Chapter 14 Older Adults And Chapter 11Developmental Theories Chp 36 Loss And Death

Front 1

Promoting Older Adutl Learning- Make sure that the pt is ready to learn before trying to te_____. Watch for clues that the pt is too preocuppied or too anx))))) to comprehend the material.

Back 1

teach
anxious

Front 2

Is the pt physically well enough to be taught or is he or she in p+++++

Back 2

pain

Front 3

Sit facing the pt so that he or she is able to watching you lip move_____ and facial expressions.

Back 3

movements

Front 4

INTEGUMENTARY- Loss of skin elasticity with fat lo___ in the lower extremities and pigmentation chan_____

Back 4

fat loss
pigmentation changes

Front 5

Aging INTEGUMENTARY- Glandular atrophy (oil, moisture, and sweat glands) hair decreased in men and increased in w______

Back 5

women

Front 6

Aging INTEGUMENTARY-Atrophy of epidermal arterioles and slower nail g______

Back 6

growth

Front 7

Aging RESPIRATORY= Decreased cough reflex, decreased cil____
increased anterior posterior chest diameter, and increased chest wall rig_____

Back 7

cilia
rigidity

Front 8

Aging RESPIRATORY= Fewer alveoli; Increased airway resist____; and increased risk of respiratory infec___

Back 8

resistance
infection

Front 9

Aging Cardiovascular- Thickening of blood vessel walls; narrowing of vessel lu____, loss of vessel elas___; Calci______ of heart valves; lower cardiac output; decreased barore_____ sensitivity;

Back 9

lumen
elasticity
calcification
baroreceptor

Front 10

Development refers to biological, cognitive, and socio-emotional changes that begin at the conception and continue to life In some conditions, development is de______ or regresses

Back 10

delayed

Front 11

ERIKSON- Every individual has to complete particular ta___ before moving to the next one
Erickson has _____stages of life

Back 11

task
8

Front 12

ERIKSEN- Trust vs Mistrust
(B_____ to 1___ months)

Back 12

BIRTH
18 months

Front 13

ERIKSON Autonomy vs S______
(18 months to 3 years)

Back 13

SHAME

Front 14

Initiative vs guilt
(3 – ___ years)

Back 14

5

Front 15

Erikson- Industry vs infer_____
(6 – ___ years)

Back 15

inferiority
12

Front 16

Erikson- Identity vs role confu_____
(12 – ____years)

Back 16

confusion
19

Front 17

Erikson- Intimacy vs isol_____
(18 – ____ years)

Back 17

isolation
29

Front 18

Erikson-Generativity vs self-absorption
& stag_______
(35 – ____ years)

Back 18

stagnation
64

Front 19

ERIkson- Integrity vs des____
(____ years and up)

Back 19

despair
65

Front 20

Freud Every individual go through
____stages of psychosexual
development.

Back 20

5

Front 21

Freud Every stage is characterized
by body parts se_____l pleasure
(mouth, anus, and gen____).
Personality is the result of how
individuals resolve conflicts these
sources

Back 21

sexual
genitals

Front 22

Freud Oral stage
(Birth - ____ to ____
months)

Back 22

12 to 18

Front 23

Freud Anal stage
(---- to ----- months
to 3 years)

Back 23

12 to 18 months to 3 years

Front 24

Freud Phallic stage
(3 to --- years)

Back 24

6

Front 25

Freud Lat_____stage
(6 to 12 years)

Back 25

latent

Front 26

Freud Genital stage
(Puberty through
adu_______)

Back 26

adulthood

Front 27

Kohlberg- Moral stages develop in stages.
Recognizes ___ stages of moral
development in ___levels.

Back 27

6, 3

Front 28

Pre-conven______ reasoning
Conventional reasoning
Post-conventional reasoning

Back 28

Pre-conventional

Front 29

Havighurst Conducted ext______ research and developed a theory of human development based on developmental ta____.

Back 29

extensive
tasks

Front 30

Havighurst theory: 3 developmental tasks:
1. Tasks that surface because of physical
mat_______
2. Tasks that evolve from personal val_____
3. Tasks that are the result of pressure from
soc_____.

