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207 Cards in this Set
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This may be influenced by internal or external factors,may indicate complications, body temperature, and heat produced minus heat loss?
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Temperature
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Surface temperature fluctuates depending on what?
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amount of blood flow to the skin,
amount of heat loss to the external environment |
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what do you call the kind of temperature that is in the deep tissues and is relatively constant?
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core temperature
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What is the normal temperature range in celcius?
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36degC - 38degC
this is the optimum functioning for cells and tissues |
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What is the normal temperature range in farenheit?
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98.6F-100.4F
this is the optimum functioning for cells and tissues |
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what are some typical sites of temperature measurement?
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oral, axillary, tympanic membrane, and rectal
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what are some other sites/methods for taking temperature besides oral, axillary, tympanic membrane, and rectal?
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Esophageal,
Pulmonary artery, and Urinary bladder |
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This site of temperature measurement is not for a client that isn't completely alert and should not be done after hot or cold beverages (wait 30 min)
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Oral
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How long should you wait prior to taking an oral temp. from someone who has just finished drinking something hot/cold?
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30min.
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This site of temp is less accurate than oral/rectal?
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axillary because your trying to get a core temp.
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this site of temperature offers quick results and oten not utilized correctly?
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tympanic membrane
(they tympanic membrane has the same blood supply as the hypothalamus) |
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This site of temp. is often thought of as most accurate method?
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Rectal
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These sites require continuos invasive devices and used in critical care settings?
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Esophageal,
Pulmonary, Urinary bladder (a therm. on foley) |
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This controls body temperature?
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Hypothalamus (cerebral hemisphere)
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what part of the hypothalamus controls heat loss?
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anterior hypothalamus
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what part of the hypothalamus controls heat production?
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posterior hypothalamus
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this is considered to be the body's thermostat?
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hypothalaus (cerebral hemisphere)
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The balance between these gives you your temperature?
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anterior and posterior hypothalamus
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What are some mechanisms of heat loss?
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Sweating (release heat),
vasodilation, inhibitions of heat production, and blood is redistributed to the surface to produce heat loss, radiation, conduction, convection, evaporation, diaphoretic |
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This term is considered to be transfer of heat w/out contact?
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radiation
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This term is considered to be transfer of heat by direct contact?
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conduction
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This term is considered to be transfer fo heat by air movement?
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convection
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This term is considered to be turning liquid to gas?
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evaporation
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This term is considered to be visual perspiration?
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diaphoretic
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Using an ice pack, cold cloths would be considered what type of heat loss?
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conduction
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this method of heat loss is when you cover the head to prevent heat loss this is considered what?
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radiation
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Alteration in Temperature control is not only the cause of infection it may also be the result of?
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lesion on the hypothalamus or spinal cord, or
Trauma to the hypothalamus or spinal cord |
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Shivering is initiated as a means of what?
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porducing heat,
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Heat production occurs during?
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rest, voluntary movement, involuntary movement, involuntary shivering, and nonshivering thermogenesis
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Temperature is affected by?
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age, (elderly)
Exercise, Hormone level, circadian rhythm,(pattern w/in 24hrs) stress, and environment |
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Describe heat production.
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*produced by metabolism,
*food is 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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what are the 2 types of pyrexia
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hyperthermia,
fever |
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what term is used when the temperature is above the normal range?
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pyrexia
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this is the body's inability to promote heat loss or reduce heat production?
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hyperthermia
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what is the cause of hyperthermia?
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disease or trauma to the hypothalamus
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This is a reaction to some anesthetic drugs given to persons w/ hereditary condition of uncontrolled heat production?
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malignant hyperthermia (rare)
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this term is described as prolonged exposure to the sun or environmental temp. and the heat depresses the hypothalamus function?
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heatstroke
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What are some sign and symptoms of heatstroke?
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*hot, dry skin (does not sweat)
*headache, dizziness, faintness *delirium, giddiness, confusion *excessive thirst *nausea, muscle cramps *incontinence *visual disturbances |
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what are some benefits of fever?
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*wbc production increases
*hormone-like substances are reproduced and defend the body *enhance the body's defense mechanism *suppress the growth of bacteria *fights viral infections by stimulating interferon (the body's natural virus-fighting substance) *aid in diagnosis * |
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What are some negative effects of fever?
