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149 Cards in this Set

  • Front
  • Back
List the 4 basic characteristics of culture
is learned from birth through the processes of language and socialization, shared by all members of the same cultural group, adapted to specific conditions related to environmental and technical factors and to the availability of natural resources, dynamic ever changing
dominant value orientation
a basic value orientation that is shared by the majority of its members as a result of early common experience
state the 5 common human problems with respect to value
the innate human nature of people, relationship to nature, time dimentsion, the purpose of existence, and relationships with others
list 3 perceptions of the human's relationship to nature,
destiny, harmony, mastery,
"why should I bother watching my diet? my diabetes is part of my genetic there is nothing I can do to change the outcome"
"If I follow the diet prescribed I can achieve the balance"
"I will overcome the diabetes no matter what"
List 3 major ways that people can perceive the time dimension,
the focus may be on the past,
the focus may be on the present, the focus may be on the future
"may consult with ancestors or ask for their guidance or protection during the illness"
focus may be on the past
"concerned with now future is perceived as vague or unpredictable"
focus may be on the present
"latest treatment"
focus is on the future
refers to those that exist by virtue of herdity and kinship ties
lineal relationships
working together toward achievement of a group
personal autonomy and independence
list 7 categories of families
nuclear, extended, blended, single parent, communal, cohabition, gay/lesbian
husband wife and children
nuclear family
nuclear plus blood relatives and even people who are not biologically related
extended family
husband, wife, and children from previous relationship
blended family
group of men and children
communal family
unmarried man and women sharing a household with children
list 3 major theories on the ways in which people view the causes of illness
biomedical or scientific, naturalistic or holistic, and magico-religious perspective
define yin/yang theory of health and illness and relate this to differet types of foods
foods are classified as hot and cold in this theory and are transformed into yin and yang energy when metabolized by the body. Yin foods are cold and yang are hot foods. Cold foods are eaten with a hot illness, and hot foods are eaten with a cold illness.
list at least 5 names for various folk healers,
curandero, espiritualista, yerbo, sabedor, hogan, spiritualis
a voodoo priest or priestess
some people may have a condition that is culturally defined.
culture bound syndrome
what is an example of a culture bound syndrome for an hispanic
evil eye
religion is best describes as
an organized system of beliefs concerning the cause, nature, and purpose of the universe
list 8 items that should be communicated to the patient concerning the terms or expectations of the interview
time and place fo the interview and succeeding physical examination, introduce yourself and a brief explanation of your role, the purpose of the interview, how long will it take, expectation of participation for each person, presence of any other people, confidentiality and to what extent it may be limited, and any costs that the patient must pay
describe the points to consider in preparing the physical setting for the interview
ensure privacy, refuse interrupions, physical environment, dress, note-taking tape and video recording
list the pros of note taking
so you won't forget main points
list the cons of note taking
it breaks eye contact too often, it impedes your observaion of the patient's nonverbal behavior
it states the topic to be discussed but only in general terms
open ended questions
asks for specific questions
closed or direct questions
9 types of examiner responses that could be used during the interview,
facilitation, silence, reflection, empathy, clarification, confrontation, interpretation, explanation, summary
an example of facilitation
"go on"
when your reactions to the facts or feeling the person has communicated is an ex of
10 traps of interviewing
providing false assurance or reassurance, giving unwanted advice, using authority, (dr. knows best),using avoidance language, engaging in distancing, using professional "jargon", using leading or biased questions, talking too much, interrupting, using "why" questions
state 7 types of nonverbal behaviors that an interviewer could make
physical appearance, posture, gestures, facial expressions, eye contact, voice, touch
discuss special considerations when interviewing the older adult
takes longer, adjust the pace, a lot more to cover with the background, may need more time to respond, may fatigue earlier, and may require the interview to be broken up into shorter segments
discuss ways you would modify your interviewing technique when working with a hearing impaired person
ask his or her preferred way to communicate, by signing, lip reading or writing a complete health history requires a sign language interpreter
formulate a response you would make to a patient who has spoken to you in ways you interpret as sexually aggressive
"i wonder if the way you're feeling now relates to your illness or being in the hospital
Discuss the ways that nonverbal behavior may vary cross culturally
vocal ones(pitch, tone)
action cues (posture)
object cues ( clothes)
use of personal and territorial space
list at least 5 points to consider when using an iterpreter during an interview
plan what you want to say, ask the interpreter to provide a line by line verbadim acct. of the conversation, before locating the interpreter identify the language the person speaks at home, whenever possible use a trained interpreter, preferbly who knows medical terminology, to ensure confidentiality and privacy avoid using interpreters children or strangers who may be visiting
an accurate understanding of the other person's feelings within a communication context is an ex. of
a good rule for an interviewer is to
spend more time listening to the patient talking
students frequently ask "may i ask you a question?" this in an ex. of
closed question
touch should be used during the interview
only if the interviewer knows the person well
personal distance is generaly considered to be
1 1/2 to 4 ft.