Back 30

physical maturation
values
societal pressure

Front 31

Havinghurst believes that the number of tasks differs in each age level for individuals due to interr_______ among biology, society, and personal values.

Back 31

interrelationship

Front 32

Havinghurst He identified six stages:
1. infancy and adulthood
2. mid____ childhood
3. adolescence
4. early adulthood
5. middle adulthood
6. late adulthood.

Back 32

middle childhood

Front 33

Every individual is unique and nurses need to approach every person without gene______ all patients.
The number of older adults is increasing in the United States.
According to the Administration of Aging, there were 39.6 million adults over age 65 in the United States.
According to estimates, the number of older adults will increase to 72.1 million by 2030.

Back 33

generalizing

Front 34

The following are some of the contributing factors for the increase of older adults:
a) aging of the baby-b_____ generation
b) growth of the population segment over age 85
The diversity of multicult____ population who are over 65 is also increasing.
In 2008, minority group were 19.6% of the population over 65 (African Americans, Hispanics, Asians, American Indians, and other Pacific Islanders).

Back 34

baby boom
multicultural

Front 35

Sit or stand at eye level, in front of the patient in full
view.
Face the older adult while speaking; do not cov___ your
mouth. Speak clearly.
Provide diffuse, bright, non glare lighting.
Encourage the older adult to use his or her familiar
ass_____ devices such as glasses or magnifiers.

Back 35

cover
assistive

Front 36

Use caution when interpreting signs and symptoms of dis_____ and laboratory values.
It is important to recognize early indicators of an acute ill____ in older adults.

Back 36

diseases
illness

Front 37

Some mental changes are often drug related, caused by drug tox_____ or adverse drug events.
Many conditions are common causes of functional dec____; thus nurses are essential in early identification, referral, and treatment of health problems in older adults.

Back 37

toxicity
decline

Front 38

Percep____ of well-being defines quality of life.
Older patients’ concept of health revolves around how they perceive their ability to funct____.
Nurses need to be cognizant of normal age-rel____ changes.
Not all physiological changes are pathological.

Back 38

perception
function
related

Front 39

Systems affected in elderly: Integumentary
Respiratory
Cardiovascular
Gastrointestinal
Musculoskeletal
Neurological
Sensory
Genitourinary
Repro______
Endocrine
Immune System

Back 39

reproductive

Front 40

Cardiac and Elderly: Decreased efficiency of venous valves, increased pulmonary vascular ten_____, increased systolic _____, decreased per_____ circulation

Back 40

tension
BP
peripheral

Front 41

Elderly and Gastrointestinal-Periodontal disease; decrease in saliva; gastric secretions; pancreatic enz____; smooth muscles changes with decreased esophageal peri____ and small intestinal moti____

Back 41

enzymes
peristalsis
motility

Front 42

Elderly and Gastrointestinal-gastric atrop___; decreased production of intrin___ factor; increased stomach p___; and loss of sm_____ muscle in the stomach

Back 42

atrophy,
intrinsic
ph
stomach

Front 43

Elderly and Gastrointestinal-hemmoroids and anal fissures; rectal prol____; and impaired rectal se________

Back 43

prolapse
sensation

Front 44

Musculoskeletal and Elderly- decreased muscle ma____ and strength, decalci_____ of bones; degenera___ joint changes, dehydration of inver____ disc

Back 44

mass
decalcification
degenerative
invertebral

Front 45

Neurological and Elderly- degeneration of nerve cells; decrease in neuro_____; decrease in rate of cond______ of impulses.