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*metabolism increases,
*heart and resp. rate increases *demand for O2 increases *inadequate supply of O2 results in myocardial hypoxia and cerebral hypoxia *dehyhdration in older adults and children |
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this interferes w/ pathogens
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fever.
frequently caused by pyrogens. the hypothalamus changes the set point it goes up and then it maintains it and then it comes back down |
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What is the main concern for a fever?
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is core temp, because it can cause permanent danger when it gets too high ex. seizures in children
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what are some important factors in reference to fever?
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*severity
*client's response to the elevation *client's general health status *client's general health status *client's age *duration *fever patterns |
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this term is used when fluctuaions in temp. occur; normal, above, back to normal lots of spikes
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intermittant
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this term is used when the fever spikes and falls but never gets back to normal
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remittant
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this term is used when a fever lasts days or weeks and then it goes away an ex. is malaria
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relapsing
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What is the goal of fever therapy?
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reduce heat production,
prevent complications, provide comfort, maintain a core temp. w/in normal range, identify underlying cause or contributing factor, prevent complications, provide comfort |
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what is the nursing interventions for someone who has had a fever during onset?
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monitor vitals, light blanket, provide fluids at room temp. and give antipyretic meds
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what is the nursing interventions for someone who has had a fever during the main period?
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antipyretic meds; limit physical activity, tepid bath; provide safety measures of disoriented provide fluids to prevent dehydration; oral care
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what is the nursing interventions for someone who has an abatement period during a fever?
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prevent shivering; provide dry bedding, provide fluids, monitor I&O
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this period of the fever's clinical symptom include ^HR & ^RR, feeling cold w/ shivering, pale, cold skin w/ "goose bumps" cessation of sweating?
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onset period
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this period of the fever's clinical symptom include ^HR and ^RR absence of chills, skin feels warm; light sensitivity w malaise and weakness. ^thirst, may be disoriented, may be dehydrated, photphobia
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this occurs during the main period of a fever
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this period of the fever's clinical symptom include the skin feeling warm and flushed; diaphoresis, decrease in shiverin; may become dehydrated
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this occurs during the abatement period of a fever
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What occurs when the temperature is below set point?
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*posterior hypothalamus senses the change,
*efforts to conserve heat are initiated, *vasoconstriction (blood flow to the extremeties and skin is reduced), *heat production is stimulated via voluntary muscle contraction and muscle shivering |
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this term is used to describe prolonged exposure to cold overwhelms the body's ability to produce heat.
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hypothermia
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when the body's reaction to temp. is 35degC (95F) what term is this considered
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hypothermia
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What are some body's reaction when the temperature is below 35C (95F)?
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*uncontrolled shivering,
*memory loss, *depression *poor judgement |
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what are some body's reaction when the temp is 34.4C (94F)
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*vital signs fall
*skin becomes cyanotic *cardiac arrhythmias *loss of consciousness |
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when a person's body is is reacting to hyporthermia are they responsive or unresponsive to stimuli?
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unresponsive
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What are some nursing interventions for someone who is reacting to hypothermaia?
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*passive rewarming measures
*Warm enviornment *warm blankets *warm blood *active external rewarming avoided *can result in metabolic acidosis |
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what are some things used to induce hypothermia and is sometimes often done for stroke victims
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*central cooling,
*cardiac, transplant or neurosurgery, *rewarm blood *warming blanket *pharmacological agents (watch lab results carefully, turn them frequently, watch out for edema) |
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describe thermal therapy
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application of hot or cold
requires a physicians order need to assess area to be treated |
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the risk of damage is increased in thermal therapy if:
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impaired circulation in that area
impaired skin integrity in that area edema in that area decreased sensation, nacrothepy, |
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this type of therapy is benficial during subacute or chronic inflammation
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heat therapy
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this type of therapy promotes analgesia
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heat therapy
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this type of therapy facilitates soft tissue repair
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heat therapy
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this type of therapy relaxes skeletal muscle
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heat therapy
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if the skin is broken what therapy would you use?
