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227 Cards in this Set
- Front
- Back
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Temperature (general)
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-may be influenced by internal or external factors
-may indicate complications -body temp -heat prod minus heat loss |
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Core Temperature
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-temp of the deep tissues of the body are relatively constant
-surface temp fluctuates depending on the: amt of bld flow to the skin amt of heat loss to the external environment |
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Normal Temp Ranges
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36 C to 38 C
98.6 F to 100.4 F -optimum functioning for cells and tissues |
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Oral temp msmt
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-not for a client that isn't completely alert
-not after hot or cold beverages (wait 30 mins) |
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Axillary Temp Msmt
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less accurate than oral/rectal
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Tympanic temp msmt
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-quick results
-often not utilized correctly |
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Rectal temp msmt
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often thought of as most accurate method
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Other methods/sites of temp msmt?
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-esophageal
-pulmonary artery -urinary bladder ~require continuous invasive devices ~used in critical care settings |
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Hypothalamus(Cerebral Hemisphere)
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-controls body temp as close as possible to constant or set temp
-anterior hypothalamus controls heat loss -posterior hypothalamus controls heat prod |
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Mechanisms of Heat Loss
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-Sweating
-Vasodilation -inhibitions of heat prod -bld is redistributed to the surface to prod heat loss |
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Radiation (heat loss)
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transfer of heat w/o contact
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Conduction (heat loss)
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transfer of heat by direct contact
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Convection (heat loss)
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transfer of heat by air mvmt (fan)
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Evaporation (heat loss)
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turning liquid to gas
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Diaphoretic (heat loss)
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visual perspiration
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When would the use of hot and cold therapy be contraindicated?
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-impaired circulation
-bleeding -wound complications -inability to tolerate tx |
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Warm water is defined as...
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105 to 115 degrees
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A compress is?
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a moist gauze dressing applied to a wound. soaked in heated soln
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A soak involves?
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immersing the affected area
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A sitz bath soaks the?
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pts perineal area
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Aquathermia pads?
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aka K-pads. plastic or vinyl pads that circulate water in the interior.
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What is considered a fever high enough to use a cooling bath?
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above 104 degrees F.
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What is rebound phenomenon?
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at the time the cold reaches max therapeutic effect, the opposite effect begins.
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What is thermoregulation?
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process of temperature regulation
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What is the BMR?
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basal metabolic rate
-the amt of energy required to maintain the body at rest |
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What is insensible water loss?
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water loss that we don't see
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Do we want to provide ice baths to a client w/ an elevated temp?
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No, bc they will shiver which will raise temp more. Tepid bath is ok.
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Alteration in temp control is the result of?
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-lesion on the hypothalamus or spinal cord
-trauma to the hypothalamus or spinal cord. ~not always inf |
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About Heat Production(gen.)
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-prod. by metabolism
-food is the fuel source -functional heat-producing process is present -metabolic rate increases when activities require more heat -most influenced by muscle activity |
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Heat production occurs during?
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-rest
-voluntary mvmts -involuntary mvmts -involuntary shivering -nonshivering thermogenesis |
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What is pyrexia?
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-body temp is above the normal range
-2 types: hyperthermia fever |
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How does age affect temp?
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-infants lose 30% of body heat thru head
-older adults have difficulty maintaining body heat bc of slower metabolism, decr. vasomotor control, loss of subQ tissue. |
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How does exercise affect temp?
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increases metabolism
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How does hormone level affect temp?
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-woman's body temp varies w/ menstrual cycle.
-menopause causes hot flashes- |
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How does circadian rhythm affect temp?
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temp lowest in early morning and highest in late afternoon or early evening.
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What is Circadian rhythm?
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cyclical repetition of certain physiological processes that occur every 24 hrs.
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How can emotions and stress affect temp?
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stimulate sympathetic nervous system, czing prod of norepinephrine and epinephrine which incrs. metabolic rate
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What is Hyperthermia?
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body's inability to promote heat loss or reduce heat prod.
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Causes of hyperthermia?
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dz or trauma to the hypothalamus
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What is Malignant Hyperthermia?
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a rxn to some anesthetic drugs given to persons w/ hereditary cond of uncontrolled heat prod.
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What is heatstroke?
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-prolonged exposure to the sun or environmental temps
-heat depresses the hypothalamus function |
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What are the S/S of heatstroke?