Back 45

neurotransmitters
conduction

Front 46

Sensory Eyes and Elderly: decreased accomo____ to near/far vision presbyopia- is a condition in which the le___ of the eye loses its ability to focus, making it difficult to see objects up clo___. Symptoms: Decreased focusing ability for near objects;

Back 46

accomodation
lens
close

Front 47

Sensory Ears and Elderly: Loss of acuity for high freq____ tones, this is called presbycu____

Back 47

presbycusis

Front 48

Sensory Ears and Elderly: Thickening of tymp_____ membrane; scler___ of inner ear; build-up of earwax or ceru____

Back 48

tympanic
sclerosis
cerumen

Front 49

Sensory Taste and Elderly: diminished frequently fewer taste b_____

Back 49

buds

Front 50

Sensory Smell and Elderly: Often dimin______

Back 50

diminished

Front 51

Sensory Touch and Elderly: Decreased skin recep____

Back 51

skin receptors decreased

Front 52

Elderly Propioception: Decreased awareness of body pos____ in spa____

Back 52

position
space

Front 53

Genitourinary and Elderly: fewer nephrons; 50% decrease in renal flow by age ____ Decreased blad___ capacity

Back 53

80
bladder

Front 54

Genitourinary and Male Elderly: Enlargement of pro_____

Back 54

prostate

Front 55

Genitourinary and Female Elderly: reduced sphin___ tone

Back 55

sphincter

Front 56

Elderly and Reproductive: Male sperm c____ diminished, smaller testes, erections less f___ and slow to develop

Back 56

count
firm

Front 57

Elderly and Reproductive: female: decreased estrogen production; degeneration of ov____; atrophy of vag____;

Back 57

ovaries
vagina

Front 58

Elderly- Endocrine- General alterations in hormone production with decreased ability to respond to str____

Back 58

stress

Front 59

Elderly- Endocrine- Thy____ - decreased secretions

Back 59

thyroid

Front 60

Elderly- Endocrine- cortisol- glucocorticoids- increased inflam_____ hormone

Back 60

inflammatory

Front 61

Elderly- Immune System- Thymus invol____; T cell function decreases

Back 61

involution

Front 62

Advance directives includes: a. Living w____
b. Health care proxies
c. Durable power of attorney
These documents are based on patient’s informed con____, patient autonomy, truth telling, and control over dying process.

Back 62

wills
consent

Front 63

Patient Self-Determination Act (PSDA) requires health care institutions to provide written infor_____ to patients concerning their right under state law to make dec_____ including the right to refuse treatment and formulate advance directives.
Under this act, the patient needs to have documentation if he or she has signed an advance directive.
Be familiar with policy institution!!

Back 63

information
decisions

Front 64

Living Will:
It is a written document in which
the patient determine which
medical proc_____ he or she wants
or does not want when term____ ill
or in veg_____ state.

Back 64

procedures
terminally
vegetative

Front 65

Health care proxies or Durable Power of Attorney:It is a leg___ document that designates a person or persons of one’s own choice to make health care dec____ when the patient is no longer able to make decisions of his or her own.

Back 65

legal
decisions

Front 66

DNR
“Do not resuci____” or “No code”
Be familiar with your state DNR
protocols.

Back 66

resucitate

Front 67

Assessment of medication history: Prescr____ medications
Over the Counter
Herbal products

Back 67

Prescribed

Front 68

Assessment of medication history includes: Frequency
Method of administration
Last dose and t_____ and side effects Oto____ (Gentamycin, streptomycin, tobramycin)

Back 68

time
ototoxic

Front 69

Necessary loss: people learn to expect that most nec_____ losses are eventually replaced by something different or better.
But losses like a husband, relative may cause perm____ changes in their lives.

Maturational loss: it is a necessary loss that includes all normally expec____ life changes across life span. Ex. When mother leaves son for 1st time at the school.

Situational loss: cause by sudden, unpredict_____ external events. For example: in a car accident a person got injured and cannot walk anymore. As result, the patient is impossible to go back to work.
Actual loss: occurs when a person can not longer feel, hear, see. Example: loss of body part, death of a family member or loss of a job.
Perceived loss: people who are rejected by peers as results lack of confidence or changes happen in a group.

Back 69

necessary
permanent
expected
unpredictable

Front 70

Normal grief: uncomplicated is a common universal reaction characterized by complex emotional, cog____, social, physical, behavioral and spiritual responses to loss and death. Feelings of acceptance, anger and depression are seen in this patient. Viol____ behavior may poses at risk to survivors.

