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52 Cards in this Set
- Front
- Back
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assessing altered self concept in a client |
1. slumped posture 2. overly apologetic 3. hesitant while speaking 4. difficulty in sharing views and opinions 5. avoids eye contact 6. not well groomed |
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When developing an appropriate outcome for a 15-year-old girl, the nurse considers that a primary developmental task of adolescence is to:
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form a sense of identity |
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A client underwent six cycles of chemotherapy for her cancer. She lost all of her hair due to drug effects. She is very worried and says, "My children may find me ugly. I will not be able to tolerate that." What stressor is most affecting her self-concept?
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body image |
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How does the nurse ensure that he or she meets the goals related to self-concept alterations in an acute care setting? Select all that apply.
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1. plan for the clients discharge to home 2. make referrals to other health care professionals 3. schedule routine follow-ups |
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What are the appropriate questions for the nurse to ask during assessment of her self-esteem?
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"How do you feel about yourself?
The nurse's assessment should focus on individual components, and asking the client how she feels about herself helps the nurse to identify any identity crises the client might have. |
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role conflict |
when a person has to assume two or more inconsitent roles ex. 20 year gives birth to a baby, and family adopts 5 year old. |
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Role ambiguity
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person is confused and not sure of his or her role |
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role strain |
results from role conflict and role ambiguity |
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role overload |
When a person has more responsibilities within a role than she can manage
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An adult woman is recovering from a mastectomy for breast cancer and is frequently tearful when left alone. The nurse's approach should be based on an understanding of which of the following?
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clients need support in dealing with the loss of a body part -the nurse should encourage the client to talk about the threats to body image, including the meaning of loss, the reactions of others, and the ways in which the client is grieving |
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A nurse is outlining a plan of care for a 9-year-old client. What primary developmental task for this client should the nurse consider?
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mastery of a new skill -primary tasks is to increase self-esteem |
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during the age of 1-3 years |
person distinguisshes self from the enviroment |
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during 3-6 years of age |
communication of likes and dislikes |
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12-20 years |
body changes and maturation are accepted |
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What are the chief factors that determine the self-concept of an individual?
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1. identity 2. body image 3. role performance *age and gender do affect the self-concept of a person, but are not the main components |
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factors that influence the self-concept of a person are |
1. chronic illness 2. dependency on others 3. physical impairments 4. loss of job identity |
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When planning care for improving the self-concept of a client,
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minimize self concept stressors: 1. enroll the client in a class that will teach ambulation with assistive devices 2. involve the client in planning and schedule and extent of physical therapy 3. schedule a prosthetic expert to talk to the client * therapies should not be forced upon the client |
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The developmental stage of Industry versus Inferiority (ages 8 to 12) is focused on incorporating feedback
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from peers and teachers, increasing self-esteem with new skill mastery, and promoting awareness of strengths and limitations.
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Which of the following techniques would the nurse perform to assess for low self-esteem? Select all that apply.
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1. observe clients behavior 2. ask the client to explain thoughts and feelings about self 3. note clues about both stressful and supportive relationships |
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An appropriate nursing diagnosis for an individual who experiences confusion in the mental picture of his physical appearance is:
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disturbed body image |
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After assessing a 2-year-old child, the nurse observes that the child is in the autonomy versus shame and doubt stage of psychosocial development, according to Erikson’s theory of self-concept. Which developmental tasks does the nurse observe in the child? Select all that apply.
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1. communication of likes and dislikes 2. appreciation of body appearance and function 3. increased independence in thoughts and actions |
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A nurse is interviewing a 15-year-old female client and finds that the client has an altered body image. Which factors can affect body image in this client? Select all that apply.
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1. cognitive and physical growth 2. cultural and societal attitudes |
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When caring for an 87-year-old client, the nurse needs to understand that which of the following most directly influences the client's current self-concept?
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adjustment to role change, loss of a loved ones, and physical energy
Older adults experience significant challenges to self-concept, including mental and physical changes associated with aging and changes in identity and role following retirement and/or loss of significant others. The adjustment to stressors is most important. The other influences are important but to a lesser degree. |
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self concept: birth to 1 year |
TRUST VERSES MISTRUST 1. develops trust following consistency in caregiving and nurturing interactions 2. distinguishes self from environment |
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self concept: 1-3 years |
AUTONOMY VERSES SHAME AND DOUBT 1. begins to communicate likes and dislikes 2. increasingly independent in thoughts and actions 3. appreciates body appearance and function -ex: dressing, feeding, talking, wlaking |
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self concept: 3-6 |
INTIATIVE VERSES GUILT 1. identifies with a gender 2. enhances self-awareness 3. increases language skills, including identification of feelings |
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self concept: 6-12 |
INDUSTRY VERSES INFERIORITY 1. incorporates feedback from peers and teachers 2. increases self-esteem with new skill mastery 3. aware of strengths and limitations |
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12-20 self concept |
INDENTITY VERSES ROLE CONFUSION 1. accepts body changes/maturation 2. examines attitudes, values, and beliefs 3. establishes goals fro the future 4. feels positive about expanded sense of self |
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self concept: mid 20s-mid 40s |
INTIMACY VERSES ISOLATION 1. stable, positive feelings baout self 2. experiences successful role transitions and increased responsibilities |
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Mid 40s-mid 60s |
generativity verses self absorption 1. able to accept changes in appearance and physical endurance 2. reassesses life goals 3. shoes contentment with aging |
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late 60s to death |
1. feels positive about life and its meaning 2. interested in providing a legacy for the next generation |
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clients with deficits in self concept |
difficulty making decisions |
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identity |
internal sense of individuality, wholeness, and consistency of a person in different situations |
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which factors/experiences disturb the internal sense of individuality and consistency of an individual? |
repeated failures conflicts with others dependency on parents |
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Self-esteem
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individual's holistic feeling of self-worth or emotional appraisal.