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warm moist heat
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what are the two moist(wet) heat application
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wet compress and baths
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this type of heat aplication
can submerge compress in warm sol. wring out and apply |
heat applicaiton moist
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you can apply dry and use a syringe to apply solution is described as what type of application
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heat moist application
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describe some things that could be considered wet compresses in ref to heat applications: moist (wet)
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*can submerge compress in warm sol., wring out and apply,
*can apply dry and use a syringe to apply sol. *can use a hot water bottle *use a waterproof pad *no heating pads or anything electrical |
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describe some form of baths that are considered a heat applications moist (wet)
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*sitz baths increase circulation to anal/perineal areas-very soothing after surgery
*warm whirlpool baths |
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What are some forms of dry heat applications?
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hypothermia blanket
heat lamps electric heating pads aquathermic pad chemical heat packs |
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Describe a hypothermia blanket
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this is considered a dry heat applications
*large body-sized blanket *fluid is heated and circulates through blanket *rectal probe in place to monitor temp. |
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Describe when a heat lamp would be used and what type of application is it?
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its a form of dry heat application and is often used in infants and monitor for movemtent toward lamp (monitor temp. constantly)
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describe an electric pads
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its a form of dry heat application,
*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 (never lie on heating pad to prevent injury) |
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describe an aquathermic pad
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this is considered to be a dry heat application
*plastic pad w./ warm water running thru hose (put towel on pt. then put pad on top) |
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describe the chemical heat packs
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its a form of dry heat applications
*2 separate compartments filled w/ chemical *when combined, produces heat |
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what is also known as Cryotherapies?
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cold therapies
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when would you use a cold therapy?
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*constrict vessels (controls bleeding)
*reduces edema formation *decreases nerve conduction velocity *increases pain threshold *decreases muscle spasticity (1st 24-72 hr. after acute injury RICE rest, ice, compression, and elevation) |
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what is "RICE"
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a cold therapy, used during the 1st 24-72 hr. after acute injury
rest, ice, compression, and elevation |
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what would you do for a sprain cold/hot?
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use cold therapy at first (RICE)put ice to slow down the swelling process but then eventually any edema that has now developed you would need to use a warm therapy
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What is the treatment of choice for cold therapy?
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immediately following local tissue injury
during acute inflammatory phase usually accompanied by *compression *elevation |
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waht is usually acompanied by a cold therapy
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compression and elevation
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therapy should be limited for how long for cold therapy?
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15 min on distal extremities
or open wounds |
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on which part of the extremety would you limit a cold therapy for 15 min.?
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distal extremities
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how long after the cold treatment has been removed does it remain?
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1-2 hours after removal of cooling modality
(ck. skin for color, and numbness) |
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What are some types of cold therapy?
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*ice pack
*cold pack *cold compress (something moldable areound the air) *cool sponge bath (post partum delivery) |
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Describe the psycosocial theory.
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its understanding people as a combination of psychological and social events
bio psycho social wellbeing (we are holistic beings: mind, body, and spirit) |
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Patient responses to illness' are influenced by the relationship among?
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physical pathology,
psychosocial health (some people cope better w/ health), and overall wellness |
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what are some factors affecting self concept?
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*gender
*developmental level *socioeconomic status(feel more powerful) *family *peer relationships *internal locus of control ("I am in charge") |
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Self Concept: overall view of oneself forms out of a person's evaluation of his/her what are some examples?
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*physical appearance,
*friendships *sexual performance *intellectual abilities *success in the workplace *problem solving and coping abilities *unique talents |
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what are some components of self-concept?
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*body image(mental image of the self ex.anorexia, accidents, paralysis, colostomy)
*role performance *personal identity *self-esteem |
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Body Image: mental image of physical self is influenced by?
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*ideal vs. perceived and actual body image
*appearance and function of body *gradual vs. sudden body changes |
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this is defined as the actions a person takes and the behaviors demonstrated in fulfilling a role.
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role performance
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describe personal identity.
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*your view of yourself as a unique human being, different and separate from all
*relatively constant and consistent |
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describe self esteem
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*how well a person likes one's self
*the difference between ideal self and actual self |
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this is defined as well being
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biopsychosocial
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A comprehensive psychosocial assessment should include the following categories?