Anticipatory grief: it is the unconscious process of letting go before the actual loss or death occurs.
Disenfranchised grief: unsupported grief when the person’s loss and grief do not meet the norms of grief acknowledge by his or her culture such the death of pet.
Complicated grief: person has a prolong and difficult time moving forward after loss. Patient has trouble accepting the loss. Occurs when persons have conflicted relationshiop.

Back 70

cognitive
violent

Front 71

Anticipatory grief: it is the unconscious process of letting go before the actual lo____ or death occurs.

Back 71

loss

Front 72

Situational loss: cause by sud____, unpredictable external events. For example: in a car accident a person got injured and cannot walk anymore. As result, the patient is impossible to go back to work.

Back 72

sudden

Front 73

Actual loss: occurs when a person can not longer feel, hear, see. Example: loss of body pa___, death of a family member or loss of a job.

Back 73

body part

Front 74

Perceived loss: people who are rej_____ by peers as results lack of confidence or changes happen in a group.

Back 74

rejected

Front 75

Cognitive Symptoms of Grief: disbelief, confu____, difficulty with decision making, and inability to con_____

Back 75

confusion
concentrate

Front 76

Feelings: sorrow, anger, fear, gui___, and anx____

Back 76

guilt anxiety

Front 77

Factors affecting grief:
Human development
Personal relatio____
Nature of the loss
Coping strategies
Socioeconomic status
Culture and ethn_____
Spir_____ and religious beliefs

Back 77

personal relationship
ethnicity
spiritual

Front 78

C. Thinking and Loss: Listen carefully to the patient’s percep____.
Use cult____-specific understanding.

Back 78

perceptions
culture

Front 79

C Thinking and Loss: Use Professional Standards:
Nursing Code of Ethi___
Dying Person’s Bill of Rig___
ANA Scope and Standards of Hospice and Palliative Nursing
Use Clinical Standards: American Society of Pain Management Nurses’ Guidel____

Back 79

ethics
rights
Am Society of Pain Management Guidelines

Front 80

Nursing Process and Grief

Back 80

know

Front 81

Jennifer will ensure that Mrs. Kelly's pain is well managed before asking about her other priorities for care. Jennifer knows that many families have never given end-of-life care, so she plans to provide teaching for their priority concerns.

Back 81

case study

Front 82

Assessment:Conversations about the meaning of loss to a patient often lead to other important areas of assessment:
Patient’s cop___ style
The nature of fam___ relationships
Social sup____ systems
The nature of the loss
Cultural and spiritual beliefs
Life goals
Family grief pat_____
Self-care
Sources of ho____

Back 82

coping
family
support
family grief patterns
sources of hope

Front 83

Nursing DiagnosisAnticipatory grieving
Compromised family coping
Death anxiety
Fear
Ineffective denial
Grieving

Back 83

Read in little book

Front 84

planning
Care plans for the dying patient focus on
comfort
Preserving dignity and quality of life
Providing family members with emotional, social, and spiritual support
Give priority to a patient’s most urgent physical or psychological needs while also considering his or her expectations and priorities.

Back 84

Read in little book

Front 85

Nurse presence read in chap on lo____

Back 85

loss

Front 86

ORAL STAGE-Freud- Erikson- trust vs ____ piaget- sensorimotor period- from reflex activity to re____ actions
0-18 months

Back 86

mistrust
reflex

Front 87

ANAL STAGE- Freud 18months- 3years- autonomy vs shame and do____ Self-control and independence. Piaget- preoperational period thinking and using sym____ Preconventional morality- Kohlberg- punishment- obe____ orientation. Interest in pleasure but delay of grat_____ Self-control, willpower, and choi___

Back 87

doubt
symbols
obedience
gratification
choices

Front 88

ANAL STAGE-18 monts vs 3 yrs Piaget- use of sym____ and images. Fantasy and magical thinking- Difficulty conceptualizing ti____ Nursing interventions involve play because play important to cog______ development- Erikson Autonomy vs Shame and D_____Limiting choices or harsh punishment leads to shame and doubt/ self care toileting and feeding. Piaget preoperational ages 2- ___

Back 88

symbols
time
cognitive
doubt
7

Front 89

ORAL STAGE- Piaget- Infants develop a sche___ or action pattern for dealing with the environment. Freud- oral satisfaction and realizes parent is separate from sel___; inadequate bonding could affect development

