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149 Cards in this Set
- Front
- Back
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List the 4 basic characteristics of culture
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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
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dominant value orientation
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a basic value orientation that is shared by the majority of its members as a result of early common experience
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state the 5 common human problems with respect to value
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the innate human nature of people, relationship to nature, time dimentsion, the purpose of existence, and relationships with others
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list 3 perceptions of the human's relationship to nature,
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destiny, harmony, mastery,
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"why should I bother watching my diet? my diabetes is part of my genetic there is nothing I can do to change the outcome"
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destiny
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"If I follow the diet prescribed I can achieve the balance"
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harmony
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"I will overcome the diabetes no matter what"
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mastery
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List 3 major ways that people can perceive the time dimension,
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the focus may be on the past,
the focus may be on the present, the focus may be on the future |
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"may consult with ancestors or ask for their guidance or protection during the illness"
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focus may be on the past
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"concerned with now future is perceived as vague or unpredictable"
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focus may be on the present
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"latest treatment"
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focus is on the future
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refers to those that exist by virtue of herdity and kinship ties
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lineal relationships
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working together toward achievement of a group
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collateral
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personal autonomy and independence
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individual
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list 7 categories of families
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nuclear, extended, blended, single parent, communal, cohabition, gay/lesbian
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husband wife and children
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nuclear family
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nuclear plus blood relatives and even people who are not biologically related
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extended family
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husband, wife, and children from previous relationship
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blended family
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group of men and children
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communal family
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unmarried man and women sharing a household with children
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cohabition
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list 3 major theories on the ways in which people view the causes of illness
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biomedical or scientific, naturalistic or holistic, and magico-religious perspective
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define yin/yang theory of health and illness and relate this to differet types of foods
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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.
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list at least 5 names for various folk healers,
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curandero, espiritualista, yerbo, sabedor, hogan, spiritualis
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cuarandero
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ra
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espiritualista
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spiritualist
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hougan
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a voodoo priest or priestess
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some people may have a condition that is culturally defined.
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culture bound syndrome
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what is an example of a culture bound syndrome for an hispanic
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evil eye
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religion is best describes as
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an organized system of beliefs concerning the cause, nature, and purpose of the universe
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list 8 items that should be communicated to the patient concerning the terms or expectations of the interview
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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
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describe the points to consider in preparing the physical setting for the interview
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ensure privacy, refuse interrupions, physical environment, dress, note-taking tape and video recording
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list the pros of note taking
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so you won't forget main points
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list the cons of note taking
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it breaks eye contact too often, it impedes your observaion of the patient's nonverbal behavior
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it states the topic to be discussed but only in general terms
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open ended questions
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asks for specific questions
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closed or direct questions
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9 types of examiner responses that could be used during the interview,
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facilitation, silence, reflection, empathy, clarification, confrontation, interpretation, explanation, summary
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an example of facilitation
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"go on"
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when your reactions to the facts or feeling the person has communicated is an ex of
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clarification
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10 traps of interviewing
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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
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state 7 types of nonverbal behaviors that an interviewer could make
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physical appearance, posture, gestures, facial expressions, eye contact, voice, touch
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discuss special considerations when interviewing the older adult
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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
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discuss ways you would modify your interviewing technique when working with a hearing impaired person
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ask his or her preferred way to communicate, by signing, lip reading or writing a complete health history requires a sign language interpreter
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formulate a response you would make to a patient who has spoken to you in ways you interpret as sexually aggressive
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"i wonder if the way you're feeling now relates to your illness or being in the hospital
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Discuss the ways that nonverbal behavior may vary cross culturally
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vocal ones(pitch, tone)
action cues (posture) object cues ( clothes) use of personal and territorial space touch |
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list at least 5 points to consider when using an iterpreter during an interview
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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
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an accurate understanding of the other person's feelings within a communication context is an ex. of
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empathy
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a good rule for an interviewer is to
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spend more time listening to the patient talking
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students frequently ask "may i ask you a question?" this in an ex. of
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closed question
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touch should be used during the interview
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only if the interviewer knows the person well
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personal distance is generaly considered to be
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1 1/2 to 4 ft.