because of adolescents development level not all interviewing techniques can be used with them the two that are avoided
silence and reflection
Mr. b tells you, "everyone here ignores me" you respond "ignores you" this technique is best describes as
at what age should the interview begin to question the child him or herself regardign presenting symptoms
state the purpose of the complete health history
is to collect subjective data and is combined with the objective data
what the person says about himself or herself
list the critical characteristics used to explore each symptom the patient identifies
biographical data, reason for seeking care, present health or history of present illness, past history, family history, review of systems, functional assessment of daily livings
discuss the rationale for obtaining a family history
these data may have genetic significance for the patient,
discuss the rationale for obtaining a systems review
to evaluate the past and present health state of each body system, to double check in case any significant data were omitted in the present illness section, to evaluate health promotion practices
describe the items included in a functional assessment
measures a person's self-care ability in the areas of general physical health or absence of illness, adl's, may mean organizing the entire assessment around functional "pattern areas"
describe the additions you would make in environment pacing, and content when conductiong a health history on an older adult
then environment needs to be comfortable, the pace might have to be slower, and you need to be patient, there are some quest you might not ask an older adult vs. an adolescent
pain lasting two hours is an considered to be
is apparent when person's response is much greater than the expected reaction to a traumatic life event
mental disorder
4 situations in which it would be necessary to perform a complete mental status examination
family members concerned about a person's behavioral changes, symptoms of psychiatric mental illness, brain lesions, aphasia
voice difficulty or discomfort in talking with abnormal pitch or volume due to laryngeal disease voice sounds hoarse or whispered, but articulation and language are intact
articulation distorted speech sounds
total inattention to one side fo the body occurs following some cerebrovascular accidents
unilateral neglect
state convenient ways to assess a person't recent memory within the context of the initial health history
24 hr. diest recall or by asking the time the person arrived at teh agency
which mental function is the four unrelated words test intended to test
person' ability to lay down new memories
explain 4 factors that could affect the patient's response to the mental status examination but have nothing to do with mental disorders
any known illnesses or health problems such as alcoholism, current med, the usual educational and behavior level, responses to personal history questions, indicating current stress, etc.
3 quest you could ask a patient that would screen for suicide ideation
have you ever felt so blue you thought of hurting yourself?, do you feel like hurting yourself right now?, what would happen if you were dead
not full alert, drifts off to sleep when not stimulated, looks drowsy thnking seems slow and fuzzy
lethergic or somnolent
sleeps most of time difficult to arouse needs loud shout or vigorous shake acts confused when is aroused
spontaneously unconscious responds only to persistant and vigorous shake or pain, her appropriate motor responses , will draw hand up for pain otherwise commonly groan
stupor, or semi-coma
completely unconscious, response to pain or to any internal stimuli
clouding of consciousness inactive, incoherent converstaion, impaired recent memory
symptoms and physical sign that are characteristics of alcohol withdrawal
uncomplicated, and withdrawal delirium
uncomplicated symptom of alcoholism
shortly after cessation of drinking lasts 5-7 days cause tremor of hands, tongue, eyelids, anorexia, nausea, and vomitting, malaise, autonomic hyperactivity (tachycardia, sweating, elevated bp), headache, insomnia, anxiety, depressions or irritability transient hallucinations or illusions
withdrawal symptom of alcoholism
much less common occurs within 1 week of course irregular tremor, marked autonomic hyperactivity, vivid hallucinations, agitated behavior fever
Lack of emotional response
flat affect
loss of identity
excessive well being
aprehensive form the anticipation of a danger whose source is unknown
annoyed easily provoked
loss of control
sad, gloomy, defected
rapid shift of emotions
worried about known external danger
refers to the degree of balance between nutrient intake and nutrient requirements
nutritional status
state 3 purposes of a nutritional assessment
identify individuals who are malnoursished or at risk of developing malnutrition, provide data for designing a nutrition plan of care that will prevent or minimize the development of malnutrition, establish baseline data for evaluating the efficancy of nutritional care
list and describe 5 factors that place an individual at nutritional risk
persons who have had a recent unintentional wt. loss, underweight individuals are vulnerable because their full reserves may be depleted. excess wt. is associated with a number of health problems, protein and calorie needs are often overlooked in acutely ill obese persons
what is wellness
absence of illness, perfect health, opitmal functioning, biopsychosocial ideal
"is she well" "is he well"
biomedical model of wellness
client states nasal congestion
you observe thru your senses
an immediate impression of the general health of your patient
general survey
General survey includes
physical appearance, body structure, mobility, behavior
what are some of the questions or concerns when looking at physical appearance
do they look the stated age, sex development appropriate for age and gender, level of consciousness answers quest oriented to surrroundings, facial features relaxed vs. pain
What are some of the things you look for to determine body structure
structure height w/in a normal range for sex and age, nutrition wt. w/in normal range vs. obese or cachtic, symmetry body parts look equal bilaterally, posture stands comfortably erect vs. kyphotic or lordotic, position erect comfortable
what are some of the characteristics for behavior
facial expression normal animation vs. lack of eye contact, mood and affect comfortable w/ nurse interacts pleasantly, speech clear, fluent, dress clean, fits, culturally appropriate, personal hygiene clean, culturally appropriate
components of cognitive assessment
appearance, behavior, concentration, thought processes (abct)
what is the first thing you do to assess level of consciousness
in order to determine the depth of assessment needed you introduce yourself
(keep in mind language, educational, & sensory barriers)
you would use this tool to assess the level of consciousness
Glasgow coma scale
what are examples of things you can do to determine whether or not the person responds to pain
sternum rub, press on nail
Cognitive assessment:
what do you look for in appearance
posture, body movements, dress, and hygiene and grooming
Cognitive assessment:
what do you assess in reference to behaviors and moods aka affect
depressed/sad, flat, depersonalized (3rd person), elation, hymonia/mania, anxiety/paranoia/hypervigilant (can be temporary because of their state of mind in the hospital however, they need continuing reinforcement)
Cognitive assessment:
what do you assess in ref to concentration
Orientation(person, place, time), attention span, recent memory, remote memory, new learning (4words), judgement,
a 24 hr recall would be considered what?