Back 89

schema
self

Front 90

LEVEL 1 Kohlberg- likes and dislikes; egocentric; punishment and obed_____

Back 90

obedience

Front 91

Initiative vs Guilt- 3 to 6 years- Role-playing, fantasy. Developing superego or con______. Sense of initative without imposing on freedoms of o_____. Guilt. learn impulse con____ and cooperative behavior. Still at Piaget Preoperational 2-__. Freud Phallic Stage Ages 3-5- genitals are the focus. Fantasizes about parent of opposite sex. At end identifies with same sex parent. Exploration and imagination

Back 91

conscience
others
control
7

Front 92

Industry vs Inferiority Erikson- Ages 6-11 Freud latent stage. Socially productive skills and too___. Sense of inadequacy or inferiority. Freud- latency- sexual urges repressed and sublimated to socially accep___. Social and Educational

Back 92

tools
acceptable

Front 93

Trust vs Mistrust Erikson- healthy personaliy consistent caregiver; anticipatory guid_____

Back 93

guidance

Front 94

Industry and Inferiority - sense of competency- school age child should understand hospital routines and participate in own t_____

Back 94

treatment

Front 95

Identiy vs Role confusion- Erikson Puberty decisions such as vocation and marriage; Sense of identiy; devotion and fidelity to oth____

Back 95

others

Front 96

Intimacy vs Isolation Erikson young adult. Meaninful friendships and intimacy. Nurses must understand hospitalization increases need for in_____

Back 96

intimacy

Front 97

Generativity vs Self-Absorption and Stagnation ERIKSON Middle Age- Expansion of social and personal involvement. Contribute to future generations. Volunteering. Nurses foster social dev+++++

Back 97

development

Front 98

Integrity vs Despair Old Age- ERIKSON- Loss of Status and function; appraisal of l____; Search for the meaning in life; Integrity enough not to fear d______

Back 98

life, death

Front 99

Havinghurst- successful resolution of the developmental task is essential to successful prog____ thru life.

Back 99

progression

Front 100

Havinghurst 6 stages and 6 developmental ta____ for each stage.

Back 100

tasks

Front 101

Havinghurst-activity theory- active involved lifestyle leads to greater satisfaction and well be____

Back 101

well-being

Front 102

Havinghurst inf_____ and early childhood birth to age 6, middle childhood age 6 to age12, adolescene 13 to 18, early adult 19 to 30, middle adult 30 to 60, and late adult age 60 and over.

Back 102

infancy

Front 103

Havinghurst older adults should not have to w_____ from society

Back 103

withdraw

Front 104

ORAL STAGE Sensorimotor- Piaget- Infants develop a sche___ or action pattern for dealing with the environment. Preoperational- fantasy, symbols, and magical _______

Back 104

thinking

Front 105

Preoperational- Piaget- 2 to 7 play, egocentric, and have difficulty conceptualizing t_____

Back 105

time

Front 106

Kohlberg- STAGE !-Preconventional Reasoning level 1- egocentric and limited cognitive thinking. Likes and pleasures. Ilness as a punis______

Back 106

punishment

Front 107

Kohlberg- STAGE 2- Instrumental Relativist Orientation- more than one right view. Parent may or may not be wrong. Punishment as something to avo____

Back 107

avoid

Front 108

Kohlberg- LEVEL 2- Conventional Reasoning- Sees moral reasoning as based on his or her own personal internalization of societal expectations. Loyalty to social order. How will it affect oth+++++

Back 108

others

Front 109

Kohlberg- STAGE 3- Good boy Good Girl Orientation- to win appro____

Back 109

approval

Front 110

Kohlberg- STAGE 4- Society Maintaining Orientation- Expand relationship with others to societal concerns. Know not rig____

Back 110

right

Front 111

Kohlberg- STAGE 5-Social Contract Orientation- Basic Rights- Not on societal concerns but an independant effort as to what society should val____

Back 111

value

Front 112

Kohlberg- STAGE 6 Universal Ethical Principle Orientation- Conscience Abstract Principles, Equal respect for all Civil dis_____