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*biological, psychologica,and social details
*functional abilities (behavioral performance) *self-efficacy *family relationship *relationships w/ the wider social environment *interpersonal communicaiton *social resources and networks *understanding about current illness *usual coping mechanism *health priorities |
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this term is defines as the belief that you can influence your own behaviors and outcomes
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self-efficacy
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psychosocial information is personal and sometimes sensitive. To encourage patients to share this information yoiu will need to use your developing communication skills.
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*use active listening through eye contact and verbal response
*proceed from general details to the specific *use an open and positive voice tone, facial expression,and body language *be respectful and sensitive to cultural and genderspecific details *use open ended questions *follow the patients cues by using reflection and restating *be flexible and use humor as appropriate *provide empathetic feedback and touch as appropriate |
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when assessing self-concept and self-esteem, you would also observe for behaviors and comments specifically associated w/ low self esteem. what are some ex.
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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 *unkept appearance |
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psychosoical and self-concept issues can be a problem, a symptom of a problem, or the etiology of a problem. it is important for you to determine what is the cause and what is effect,
what are some possible psychosocial diagnosis? |
*interrupted family processes
*family coping (compromised and/or disabled) *parental role conflict *ineffective individual coping *post trauma syndrome *risk for loneliness *social isolation *risk for violence *impaired social interaction |
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this nursing diagnoses is used when there has been a change in family relationships and/or funcioning that is significantly affecting the patient's health
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interrupted family processes
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this nursing diagnoses is used when support (comfort and assistance)from a usual famly member or significant other is either compromised (insufficient or withdrawn) or disabled (competing or maladapted), causing a significant health challenge
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social isolation
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this nursing diagnoses is used when the patient fails to comprehend and effectively judge stressors, when he perceives incorrect or dangerous life choices as normal, and when there is an inablility to use available resources. inability to identify strenths and resources may be secondary to low self esteem
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ineffective individual coping
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this nursing diagnoses applies where there is a maladaptive learned response to a traumatic and distressing event.
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post trauma syndrome
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this nursing diagnoses exists when there is a separation from persons, culture, objects, or environments to which a person may have ongoing attachements.
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risk for loneliness
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this nursing diagnoses is used when the person experiences significant aloneness that has a negative impact on health, or when the isolation is perceived as a threat to health.
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social isolation
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this nursing diagnoses can be used in situations in which a person threatens or uses aggression or violence to harm others. the intention of harm may not be limited to physical harm.
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risk for violence
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this nursing diagnoses is used for patients who show significant difficulties in social exchange due to an inability to use social skills
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impaired social interaction
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Self concept or body image as a problem: a problem w/ body image or self concept occurs when the problem is the result of a condition and might not exist if not for the condition. What are some nursing diagnoses that may be useful for patients w/ either low overall self concept ro difficulties in specific domains of self concept?
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*chronic low self-esteem
*situationa low self-esteem *disturbed personal identity *ineffective role performance *disturbed body image |
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Psycholsocial outcomes: (psychosoical, self-concept, and self-esteem) health domain fo the NOC taxonomy include approximately 30 outcomes to describe what?
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psychological well-being, psycholocail adaptation, self control, and social interaction.
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where could you find some of the psychosocial outcomes in the NOC?
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they are found in psychosoical health and family health domains
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this is defined as a common emotional response to a stressor.
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anxiety
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describe the psychosocial illness: anxiety
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*common emotional response to a (usually unknown) stressor
*results form psychological conflicts *accompanied by physical symptoms *can be mild, moderate, severe, disabling |
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this is referred to as normal anxiety, experienced in response to the events of day-to-day living.
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mild anxiety
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if present, what are some symptoms of mild anxiety?
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may include muscle tension, restlessness, irritability, and a sense of unease. The person rarely experiences is as distressful
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this type of anxiety is referred to as the perceptual field narrows, and the person begins to focus on self and the need to releve his discomfort.
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moderate anxiety
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what are some physical symptoms of moderate anxiety
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increased heart and respiratory rate, increased perspiration, gastric discomfort, and increased muscle tension. He may speak more rapidly, loudly, and at a higher pitch.
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this type of anxiety is referred to as the perceptual field is so narrow that the person can focus on only one particular detail or may shift focus ot many extraneous details. The person may report feelings of dread, confusion, and other unpleasant emotions.
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severe anxiey
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this type of anxiety is when the person becomes unreasonable and irrational and is unable to focus on even one detail in the environmen. She may misperceive environmental cues or lose contact w/ reality.
