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holistic nursing


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what is "presencing" and what are 4 features of "presencing"?
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)
-Partial presence
-Full Presence
-Transcendent Presence
True or false? Prayer has many health benefits and healing properties.
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?
-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?
-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
-sense of inner peace
-compassion for others
-reverence for life
-appreciation of both unity and diversity
-ability to transcend the self
-capacity for unconditional love
11 examples of spiritual needs
need for:
-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
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.
which two hormones are released in large amounts during the "shock phase" of the "alarm reaction" after initially experiencing a stressor?
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
-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?
-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?
-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?
-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)
-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)
-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?
-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?
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?
-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?
-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?
-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?
-decreased blood flow to the kidneys


-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?
-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?
-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?
-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?
-safety and security
-love and belonging
in the publication of Healthy People 2010, what are the leading health indicators?
-physical activity
-overweight and obesity
-tobacco use
-substance abuse
-responsible sexual behavior
-mental health
-injury and violence
-environmental quality
-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"?
-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

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