Back 112

civil disobedience

Front 113

Kohlberg= age and gender bi___

Back 113

bias

Front 114

Teach Elderly: Speak Slowly in a nor___ tone of voice
Present one concept at a t_____
Concrete vs ab_____

Back 114

normal
time
abstract

Front 115

Ego defense mechanisms- COMPENSATION- Making up for a deficiency in one's aspect of self image by strongly emphasizing a feature considered an asset. Person with poor communication relies on organizational sk_____

Back 115

skills

Front 116

Ego defense mechanisms- CONVERSION- unconsciously repressing an emotional conflict and transforming it into nonorg)))))) symptoms. Going through a divorce and insomnia and/or overeating.

Back 116

nonorganic

Front 117

Ego defense mechanisms- DENIAL - avoiding emotional symptoms by consciously refusing to ack_____ Person refuses to discuss personal loss.

Back 117

acknowledge

Front 118

Ego defense mechanisms- DISPLACEMENT= Transferring emotions, ideas, or wishes from a stressful stituation to an less anxiety provoking sub____

Back 118

substitute

Front 119

Ego defense mechanisms-IDENTIFICATION- Pattern+++++behavior after that of another person and assuming that person's qualities, charac and actions.

Back 119

patterning

Front 120

Ego defense mechanisms- DISSOCIATION- is experiencing a subjective sense of numb____and a reduced aware))))) of one's surroundings.

Back 120

numbness
awareness

Front 121

Ego defense mechanisms-REGRESSION is coping with a stressor thru actions and behaviors associated with an ear)))))) developmental period.

Back 121

earlier

Front 122

Factors that influence stress and coping are situational: promotions, relocation, downsiz)))))). Other factors that affect stress and coping are matur______ and vary with life stage. child: appearance; preadol self-esteem; adol with peers; adults major life changes; in elderly loss of autonomy or frailty or health AND SOCIOCULTURAL

Back 122

downsizing
maturational

Front 123

The 3 stages of the GENERAL ADAPTATION SYNDROME are ALAR______ Blood glucose up, Epinephrine up, NE up, Heart r____ up, Blood flow to mus_____, oxygen intake and mental alertness.

Back 123

ALARM
Heart rate
muscles

Front 124

The 3 stages of the GENERAL ADAPTATION SYNDROME are : RESIST stabilizes and responds in a manner opposite to ALARM.

Back 124

RESISTANCE

Front 125

The 3 stages of the GENERAL ADAPTATION SYNDROME are : the EXHAUST))))) stage occurs when the body is no longer able to resist the effects of the stres))))) and has depleted the energy necessary to maintain adaptation. Same response depleted energy

Back 125

EXHAUSTION
stressor

Front 126

ALLOSTATIC LOAD- the chronic arousal with the presence of powerful hormones causes excessive wear and tear on the person and is called allostatic +++++

Back 126

allostatic load

Front 127

Coping is the effort to manage psych stre+=++
Coping mechanisms include psychologically adaptive and task oriented behaviors including prob))))) techniques

Back 127

stress
problem- solving

Front 128

Ego defense mechanisms- regulate emotional distress and give a person protection from anxiety and str-----

Back 128

stress

Front 129

Crisis- stress overwhelms coping mech_____ and pts lose emotional bal+++++

Back 129

coping mechanisms
emotional balance

Front 130

Fight or Flight syndrome to stress= arousal of Sympath_____ ))))))) preparing a person for action.

Back 130

sympathetic nervous system

Front 131

Medulla oblongata, RAS and pitu_____ control reaction to stress.

Back 131

pituitary

Front 132

GENERAL ADAPTION SYNDROME IS A 3 STAGE REACTION TO STRE____AND DESCRIBES HOW BODY RESPONDS TO A STRESSOR.

