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139 Cards in this Set
- Front
- Back
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Common health problems for specific populations Native Americans and Alaskan Natives |
heart disease, cirrhosis of the liver, diabetes, fetal alcohol syndrome |
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Common health problems for specific populations African Americans |
hypertension, stroke, sickle cell anemia, lactose intolerance, keyloids |
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Common health problems for specific populations Asians |
Hypertension, cancer of the liver, lactose intolerance, thalassemia |
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Common health problems for specific populations hispanics |
diabetes, lactose intolerance |
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Common health problems for specific populations Whites |
breast cancer, heart disease, hypertension, diabetes, obesity |
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Cutaneous Stimulation |
massage, vibration, heat, cold, or nerve stimulation reduces the intensity of the sensation of patients pain |
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Therapeutic touch |
intentional act that involves an energy transfer from the healer to the patient to stimulate the patient's own healing potential |
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Accupuncture |
long used in China, method of preventing, diagnosing, and treating pain and disease by inserting special needles into the body at specific locations |
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Accupressure |
involves deep-pressure massage of appropriate points of the body |
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Culture imposition in health care |
tendency for health personnel to impose their beliefs, tendencies, and values onto people of other cultures |
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factors that affect nurse-patient interactions in health care |
-culture background of each patient -expectations and beliefs of each patient about health care -cultural context of the encounter (hospital, clinic, home) -extent of agreement between the two persons' sets of beliefs and values |
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ethnocentrism |
beliefs that the ideas, beliefs, and practices of one's own culture is superior to that of another's culture -this is also culture imposition |
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Standards to assure cultural competence in health care |
-diverse medical staff, those that represent the demographics -care provided in a the patient's preferred language, with their cultural beliefs -staff gets ongoing training and education with culturally appropriate material -provide and offer language assistance services -Make available easily understood patient-related materials |
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trans-cultural assesment: health-related beliefs and practices |
-what cause does the pt. contribute illness and disease -what is the pt. ideal of body shape and size -what name does the pt. give to their medical condition -what does the pt. believe promotes health -what is the pt. religious affiliation -does the pt. rely on cultural healers -what types of cultural healing does pt. engage -how are scientific healthcare providers perceived -who cares for the pt. at home, how does pt handle emotion -how does the pt. culture view mental illness |
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cultural factors that affect nursing care White people "family" |
Family -nuclear family is highly valued -elderly family members may live in an assisted living facility |
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Cultural factors that affect nursing care White people "folk and traditional healthcare" |
-self-diagnosis of illness -OTC drug use -dieting (often fad diets) -extensive use of exercise and gyms |
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Cultural factors that affect nursing care White people "values and beliefs" |
-youth is valued over age -cleanliness -orderliness -attractiveness -individualism -punctuality |
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Cultural factors that affect nursing care White people "nursing considerations" |
-careful assessment of pt. use of OTC medications -nutritional assessment of diet |
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Cultural factors that affect nursing care African Americans "family" |
-close and supported extended families -strong bonds with non-relatives -family, unity, loyalty are important -matriarchal |
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Cultural factors that affect nursing care African Americans "folk and traditional healthcare" |
varies, may include spiritualist, herb doctors, root doctors, conjurist, skilled elderly family members, voodoo, faith healing |
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Cultural factors that affect nursing care African Americans "values and beliefs" |
-present oriented -members of the african american clergy are highly important -frequently highly religious |
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Cultural factors that affect nursing care African Americans "Nursing Considerations" |
-Many African American families may still use various folk healing practices and home remedies for treating particular illnesses. -Special care may be necessary for the hair and skin. -Special consideration should be given to the sometimes extensive and frequently informal support networks of patients |
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Cultural factors that affect nursing care Asian "family" |
-welfare of family is valued above the pt. -extended families are common -a person's lineage is respected -sharing among family members is expected |
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Cultural factors that affect nursing care Asian "folk and traditional health care" |
-theoretical basis in Taoism, which seeks balance in all things -good health is achieved through balance of yin and yang -imbalance in energy is caused by an improper diet or strong emotions. -use of herbs, diet, acupressure, accupuncture |
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Cultural factors that affect nursing care Asian "values and beliefs" |
-strong sense of self-respect and control -respect for age, authority, hard work, harmony and avoidance of conflict -praise of self or others is considered poor manners |
