Nursing I Test VIII

sensory, coping, cultural diversity, sexuality, etc

Local adaptation syndrome (LAS)

reflex pain response, inflammatory response. pricking of the finger

general adaptation syndrome

GAS-A pattern of general physical responses that take essentially the same form in responding to any serious chronic stressor.

alarm reaction (GAS)

the body mobilizes its resources to cope with a stressor. the stressor upset homeostasis or cellular balance. out in the woods running from a bear, you are coping with that stress.

Resistance (GAS)

the body seems to adapt to the presence of the stressor. body fights back by adjusting to the stress. trying to fight off the bear. vitals typically shoot up

exhaustion (GAS)

the body depletes its resources. rest permits enhanced adaptation. no rest=overtraining, injury, and lack of adaptation. think the signs of impending death. all vitals typically decline

anxiety

the most common mechanism of stress

coping

effort to manage psychological stress (defense mechanisms)

psychological homeostasis

mind-body interaction, anxiety

ego-defense mechanisms

protection from anxiety and stress. anger. denial. regression(bedwetting and pacifiers). displacement (employee who is angry when a coworker kicks a chair)

types of stress

acute, chronic, PTSD

what should you do to provide PTSD relief

promote relaxation techniques. long term

types of crisis

developmental(coming of age, dealing with dying friends and family), situational(marriage and divorce), adventitious (something beyond your control)

spirituality

awareness of inner self and connection to a higher being, to nature, or to some purpose greater than oneself

spiritual assessment

begins with the nurse, through reflection of own spiritual beliefs and practices

when someone doesn’t check the box saying they are religious

don’t assume they are not a religious person. you can be spiritual and not religious.

atheist

no belief in God

agnostic

believes there is no known ultimate reality

self-transcendence

connects to inner self

transendence

believes that a force outside of and greater person exists beyond the material world

religious

helping maintain faithfulness to their belief system and worship practices

the main thing you can do as a nurse when it comes to religion

respect their beliefs. do not try to change them.

hope

the ingredient in life responsible for a positive outlook even in lifes weakest moments.

spiritual

helping identify meaning and purpose in life, look beyond the present and maintain personal relationships

factors influencing spirituality

acute, chronic illness, terminal illness (uncertainty), near-death experience

nurses who are comfortable with their own spirituality

are more comfortable when caring for patients spiritual needs

aspects of stress and coping

stress, stressor, coping, adaptation, homeostasis

stress

state of worry caused by a difficult situation

stressor

how you perceive that difficult situation

adaptation

the change in response to stress

coping

how you deal with stress

homeostasis

internal and external balance

physiological homeostasis

local adaptation syndrome (LAS), general adaptation syndrome (GAS)

cultural sensitivity

the ability to be open to learning about and accepting of different cultural groups

multiculturalism

recognition and acknowledgement that society is pluralistic. there are many other cultures based around ethnicity, sexual, orientation, geography, religion, gender, and class

culture

values, beliefs, standards, language, thinking patterns, behavioral norms, communication styles, shared by a group of people. guides decisions and actions of a group through time.

being sensitive to language barriers

does this patient speak english?

consider literacy level?

use visual aids and demonstrate procedures.

check understanding

is an interpreter necessary?

ways to facilitate communication across cultural boundaries

recognize differences

build self-awareness

describe and identify, then interpret

don’t assume your interpretation is correct

verbalize your own non-verbal signs

share your experience honestly

acknowledge any discomfort, hesitation, or concern

practice politically correct communication

give your time and attention when communicating

don’t judge or evaluate

ethnicity

sense of identification that a cultural group collectively has; the sharing of common and unique cultural and social beliefs and behavior patterns including language and dialect, etc. theres a lot more. based on heritage.

race

identification.

stereotyping

assigning characteristics to a group of people without considering specific individuality

cultural blindness

the process of ignoring differences in people and proceeding as though the differences do not exist.

ethnocentrism

belief that one’s own ideas, beliefs, and practices are best, superior, or most preferred to those of others; using one’s cultural norms as the standard to evaluate others’ belief

3 dimensions of self-concept

self knowledge, self expectation, self-evaluation (who am i, who or what do i want to be, how well do i like myself)

which best describes a persons need to reach ones potential by pursuing a career in medicine?