Back 132

STRESS

Front 133

CRISIS MEANS FACING A TURNING POINT. 3 TYPES: MATURATIONAL OR DEVELOPMENTAL; SITUATIONAL; AND ADVENTITIOUS (MAN- MADE DISASTER; CRIME OF VIO_____

Back 133

VIOLENCE

Front 134

FACTORS INFLUENCING STRESS: SITUATIONAL, MATURATIONAL, AND SOCIO+++++and Environmental, social, and cultural stressors perceived by children, adolescents, and adults

Back 134

SOCIOCULTURAL

Front 135

STRESS- AN EXP)))))) TO WHICH A PERSON IS EXPOSED THRU A STIMULUS OR STRESSOR.

Back 135

EXPERIENCE

Front 136

STRESSOR= TENSION PRODUCING STIMULI ACTING ON OR WITHIN A SYS_____

Back 136

SYSTEM

Front 137

BURNOUT IS THE RESULT OF CHRONIC STRESS. NURSING; INTENSE CAREGIVING AND LOOKS LIKE EMOT EXHAUST++++

Back 137

EMOTIONAL EXHAUSTION

Front 138

STRESS MANAGEMENT TECH: EXERCISE; SUPPORT SYSTEMS; JOURNAL WRITING; PROG MUSCLE RELAX_____; AND GUIDED IMAGERY AND VISUALIZATION

Back 138

MUSCLE RELAXATION

Front 139

Strategies to prevent burnout: Identify your limits and scope of responsibilities at work.
Recognize the areas that you can control and you are able to change.
Recognize the areas that are not part of your respon_____.
Separate work from home.
Friends
Avoid social isolation
Engage in activities for fun!!! (beach, park, traveling, exercises, movies).

Back 139

responsibility

Front 140

local adaptation syndrome- the loc_____ response of a tissue, organ, or system that occurs as a reaction to stress.

Back 140

localized

Front 141

, James Fowler presented a six-stage theory of faith development The adult stages in Fowler's theory typically include stages three through six.Stage 3. Synthetic-conven)))))): In this stage, a person knows why he/she believes. One pulls together various parts of faith and tends to conform to the majority, and people are rewarded or punished for following rules laid down by the proper authority (the church or Bible). Views at this stage are often stereotyped.

Back 141

synthetic-conventional

Front 142

Stage 4. Individuative-reflective: There is a relocation of auth____ within the self, along with a critical reflection of one's beliefs. Faith becomes uniquely one's own. In addition, there is usually a struggle to grow and understand.

Back 142

authority

Front 143

Stage 5 Conjunctive: Individuals realize the parado___ in faith, and learn to live with their faith and their questions. This stage involves a dynamic, trusting relationship with God.

Back 143

paradoxes

Front 144

Stage 6. Universalizing Faith: This stage is defined by feeling at one with God. People here invest their lives in a larger cause without being concerned by the personal cost (Parrott & Steele, 1995; Swensen, Fuller, & Clements, 1993). These stages are simply frameworks of underst____ people and where they are in regard to their faith.

Back 144

understanding

Front 145

According to Fowler, "human beings are genetically potentiated -that is gifted at birth- with readiness to develop f____(Lownsdale, 1997).

Back 145

faith

Front 146

AGE COHORT- elderly- young/old=60-74, middle/old=75-84, and old/old-= ____ and above

Back 146

85

Front 147

gray panthers are a support group for the elderly and AARP an advocacy g)))))))

Back 147

group

Front 148

Features of Dementia: insidious, slow on____, long course no diurnal effects, progressive yet relatively st_____ over time course, duration of months to y_____, consciousness is cl+++++, alertness and attention is generally norm____

Back 148

onset
stable
years
clear
normal

Front 149

Features of Dementia: Orientation generally normal to person and place but not to ti))))))). Recent and remote mem____ impaired.

Back 149

time
memory

Front 150

Features of Dementia: Thinking difficulty with ab+++++, thoughts diminished, judgement impaired, words difficult to f_____

Back 150

abstraction
find

Front 151

Features of Dementia: Perception and psychomotor behavior usually norm____ with some apraxia

Back 151

normal

Front 152

Features of Dementia: sleep wake cycle frag_____

Back 152

fragmented

Front 153

Needs of ElderlySit or stand at eye level, in front of the patient in full
view.
Face the older adult while speaking; do not cover your
mouth. Speak clearly.
Provide diffuse, bright, non gla___ lighting.
Encourage the older adult to use his or her familiar
assistive devices such as glasses or magnifiers.