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Cultural factors that affect nursing care Asian "special considerations for nurses" |
-some pt. may be upset by lab work or drawing blood, they consider blood to be life's force -some believe it is best to die with body intact, may refuse surgery -many do not complain -some feel it is polite to give someone the response someone else is expecting -some may change physicians in order to cure an illness -many asian foods have high salt-content, dietary counseling may be necessary |
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Cultural factors that affect nursing care Hispanic "family" |
-family role is important -family is the primary unit of society -Compadrazgo: special bond between a child’s parents and the child’s grandparents |
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Cultural factors that affect nursing care Hispanic "folk and traditional health care" |
-Curanderas(os): folk healers who base treatments on humoral pathology—basic functions of the body are controlled by four body fluids or “humors”: Blood—hot and wetYellow bile—hot and dryBlack bile—cold and dryPhlegm—cold and wet - secret to good health is to balance hot and cold within the body |
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Cultural factors that affect nursing care Hispanic "values and beliefs" |
-respect is given according to age(older) and sex (male) -roman catholic church -God gives health and gives illness for a reason |
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Cultural factors that affect nursing care Hispanic "nursing considerations" |
-it may be difficult to diagnosis a patient that is not showing symptoms -special diet considerations needed if patient believes in balance of hot and cold foods -diet counseling may be needed because most diets are high in starch |
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Cultural factors that affect nursing care Muslim "family" |
-family forms the basic block of muslim society -man in considered head of the family -marriage forms sole basis of sex and family -islamic law discourages contraception, seems to be a trend in smaller families |
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Cultural factors that affects nursing care Muslim "folk and traditional healthcare" |
-some may see sudden death as a sign of punishment from God -preventitive healthcare includes diet restrictions, no alcohol or pork, personal hygiene no smoking |
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Cultural factors that affect nursing care Muslim "values and beliefs" |
-there is no God by Allah -God gave their bodies as gifts and they should be taken care of by diet and personal hygiene -Allah will determine when they die |
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Cultural factors that affect nursing care Muslim "nursing considerations" |
-respect modesty needs of both men and women, special clothing, assign healthcare providers of the same sex, avoid touching patients of the oppisite sex -make accomodation for prayer needs -During Rahmadan, muslims fast from all, including medications and IV solutions -offer a halal diet free of alcohol and pork |
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Cultural factors that affect nursing care native americans "family" |
-families are large and extended -grandparents are official and symbolic leaders -a child's namesake may become the equivalent to another parent of the child |
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Cultural factors that affect nursing care native americans "folk and traditional medicine" |
-medicine men (shaman) are used often -heavy use of herbs and ceremonies |
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Cultural factors that affect nursing care native americans "values and beliefs" |
-present oriented, taught to live in the present and not be concerned with the future -high respect for age -work together and share resources -failure to reach goal is perceived as competition -respect is given to those that give to others |
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Cultural factors that affect nursing care native americans "nursing considerations" |
-family is expected to be a part of the nursing care plan -note taking is often taboo, often seen as an insult because nurse is not giving pt. full attn. -indirect eye contact is acceptable and sometimes preferred -sometimes it is viewed as impolite to not hear someone the first time -a low tone of voice is considered respectful -a native american patient may prefer provider to solve the problem through instinct |
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Cultural factors that affect nursing care Hawaiian "family" |
-family role is important -extended families are involved in childrearing -each gender and age have specific duties -families are in small, isolated communities |
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Cultural factors that affect nursing care Hawaiian "folk and traditional healthcare" |
-Kahuna La’au Lapa’au is the ancient Hawaiian medical practitioner -view patients illness as a whole -Relationships among the physical, psychological, and spiritual -emphasis on prevenitive medicine -tx. uses more than 300 medicinal herbs |
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Cultural factors that affect nursing care Hawaiian "nursing considerations" |
-many still use folk practices and healers with home remedies -special considerations given to the specific extensive family network |
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Cultural factors that affect nursing care Hawaiian "values and beliefs" |
-deep love and respect for people and the land -Christian God replacement hawaiian God -lifestyle more revered than compliance with healthcare -less intitiative and drive, less motivation -death seen as part of life and not feared |
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Cultural factors that affect nursing care Appalachian "family" |
-intense interpersonal relations -family is cohesive and several generations often live close to one another -elderly are respected as providers -tend to live in rural, isolated areas |
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Cultural factors that affect nursing care Appalachian "folk and traditional healthcare" |
-"granny" woman or folk healer, provides care and may be consulted even if receiving traditional care -various herbs are used -Elderly may have had only limited contact with health care providers and may be skeptical of modern health care |
