ATI Nursing Fundamentals: Psychosocial Integrity, Hygiene, and Rest & Sleep

Comprehensive practice flashcards covering therapeutic communication, coping and adaptation, self-concept and sexuality, cultural and spiritual care, grief and palliative care, hygiene, and rest and sleep.

What is intrapersonal communication?

Communication within an individual, often referred to as self-talk. It is the internal discussion that occurs when thinking without outwardly verbalizing thoughts, helping nurses assess clients and situations critically.

How is interpersonal communication defined?

Communication between two people involving an exchange of information. It is the most common form of communication in nursing.

What physical actions demonstrate an empathic presence to a client?

Appearing relaxed and comfortable, sitting facing the client, maintaining an open posture, leaning toward the client, and establishing and maintaining good eye contact (unless cultural norms discourage it).

How do the therapeutic clarifying techniques of restating, reflecting, and paraphrasing differ?

Restating uses the client's exact words; reflecting directs the focus back to the client so they can examine their feelings; paraphrasing restates the client's feelings and thoughts for them to confirm what was communicated.

What are incivility, bullying, and lateral violence in professional health care communication?

Incivility is rude dialogue or actions (such as sarcasm and eye rolling); bullying is repeated words or acts of intimidation; lateral violence is abusive words or actions of peers (such as gossiping, exclusion of information, threats of harm, or actual harm).

What physiological changes occur during the alarm stage of the general adaptation syndrome (GAS)?

Body functions heighten to initiate the fight-or-flight response. The body releases hormones (epinephrine, norepinephrine, cortisone), resulting in elevated blood pressure and heart rate, heightened mental alertness, and increased blood flow to muscles.

How do the resistance stage and exhaustion stage of the general adaptation syndrome (GAS) differ?

In the resistance stage, body functions normalize as the body attempts to cope with the stressor and return to homeostasis (stabilizing blood pressure, heart rate, and hormones). In the exhaustion stage, body functions can no longer maintain a response to the stressor, resulting in recovery or death.

When is the optimal time for a nurse to teach a client stress-management skills?

After the client has coped with a crisis successfully.

Which nursing approach should be used when assisting a family that uses an open structure to cope with a crisis?

Convening a family meeting, which accommodates the loose boundaries of an open structure and gives all family members input and the opportunity to express their feelings.

What do the four components of the PLISSIT assessment tool for sexuality represent?

$P$ represents Permission (obtaining permission to discuss sexuality); $LI$ represents Limited Information (related to sexual health patterns); $SS$ represents Specific Suggestions (using assessment data to make recommendations); $IT$ represents Intensive Therapy (referral for specialized care).

What is role conflict, and what is an example of an inter-role conflict?

Role conflict develops when a person must assume opposing roles with incompatible expectations. An example of inter-role conflict is a mother who wishes to stay at home with her infant but must work outside the home due to family finances.

What is role strain, and what long-term outcome can it produce?

Role strain is the frustration and anxiety that occurs when an individual feels inadequate for assuming a role (such as caring for a parent with dementia). Over time, ongoing stress from caring for someone else leads to caregiver burden.

Which client behavior postoperatively indicates an issue with body image?

A refusal to look at or care for surgical incisions or ostomies after surgical alterations.

What is the difference between cultural sensitivity, cultural appropriateness, and cultural competence?

Cultural sensitivity means nurses are knowledgeable about cultures prevalent in their area of practice; cultural appropriateness means nurses apply that cultural knowledge to care delivery; cultural competence means nurses understand and address the entire cultural context of each client, developing skill across a lifetime.

What is cultural imposition?

The act of a nurse imposing the rules or beliefs of their own culture onto another person. It is similar to ethnocentrism and is sometimes referred to as cultural blindness.

What guidelines must a nurse follow when using an interpreter for client communication?

Use only a facility-approved medical interpreter (never family or friends); inform the interpreter of questions beforehand; speak clearly and slowly without metaphors; direct questions and maintain eye contact with the client rather than the interpreter; ask one question at a time; and do not interrupt.