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because of adolescents development level not all interviewing techniques can be used with them the two that are avoided
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silence and reflection
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Mr. b tells you, "everyone here ignores me" you respond "ignores you" this technique is best describes as
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reflecting
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at what age should the interview begin to question the child him or herself regardign presenting symptoms
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7
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state the purpose of the complete health history
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is to collect subjective data and is combined with the objective data
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what the person says about himself or herself
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subjective
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list the critical characteristics used to explore each symptom the patient identifies
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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
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discuss the rationale for obtaining a family history
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these data may have genetic significance for the patient,
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discuss the rationale for obtaining a systems review
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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
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describe the items included in a functional assessment
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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"
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describe the additions you would make in environment pacing, and content when conductiong a health history on an older adult
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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
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pain lasting two hours is an considered to be
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subjective
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is apparent when person's response is much greater than the expected reaction to a traumatic life event
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mental disorder
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4 situations in which it would be necessary to perform a complete mental status examination
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family members concerned about a person's behavioral changes, symptoms of psychiatric mental illness, brain lesions, aphasia
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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
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dysphonia
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articulation distorted speech sounds
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dysarthria
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total inattention to one side fo the body occurs following some cerebrovascular accidents
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unilateral neglect
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state convenient ways to assess a person't recent memory within the context of the initial health history
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24 hr. diest recall or by asking the time the person arrived at teh agency
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which mental function is the four unrelated words test intended to test
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person' ability to lay down new memories
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explain 4 factors that could affect the patient's response to the mental status examination but have nothing to do with mental disorders
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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.
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3 quest you could ask a patient that would screen for suicide ideation
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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
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not full alert, drifts off to sleep when not stimulated, looks drowsy thnking seems slow and fuzzy
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lethergic or somnolent
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sleeps most of time difficult to arouse needs loud shout or vigorous shake acts confused when is aroused
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obtunded
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spontaneously unconscious responds only to persistant and vigorous shake or pain, her appropriate motor responses , will draw hand up for pain otherwise commonly groan
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stupor, or semi-coma
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completely unconscious, response to pain or to any internal stimuli
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coma
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clouding of consciousness inactive, incoherent converstaion, impaired recent memory
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delirium
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symptoms and physical sign that are characteristics of alcohol withdrawal
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uncomplicated, and withdrawal delirium
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uncomplicated symptom of alcoholism
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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
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withdrawal symptom of alcoholism
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much less common occurs within 1 week of course irregular tremor, marked autonomic hyperactivity, vivid hallucinations, agitated behavior fever
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Lack of emotional response
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flat affect
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loss of identity
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depersonalization
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excessive well being
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euphoria
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aprehensive form the anticipation of a danger whose source is unknown
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anxiety
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annoyed easily provoked
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irritability
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loss of control
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rage
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sad, gloomy, defected
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depression
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rapid shift of emotions
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lability
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worried about known external danger
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fear
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refers to the degree of balance between nutrient intake and nutrient requirements
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nutritional status
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state 3 purposes of a nutritional assessment
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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
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list and describe 5 factors that place an individual at nutritional risk
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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
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what is wellness
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absence of illness, perfect health, opitmal functioning, biopsychosocial ideal
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"is she well" "is he well"
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biomedical model of wellness
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subjective
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symptoms
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client states nasal congestion
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subjective
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objective
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you observe thru your senses
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an immediate impression of the general health of your patient
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general survey
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General survey includes
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physical appearance, body structure, mobility, behavior
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what are some of the questions or concerns when looking at physical appearance
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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
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What are some of the things you look for to determine body structure
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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
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what are some of the characteristics for behavior
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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
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components of cognitive assessment
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appearance, behavior, concentration, thought processes (abct)
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what is the first thing you do to assess level of consciousness
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in order to determine the depth of assessment needed you introduce yourself
(keep in mind language, educational, & sensory barriers) |
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you would use this tool to assess the level of consciousness
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Glasgow coma scale
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what are examples of things you can do to determine whether or not the person responds to pain
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sternum rub, press on nail
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Cognitive assessment:
what do you look for in appearance |
posture, body movements, dress, and hygiene and grooming
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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)
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Cognitive assessment:
what do you assess in ref to concentration |
Orientation(person, place, time), attention span, recent memory, remote memory, new learning (4words), judgement,
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a 24 hr recall would be considered what?