self-actualization. the need to reach ones potential through full development of ones unique capability

self esteem

the need to feel good about oneself and believe others hold one in high regards

self-concept

the mental image or picture of self

self-knowledge

the composite of the facts, qualities, images, and feelings one hold about oneself

self esteem (maslow)

strength, achievement, mastery, and competence, confidence in the face of the world, independence, freedom

respect needs (maslow)

status, dominance, recognition, attention, importance, appreciation

coopersmith four bases of self esteem

significance, competence, virtue, power

t/f: the ideal self constitutes the self one wants to be

true

pride

based on positive self eval

guilt

based on behaviors incongruent with the ideal self

shame

associated with low global self-worth

formation of self-concept

infants learns physical self different from the environment

if basic needs are met, child has positive feelings of self

child internalizes other peoples attitudes toward self

child or adult internalizes standard of society

t/f: a false self might develop in individuals who have the emotional need to respond to the needs and ambitions that significant people, such as parents have for them

true

stages of development of self

self awareness (infancy)

self recognition (18 months)

self definition (3 years)

self concept (6-7 years)

t/f: people are born with self concept

false. this develops over time

factors affecting self concept

culture, internal and external resources, hx of success or failure, crisis or life stressors, aging, illness, trauma.

assessing self-concept

personal identity, body image, self-esteem, role performance

assessing self esteem

socialization, significance, competence, virtue, power

nurse asks patient “how important is it to you to believe that your work has value to others?” which aspect of self esteem is she assessing?

competence. this refers to a persons ability to perform a job or role in life

socialization and communication

refer to the quantity and quality of a persons interpersonal relationshipsv

virtue

refers to the moral-ethical principles guiding a persons life

power

refers to the control people have over their lives

nursing strats to identify personal strengths

help pt identify and use personal strengths. help at risk pt maintain sense of self. enhancing or modifying the self-concept. develop a positive body image. working with parents and educators to develop self esteem in children, teens, and older adults

what is the term for a person with a certain biologic gender who lives full-time as a member of a gender that differs from the sex and gender they were assigned at birth?

transsexual. they feel that the sex they were assigned at birth incompletely or fails to describe them.

external female genitalia

mons pubis, labias, clitoris, hymen

internal female genitalia

ovaries, fallopian tubes, uterus, vagina

causes for irregular cycles

pregnancy/breast/feeding, eating disorders, PCOS, premature ovary failure, PID, fibroids

three layers of the uterus

permetrium, myometrium, endometrium

which layer comprises tissue that thickens and sloughs off during menses

endometrium. innermost layer

perimetrium

outermost layer of the uterus and consists of elastic tissue

myometrium

muscular middle layer of the uterus

follicular stage

one follicle produces a mature ovum

proliferation phase

the endometrium becomes thick and velvety

luteal phase

the corpus luteum develops

secretory phase

the endometrial lining disintegrates

external male genitalia

testes, scrotum, penis

internal male genitalia

epididymis, vas deferens, seminal vesicles, prostate gland, cowpers glands

what male reproductive gland produces sperm and the hormones necessary for the maintenance of male sex characteristics

testes. located in the scrotum and produce sperm and hormones that maintain sex characteristics

penis

functions to eliminate urine and ejaculate semen

the scrotum

loose, bag-like structure that houses the testes

epididymis

tubules from the testes drain here, and then drain into the vas deferens and ejaculatory ducts

four phases of sexual response cycle

excitement, plateau, orgasm, resolution

in which phase of the sexual response cycle does involuntary spasmodic contractions of the genital organs occur

orgasm

forms of sexual expression

masturbation, intercourse, oral stimulation, abstinence

alternate forms of sexual expression

voyeurism, sadism, masochism, sadomasochism, pedophilia

health states affecting sexuality

pain, DM, CHF, joint disease, body image, spinal cord injuries, mental illness, medications

patients who need sexual history

seeking care for pregnancy, STI, infertility, contraception. sexual dysfunction or illness will affect sexual functioning

male sexual dysfunction

erectile dysfunction, premature ejaculation, retarded ejaculation

female sexual dysfunctions

inhibited sexual desire, dyspareunia, vaginismus, vulvodynia

level 1 sex hx

part of the comprehensive health history, obtained by a nurse

level 2 sex hx

sex history, obtained by a nurse trained in sexuality

level 3 sex hx

sexual problem hx, obtained by a sex therapist

level 4 sex hx

psychiatric/psychosocial hx, obtained by a psychiatric nurse clinician

BETTER

Bring up topic, explain that you are concerned, tell patients dysfunction can happen and you will address concerns, timing is important, educate about side effects, record your assessments

prevention of STIs

have regular checkups, learn common symptoms, avoid having sex during menstruation or doing anal or douching.

methods of contrception

behavioral, barrier, hormonal, IUD, emergency, sterilization