What actions do the steps of the LEARN assessment tool represent?

Listen actively to the client's perception of the problem with empathy; Explain the health care professional's perception; Acknowledge differences and similarities between perceptions; Recommend treatments incorporating client choices; Negotiate a mutually agreed-upon plan involving medical recommendations and client preference.

What are the four components of the FICA screening tool for spiritual assessment?

Faith or beliefs; Implications, importance, or influence; Community; and Address (how personal beliefs should affect healthcare and treatment choices).

What initial nursing action should be taken when entering the room of a client who is crying and asks to be left alone while reading a sacred text?

Respect the client's wishes by providing privacy (closing the door) and giving uninterrupted time to pray and reflect, then later returning to establish a supportive presence and offering to contact a spiritual care provider.

What are the five stages of grief described in the Kübler-Ross model?

Denial, Anger, Bargaining, Depression, and Acceptance.

How do normal (uncomplicated) grief and complicated grief differ in progression?

Normal grief involves negative emotions that transition toward acceptance, with some acceptance evident by $6\,\text{months}$ after the loss. Complicated grief involves prolonged, difficult progression through grief stages with severe manifestations (such as suicidal ideation, intense guilt, lowered self-esteem, or persistent somatic complaints).

What is disenfranchised grief?

An experienced loss that cannot be publicly shared or is not culturally acceptable, such as the loss of an incarcerated person or an abortion.

What criterion distinguishes hospice care from general palliative care?

Hospice care is specifically implemented when a client is not expected to live longer than $6\,\text{months}$, at which point curative medical care is stopped and focus turns entirely to quality of life and a peaceful death. Palliative care can be provided at any stage of chronic or curable illness alongside curative treatments.

Under what circumstances does the law require that an autopsy be performed?

When death is due to homicide, suicide, or accidental death, or when death occurs within $24\,\text{hr}$ of hospital admission.

Why should a nurse elevate a deceased client's head with a pillow immediately after death?

To prevent facial discoloration caused by blood pooling in the head and neck.

What is the recommended water temperature range for administering a bed bath?

Between $43^\circ\text{C}$ and $46^\circ\text{C}$ ($110^\circ\text{F}$ and $115^\circ\text{F}$).

How should foot and nail care be modified for a client with diabetes mellitus or peripheral vascular disease?

Do not soak the feet due to infection risk, do not cut the nails (file them straight across with an emery board or file), and do not apply lotion between the toes or fingers because excess moisture can cause skin breakdown.

How should an unconscious client be positioned during oral hygiene to prevent aspiration?

Position the client on one side with the head turned toward the mattress so that fluid and oral secretions drain out of the dependent side of the mouth, keeping suction equipment ready at the bedside.

Which clients require the use of an electric razor for shaving?

Clients who are prone to bleeding, receiving anticoagulant therapy, or have low platelet counts.

What are the physiological and timing characteristics of rapid eye movement (REM) sleep?

REM sleep accounts for $20\%$ to $25\%$ of sleep time, first occurs about $90\,\text{min}$ after falling asleep and recurs every $90\,\text{min}$ (averaging $20\,\text{min}$ per cycle). It is characterized by vivid dreaming, loss of skeletal muscle tone, varying vital signs, and cognitive restoration.

What clinical criteria define sleep apnea?

More than $5$ breathing cessations lasting longer than $10\,\text{seconds}$ per hour during sleep, which results in decreased arterial oxygen saturation.

What timing restrictions should nurses advise clients regarding exercise, substances, and fluids before bedtime?

Complete exercise at least $3\,\text{hr}$ before bedtime; avoid alcohol, caffeine, and nicotine for at least $4\,\text{hr}$ before bedtime; and limit fluid intake to between $2$ and $4\,\text{hr}$ before bedtime.

What client education guidelines should be provided to manage narcolepsy?

Exercise regularly, eat small meals high in protein, take naps when drowsy or when narcoleptic events are likely, avoid alcohol and warm environments, avoid activities that could cause injury if falling asleep (such as driving or heights), and take prescribed stimulants.