Back 153

glare

Front 154

Use caution when interpreting signs and symptoms of diseases and laboratory values.
It is important to recognize early indicators of an ac____ illness in older adults.
Some mental changes are often drug related, caused by drug tox))))))) or adverse drug events.
Many conditions are common causes of functional decl____; thus nurses are essential in early identification, referral, and treatment of health problems in older adults.

Back 154

acute
toxicity
decline

Front 155

Features of Dementia: Associated Features: variable affect, symptoms of autonomic hyperarousal, exaggeration of personality type, and associated with ac____ illness.

Back 155

acute

Front 156

stochastic- aging result of phys changes. nonstochastic genetically programmed ch____

Back 156

changes

Front 157

Health Care Proxies or Durable Power of Attorney: DPAHC designates the person or person's of one's choosing to make health care deci_____ when the person is no longer when individual no longer able to make decisions on own behalf.

Back 157

decisions

Front 158

In addition to federal statues, the ethical doctrine of autonomy ensures the pt the right to ref++++ med tx.

Back 158

refuse

Front 159

Perform CP)))) unless there is a DNR order in pt chart

Back 159

CPR

Front 160

Continuity or Developmental theories= personality stable and behavior more pred____ as we age. geotranscendence from a materialistic to a cosmic view

Back 160

predicatable

Front 161

Cogntive signs of stress : Memory problems
Inability to concen((((((
Poor judgment
Seeing only the negative
Anxious or racing thoughts
Constant worrying

Back 161

concentrate

Front 162

Emotional signs of stress: Moodiness
Irritability or short temper
Agitation, inability to relax
Feeling over_______
Sense of loneliness and isolation
Depression or general unhappiness

Back 162

overwhelmed

Front 163

Physical Signs of stress
Aches and pains
Diarrhea or constipation
Nausea, diz)))))))
Chest pain, rapid heartbeat
Loss of sex drive
Frequent colds

Back 163

dizziness

Front 164

Nursing diagnoses and stress: anxiety, caregiver role strain, ineffective coping, fear, risk for PTSD, inso____, situational loss of self esteem, and stress overload.

Back 164

insomnia

Front 165

Alarm Reaction: Posterior Pituitary: Increased ADH leads to increased water reabsorption, Increased ACTH, Increased Cortisol leads to increased gluco++++++

Back 165

gluconeogenesis

Front 166

Alarm Reaction: Increased protein catabolism, fat catabolism, Increased aldosterone leads to increased sodium reab+++++

Back 166

reabsorption

Front 167

normal uncomplicated grief- common reaction characterized by emotional, cognitive, social, physical, behavioral, and spir+++++ responses to loss- Normal grief

Back 167

spiritual

Front 168

anticipatory grief- this is the unconcious process of disengaging or letting go before the actual loss or death occurs. prolonged or pred____ grief

Back 168

predicted

Front 169

disenfrancized grief- marginal or unsupported grief. Relationship to the deceased person is not socially san_____

Back 169

sanctioned

Front 170

Ambiguous Loss- lost person is physically present but not psych availble as in dementia or brain in)))))). Psych attachment but no phy____ attachment

Back 170

brain injury
physical

Front 171

complicated grief- prolonged or difficult time after a loss. Homicide suicide accidents death of a ch____

Back 171

child

Front 172

Exaggerated Grief- self-destructuve and mala____ behavior, obsessions, psychiatric

Back 172

maladaptive

Front 173

Delayed Grief- post)))))) grief usually to a second loss

Back 173

postponed

Front 174

Masked Grief- behave in ways that interfere with normal functioning but unaware that disruptive functioning is result of lo++++

Back 174

loss

Front 175

Types of loss: necessary (threatening), maturational (life changes), situational (unexpected, unpredicatable life events), actual, and perceived (less obvious to othe____)

Back 175

others

Front 176

A person experiences stress only if the event or circumstance is personally significant. Evaluating an event for its personal mean____ is primary appraisal.

Back 176

meaning

Front 177

Secondary appraisal focuses on coping str______

Back 177

strategies