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Cultural factors that affect nursing care Appalachian "values and beliefs" |
-independence and self-determination -isolation is accepted as a way of life -person oriented -may be fatalistic about life and death -belief in divine existence rather than attending a particular church |
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Cultures that affect nursing care Appalachian "nursing considerations" |
-treat each person with regard for personal dignity -allow family members to remain with pt. as support system -accept the pt. current health practices and lifestyle -allow pt. to make their own decisions about healthcare |
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Communication is the process of: |
exchanging information and generating and transmitting meaning between two or more people |
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list the 6 parts of the communication process |
-stimulus -source -message -channel -receiver -feedback/confirmation |
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Stimulus |
begins the communication process |
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channels |
auditory, visual, kinesthetic (movement/touch) |
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Receiver |
must translate the message |
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Source |
sender/encoder |
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Complementary Exchange |
in each exchange, the participants are, in turn, either a sender or receiver -as each transmission is completed, the receiver perceives the message, interprets the symbols, and responds again using symbols |
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3 forms of communication |
nonverbal- body language verbal- written noise- factors that distort the quality of the message and interfere with the communication process |
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nonverbal forms of communication |
-physical appearance -personal appearance -posture and gait -facial expressions -eye contact -gestures -sounds -personal space -silence |
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forms of verbal communication |
-vocabulary- denotative and connotative meaning -innotation- clarity and brevity -pacing- timing and relevance |
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Levels of communication |
-intrapersonal -interpersonal -group |
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intrapersonal |
self talk |
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interpersonal |
talk between two or more people |
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small group communication |
2+ people, goal oriented, the more people involved the more complex |
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organizational group communication |
people/groups within an organization that work together to acheive a goal (ex. quality assurance counsels) |
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Group dynamics (group communication) |
how individual group members interact/relate to one another -can be ineffective or effective |
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factors influencing communication |
-developmental level -gender -sociocultural differences -roles and responsibilities -space/territory -physical/mental/emotional state -values -environment |
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5 factors of developing communication skills |
-critical thinking -perservearnce and creativity -self-confidence -fairness and intergrity -humility |
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The helping relationship |
-Only exists among people who provide and receive assistance in meeting human needs. -helping/trusting is the basis of relationship |
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The helping relationship is different from the social relationship. Social Relationship- |
-does not occur spontaneously -unequal sharing of information -built on pt. needs, not on the needs of helping someone |
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Phases of the helping relationship |
-orientation -working -termination - |
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Orientation phase of the helping relationship |
-tone and guidelines are established -introduce self -roles of people are clarified -agreement of goals and means of obtaining them -pt. is oriented to healthcare facility |
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working phase of the helping relationship |
-usually the longest -nurse works with the patient to meet needs -interpersonal skills are used to their fullest -success= preserving pt. integrity while promoting a positive atmosphere |
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the termination phase of the helping relationship |
-occurs when conclusion of initial agreement is acknowledged -examine pt. goals and evidence of progress -pt. should verbalize feelings about termination of the relationship -regret(typically occurs in a satisfactory outcome) -anxiety -Can occur because of shift changes, vacation, discharge, ect. |
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promoting communication in the helping relationship |
-dispositional traits -rapport builders -therapeutic communication |
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dispositional traits |
-how you present yourself and behave |
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rapport builders |
-specific objectives, comfortable environment, privacy, confidentiality, patient focus, using nursing observations |
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therapeutic communication |
-requires multiple skills used simultaneously -conversation skills -listening skills -silence -touch -humor -interviewing techniques **avoid sematics |
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interviewing techniques |
-open-ended -closed -validating -clarifying -reflective -sequencing -directing *open-ended questions are ideal, allow more freedom with responses, |
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close-ended questions |
information gathering |
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validating questions |
dont' overuse, can lead patient to believe you aren't listening |
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relflective questions |
allows patient to discuss emotions |
