Fundamentals Ch 7, 8, 9, and 10

dunn’s theory of high-level wellness

theory about achieving high-level wellness

not only a continuum of health and wellness (health axis) but also a vertical axis to represent the person’s environment

four quadrants to describe a person’s condition based on the influences of wellness or illness and a favorable or unfavorable environment

four quadrants of theory of high-level wellness

protected poor health

poor health

emergent high-level wellness

high-level wellness

protected poor health

occurs when the environment is favorable, but health is not

poor health

occurs when both health and environment are not favorable

emergent high-level wellness

occurs when the environment is not favorable, but health is favorable

high-level wellness

occurs when both environment and health are favorable

illness

causes changes in a person’s functioning, whether it be physical, mental, spiritual, or emotional

fitzpatrick’s rhythm model

health is dynamic state that results from the interaction of a person their environment

health literacy

ability of individuals to understand basic health information and to use it to make good decisions about their health

assessing is referred to as the “newest vital sign”

types of illnesses

acute

chronic

acute illness

strikes suddenly, lasts for limited time

chronic illness

6 months or longer

intensifying or improving symptoms

periods of remissions and exacerbations

phases of illness

prodromal

symptomatic

seeking help

dependency

recovery

prodromal

when people don’t feel good

symptomatic

when observable symptoms develop; make a choice in this phase; wait and see if it goes away

treat illness with OTCs and home remedies

seek advice

seeking help

people seek help from a medical practicioner

dependency

person relies on others for diagnosis and treatment

recovery

person regains independence and has regained health

risk factors

contribute to development of an illness or disease

types of risk factors

physiological

psychological

genetic elements

environmental elements

modifiable alterations

change lifestyle and nutrition

non-modifiable alterations

cannot change (hereditary, age, sex assigned at birth)

stress

identified as a nonspecific response of the body to any demand made on it

adaptation

ability to positively adjust to changes that occur in an individual’s world

how body responds to stress

alarm response

resistance response

general adaptation syndrom

exhaustion response

alarm phase

body response with flight-or-fight response

flight-or-fight response

innate protection response; brain emerges the sympathetic nervous system enabling you to hit harder, jump higher, see further, and think or run faster

resistance phase

body works hard to resist threats of stress to prevent illness

exhaustion phase

bodies cannot keep pace of dealing with stressors and fighting off illness; can last months, weeks, or years

general adaptation syndrome

describes body’s attempt to adapt to stressors we encounter

response to stress depends on several factors:

how do you view the stressor?

what is your current health status?

what are your support system?

what other factors are at play?

defense mechanisms

unconscious reactions to decrease stress

avoidance (defense mechanism)

unconsciously staying away from events or situations that might open feelings of anxiety or aggressiveness

compensation (defense mechanism)

conversion reaction (defense mechanism)

anxiety is channeled into physical symptoms

denial (defense mechanism)

unconscious refusal to see reality

displacement (defense mechanism)

transferring anger and hostility to another person or object that is perceived to be less powerful

dissociation (defense mechanism)

painful events or situations are separated or dissociated from the conscious mind

identification (defense mechanism)

a person takes on the ideas or personality traits of someone that they fear or respects

intellectualization (defense mechanism)

an individual separates self from uncomfortable emotions by focusing on facts and logic

isolation (defense mechanism)

emotion that is separated from the original feeling

minimization (defense mechanism)

not acknowledging or accepting the significance of one’s own behavior, making it seem less important

projection (defense mechanism)

blaming others

rationalization (defense mechanism)

use of a logical-sounding excuse to cover up true thoughts and feelings

reaction formation (defense mechanism)

similar to compensation, person usually develops the exact opposite trait

regression (defense mechanism)

emotionally returning to an earlier time in life when there was far less stress

repression (defense mechanism)

an unconscious “burying” or “forgetting” mechanism; excludes or withholds from our consciousness events or situations that are unbearable

restitution (defense mechanism)

making amends for a behavior one thinks is unacceptable

sublimation (defense mechanism)

unacceptable traits or characteristics are diverted deeper into acceptable traits or characteristics

coping strategies

actions people use to combat stress, it varies from person to person

ethnicity

categorization of people by a distinct trait (line of genealogy, race, or nationality)

culture

the way of life that distinguishes a particular group of people from other groups (beliefs, values, attitudes, religion, laws, morals)

transcultural nursing

care that crosses cultural boundaries or combines the elements of more than one culture

