Study Guide Chapter 3- Topics of Nursing

8/9/2019 Study Guide Chapter 3- Topics of Nursing

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Chapter 10- Illness, Culture and Caring: Impact on Pts., Families and Nurses

What are acute vs. chronic illness? Name some acute illnesses and somechronic illness?- Illness affects not just the sick person, but the people providing care - the spouse, the

partner, their children. Illness changes lives.- A unique characteristic of nursing is the emphasis on viewing patient holistically.

Nurses recognize that human beings are complex beings with physical, mental,emotional, spiritual, social and cultural dimensions.

SUMMARY:

Acute Illness Chronic Illness

- characterized by severe symptoms that are short-lived - usu. develops gradually (pervasive and life altering)- requires ongoing medical attention (nancial hardship)- may continue for the duration of the individual’s life- pervasive and life altering for family and individual

- symptoms tend to appear suddenly, progress steadily, andsubside quickly

- have a signicant social and economic impact, being one of thefastest-growing health problems in the US

Ex: COMMON COLD Factors such as sedentary lifestyle, obesity, and the aging of thepopulation are expected to contribute to a continued increase inthe number of chronically ill Americans for the foreseeable future

- usually return to their previous level of wellness c/b PERMANENT changes that leave RESIDUAL DISABILITY

- some acute illness may lead to chronic conditions Ex: acute MI --> congestive HF

- some chronic illness are progressively debilitating and result inpremature death Ex: TB & autoimmune diseases, OBESITY

- Individuals with sudden, catastrophic injuries (such as spinalcord injury or major stroke) experience dramatic andextensive change in an instant

- face daily challenges that may seem unbearable- use a variety of coping mechanisms, strategies that differ

from person to person

Some chronic illnesses go through periods of REMISSION(when symptoms subside) and EXACERBATION (whensymptoms reappear or worsen) - may undergo cycles of depression- pts. become experts in their own care and management of their

conditions

Topics - Test 3 SG


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How do the different types of illness affect family? - Change in one family member changes the functioning of the total family

- Illness drastically increases the stress in a family and disrupts usual familyfunction

- Sick family member has to give up responsibility to other family members- Family members who are able to shift and assume different roles, who can share

their feelings, and who seek assistance can be expected to to adjust betterto changes than those who are inflexible.

Chronic illness = usually stressful because it us never completely cured- families experience emotional highs and lows as the pt. has remissions and

exacerbations.- may experience resentment and other negative feelings- family members who must take over the sick person’s responsibilities may

be angry and then feel guilty about their anger- family members may withdraw from each other because they fear that their

negative feelings may not be understood and accepted= leads to feelings of isolation for both patients and family members

- families are often confused or uncertain about how to treat the sick member- families may find it difficult to shift responsibilities back to the formerly ill

member as he or she become able to resume role functions, thereby prolonging dependence; due to pt. self-care deficit

What are the stages of adjustment to illness? Give some examples? Stages = descriptive; patients do not move through these states in a LINEAR way

1) Disbelief and Denial = defense mechanism used to avoid anxiety and fear - fear of illness often leads to the mistaken belief that they s/s will

subside without treatment and can delay seeking a diagnosisEx: breast cancer pt. feels a lump on her breast and denies the fact

to check it out; leading the cancer to metastize to the spine2) Irritablilty and Anger = emotions related to alterations of functioning

caused by illness = Pt. get irritable as their ability to function declines (prolonged = depression)= Anger may: be directed toward the body because it is not performing as it

did

- GUILT feelings may occur for failing to prevent the illness- directed toward others - family, friends, co-workers, HCPs3) Attempting to Gain Control = pts. are knowledge-seeking to understand

the options of treatments to gain control over the illness Ex: Pts. may consult HCPs or use over-the-counter medications,

folk practices, or home remedies= FEARS: stimulate treatment-seeking behavior & can lead to further denial

and avoidance


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4) Depression and Despair - Common mood resulting from: ability to work is altered

- modification of daily activities- diminished sense of well-being & freedom

- pain

Ex: Pt. will not eat, get out of bed, or perform to ADLs = s/s of depression5) Acceptance and Participation

- Patient has acknowledged the reality of the illness and is ready to participate in decisions about treatment

* pts. work WITH the doctor ( active involvement )

** Nurses should NOT use these stages to characterize a particular pt’s response **

How do we view illness today? How does it differ from the past? Sick role = behavior that is dependent, passive, and submissive

1) Is exempt from social responsibilities2) Cannot be expected to care from himself or herself3) Should want to get well4) Should seek medical advice5) Should cooperate with the medical experts

** This view is NO LONGER ADEQUATE, because different cultures have differingsick role expectations **

What are illness behaviors? Give an example .