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Role performance
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is the way in which an individual perceives his or her ability to carry out significant roles responsibly.
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A nurse is teaching a group of young adults about the normal changes in role performance associated with maturation. What are the common stressors related to role performance in all ages?
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transition from school to work setting physical, emotional or cognitive deficits preventing role assumption death of a loved one |
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Self-concept
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is how a person thinks of one's self. It is subjective and a mixture of conscious and unconscious thoughts, attitudes, and perceptions
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Self-esteem
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how a person feels about one's self
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The nurse is trying to assess if a client is free from identity stressors. What would suggest that the client has a strong identity?
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The client has been happily married for 10 years.
dentity achievement is reflected by a client's intimate relationships. |
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Which role performance is a nurse experiencing when the nurse is on duty for both morning and night shifts for the last 2 days due to a shortage of staff?
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role overload: unseccessful meeting of work demands and carving out some personal time for family. |
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self esteem stressors |
children: inability to meet expectations of parents and sibling rivalry adult: unsuccessful relationship older adult: loss of a companion |
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A nurse is teaching a 12-year-old client who suffers from asthma the proper technique for using an inhaler and also exercises to improve the breathing process. What should the nurse focus on to avoid development of altered self-concept? Select all that apply.
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1. awareness of limitations 2. awareness of strengths 3. accpetance of changes in physical endurance 4. provide reinforcement for mastery of new skill |
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A nurse cares for a family of four, offering routine medical care throughout the year. Which member of the family does the nurse expect to exhibit the highest levels of self-esteem?
1. 43 year old father 2. 8year old boy 3. 15 year old girl 4. 71 year old grandmother |
answer: 8 year old boy Low self-esteem is a risk factor for health problems, so the nurse would monitor this in a family that he or she sees often. Self-esteem is highest in childhood. When a person reaches adolescence, self-esteem levels decline. Self-esteem then gradually rises during adulthood and again declines slightly in old age. The pattern may vary slightly in individuals, but seems unaffected by gender, socioeconomic status, and ethnicity. The 8-year-old boy is in the childhood stage and is thus expected to show the highest levels of self-esteem in the family. The father will have high self-esteem but it may not be as high as in the child. The girl, an adolescent, will generally have a low level of self-esteem. The grandmother is elderly and thus is expected to have a lower level of self-esteem. |
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How does the nurse ensure that he or she meets the goals related to self-concept alterations in an acute care setting? Select all that apply.
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1. plan for clients discharge to home 2. makereferrals to other health care professionals 3. schedule routine follow-ups In an acute care setting where the length of stay for the client is short, the nurse should make arrangements for the client's discharge to home, make appropriate referrals to other health care professionals, and schedule routine follow-ups to evaluate progress. Renewing prescriptions and scheduling diagnostic tests would help the client's medical condition, not his or her self-concept. |
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A nurse is examining a client who just had a spontaneous abortion. What observations suggest to the nurse that the client has a good self-esteem post incident and is coping well? Select all that apply
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1. the clients husband stays by her side and holds her hand 2. client seems depressed but is asking the health care provider about conceiving again |
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A 50-year-old female client is admitted to the hospital for surgical management of breast cancer. The client is now at home after a successful operation. During a home visit, the client breaks down and expresses that she is overburdened with responsibilities. She takes care of her 8-month-old granddaughter as well as her 80-year-old mother with Alzheimer's disease. What stressors is the client facing?
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role conflict role overload |
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role conflict |
results when aperson had to handle two different responsibilities that are mutually exclusive |
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The home health nurse is visiting a 90-year-old man who lives with his 89-year-old wife. He is legally blind and is 3 weeks' post right hip replacement. He ambulates with difficulty with a walker. He comments that he is saddened now that his wife has to do more for him and he is doing less for her. Which of the following is the priority nursing diagnosis?
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risk for situational low self-esteem |
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A 20-year-old client diagnosed with an eating disorder has a nursing diagnosis of situational low self-esteem. Which of the following nursing interventions would be best to address self-esteem?
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offer independent decison-mnaking opportunities Offering opportunities for decision making promotes a sense of control, which is essential for promoting independence and enhancing self-esteem. Reviewing successful coping strategies is a priority intervention for the nursing diagnosis of ineffective coping. |
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promoting self awareness |
-Helping the client define her problems clearly -Allowing the client to openly explore thoughts and feelings
--Re-framing the client's thoughts and feelings in a more positive way |
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Which question should the nurse ask a patient with low self-esteem in order to assess the nature of the problem?
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During the assessment process, the nurse asks open-ended, focused, and specific questions in order to determine accurate data. The nurse asks the patient about the perception of his or her own appearance to understand the nature of the problem. The nurse asks about the times the patient has felt good about self to help the nurse to determine which area is important for patient care. To know the effects of low self-esteem on a patient, the nurse asks about the impact of relationships on the patient’s self-esteem. To assess the onset and duration of symptoms, the nurse asks about the beginning of different feelings or thoughts about self. Text Reference - p. 665
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