Bradley university NUR 200 exam 3

child (self concept)

internalizing others attitudes about the self, primarily parents and peers

"who do they say that i am"

adult (self concept)

self-actualization and self-adjustment

"this is who I am and who I will continue to be"

factors affecting self concept

- gender (role expectations)

- developmental level

- family and peer relationships

- illness and hospitalization

- locus of control

locus of control

- internal: internal monologue with more control

- external: low self control with lack of ability to change it and less control

body image

your mental image of physical self, apperance, and physical functioning

what is body image influenced by

- family, social, ethnic norms

- education

- exposure to alternative values

- developmental

- social media

role performance

the actions a person takes and the behaviors demonstrated in fulfilling a role

role strain

a mismatch between role expectations and performance

interpersonal role conflict

how individuals carry out their significant roles vs. expectations by others

interrole conflict

two roles make competing behaviors

personal identity

your view of yourself as a unique human being

- different and separate from all others

- develops over time

- chronic illness can negatively affect it

self esteem

how well a person likes oneself

stressors affecting self-concept

- identity stressors

- role overload

- body image stressors

- self-esteem stressors

psychosocial assessment

be sensitive to client, start general and work towards deep information

- watch for changes in behavior/posture

- only use humor when appropriate

- perform active listening

- ask open ended questions that are positive and respectful

psychosocial goals/outcomes example

the patient will verbalize increased positive feelings by the end of the shift

psychosocial interventions/implementations

- DO NOT PROMOTE A SENSE OF FALSE HOPE

- prevent depersonalization

- promote positive body image

- facilitate role enhancement

family (structure)

two or more people related by birth, marriage, or adoption residing in the same household

family (function)

two or more individuals who provide physical, emotional, economic, or spiritual support to each other

- may or may not be blood related, but are involved in each others lives

family (transition)

blended together through relationships, shared meaning, communications, rituals, and/or ideological identity

family centered nursing

nursing care that is holistically directed towards the entire family

what does family centered nursing promote

- health and wellness

- communication

- unity and conflict resolution

what does family centered nursing prevent

- disease

- conflict

- maladaptive coping

traditional nuclear families

married couple with at least one child and one parent working

- similar to what was seen in the 1950's

grandparent families

grandparents raise kids because the parent's aren't

dual-earner families

both parents work with at least one child

single parent families

one parent in the home, could be due to death, divorce, or choice not to marry/live together

blended families

both partners have kids from other relationships

extended families

households made up of several generations, live close in distance to one another

sandwich families

middle-aged adults who still have children at home must care for and share their household with aging parents

same sex couples

families that may or may not be married/have children

cohabiting adults

live together but not married, possibly doing a "trial run" before moving in/getting married

- no kids

family as context

can be a resource but also a stressor

family as a unit of care

nursing interventions to individual family members

family as a system

family as a whole, keep them formally informed

health risk factors for childless and childbearing couples

adapting to new roles, lead to maladaptive coping

health risk factors for families with young children

experience financial difficulties, illness and injury, and demands more

health risk factors for families with adolescents and young-adults

life transitions between dependence and independence

health risk factors for families with older adults

falls and trauma, risk for social isolation

poverty and unemployment

- inadequate or no health insurance

- teen pregnancy is trending low, higher rate of health disparities

family assessment

- identify data (medical, social, family hx)

- family composition (identifies genetic trends)

- WHO IS THE DECISION MAKER FOR THE FAMILY?

- culture

family goals and outcomes

set realistic goals with family, should be mutually agreed upon goals

- assist the family in working towards a common goal

family interventions/evaluation

- assess and monitor

- arrange for respite care

- set realistic goals with family

- encourage family to be assertive in dealing with healthcare agencies

community

fellowship of common relations and feelings

- share a common language, certain rituals, and special customs

population

group of people of a particular race or class in a specified place

vulnerable populations

an aggregate that is at an increased risk of adverse health outcomes and a higher probability of developing illness

where does community based nursing occur?