reecent memory
using health history would be considered what form of memory
what does "if you found a letter with an address on it what would you do" be considered in the concentration process
drugs, illness
impaired memory, cognition
impaired memory, social functioning
what are some contributing factors to cognitive deficits
medications, illnesses, baseline behavior, age & culture, education, sensory deficits
what would use to determine mental status and it works on a point system
Folstein Mini Mental Examination
all sign off forms need to be written in terms to grade
under 8th grade 3rd-5th is baseline
What are some things on the Folstein Mini Mental Status Exam
Date orientation, place orientation, register 3 objects, serial sevens, recall 3 objects, naming, repeating a phrase, verbal commands, written commands, writing, drawing, scoring
what is a normal score in the fmmse
a score of 24 or more is considered to be normal
what are some risk factors for suicide
prior suicide attemps, depression, hopelessness, social withdrawal, running away, self-mutilation, sleep problems, hypersomnia or insomnia, verbal suicide messages, giving away prized pocessions, saying goodbye
CAGE screening is for whom
a person who answers "yes" "sometimes" or often to 2 or more of the questions may have a problem w/ alcohol
Nutritional assessment:
Ideal Body Weight is based on what:
ht, wt, geder, age, health and activity needs
what is an ideal body weight
%ibw=current wt/ibw*100
what would the % be for someone who is under nutrition
inadequate to meet daily needs <70% ibw
what would be the % for someone over nutrition
consumption in excess of daily needs >120% ibw
optimal nutrition would be considered what in reference to ibw
supports daily needs
nutritional assessment
assess directly and indirectly what are you looking for
amounts, patterns, types of food, acess ability( resource, obtain, feed self, swallow)
what is considered to be a baseline assessments
24 hr recall and 3 d diet diary
what days would you recommend a 3 d diet be on
one of those days be a weekend for it to be accurate
What are the nutritional assessment diagnostic tests
U/A, CBC, Iron, Protein
what are some cultural considerations when taking a nutritional assessment
customs, rituals, preference, food meaning
what is an example of a cultural consideration
kosher diet
What are some developmental considerations in reference to nutritional assessment
Adolescents, adulthood, aging adult,pregnancy
Development considerations for nutritional assessment
adulthood, promoting healthy habit (alcohol, chol., sodium,calcium)
why might adolescents have a developmental consideration
(body image, happy w/ wt., exercise history, eating in secret, affect of wt. on self regard)
what are some developmental considerations for someomone who is pregnant
extra caloric and nutrient needs
what are some developmental considerations for the aging adult
health restored needs, isolation, and money, (dentures, saliva productivity decrease, nothing tastes good)
What are some nutritional interventions
Low fat, Low sodium, BRAT( feed the children regular health food diet), ORT oral rehydration therapy (ex pedialyte), Lacose intolerant, Food allergies, Low carbohydrate, gluten free, (celiac dz)Diverticulosis, low residue
what is an ex of a low residue diet
easy to digest foods, yogurt
what are the three main points in an interview
purpose, interview, health history, and soap (charting)notes
SOAP charting
develop rapport, collect subjective data, set expectations,
(Subjective, objective, assessment, plan)
3 phases of interview
introduction, working, and closing
provacative & palliative factors, quality and quantity, region & radiation, Severity scale, timing, understand patients perspective
WHat are some Provocative or palliative factors
What makes it worse? what makes it better?
What are you looking for in the quality or quantity
description: sharp, dull, stabbing, spasmodic, pressure, throbbing, mild modeate, severe
Region or radiation what are some terms
where does it start?, where does it move to (radiate), where is it more severe
Severity scale:
intensity scales and face scale
1-10 its a linear analogue scale, and look at objective measures in children who can't speak
Obstetrical health assessment
gravida, term, preterm, abortions, living children