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-hot,dry skin(doesn't sweat)
-headache,dizziness,faintness -delirium,giddiness,confusion -excessive thirst -nausea,muscle cramps -incontinence -visual disturbances |
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What is fever?
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-alteration in hypothalmic setpoint.
-abnormal high body temp |
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Benefits of fever?
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-WBC prod incr.
-hormone-like subs are reproduced and defend the body -enhance the body's defense mechanism -suppress the growth of bacteria -fights viral infs by stimulating interferon -aid in dx |
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What is interferon?
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the body's natural virus-fighting substance
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Negative effects of fever?
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-metabolism incr
-heart & respiratory rate incr -demand for O2 incr -inadequate supply of O2 results in myocardial hypoxia and cerebral hypoxia -dehydration in older adults and kids |
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What can cz seizures in kids?
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if brain temp gets too high due to fever
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Important factors R/T fever?
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-severity
-client's response to the elevation(how pt responds to fever) -client's general health status -client's age -duration -fever patterns |
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What is intermittent fever?
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temp alternates regularly bw periods of fever and periods of normal or below-normal temp
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When may intermittent fever be seen?
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seen in TB and flu
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What is remittent fever?
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wide fluctuations in temp(>3.6°F),all above normal, during a 24-hr per.
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What constant(sustained) fever?
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temp may fluctuate slightly but is always above normal.
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What is relapsing fever?
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short periods of fever alternating w/ periods of normal temps, each lasting 1-2 days.
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When might you see relapsing fever?
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Malaria
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6 Goals of Fever Therapy?
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-reduce heat prod
-incr heat loss -prevent complications -provide comfort -ID underlying cz or contributing factor -maintain core temp w/in normal range |
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What is the Initial stage of fever?
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period when body temp is rising but has not yet reached new set pt.
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S/S of Inital stage of fever?
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person usually feels chilly and generally uncomfortable and may shiver.
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What is the 2nd phase(course) of fever?
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per. when body temp reaches its max set pt and remains fairly constant @ the new higher level.
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S/S of 2nd phase of fever?
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person feels warm and dry, phase may last from a few days to a few wks
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What is the 3rd phase(defervescence or crisis) of fever?
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per when the temp returns to normal.
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S/S of 3rd phase of fever?
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person feels warm & flushed in response to vasodilation.
-diaphoresis occurs. |
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Nursing Diagnoses R/T Pyrexia?
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-risk for imbalanced body temp r/t..
-hyperthermia r/t inf of lung aeb temp elevation of 102.4 -ineffective thermoregulation r/t injury to hypothalamus |
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Antipyretics include...
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-nonsteroidal compounds
acetaminophen,salicylates,indomethacin,ketoralac) -reduce fever by incr heat loss -usually RXed for temp control -some also decr discomfort |
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Nonpharmacological therapy for Pyrexia?
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-Increase heat loss by:
evaporation conduction convection radiation |
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Interventions for fever?
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-focused assessments
-min heat prod -max heat loss -meet reqts for incr metabolic rate -promote comfort |
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Temp below set pt?
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-posterior hypothalamus senses the change
-efforts to conserve heat are initiated -vasoconstriction(bld flow to extremities & skin is reduced) -heat prod is stimulated via voluntary muscle contraction and muscle shivering |
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What is hypothermia?
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-prolonged exposure to cold overwhelms the body's ability to prod heat.
-the body's rxn to temp below 95°F |
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How does the body react to temp below 95°F? (hypothermia)
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-uncontrolled shivering
-memory loss -depression -poor judgment |
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Effects of temp 94°F?
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-vital signs fall
-skin becomes cyanotic -cardiac arrhythmias -loss of consciousness -unresponsive to stimuli |
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Interventions for Hypothermia?
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-passive rewarming measures
-warm environment -warmed blankets -warming blood -active external rewarming avoided -can result in metabolic acidosis |
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Induced Hypothermia?
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-central cooling:helps in stroke pts
-cardiac,transplant or neurosurgery -rewarm bld -warming blanket -pharmacological agents -carefully watch lab values:K,glucose |
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Thermal Therapy
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-application of hot or cold
-requires a docs order -need to assess area to be txed -risk of damage is incr if: impaired circulation impaired skin integrity edema |
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Heat therapy benefits...