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sequencing |
helps patients put events in order |
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directing |
allows nurses to expand on related subject or subject mentioned earlier |
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blocks to communication |
-failure to view patient as human being -failure to listen -nontherapeutic questions/comments -changing the subject -giving false assurance -gossip/rumor -disruptive behavior |
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Assertive behavior |
-open -honest -direct -focus on issue- not the person -"i" statement -eye contact -give and accept compliments -admit mistakes and take responsibility for them |
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aggressive behavior |
-asserts rights in a negative way that violates the rights of others (can be physical or verbal) -marked by tension or anger -angry tone of voice -accusations -"winning at all costs" -invading personal space |
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Impaired verbal communication |
-may be due to speech, language, or hearing disorders -avoid "baby talk" or "elderspeak" -orient patient to your presense in the room -personalize to patients needs |
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communicating with other cultures |
-assess your personal beliefs and culture -assess communication needs for the client's culture -plan care based on communicated needs and cultural background **do not make assumptions- ask -modify approach as needed -communicate in a nonthreatening manner -use interpreters and modify approach with patients who speak a different language |
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modes of communication in healthcare |
-verbal -nonverbal -electronic |
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Communication in healthcare -documentation |
client records are used for communication -planning client care -auditing health agencies -research -education -reimbursement -legal documentation -healthcare analysis |
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forms of healthcare documentation |
-source oriented records -problem oriented records -computerized documentations -PIE- problem, intervention, evaluation -focus charting -charting by exception -case management model |
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Problem Oriented Records |
SOAP notes- subjective, objective, assessment, plan |
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Source oriented records |
paper documentation in which each healthcare group/discipline keeps data on its own form |
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general guidelines for recording |
-date and time -timing (no recording prior to tx.) -legibility -permanence -accepted terminology(approved by agency, joint commission DO NOT use list) -correct spelling -use signature -accuracy |
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progress notes are |
only written by physicians |
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components of source oriented record |
-admission sheet -graphic record -MAR -nurse notes -diagnostic reports -referral summary -physician order sheet -flowsheet -daily care record |
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legal prudence of nursing documentation |
-Legal protection to nurse, caregivers, facility, and client -Admissible in court as legal document -Adhere to professional standards -Follow agency policy and procedures |
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telephone orders |
-Write complete order while provider gives it -Read it back to primary care provider -Question provider if ambiguous, unusual, contraindicated -Transcribe order onto physician’s order sheet or into computerIndicate as verbal order (VO) or telephone order (TO) -Have primary care provider countersign order within agency-specific time period |
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SBAR |
s-situation b-background a-assessment r-recommendation |
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SBAR situation |
I am (name) a nurse a (unit) I am calling about patient (name) I am calling because I am concerned that .. Early warning score is (xx) |
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SBAR background |
child (name) was admitted on (date) with (prob.) They have had (procedure) Child (name) condition has changed in the last (minutes, hours) their last set of vitals were (xx) the child's normal condition is (xx) |
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SBAR assessment |
I think the problem is (xx) and I have given (xx) OR I am not sure what the problem is but child(name) is deteriorating OR I do not know what is wrong but i am worried |
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SBAR recommendation |
I need you to come see the child in the next (minutes) AND is there anything I can do in the meantime |
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Telehealth |
use of telecommunication and computers to provide services to clients at remote locations -consultations -radiography -decrease healthcare costs -review slides and lab reports |
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nursing informatics |
a specialty that integrates nursing, computer, and information sciences to manage and communicate data -intended to support patients, nurses, and providers |
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healthcare information systems |
-clinical information systems -administrative information systems |
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clinical information systems |
typically contain patient information |
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administrative information systems |
help track large quantities of patient data used for studies and quality improvement |
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computerized documentation pros |
-facillitates focus on client outcome -fast, efficient use of time -legible -link various sources, link to monitors -bedside terminals -synthesize info -eliminate need for notes -permit immed. order checking |
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computerized documentation cons |
-client privacy concerns -breakdowns make information unavailable -systems are expensive -extended training periods |
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Nursing Informatics considerations |
ergonomics |
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ergonomics |