cultural diversity

the differences between groups of people in a certain geographical area, a specific place, or a conceptual community

types of transcultural care

cultural preservation and maintenance

cultural accommodation and negotiation

cultural repatterining or restructuring

cultural preservation and maintenance

professional acts or decisions that help cultures retain, preserve, or maintain beneficial care beliefs and values or face disabilities and death

cultural accommodation and negotiation

actions or decisions that facilitate adaptation to or negotiation with others to promote culturally congruent, safe, and effective carecu

cultural repatterining and restructuring

professional actions and mutual decision that help people to reorder, change, modify, or restructure their lifeways and institutions for better health-care patterns, practices, or outcomes

cultural awareness

knowledge of various cultural beliefs and values

cultural sensitivity

you provide care to the patient and show respect for and incorporate the patient’s specific cultural beliefs and values into your nursing care

cultural competence

occurs when the nurse provides care to the whole patient

influence of patient’s health

perceptions

expectations

behavior

decision-making process

beliefs about health

scientifically based beliefs, biomedical

naturalistically or holistically based beliefs

religiously based beliefs

folk hearing

scientifically based beliefs, biomedical

based on scientific research leading to best practices

naturalistically or holistically based beliefs

a healthy state is one of balance and harmony (yin yang)

religiously based beliefs

principles of these beliefs is that disease is caused by supernatural forces and health can be restored by supernatural forces

folk hearing

beliefs in practitioners of specific alternative therapies

barriers to health care

economics

education

geography

language

stereotyping

prejudice and discrimination

misunderstanding

stereotyping

a person or group is looked at by another person or group through preconceived ideas and fixed impressions

unconscious bias

an individual unconsciously stereotypes, judges, or discriminates against an individual or group of people

prejudice

attitude, determination, or judgment about a person or group based on irrational suspicion or hatred of a particular group, race, sexual orientation or identity, or religion

discrimination

action of unfair treatment of one or more persons or groups

misunderstanding

barrier that is caused by a mistake of meaning or intention

religion

formal structured system of beliefs, values, rituals, and practices of a person or group

spirituality

explains the spirit and relationship of the body, mind, and environment, including patient’s relationship to others

spiritual care

begins with an understanding of the differences between spirituality and religion, in addition into understanding of one’s own spirituality, beliefs, and values

growth

physical changes that occur in the human body

development

behavioral aspect of growth and includes walking, talking, and meeting psychological benchmarks

factors that influence growth and development

biological and hereditary

environmental

social

biological and hereditary factors

include presence of physical and mental impairments that may delay or prevent a person from completing developmental tasks or growth benchmarks

environmental factors

includes nutritional concerns and exposure to pollution and chemicals

social factors

include expectations, violence and abuse, resources and support systems, and parental influence

theories of development

physical

psychosocial

cognitive

moral

physical development

physical size and functioning of a person

examples: nutrition, genetics

psychosocial development

developed by Erik Erikson

occurs throughout our lives in distinct stages

cognitive development

refers to how we learn

developed by Jean Piaget

occurs from birth to adolescence in an orderly sequence

moral development

developed by Lawrence Kohlberg

ability to think at highest levels and develop a value system that differentiates right from wrong

erikson’s stages of psychosocial development

intimacy vs. isolation

generatively vs. stagnation

integrity vs. despair

intimacy vs. isolation

ages 18 to 40

develop intimate relationships and choose a career

generatively vs. stagnation

ages 40 to 65

become a productive member of society and establish a family

integrity vs. despair

ages 65+

accept worth, uniqueness, and death

piaget’s four stages of cognitive development

1. sensorimotor

2. pre-operational

3. concrete operational

4. formal operational

sensorimotor

brith to 2 years

concept of cause and effect develops

pre-operational

2 to 7 years

relates objects and events to self

concrete operational

7 to 11 years

concrete problem solving and inductive reasoning develop

formal operational

11 years and older

develops ability to analytically solve problems and engage in abstract reasoning

spiritual development

developed by James Fowler

defines faith as a universal concern that is a process of developing trust

development of young adults (physical)

• body systems are fully developed

• optimal physical health

• childbearing age

• increased cholestrol

development of young adults (psychosocial)

• establishing intimacy vs. feelings of isolation

• engage in productive work

• assume new roles as a spouse or partner or parents

development of young adults (cognitive)

• become less egocentric

• able to reason and realistically problem-solve