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-beneficial during subacute or chronic infl
-promotes analgesia -facilitates soft tissue repair -relaxes skeletal muscle |
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Moist Heat Applications
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-Wet Compresses
can submerge compress in warm soln, wring out & apply can apply dry & use a syringe to apply soln can use a hot water bottle use a waterproof pad no heating pads or anything electrical |
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Moist heat applications(Baths)
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-sitz baths incr circulation to anal/perineal areas
very soothing after surgery -warm whirlpool baths |
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Dry heat works to about how many cms?
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about 2 cm.
-moist heat conducts better. |
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Dry heat applications(hypothermia blanket)
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-large body-sized blanket
-fluid is heated and circulates thru blanket -rectal probe in place to monitor temp |
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Dry heat appl.(heat lamps)
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-monitor temp constantly
-often used in infants -monitor for mvmt toward lamp |
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Dry heat appl(electric heating pads)
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-dry heat to small area
-never use more than low setting unless order specifically says to do so -put on top, never underneath -make sure linens are dry |
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Dry heat appl(chemical heat packs)
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-2 seperate compartments filled w/ chemicals
-when combined, prod. heat |
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Cold therapies(Cryotherapies)
Cold... |
-contricts vessels(conrols bleeding)
-reduces edema formation -decr nerve conduction velocity -incr pain threshold -decr muscle spasticity |
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When is cryotherapy most effective?
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in acute infl. phase
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Cryotherapy Tx of Choice
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-immediately following local tissue injury
-during acute infl phase -usually accompanied by: compression elevation |
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Cryotherapy...
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-therapy should be limited to 15 min on distal extremities
-area temp remains lower for 1-2 hrs after removal of cooling modality |
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What should skin be checked for after removal of cold therapy?
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purplish color
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Types of Cold Therapy?
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-ice pack
-cold pack -cold compress -cool sponge bath |
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What is psychosocial theory?
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understanding ppl as a combo of psychological and social events
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Pt responses to illness are influenced by the relationship among:
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-physical pathology
-psychosocial health -overall wellness |
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What is biopsychosocial?
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overall well-being
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What is self-concept?
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one's overall view of oneself.
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What forms a person's self-concept?
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Forms out of a person's eval of:
-physical appearance -sexual performance -intellectual abilities -success in workplace -friendship/approval 4m others -problem-solving & coping abilities -unique talents, etc. |
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Factors affecting self-concept?
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-gender
-developmental level -socioeconomic status -family -peer relationships -internal locus of control |
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Components of Self-Concept?
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-Body Image
-Role Performance -Personal Identity -Self-esteem |
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What is the internal locus of control?
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the inner "voice" that influences our self-concept
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What is an external locus of control?
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ppl who attribute control of their situation to external factors,including other ppl, institutions, and God.
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What is body image?
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mental image of your physical self, including physical appearance & physical functioning.
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What is body image influenced by?
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-Ideal vs perceived and actual body image
-appearance & function of body -Gradual vs. sudden body changes |
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What can make a person's body image more ideal?
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the closer the match bw a person's ideal body image and sensory input about his or her body the more pos. the body image
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What type of feelings can occur with an abrupt change in appearance or functioning?
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-denial
-anger -self-hatred -despair |
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What is role performance?
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the actions a person takes and the behaviors demonstrated in fulfilling a role.
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What is interrole conflict?
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when 2 roles make competing demands on an individual
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What is interpersonal role conflict?
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a mismatch bw 2 ppls ideas of how to perfom a role
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What is role strain?
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a mismatch bw role expectations and role performance.
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What is personal identity?
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your view of yourself as a unique human being, different and seperate 4m all others.
-relatively constant and consistent. |
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What is self-esteem?
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how well a person likes one's self.
-the diff. bw ideal self and actual self. |
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What categories should a comprehensive psychosocial assessment include?
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-biological,psychosocial,& social details
-functional abilities -Self-efficacy -family relationships -relationships w/ the wider social environment -interpersonal communication -social resources and networks -understanding current illness -usual coping mechanisms -health priorities |
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What is self-efficacy?
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the belief that you can influence your own behaviors and outcomes
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Behaviors to look for during a psychosocial assessment.
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-avoidance of eye contact
-hesitant speech -overly critical -excessive anger -frequent crying -putting self down -slumped posture -lack of interest -passive attitude -difficulty in making decisions -unkempt appearance |
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Why is it important to determine cause and effect in a psychosocial diagnosis?