-Study and design of the work environment as it relates to operator fatigue, discomfort, and productivity -Related problems: computer vision syndrome (CVS) & repetitive motion disorders (RMD) |
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good ergonomics at work |
-Optimal settings for equipment vs. workflow -Use chair with good lumbar support -Good body mechanics -Position computer monitors properly -Good lighting -Frequent breaks |
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Culture influence on healthcare |
-physiological variations -reactions to pain -mental health -gender roles -language and communication -personal space -socioeconomic factors |
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stimulus |
ex. patient need that needs to be addressed |
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source (encoder) |
person or group that initiates or begins the communication process |
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message |
actual communication product from the source, could be a speech, interview, conversation, chart, gesture, or nursing note |
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channel |
the medium the sender has selected to send the message; can be sent through any of the following channels -kinesthetic -visual -auditory |
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receiver (decoder) |
must translate and interpret the message sent and received, receiver must make the decision on the appropriate response back |
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Verbal communication depends on ________, or a prescribed way of using words so that people can share information effectively |
lanuage |
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3 types of channels in the communication process |
-visual -auditory -kinesthetic |
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examples of nonverbal communication |
-body language -facial expression -tone -gestures -patient silence -touch -sounds -gait |
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American Nurse Association principles for social networking |
1. nurses must not place patient indentifiable information online 2. nurses must be ethically professional and respect nurse-patient boundaries 3. nurses must understand that ANYONE can read their posting, even after being deleted 4. nurses should take advantage of privacy settings 5. Nurses should bring content that could harm a patient’s privacy, rights, or welfare to the attention of appropriate authorities. |
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"self-talk" is called |
intrapersonal communication -can affect the nurse's behavior, can enhance or detract from patient interactions |
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______ occurs when nurses interact with 2 or more people, members must communicate to be successful. ex. staff meetings, patient care conferences, treaching sessions, and support groups |
small group communication |
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__________ communication occurs when people and groups within an organization communicate to achieve their goals. |
organizational communication |
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culture |
refers to common lifestyles, languages, behavior patterns, traditions, and beliefs that are learned and passed from one generation to the next |
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proxemics |
the study of distance zones between people during communication |
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intimate zone |
interaction between parents and children or people who desire close personal contact |
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personal zone |
distance when interacting between close friends |
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social zone |
space when interacting with accquaintances such as in a work or social setting |
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public zone |
communication when speaking to an audience or small groups |
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increasing levels of privacy on a person's body |
-mouth and feet -face, neck, and front of body -genitalia |
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characteristics of the "helping relationship" |
-does not occur spontaneously, occurs for a purpose (to help the patient) -unequal sharing of information (pt. shares) -relationship built on the patients needs -it is dynamic both people are active participants -it is purposeful and limited (specific goals to be met in a specific amt. of time) -person providing the help is held accountable |
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phases of the helping relationship |
-orientation phase -working phase (longest phase) -termination phase |
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rapport |
feeling of mutual trust experienced by people in a satisfactory relationship |
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most highly developed sense from birth? |
touch |
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interviewing techniques |
-ask open-ended questions to give the patient opportunity to be an active patient ex. Do you know why your doctor wanted you to be hospitalized? -closed questions- may need to be avoided, only use if you need specific information |
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pros and cons to validating questions/comments during the interview process |
-overusing this technique can make the patient think you're not listening -can be used to validate what the nurse thinks she understands |
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what is the purpose of reflective questions or comments |
-involves repeating what the person has said or describing the person's feelings, this encourages patients to elaborate ex.Patient: I’ve been really upset about my blood pressure and have to take these pills. Nurse: You’ve been upset . . . Patient: I guess I’m worried about what could happen if my blood pressure gets too bad. |
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aggressive behavior |
asserting one's rights in a negative way that violates the rights of others, can be verbal or physical, it is communication that is marked by tension or anger |
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assertive behavior |
ability to stand up for one's self and others by using open, honest, and direct communication ex. "I think, I feel do not express judgement or blame towards another person |