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Panic anxiety (disabling?)
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what are some physical symptoms for someone who may be under severe anxiety?
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may include headaches, palpitations, tachycardia, insomnia, dizziness, nausea, trembling, hyperventilation, urinary frequency, and diarrhea.
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what are some physical symptoms w/ panic anxiety?
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include dilated pupils, labored breathing, severe trembling, sleeplessness, palpitations, diaphoresis, pallor, and muscular incoordiantion
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what are some psychosocial interventions for someone w/ anxiety?
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*provide support measures to reduce anxiety
*prevent client isolation *help establish simple routines *encourage self care *allow client to make decisions regarding treatment and routine *use therapeutic communication *explore use of coping resources *reinforce client's strengths *support from family and friends |
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What are some things a nurse can evaluate for a person w/ anxiety
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*observe cleint's non verbal 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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this term is described as a "central aspect of being human throughout life and encompasses sex, gender identitiies and roles, sexual orientation, eroticism, pleasure, intimacy and reroduciton"
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sexuality
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this is a person's perception of his or her gender, gender identity, gender role, and sexual orientation.
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sexual identity
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this is the term to indicate biological sex status
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gender
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this is the societal norms for genderappropriate behavior
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gender roles
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this refers to the blending of traditional masculine and feminine roles. It means that everyone has some skills, traits, and behaviors that may be classified as "masculine" and some htat may be "feminine" this is a positive trait in thatt it gives an individual greater adaptability in life situations.
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androgyny
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refers to the general tendency of a person to feel sexually attracted to people of a certain gender
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sexual orientation
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are people who are sexually and emotionally attracted to members of the opposite sex.
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heterosexual (athough some heterosexuals have had same-gender sexual experiences during childhood, adolescenece, or adulthood, they still consider themselves heterosexual and have committed relationships w/ members of the opposite sex.
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the focus of sexual attraction is a person of the same gender.
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homosexuality
(because it is not as an aspect of the dominant culture and is prohibited by some religions, there has been significant discrimination against homosexuals) |
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a person is sexually and emotionally attracted to both males and females.
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biosexuality.
(least understood and least accepted by both heterosexual and homosexual communitites. They are less likely to found in longterm monogamous relationships, because in such a relationship they would more likely to be identified as either.) |
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how does sexuality develop in infancy/early childhood?
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*gender identity
*role identification (male or female) |
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how does sexuality develop in school-age years?
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*parents, teachers, peers are role models
*may ask questions (school age child strongly identifies w/ the same-sex parent and has mostly same-sex friends. through interatction at home, school, and other activities, children gain awareness of gender roles and emerging gender identity.) (from 8-12 the child is in transition between childhood and puberty. Secondary sex characteristics become apparent. many school-age children are curious about sex, reproduction, and sex roles, and they may ask explicit questions. by age 10 parents should begin teaching children basic information about approaching body changes, menstruation, sexual intercourse, and reproduction) |
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how does sexuality develop in puberty/adolescents?
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*physical/emotional changes
*exploration(same sex encounters, not pathologically abnormal) ((adolescence is a time of heightened sexual interest and activity. There are two reasons fro this: 1. the hormonal changes accompanying puberty and 2. the culture's emphasis on sex. masturbation is a safe and comforting sexual activity that has neither interpersonal nor disease risks. However, some adolescents may encounter parental, cultural, or religious disapproval of masturbation. to make informed choices as they move toward adulthood, adolescents need infromation about body changes, interpersonal relationships, contraception and preventing STIs. |
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how does sexuality develop in the young adulthood?
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*intimacy and sexuality (pregnancy, marriage)
(today marriage is often delatyed, and young adults engage more openly in premarital sex. People define their sexual identity and resolve issues related to their sexual orientation. Young adults often wonder whether their sexual behaviors and responses are normal and many still need info. about birth control, prevention of STIs and relationship and communication issues. |
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how does sexuality develop in middle adulthood?