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bc psychosocial and self-concept issues can be a prob, a symptom of a prob, or the etiology of a prob.
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11 common psychosocial diagnoses?
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-interrupted family processes
-family coping -parental role conflict -ineffective individual coping -post-trauma syndrome -risk for loneliness -social isolation -risk for violence:directed at others -impaired social interaction -coping ineffective -hopelessness |
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Self-Concept Diagnoses?
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chronic low self-esteem
situational low self-esteem disturbed personal identity ineffective role performance disturbed body image |
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Psychosocial,Self-concept,and Self-Esteem Outcomes
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Approx. 30 NOC standardized outcomes to describe:
psychological well-being psychological adaptation self-control social interaction |
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What domain can you find psychosocial, self-concept, and self-esteem outcomes in?
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found in psychosocial health and family health issues.
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Psychosocial Illness:Anxiety
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-common emotional response to a (usually known) stressor
-results 4m psychological conflicts -accompanied by physical symp -can be mild,moderate,severe,disabling |
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Psychosocial Interventions for Anxiety?
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-provide support measures to reduce anxiety
-prevent client isolation -help estab. simple routines -encourage self care -allow client to make decisions regardign tx & routine -use therapeutic comm skills -explore use of coping resources -reinforce client's strengths -support 4m family & friends |
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Evaluation for Anxiety Interventions?
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-observe clients nonverbal behavior
-verbal cues statements of self acceptance acceptance of change in appearance or function willingness to share opinions and ideas -observe appearance |
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What is grieving?
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the physical, psychological & spiritual responses to a loss
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What does the intensity of the grieving depend on?
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the meaning the person attaches to the loss-what the loss represents to the person.
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Complicated grief(dysfunctional grief)?
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-a person's responses are maladaptive,unusually prolonged or overwhelming.
-severe depression -drug/alcohol abuse -suicidal -several yrs later person may be having same intensity of grief initially experienced |
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7 kinds of losses?
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-loss of loved ones
-physical -psychological -loss of role -maturational loss -significant relationships -anticipatory |
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What is a perceived loss?
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internal; identified only by the person experiencing it
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What is a physical loss?
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Includes:
1.injuries 2.removal of a bodily organ 3.loss of function |
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What is a psychological loss?
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challenge our belief system. Commonly seen in areas of sexuality,control,fairness,meaning,and trust.
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What is an external loss?
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actual losses of objects that are important to the person bc of their cost or sentimental value.
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What is loss of aspects of self?
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includes physical losses such as body organs,limbs,body functions,and/or body disfigurement.
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What is environmental loss?
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involves a change in the familiar,even if change is seen as positive.
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According to Worden, what are the 4 tasks of grieving?
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-Accepting the reality of the loss
-working thru the pain & grief -adjusting to the environment in which the deceased is missing -emotionally relocating the deceased & moving on w/ life |
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Stages of grieving according to Rando? (6 R's of grieving)
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-Recognizing the loss
-Reacting to the separation(feel the loss) -Recollecting memories of the deceased(remembering,reliving) -Relinquishing the old attachment (new ways of living w/o the deceased) -readjusting to the new environment(new coping skills) -reinvesting self(energy once turned inward on grief begins to be focused outward again) |
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Stages of grief according to Bowlby?
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-Shock and Numbness
-Yearning & Searching -Disorganization & despair -Reorganization |
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3 Phases of grieving according to Rando?
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-Avoidance
-Confrontation -Accomodation |
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Moving thru Stages of Grief
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-ppl don't fit neatly into or match exactly the phases described
-ppl go back & forth bw phases or are in more than 1 at the same time -important for recognizing what person goes thru,not for categorizing -most important to find out what an individual is experiencing |
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Factors Affecting Grief
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Significance of the loss
Amt of support for the bereaved conficts existing @ time of death circumstances of the loss:guilt or feeling of being responsible may be present previous losses developmental stages spiritual/cultural factors timeliness |
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Developmental Considerations conc. Grief (Early Childhood)
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-don't understand finality until around 5 yrs
-bw 5-9 understand its permanent but believe it will never happen to them or anyone they know -magical thinking -regression |
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Developmental Considerations conc Grief (Adolescence)
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-pushing away:guilt
-may look mature, but lack maturity |
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Physical Responses to Grief?
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-loss of appetite
-fatigue -headache -nausea -stomach pain -decr libido -decr energy -decr immune system response -weight loss or gain |
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Emotional responses to Grief?