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reecent memory
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using health history would be considered what form of memory
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remote
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what does "if you found a letter with an address on it what would you do" be considered in the concentration process
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judgement
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drugs, illness
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delirium
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dementia
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impaired memory, cognition
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illusions
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misperceptions
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amnesia
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impaired memory, social functioning
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what are some contributing factors to cognitive deficits
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medications, illnesses, baseline behavior, age & culture, education, sensory deficits
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what would use to determine mental status and it works on a point system
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Folstein Mini Mental Examination
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all sign off forms need to be written in terms to grade
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under 8th grade 3rd-5th is baseline
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What are some things on the Folstein Mini Mental Status Exam
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Date orientation, place orientation, register 3 objects, serial sevens, recall 3 objects, naming, repeating a phrase, verbal commands, written commands, writing, drawing, scoring
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what is a normal score in the fmmse
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a score of 24 or more is considered to be normal
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what are some risk factors for suicide
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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
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CAGE screening is for whom
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a person who answers "yes" "sometimes" or often to 2 or more of the questions may have a problem w/ alcohol
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Nutritional assessment:
Ideal Body Weight is based on what: |
ht, wt, geder, age, health and activity needs
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what is an ideal body weight
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%ibw=current wt/ibw*100
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what would the % be for someone who is under nutrition
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inadequate to meet daily needs <70% ibw
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what would be the % for someone over nutrition
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consumption in excess of daily needs >120% ibw
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optimal nutrition would be considered what in reference to ibw
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supports daily needs
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nutritional assessment
assess directly and indirectly what are you looking for |
amounts, patterns, types of food, acess ability( resource, obtain, feed self, swallow)
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what is considered to be a baseline assessments
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24 hr recall and 3 d diet diary
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what days would you recommend a 3 d diet be on
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one of those days be a weekend for it to be accurate
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What are the nutritional assessment diagnostic tests
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U/A, CBC, Iron, Protein
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what are some cultural considerations when taking a nutritional assessment
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customs, rituals, preference, food meaning
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what is an example of a cultural consideration
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kosher diet
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What are some developmental considerations in reference to nutritional assessment
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Adolescents, adulthood, aging adult,pregnancy
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Development considerations for nutritional assessment
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adulthood, promoting healthy habit (alcohol, chol., sodium,calcium)
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why might adolescents have a developmental consideration
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(body image, happy w/ wt., exercise history, eating in secret, affect of wt. on self regard)
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what are some developmental considerations for someomone who is pregnant
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extra caloric and nutrient needs
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what are some developmental considerations for the aging adult
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health restored needs, isolation, and money, (dentures, saliva productivity decrease, nothing tastes good)
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What are some nutritional interventions
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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
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what is an ex of a low residue diet
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easy to digest foods, yogurt
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what are the three main points in an interview
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purpose, interview, health history, and soap (charting)notes
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SOAP charting
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develop rapport, collect subjective data, set expectations,
(Subjective, objective, assessment, plan) |
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3 phases of interview
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introduction, working, and closing
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PQRSTU
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provacative & palliative factors, quality and quantity, region & radiation, Severity scale, timing, understand patients perspective
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WHat are some Provocative or palliative factors
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What makes it worse? what makes it better?
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What are you looking for in the quality or quantity
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description: sharp, dull, stabbing, spasmodic, pressure, throbbing, mild modeate, severe
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Region or radiation what are some terms
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where does it start?, where does it move to (radiate), where is it more severe
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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
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Obstetrical health assessment
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GTPAL
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GTPAL
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gravida, term, preterm, abortions, living children
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