** Although every culture has expectations about how people sick people should behave; previous experience and personality characteristics also affect individuals’ response toillness **

Dependence/Independence - pts. vary along a continuum in their response to illnes s- adapt a passive attitude and overly rely on others to care for them (dep)

- others continue denial and try to live as independently as before illness (indep)


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Resourcefulness - the use of cognitive skills that minimize the negative effects ofthoughts and feelings on one’s daily life and the way one adjusts to adversity Ex: - STRESS INOCULATION = substitute anxiety with (+) thoughts

- problem solving- conflict resolution

- emotion management- skill in self regulation

Resilience - a successful adaptation despite challenging or threatening circumstances Result of 3 factors: 1) Disposition - temperament, personality

2) Family factors - warmth, support, organization3) Outside support factors - supportive network, success in

school or workEx: Cancer patient who is positive, despite all the illness

Spirituality - a belief in a higher power, interconnectedness among living beings, andan awareness of life’s purpose and meaning

- spiritual beliefs may have psychological, medical, and financial benefitsCulture - pattern of learned behavior and values that are reinforced through social

interactions- shared by members of a particular group and transmitted from one generation to

another- can exert considerable influence over meanings attached to health and illness

What is coping? What are the types of coping? Coping - the strategies a person uses to assess and manage demands of care Acute illness - short term and lead to pre-illness state coping behaviors

Chronic illness - continuous coping behaviors Types: Pet therapy

Exercise Seeing a therapist

Spiritual rituals -----> Look at family dynamics

Define culturally competent nursing? Give examples of culturally competentnursing. Cultural competence - a nurse’s knowledge about cultural influences that can

be used to plan appropriate approaches to a patient’s needs

Problems of cultural competence:- Stereotyping- Communication difficulties- Misperceptions about personal space- Differing values and role expectations- Ethnopharmacologic considerations- Ethnocentrism


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Chapter 11- The Science of Nursing and Evidence-Based Practice

What is evidence-based nursing? How do nurses use it? Evidence-based nursing = an approach to the delivery of health care that

“integrates the best evidence from (research) studies and patient caredata with clinician expertise and patient preferences and values”.- taking data and information and applying to practice of nursing -

- In nursing, EBP requires research that supports the specific interventions

What is nursing research? Nursing research = systemic investigation of PHENOMENA related to

improving pt. care ** Goal: improving patient care through EBP **

How is nursing research amenable to a nursing problem?

Why should nurses be involved with research? - IMPROVE THEIR INDIVIDUALIZED CARE

** NEED to keep informed of CURRENT EBP research literature **

What are the types of nursing research? Quantitative Research = involves standardized experimental designs driven by:

1) hypotheses, 2) measurable variables and outcomes, and 3) statisticalanalyses- EXPERIMENTAL Design- MANIPULATES variables and statistical analysis

Qualitative Research = involves exploration of HUMAN EXPERIENCE,described and interpreted by the researcher

- NON-experimental Design

Focusing on evidence of effective interventions preventspractice from deteriorating into routine or traditional care based

on “what has always been done” without concern foradvances in care.

1) A conceptual framework exists or can be constructed tologically be t with previous knowledge

AMENDABLE to being

addressed by research if these

2) The proposed research project is based on related research

ndings published in professional peer-reviewed journalscr er a are me :3) Research is carefully designed so results will be

applicable in similar situations or generate hypotheses


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Chapter 12 - Conceptual and Philosophical Bases of Nursing

What are systems? What are the different types and how do they relate to theenvironment?

Systems = is a set of interrelated parts that come together to form awhole that performs a functionOpen system = promotes the exchange of matter, energy and information

with other system and the environment (Person)Closed system = does NOT interact with other systems or with the

surrounding environment- Matter, energy, and info do NOT flow into or out of a closed sys.

Suprasystem = larger system outside of the hospital

How does environment affect patient healing? Environment = includes all circumstances, influences and

conditions that surround and affect individuals, families and groups ** can promote or interfere with homeostasis and well-being

What is Maslow’s hierarchy of needs? Maslow’s hierarchy rests on several basic assumptions about human needs:

- Basic needs must be at least partially satisfied before higher-order needs become relevant

- Individuals meet their needs in different ways- A nurse must determine a person’s perceptions of his/her needs to

provide individual care ( Adaptation )- When a person’s needs are not met, homeostasis is altered

Key Concepts aboutSystems

a system is a set of interrelatedpartsparts form a meaningful wholethe whole is different from andgreater than the sum of its partssystems may be open or closedall living systems are openssystemssystems strive for homeostasis(internal stability)

systems are part of suprasystemssystems have subsystemsA change in one part of a systemreates change in other pars

WHEN ENVIRONMENTAL FACTORS AFFECT HOMEOSTASIS OF APERSON, THE PERSON ATTEMPTS TO ADAPT TO THE CHANGE- If ADAPTATION is unsuccessful, disequilibrium may occur, setting

the stage for the development of illness or disease- Pts. respond to stress = major factor in the development of disease


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How does family influence health? Healing? Extended families = children are nurtured by a variety of relatives

Nuclear families = children are nurtured by mother & father** Single-parent families = must earn a living and fulfill nurturing roles in

the family = a demanding system

How does culture influence healing? Cultural systems = consists of attitudes, beliefs, and behaviors, of social and

ethnic groups that are perpetuated through generations- basic beliefs abut health and illness vary widely form culture to culture, nurse

needs to develop cultural competence to meet the needs of culturally

diverse patients

What is the definition of health? Health = is dynamic & viewed as a continuum

- varies day by day- “that state of optimum capacity of an individual for the effective

performance of roles and tasks” - Parsons- “ state of complete physical, mental, and social well-being and no merely

the absence of disease or infirmity ” - World Health Organization- continuum with high-level wellness at one end and death at the other

** Integrating of a patient’s cultural health beliefs into the individualized care plancan make a strong impact on the patients desire and ability to improve health**

** The quality and amount of parenting provided to infants andgrowing children constitute a major determinant of health **

** Nurses view health HOLISTICALLY, including its affect on an individual’s physical, emotional, social, and spiritual functioning, as well as its effect on the

family **

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Study Guide Chapter 3- Topics of Nursing