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-anger
-sadness -shock -numbness -loneliness -guilt -fear -relief -anxiety -powerlessness -helplessness |
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Cognitive responses to Grief?
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-decr concentration
-forgetfulness -impaired judgment -preoccupation -confusion -feel "in a fog" -questioning of spiritual beliefs -searching for understanding -searching for purpose & meaning -obsessive thoughts of the deceased or lost object -thoughts of dying |
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Behaviors r/t to Grief?
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-forgetfulness
-withdrawal -insomnia -too much sleep -dreaming of the deceased -verbalizing the loss -crying -loss of productivity at work or school |
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How can grieving affect health?
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bc it takes a lot of energy
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How is grief different for each person?
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-everyone has their own timeline
-ppl grieve differently -some losses a person never "gets over," they adjust to a new life that doesn't include the lost person/pbject -cultural expectations unrealistic -2nd yr may be worse than the 1st |
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Mourning means:
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-releasing,allowing to flow
-pouring whatever wells up 4m the soul |
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Mourning allows grief to flow:
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-without criticizing its contents
-w/o limiting its time -w/o fear:trusting in its healing mystery |
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Mourning can only be encouraged & suppported:
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-in a time & place found safe
-in a way fitting the mourning person -thru invitation to speak -thru receptive response of those who hear |
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To be safe, Mourning needs:
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-a time & place for pouring out
-a receptacle to receive the out-pouring -a response that honors the outpouring |
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Listening from the heart is:
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the authentic response to grief poured out.
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Listening from the heart does not:
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-critique the thoughts or feelings poured out
-interrupt the flow of the outpouring -give directions or advice |
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Listening from the heart does:
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-offer pure & non-anxious presence
-create space for receiving whatever the other chooses to pour out -convey reverence for the person and the contents poured out |
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Listening from the heart:
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-looks like doing nothing
-comforts like warm oil -relieves the soul & fills the heart |
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What is palliative care?
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-"comfort care"
-tx of symptoms -cure no longer the goal |
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What is hospice philosophy?
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-provide comfort
-help individuals & families make the most of the time they have -maintain dignity & choice -ease pain & tx symptoms |
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4 hospice settings?
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-homes
-LTC facilities -hospice beds in hospitals -inpatient units |
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Hospice Care:
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-criteria for admission:6 mo or less life expectancy
-interdisciplinary approach -24 hr on call nurses & social workers -respite care -crisis care -volunteers -bereavement counseling -inpt units for symptom control -specialists available -no home bound requirement -durable med eqpt |
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Hospice Interdisciplinary Team?
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-home health aides
-nurses -chaplains -counselors/social workers -physicians |
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Most common areas for dx r/t dying/hospice?
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-pain
-nausea -anxiety -constipation -self care deficits,hygiene,oral care -altered urinary elimination -risk for impaired skin integrity -knowledge deficit(caring for pt,meds,active dying phase) -ineffective breathing patterns -sensory perceptual alteration -fear -powerlessness |
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Major goals conc Hospice Care?
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-to maintain physical,psychological,& spiritual comfort
-to achieve a dignified & peaceful death |
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Ex of Desired Outcomes for client w/ Grief
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The client:
ID's areas of personal control reminisces & rvws personal life pos. participates in self care activities as able accepts limitations & seeks help as needed expresses control over present situation |
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Common Concerns of the Family for Hospice
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-pain & other symptoms
-fluid & nutrition -mobility -providing personal care for dying fam member -planning for the death-How long? Making arrangements,Calling in Family, What will it be like? |
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Interventions for Hospice Care?
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-energy conservation
-skin integrity -eye care -mouth care -hydration -elimination -respiratory secretions -pain control -mgmt of nausea -environmental mgmt -safety -communication |
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Family Support conc Hospice
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-encourage involvement in care
-acknowledge feelings & grief -encourage self care -teach them what to expect -find out if they want to be present at the time of death -keep them informed |
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Post Mortem Care
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-note time of death
-notify doc & fam -handle body w/ dignity -care for the body -support the family -observe cultural,religious & family preferences -ID the body -notify funeral home -transport to morgue |
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Advance Directives
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-instructions stating a person's health care wishes if incapacitated or unable to make decisions
-all HC providers who receive Medicare funds must educate pts & provide pts w/ opportunity to complete advance directives |
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Living will
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-document prepared by competent person giving instructions regarding medical care if unable to make decisions.