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*physical/emotional changes
*perimenopause, dyspareunia (children left home, careers are settled or winding down, and concerns about pregnancy are gone. women transition through menopause, men as a result of the aging process or diseases may experience erectile difficulty. They may perceive this problem as a threat to their masculinity, and their self image may suffer. also decrease in sex hormone testosterone. it is important to recognize that some may have sexual concerns and it can be a a challenge to view them as individuals who engage in and enjoy sexual relations because patients of this age may remind them of their parents. |
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this term is used describing when its painful during intercourse
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dyspareunia
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this is the cessation of menstruation
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menopause
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how does sexuality develop in the older adult(aging adult)?
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*going through changes(depends on the individual)
((you can help aging clients to understand that sexual fellings do not necessarily disappear w/ age; and sexual expression need not stop. suggest alternatives to intercourse when illness or disability interfere. |
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what factors affect sexuality?
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culture, religion, lifestyle, sexual knowledge, and physical health all influence our attitudes toward sexuality, sexual behaviors, and intimate relationships.
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describe per notes in ref. to gender
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*biological sex, being male or female
*gender roles -societal norms for behavior -parents are more excepting, men are crying *gender identity -transgender -transsexual -intersexed -cross dresser |
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what are some factors affecting sexuality?
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*culture
*religion *lifestyle *knowledge about sex *health status *medications |
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During the sexual health history nursing assessment, what should the nurse do?
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*determine if client has sexual concerns
*routine/matter of fact manner *"it is not unusual for people w/ your conditions 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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When obtaining a sexual history what does the nurse do?
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*examine-your own beliefs and values
*be aware of your nonverbal communication -use relaxed approach -maintain eye contact -provide privacy -watch for cues to client discomfor/concerns |
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Alterations in sexual function:
what are some examples of sexual dysfunction |
*ED (eractile dysfunction) affects 30 million men in US
*Risk factors: diabetes, hyperlipidemia, hypertension, hypothyroidism, chronic renal failure, smoking, obesity, alcohol abuse and lack of exercise *medication: antihypertensive, antipsychotic, antidepressants, antiolytics, anticonvulsants |
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also called impotence
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erectile dysfunction (ED)
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what problems affect sexualtiy?
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sexually transmitted infections, dysmenorrhea, premenstrual syndrome, negative intimate relationships, sexual harassment, rape, and sexual response cycle disroders
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what are some etilogies of sexuality diagnoses (additional nursing diagnosis)?
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*activity intolerance and fatigue
*impaired physical mobility *fear *chronic pain *chronic low self-esteem *self care deficits *delayed developement |
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this diagnoses may result from cardiac respiratory disease, cancer, imuune dysfunction, chronic pain, and morbid obesity. lack of energy may decrease the person's interest in sex, or it may require a change in the mode of sexual expression.
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activity intolerance and fatigue
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this nusing diagnosis may affect a person's ability to interact, meet potential partners, and perform sexually (eg. assume certain positions, make certain movements)
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impaired physical mobility (eg as occurs w/ arthritis, spinal cord injuries, or cerebral palsy)
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this nusing diagnosis is used for people who think that sexual activity may be dangerous can inhibit desire and the ability to perform. (ex. heart surgery also appply to client's partner)
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fear
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this nusing diagnosis may directly affect iterpersonal relationships, interest in sex, or comfort during sexual intimacy. It may cause fatigue, indirectly affecting sexuality.
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chronic pain
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this nusing diagnosis may result from chronic health problems and their consequences (eg. loss of employment, inability to perform parenting roles).
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chronic low self esteem
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this nursing diagnosis is used for clients who need assistance w/ activities of daily living, family, or caretakers often find it difficult to accept and facilitate sexual relationships. when a person w/ a physical disability lives in a residentioal facility, lack of opportunity and privacy may interefere w/ sexual expression.
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self care deficits
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this nursing diagnosis is used when relationship challenges also exist for people who are developmentally disabled
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delayed development.
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Nursing interventions center around teaching (health promotion) what are some examples.
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*education (STD, contraception, abuse, etc.)
*women-kegal exercises (strenthens pubic muscles, decreases urinary incontinence and can enhance sexual enjoyment, breast self-exam menopause) *men-testicular self-examination (assess for lumps, early detection for cancer is critical) *counseling for sexual problems |
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What would be included in your nursing 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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why might someone sexually harass someone else?
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maybe powerlessness, low self esteeem, trying not to be inappropriate
(you must always report sexual harassment) |
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our patients are not just bodies to work on, nursing is caring for what else?