- clinics

- offices

- mobile care units

- surgery centers

- mental/physical rehab

- nursing homes

- extended care facilities

why are community based nursing facilities created?

to lower costs for the public

community health nursing

how the health of the individual, family, or group affects the community as a whole

- meant to protect, preserve, and maintain

EX: diabetes education

public health nursing

how the health of the community has an impact of the individuals in the community

- meant to prevent individual disease while protecting the overall community

EX: covid-19

community oriented nursing

a combination of both public health and community nursing that serves to:

- illness prevention

- health promotion

- early detection

- treatment in the community

roles of community nurses

- client advocate

- educator

- collaborator

- counselor

- case manager

- researcher

primary prevention

promote health and prevent disease

- immunizations

secondary prevention

reduce impact of disease and early prevention

- STI screenings and diagnostic cancer exams

tertiary prevention

restore functioning to a pre-diseased status

- diabetic following a diet plan

community nursing assessment

depends on the setting and the community

- use subjective and objective data

- determine the biggest problem

home health nurses

- direct care provider

- client and family educator

- client advocate

- case manager

hospice nurses

focuses on patients that are dying (<6 months to live)

- provide comfort and quality of life care

- assess patient condition, monitor interventions to relieve distress

- family is involved

caregiver role strain

caregivers can feel:

- isolation

- anxiety

- depression

- overwhelmed

- lack of sleep

health and illness are influenced by

the client's attitude and lifestyle choices

health

state of complete physical, mental, and social well-being

health promotion

the process of equipping people to have control over and to improve their physical, emotional, and social health

health-illness continuum

sees health as a graduated spectrum that can not be divided into parts

- 10 = excellent health

- 1 = gravely ill

dunn's health grid

plots a person's status on the health-illness continuum against environmental conditions

with finances and health, ask _____ if the patient is non-compliant

"why"

what factors disrupt health

- physical disease

- injury

- mental illness

- pain

- loss

- impending death

- competing demands

- the unknown

- imbalance

- isolation

first step of illness behavior

experiencing symptoms

- signals that illness has begun

EX: cold, cough

second step of illness behavior

sick role behavior

- progress when symptoms are more severe and have normal relief from normal duties

EX: call off of work

third step of illness behavior

seeking professional care

- determining you're ill, get treatment, get validation

EX: going to the doctor

fourth step of illness behavior

dependence on others

- accept the need to depend on others once treatment is accepted

- needs are unique to the individual

EX: healthcare team

fifth step of illness behavior

recovery

- gradually resume independence and normal functioning

CHRONIC ILLNESS MANAGEMENT PHASE

remission

when symptoms are minimal to none

exacerbation

when symptoms intensify and "flare up"

hardiness

developing a strong positive force to live

- enjoying the fight

healthy people 2030

- national initiative

- address the effect of lifestyle on health

- ELIMINATE HEALTH DISPARITIES

transtheoretical model of change

change the environment to avoid a specific stimuli

- six stages

first step of the transtheoretical model of change

precontemplation

- no plan for change (unaware of an issue)

second step of the transtheoretical model of change

contemplation

- seriously thinking of overcoming the problem, haven't made any commitments

third step of the transtheoretical model of change

preparation

- intend to take action in the next month

- reporting small behavioral changes

fourth step of the transtheoretical model of change

action

- implementing the plan

fifth step of the transtheoretical model of change

maintenance

- working to prevent relapse

sixth step of the transtheoretical model of change

termination

- completed the maintenance stage, no concern for relapse

- the concern has become habit

whats an example of a health promotion program at a group level

prenatal classes

whats an example of a health promotion program at a community level

billboards about smoking, health fairs

health promotion in adolescents

- sexuality (STDs)

- firearm safety

- self-esteem issues

- oral health

- sun exposure

- drug use

- MVA accidents

health promotion in young adults

- MVA accidents

- violence

- immunizations

- sun exposure

health promotion in adults

- physical activity (obesity)

- sexuality

- oral care

- substance abuse

health promotion in older adults

- safety

- mobility issues

- isolation

- obesity

health promotion assessment

involves obtaining a health history, physical examination, fitness assessment, lifestyle and risk appraisal, life stress review, analysis of health beliefs, nutritional assessment, and screening activities

health promotion diagnoses

make sure they are congruent with patient health

health promotion nursing interventions

draw on patient and family strengths

how can I honor each client's unique health experience?

- be maximally attentive

- be aware of your abilities/limitations to communicate

- be willing to learn

when promoting health, the assessment should

facilitate communication

how to be a better communicator

- take time

- identify their main concern

- WHAT IS THE BIGGEST CONCERN YOU ARE DEALING WITH TODAY?

- develop observation skills

growth

physical changes that occur over time

- ex: height, weight, muscle gains

development

process of adapting to one's body and environment over time

- skill progression and increasing complexity of function

- ex: recognizing wrong from right

nature

influence of genetics

nurture

influence of the environment

psychosocial development theory by erikson

individuals must negotiate 8 stages as they progress through the lifespan, one can regress as well

stage 1 of erikson's psychosocial development theory

trust vs mistrust

- birth to 18 months

stage 2 of erikson's psychosocial development theory

autonomy vs shame and doubt

- 18 months to 3 years