-includes kinds of HC the person would wish to have or not have |
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Durable Power of Attorney
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a competent person names another individual to make decisions regarding HC when he is unable to do so.
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Sexual development in Infancy/early childhhod
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-gender identity
-role ID(male or female) |
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Sexual Development in School-Age years
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-parents,teachers,peers are role models
-may ask questions |
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Sexual Development in Puberty/Adolescence
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-physical/emotional changes
-exploration |
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Sexual Development in Young Adulthood
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-Intimacy & Sexuality
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Sexual Development in Middle Adulthood
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-physical/emotional changes
-perimenopause,dyspareunia |
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Sexual Development in Older Adults
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changes
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Gender
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-biological sex,being male or female
-Gender Roles societal norms for behavior |
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What is gender identity?
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the image we have about ourselves as a man or woman. An internal experience: whether we feel like a woman or man.
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What is transgendered?
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used to describe ppl whose gender ID differs in some way 4m their apparent biological gender.
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What is transsexual?
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someone who feels trapped in the body of the opposite gender.
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What is intersexed?
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ppl born w/ ambiguous sexual organs. Older term is hermaphrodite.
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What is a cross-dresser?
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AKA transvestite. person who occasionally or frequently wears the clothes of the opposite sex.
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Factors affecting sexuality?
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-culture
-religion -lifestyle -knowledge about sex -health status -meds |
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Assessment(Sexual Health History)
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-determine if client has sexual concerns
-routine/matter of fact manner -It is not unusual for ppl w/ your cond to experience sexual changes. Do you have any concerns? -opens the door for discussion/education -Gives pt permission to discuss sexual concerns |
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Obtaining a Sexual History
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-examine your own beliefs & values
-be aware of your nonverbal communication use relaxed approach maintain eye contact provide privacy watch for cues to client discomfort/concerns |
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How many men are affected by ED(erectile dysfunction)?
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30 million men in US
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Risk factors for sexual dysfunction(ED)
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-diabetes
-hyperlipidemia -hypertension -hypothyroidism -chronic renal failure -smoking -obesity -alcohol abuse -lack of exercise |
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Meds that can cz sexual dysfunction?
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antihypertensive,antipsychotic,antidepressants,anxiolytics,anticonvulsants
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Addt'l nursing dx r/t alterations in sexual function
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-activity intolerance & fatigue
-impaired physical mobility -fear -chronic pain -chronic low self esteem |
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Sexual Health Promotion
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-Education(STD,contraception,abuse,etc)
-Women:Kegel exercises -Men:testicular self-exam -counseling for sex probs |
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About Kegel exercises
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-strengthens pubic muscles
-decr urinary incontinence -can enhance sexual enjoyment |
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Sexual Health Evaluation
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-follow up discussion to determine if goals were met
-positive self esteem -dealing w/ inappropriate sexual behavior |
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What is religion?
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-A "map" that outlines essential beliefs,values,& codes of conduct into a manner of living
-many of the world's religions hold common beliefs |
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What is spirituality?
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-A "journey" that takes place over time & involves the accumulation of life experiences & understanding
-an attempt to find meaning,value,& purpose in life |
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Spirituality
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-Religion provides a framework for beliefs & rituals.
religious care is helping clients maintain their faithfulness to their belief system. |
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Spirituality is the...
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umbrella under which religion is a part.
Spiritual care is seen as helping ppl maintain personal relationships & a relationship to a higher being or life force to ID meaning & purpose in life. |
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Core issues of Spirituality
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-Faith
-Hope -Love |
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Concepts in spiritual health(spiritual well-being)
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sense of harmonious interconnectedness bw self,others/nature..
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Concepts in spiritual health(faith)
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relationship w/ a divinity,higher power,authority or spirit...
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Concepts in spiritual health(religion)
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system of organized beliefs & worship that a person practices
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Concepts in spiritual health(hope)
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provides comfort while enduring life threats & personal challenges
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Spiritual beliefs & health
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-research suggests religion has a pos influence over physcial & mental health
-research doesn't answer how or why religion affects health |
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What every nurse should know conc Spiritual health
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-Gain self knowledge
be open welcome challenges take time to reflect spiritual care demands nonjudgmental attitudes & open thinking |
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Barriers to Spiritual Care
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-lack of awareness of spirituality in general
-lack of awareness of your own spiritual belief system -diff. in spirituality bw nurse & client -fear that your knowledge base is insufficient -fear of where spiritual discussions may lead |
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What is the JAREL spiritual well-being scale?
