity for unconditional love - 11 examples of spiritual needs
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need for:
-trust
-love
-hope
-forgiveness
-dignity
-values
-creativity
-meaning to the fullness of life
-to be respected and valued
-to belong to a community
-to connect with a God or Higher Power - Spirituality includes these 5 aspects
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-meaning
-value
-transcendence
-connecting
-becoming - what is stress?
- a condition in which the person responds to changes in the normal balanced state
- what is a stressor?
- any event or stimulus that causes an individual to experience stress
- responses to stress are referred to as what?
- coping strategies, coping responses or coping mechanisms
- stressors which originate from within a person are called what?
- internal stressors
- stressors which originate outside the individual are known as what?
- external stressors
- these type of stressors occur at predictable times during a person's life.
- developmental stressors
- this type of stressors occur at unpredictable times and may occur at any time.
- situational stressor
- true or false? stress may be a positive or negative experience.
- true
- which two hormones are released in large amounts during the "shock phase" of the "alarm reaction" after initially experiencing a stressor?
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-epinephrine
-cortisone - the primary response to a stressor, the "shock phase" is also known as the "fight or flight" response. how long does it last?
- 1 minute to 24 hours
- define "illness behavior"
- a coping mechanism which involves ways individuals describe, monitor, and interpret their symptoms, take remedial actions, and use the health care system
- list 4 aspects of the sick role
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-clients are not held responsible for their condition
-clients are excused from certain social roles and tasks
-clients are obliged to try to get well as soon as possible
-clients or their families are obliged to seek competent help - what is an "illness"?
- illness is a highly personal state in which the person's physical, emotional, intellectual, social, developmental, or spiritual functioning is thought to be diminished.
- what is a disease?
- an aleration in body function resulting in a reduction of capacities or a shortening of the normal life span.
- how long does a chronic illness usually last?
- 6 months or longer
- the first stage of illness, the "symptom experiences" has 3 aspects. what are these aspects?
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-the physical experience of symptoms
-the cognitive aspect (the interpretation of the symptoms in terms that have some meaning to the person)
-the emotional response - when people seek medical advice (stage 3), what 3 types of information are they looking for?
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-validation of real illness
-explanation of the symptoms in understandable terms
-reassurance that they will be all right or prediction of outcome - what is the difference between an illness and a disease?
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-an illness is a subjective judgement
-a disease is an objective alteration in body function resulting in a reduction of capacities or a shortening of the normal life span - who can determine if a person is ill?
- illness is highly subjective; only the individual person can say he or she is ill
- 3 methods of managing stress (p 228)
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-acknowledge the mind-body connection
-monitor stress warning signs and invoke the relaxation response on a regular basis
-develop the skill of personal presence - in order to develop the skill of personal presence, you must practice what?
- to be present with others, you must practice "being there" for yourself
- what are 6 self-healing methods for nurses? (p 228)
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-clarify values and beliefs
-set realistic goals
-challenge the belief that others always come first
-learn to manage stress
-maintain and enhance physical health
-develop a support network - anxiety differs from fear in which 4 ways?
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-the source of anxiety may not be identifiable. the source of fear is identitiable.
-anxiety is related to the future. Fear is related to the present
-anxiety is vague. fear is definite
-anxiety is the result of psychologic or emotional conflict. fear is the result of a discrete physical or psychologic entity - which levels of anxiety motivate goal-directed behavior?
- mild or moderate anxiety
- what is the highest level of anxiety called?
- panic
- in regards to stress, what is "GAS"?
- it stands for "general adaptation syndrome" which is a chain or pattern of physiologic events which occur as a reaction to a stressor
- which body organs are affected by stress?
- the GI tract, the adrenal glands, and the lymphatic structures
- what physiologic changes occur in someone with prolonged stress?
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-adrenal glands enlarge
-the lymphatic structures such as the thymus, spleen, and lymph nodes, atrophy
-deep ulcers appear in the lining of the stomach - if a reaction to a stressor is found locally instead of generally, what is it called?
- local adaptation syndrome (LAS)
- both the G.A.S. and the L.A.S. occur in 3 phases. what are they?
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-the alarm reaction
-stage of resistance
-stage of exhaustion - during times of stress, the adrenal medulla secretes epinephrine and norepinephrine. what body responses are due to epinephrine?
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-increased myocardial contractility, which increases CO, which increases blood flow
-bronchial dilation which promotes increased O2 intake
-increased blood clotting
-increased cellular metabolism
-increased fat mobilization to make energy available - during times of stress, the adrenal medulla secretes epinephrine and norepinephrine. the principal effect of norepinephrine is what?
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-decreased blood flow to the kidneys
and
-increased secretion of renin. renin helps produce angiotensin which tends to increase the blood pressure by constricting arterioles. - what are 5 psychologic manifestations of stress?
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-anxiety
-anger
-fear
-depression
-unconscious ego defense mechanisms - what type of verbal communication of anger is constructive?
- a clearly expressed verbal communication of anger, including identification of the source. this communication gets anger out into the open so that the other person can deal with it.
- this is a type of behavior which is considered a coping mechanism used by people who are ill
- illness behavior
- what are four aspects of the sick role?
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-clients are not held responsible for their condition
-clients are excused from certain social roles and tasks
-clients are obliged to try to get well as quickly as possible
-clients or their families are obliged to seek competent help - define autonomy
- the state of being independent and self-directed without outside control
- how can nurses support the client's right to self-determination and autonomy?
- by providing sufficient information for the client to participate in decision-making processes and to maintain a feeling of being in control
- define "remission"
- when symptoms disappear
- define "acculturation"
- the involuntary process by which a person adapts to, or borrow traits from, a culture other than their own in which they live
- define "stereotyping"
- assuming that all members of a culture or ethnic group are alike
- define "culture shock"
- a disorder that occurs in response to transition from one cultural setting to another
- how might a person express culture shock?
- expressions of culture shock may range from silence and immobility to agitation, rage, or fury
- define "bicultural"
- describes a person who crosses two cultures, lifestyles, and sets of values
- a viewpoint based on the belief that health and illness are controlled by supernatural forces
- magico-religious health belief view
- a viewpoint based on the belief that life and life processes are controlled by physical and biochemical processes that can be manipulated by humans
- scientific or biomedical health belief
- how do most people describe what "health" is?
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-being free from symptoms of disease and pain as much as possible
-being able to be active and to do what they want want or must
-being in good spirits most of the time - what are the levels of Maslow's hierarchy of needs in order from lowest to highest?
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-physiologic
-safety and security
-love and belonging
-self-esteem
-selfactualization - in the publication of Healthy People 2010, what are the leading health indicators?
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-physical activity
-overweight and obesity
-tobacco use
-substance abuse
-responsible sexual behavior
-mental health
-injury and violence
-environmental quality
-immunization
-access to health care - "primary prevention" refers to what?
- primary prevention focuses on (a) health promotion and (b) protection of specific health problems
- "secondary prevention" refers to what?
- (a)early identification of health problems and (b) prompt intervention to alleviate health problems
- "tertiary prevention" refers to what?
- restoration and rehabilitation with the goal of returning the individual to optimal level of functioning
- what's the difference between "health promotion" and "health protection"?
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-health promotion=behavior motivated by the desire to increase well-being and actualize human potential
-health protection=behavior motivated by a desire to actively avoid illness, detect it early, or maintain functioning within the constraints of illness