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the physical, psychosical and spiritual needs of people
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this is defined as a "map" that outlines essential beliefs, values, and codes of conduct into a manner of living
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what is religion
(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 and involves teh accumualaion of life experiences and understandig
*an attempt to find meaning, value and purpose in life (if religion serves as the map, spirituality is the day-to-day moment by moment journey in life and living.) |
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what are some core issues of spirituality?
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*faith,
*hope, *love -forgiveness |
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this is our ongoing effort ot make sense of our life and purpose for being, represents a set of beliefs developed over time, through events that cause us to suffer and those that enable us to rejoice.
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faith
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this includes our basic human needs to achieve, create, and to shape something of our life that will endure.
it is rooted in purpose, "who am I, what is my purpose, and why have I been created" |
hope
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"hope must be as real..in that way it is different from optimism or wishful thinking. when we have hope, we discover powers w/in ourselves we may have never known-the power to make sacrifices, to endure, to heal, and to love. Once we choose hope, everything is possible"who wrote this quote
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chris reeve
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many people think of this as a trade: we extend our's because we hope to find it returned in some way
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love
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describe forgiveness.
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is one aspect of love. People have a spiritual need to forgive others and to be forgiven. WHen a person cannot forgive others, it separates him from them and interferes w/ giving and receiveing love. When a person cannot forgive himself, he may feel the pain of shame, guilt, and anger. Many people interpret their illness as punishment for sins.
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what are some concepts in spiritual health?
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*spiritual well-being
-sense of harmonious interconnectedness between sel, others/nature *faith -relationship w/ a divinity, higher power, authority or spirit *religion -system of organized beliefs and worship that a person practices *hope -provide comfort while enduring life threats and personal challenges... *spiritual beliefs and health |
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how might spiritual beliefs affect health?
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*research suggests religion has a positive influence over physical and mental health (they also cope better)
*research does not answer how or why religion affects health: (prayer, blind study and they didn't know they were being prayed for is an ex) |
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major religions: what religions should you know?
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Judaism,
Christianity Islam Baha'i Hinduism Sikhism Buddhism Native american religions (american indian) Rastafariansism |
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this is one of the western world's oldest religions and the foundation on which christianity and islam were built. based on the worship of one god (monotheism) carrying out the ten commandments, and practicing charity and toleance toward others they celebrate the sabbath from sunst on friday to sunset sat. evening. "work" is prohibited on sabath,
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judaism
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only kosher foods are accepted in this religion
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judaism
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judaism can be broken down to 4 forms of people what are they
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orthodox,
conservative-observes strict dietary laws: only kosher foods are accepted reform reconstructionist |
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there are many denominations w/in christianity, including?
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*roman catholicism-W/ allegiance to the pope in rome
*orthodoxy-w/ allegiance to the patriarch of constantinople *protestantism-ex. lutheran, baptist, united methodist *other-ex. jehovah's witnesses, christian science |
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this form of religion believe that "taking blood into one's body" is morally wrong
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jehovah's witness
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the word ismal means
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submission. in particular, a muslim is one who submits to Allah (god).
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this form fo religion are forbidden to eat any pork. THey may eat other meat, but it has to be halal meat, fish and eggs are allowed, but not if they are cooded near portk or non-halal meat.
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islam
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during the month of ramadan, they fast between sunrise an dsunset; however, those who are sick are not expected to fast.
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islam
(they always wash their hands before eating. pt. prefer to wash in free-flowing water, so tub baths are considered unhygienic. if shower is not available, provide a jug to use in the bath. |
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describe baha'i faith
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has its roots in babism, a reformist outgrowth of islam. pt will accept usual routines and treatment. Alcohol, including that used in cooking is not permitted.
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many reeligious scholars believe is the oldest religion, does not embrace a single body of beliefs and practices. may worship several or even hundreds of gods and goddesses.
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hinduism
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they practice ayurvedic medicine, which encompasses allaspects of life, including diet, sleep, eliminaion, and hygiene. some believe in the "hot" and "cold" foods.
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hindus
(prefer to wash in free-flowing water.) |
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some hindus wear "sacred thread" around the body or wrist. what should you do?
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do not remove or cut this thread w/out permission from the pt. or next of kin.