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Assesses 3 key dimensions:
1.faith/belief 2.life/self-responsibility 3.life-satisfaction/self-actualization |
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What is the SPIRIT model?
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involves an interview conc w/ 6 key areas designated by acronym SPIRIT:spiritual/religious belief system,integration w/ a spiritual community,ritualized practices & restrictions,implications for med care,terminal events planning.
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Spiritual Health Assessment Tools
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-JAREL spiritual well being scale
-SPIRIT model -levels of spiritual assessment |
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Sources of Info about spirituality
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-client & fam interviews
-client environment -client questions -nonverbal communication |
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Causes of Spiritual Distress
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-Illness:acute/chronic
-Loss/grief -major life change |
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Spiritual Distress Response
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-doubt
-loss of faith -feeling of being alone/abandoned -questioning of life's purpose |
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Diagnoses r/t Spiritual Health
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-spiritual distress
-risk for spiritual distress -readiness for enhanced spiritual well-being -anxiety -chronic sorrow -hopelessness -powerlessness |
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Nursing Care r/t spiritual health
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-Self awareness
-Estab caring relationship estab presence encourage expression of feelings -learn about & value other belief systems -sensitivity & compassion silence listen -use available resources pastoral care support systems supporting rituals meditation/prayer |
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Culture is ___ & ____.
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Culture is Universal & Dynamic
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Culture according to Leininger?
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learned,shared,& transmitted values,beliefs,norms & life practices of a particular group that guide thinking,decisions, & actions in patterned ways.
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Culture according to Zimbler?
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learned,shared, & symbolically transmitted design for living
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Culture according to Purnell & Paulanka?
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totality of socially transmitted knowledge of values,beliefs,norms & lifeways of a particular group that guides their thoughts & behaviors.
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What is bicultural?
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a person who identifies w/ 2 cultures & maintains some of the values & lifestyles of each.
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What is multicultural?
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refers to many cultures & is used to describe groups rather than individuals
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What is ethnocentrism?
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the tendency to think that your own group is superior to others & to view behaviors & beliefs that differ greatly from your own as somehow wrong,strange,or unenlightened.
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What is the dominant culture?
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the group that has the most authority or power to control values & reward or punish behaviors.
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What is subculture?
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groups w/in a larger culture or social system that have some char. that are diff from those of the dominant culture
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What is a minority group?
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share race, religion, or ethnic heritage but smaller than majority group
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What is a vulnerable population?
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those groups who are more likely to develop health probs & experience poorer outcomes bc of limited access to care,high-risk behaviors,and/or multiple & cumulative stressors.
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Ex of vulnerable pop as subcultures?
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-homeless
-poor -mentally ill -ppl w/ physical disabilities -young -elderly -some ethnic & minority groups |
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Components of Culture
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-religious beliefs
-rituals or ceremonies -health practices -language -family interactions -time orientation -space rqts -use of nonverbal comm -nutrition & food preferences -methods of child rearing -value systems |
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Cultural Values:
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a desirable or preferred way of acting or knowing something that over time is reinforced & sustained by the culture & ultimately governs one's actions or decisions.
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Culture is:
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-learned
-taught -shared by its members -dynamic & adaptive -complex -diverse -exists on many levels -has common beliefs & practices -is all encompassing -provides identity |
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What is indigenous health care system?
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consists of folk med & traditional healing methods,also includes OTC and self-tx remedies
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Professional health care system?
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run by a set of prof HC providers who have been formally educated & trained for their appropriate roles & responsibilities
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Biomedical health care system?
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combines Western biomedical beliefs w/ traditional North American values of self-reliance,individualism, & aggresive action
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Alternative health care?
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diet therapy,mind-body control methods,therapeutic touch, acupressure, etc.
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Culturally competent individuals:
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-value diversity & respect individual differences
-regardless of one's race, religious beliefs, or ethno cultural background. |
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Cultural competence & sensitivity in nursing care
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Is a complex combo of:
-knowledge -attitudes -skilss |
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Questions for a Cultural Assessment?
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-Where were you born?
-Who lives with you? -What czed your current prob? -What language do you speak at home? -What is your religious preference? -What do you do to keep your self well? |