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combines the teachings of hinduism and islamic sufism, which is the mystical branch fo islam. tenets of the religion include monotheism and the realization fo god through religious exercises and medicaiotn. Many are completely vegetarian. alcohol and tobacco are forbidden. may use contraception but do not speak openly about it.
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sikhism
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this is revered not as a god, but as an example of a way of life.
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buddha, or the "awakened one"
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what kind of diet do buddhists follow?
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vegetarian; in some cases, the diet may include both milk an deggs. fasting customs vary by tradition.
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the earth is considered to be a living organism, teh body of a higher individual , and humankind has an intimate relation w/ this organism through nature
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native american religion
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health is a state of harmony w/ nature. whenever disharmony exist, disease or illness can occur many believe that eh treatments they receive from medicine men and women and traditional healers are far better than those rendered by the dominant health care establishment, which often treats the w/ scorn or disrespect. note taking is forbidden it is impolite to indicate that you did not hear the communications. they converse in a very low tone of voice and may maintain long periods of silence
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american indian
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it emphaxizes personal dignity and a deep love of god. use the old and new testaments of the bible they do not eat pork and shellfish, some are completely vegetarian, and some do not drink milk or coffee.
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rastafarian
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wearing second-hand clothing is forbidden, you may need to provide a disposable gown or allow the person to wear her own personal nightclothes.
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rastafarian
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there are no churches, services, or
official clergy |
rastafarianism
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what should every nurse know?
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*gain self knowledge(be aware of your own religion, spirtuality)
-be open -welcome challenges -take time to reflect -spiritual care demands nonjudgemental attitudes and open thinking |
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what are some barriers to spiritual care
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*lack of awareness of spirituality in general
*lack of awareness of your own spiritual belief system *differences in spirituality between nurse and client *fear that your knowledge base is insufficient *fear of where spiritual discussions may lead |
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what are some assessment tools in ref. to spirituality?
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*JAREL spiritual well-being scale
*SPIRIT model *levels of spiritual assessment (what religious preference do you have, any food pref. is a very low spiritual assessment buts its a start. ) |
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this is "impaired ability to experience and integrate meaning and purpose in life through a person's connectedness w/ self, others, art, music, literature, nature, or a power greater than oneself"
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spiritual distress
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spiritual distress is a diagnostic label that specifically deals w/ spirituality what is some of the causes?
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*illness-acute/chronic
*loss/grief *major life change (good or bad) |
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what are some forms of spiritual distress response's
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*doubt
*loss of faith *feeling of being alone/abandoned *questioning of life's purpose (why did this happen) |
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What are the three major nanda diagnostic labels that are specific w/ dealing w/ spirituality? and what also might you use.
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*spiritual distress
*risk for spiritual distress *readiness for enhanced spiritual well-being Also: *anxiety *chronic sorrow *hopelessness *powerlessness |
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this is an integral component of almost every religion
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prayer
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a time/cnn poll found 82% of americans believe that prayer can cure serious illness so it is likely that a pt. or a family member may ask you to pray for him or w/ him. if the pt. asks you to pray w/ him, you must?
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determine whether he simply wants you to be present while he or another person leads the prayer often teh pt. is merely asking you to pray for him on your own time, as frequently as your schedule allows.
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what are some prayer guidelines for nurses?
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*ask how the client prefers to address the Divine (God, Jahova, holy spirit)
*ask client if any rituals or religious items are needed before prayer *always feel free to pray or not to pray *do not be compulsive about prayer ro avoiding prayer (let your pt. be your guide) *know there are appropriate times and places for prayer *when a client asks for prayer, know how to reply *focus the prayer around the client's request *if composing prayer is difficult, use existing prayers form a religious text *thank client for being asked to participate in prayer (there's a sense of trust and belief in you. thank them for being asked) |
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what are some things you can do to show sensitivity and compassion?
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*be silent and
*listen |
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describe the nursing care in ref. to spirituality?
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*self awareness
*establish caring relationship -establishing presence (being there w/ someone) -encourage expression of feelings *learn about and value other belief systems *sensitivity and compassion -silence -listen *use available resources -pastoral care(make referral)((refer to the chaplin)) -support system (from their own church) -supporting rituals (meditation, privacy) -meditation, -prayer |
