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NR 222 Class Notes, ATI, Exams with Answers and Discussions (Well explained)
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NR 222 Unit One Outline – Nursing and Health Promotion
NR222 Unit One Outline – Nursing and Health Promotion NR 222 Unit One Outline – Nursing and Health Promotion Nursing and Health Promotion NR 222 NR... [Show More] 222 [Show Less]
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NR 222 Unit 7(Skipped Food, Nutrition, and Poverty Part and parts in Nutritional Risk Factors )
NR 222 Unit 7(Skipped Food, Nutrition, and Poverty Part and parts in Nutritional Risk Factors and last few sections) NR 222 Unit 7 Skipped Food, Nutritio... [Show More] n, and Poverty Part and parts in Nutritional Risk Factors and last few sections Nutrition Poverty [Show Less]
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NR 222 Unit 6 Health and Wellness Notes
NR 222 Unit 6 Health and Wellness Notes NR222 Unit 6 Health and Wellness Notes Health and Wellness Notes 1. Overview of growth and development 2. Growt... [Show More] h a. Quantifiable change in structure b. In the body, this change means an increase in the number and/or size of the cells, resulting in an increase in the size and weight of the whole, or any of its parts c. During childhood, physical changes in height, weight, and head circumference, or growth parameters, are measured and charted regularly d. also refers to the increases (and as we age, decreases) in the size of specific organs and systems e. genetic factors, prenatal and postnatal exposures, nutrition, environmental factors, emotional health as well as traditional cultural practices that influence childrearing, lifestyle, and health care practices influence growth 3. Growth patterns a. Growth is not steady throughout life b. The periods of extremely rapid growth (prenatal, infancy, and adolescence) are contrasted with slower rates of growth (toddler, preschool,and school-age periods) c. Different parts of the body increase in size at different rates d. during early life the head is the fastest growing section (1/4 of length vs 1/9 in adults), followed by the trunk, and then the arms and legs 4. Growth charts a. Accurate growth assessment depends on precise measurement of growth parameters using proper equipment, correct and consistent techniques, careful plotting of measurements, and thoughtful interpretation of the data b. Use 2006 WHO growth charts for 0-24months c. Use 2000 CDC growth charts for 2-20 years d. growth charts describe weight-for-age, length (or stature)-for-age, weight-for-length, and BMI-for-age, and include the 5th and 95th and the 3rd and 97th percentiles e. a single measurement taken at one point in time, although helpful in providing a baseline, does not allow for the best assessment of a child’s growth f. instead, Serial measurements, plotted on a growth chart over time, best reflect a child’s pattern of growth g. Slowed growth, plateaus, or decreases in height, weight, and head circumference, as well as rapid increases, raise questions for health care providers about the adequacy of a child’s nutritional intake, syndromes or disease states, neglect, or emotional problems 5. Concept of development a. Development refers to gradual change and expansion of ability and advance in skill from a lower to a more-advanced complexity b. is a qualitative change, so is more challenging to describe because can’t use units 6. Developmental patterns a. one stage of development building on and leading to the next i. early developmental pattern: 1. Cephalocaudal- head to toe (Infants gain neck and head control before controlling the movements of the extremities) 2. Proximodistal- midline to periphery (Infants’ central nervous systems develop before peripheral nervous systems) 3. Differentiation- follows a pattern simple to complex, and general to specific (Infants use a whole-hand grasp before learning the finer control of the pincer grasp, and they coo or babble before they speak) b. Although the sequence of development is predictable, the exact timing of the sequencing is individual because individuals develop at their own rate, on their own schedule c. Denver Developmental Screening Test is a screening tool that assists health care providers in monitoring children’s development in each of these areas from birth to 6 years of age d. Social expectations can influence when developmental tasks are learned, but cultural expectations can determine which developmental tasks are learned e. Learning is the process of gaining specific knowledge or skills that result from exposure, experience, education, and evaluation f. Maturation is an increase in competence and adaptability that reflects changes in the complexity of a structure that makes it possible for that structure to begin to function or to function at a higher level g. Learning cannot occur unless the individual is mature enough to understand and control behavior (toilet training can’t be learned until sphincters have matured) 7. Theories of Development a. Psychosocial Development Theory (Erik Erikson) i. development of identity of the self through successive stages that unfold throughout the life span ii. based on the need of each person to develop a sense of trust in self and others and a sense of personal worth AGE GROUP PSYCHOSOCIAL STAGE LASTING OUTCOMES 1. Infancy Basic trust versus basic mistrust Faith and hope 2. Toddler stage Autonomy versus shame and doubt Self-control and willpower 3. Preschool stage Initiative versus guilt Direction and purpose 4. School age Industry versus inferiority Method and competence 5. Adolescence Identity versus role confusion Devotion and fidelity 6. Young adulthood Intimacy versus isolation Affiliation and love 7. Middle adulthood Generativity versus stagnation Production and care 8. Older adulthood Ego integrity versus despair Renunciation and wisdom iii. based on critical stages, each requiring resolution of a conflict between two opposing forces iv. Each stage depends on the preceding stage, which must be accomplished successfully for the person to proceed v. acknowledges the influence of other people and the environment but maintains that it is ultimately the individual who must master each of the conflicts b. Cognitive Development Theory (Jean Piaget) i. viewed children as biological organisms interacting with their environment, and his theory contends that cognitive development reflects children’s attempts to make sense of their worlds ii. major criticism of his work is that he underestimated children’s capabilities and gave little or no consideration for cultural differences iii. concerned primarily with structure rather than content, with how the mind works rather than with what it does iv. Each person is striving to maintain a balance, or equilibrium, between assimilation and accommodation v. Through a natural unfolding of ability, the child acquires sequentially predictable cognitive abilities; given adequate environmental stimuli and an intact neurological system, the child gradually matures toward full ability to conceptualize vi. believed that development preceded learning STAGE AGE CHARACTERISTICS Sensorimotor Birth to 2 years Begins with a predominance and reliance on reflexes that permit the body to learn Reflexes decrease and voluntary acts develop Imitation predominates Thought is dominated by physical manipulation of objects and events Develops the concept of object permanence and the ability to form mental representations Preoperational 2 to 7 years Advancing use of language and movement Development of egocentric, animistic, and magical thinking Uses representational thought to interpret and learn, not in terms of general properties, but in terms of the relationship or use to them No cause-and-effect reasoning Thought is dominated by the senses—what is seen, heard, or experienced Concrete operations 7 to 11 years Mental reasoning processes assume logical approaches to solving concrete problems, including cause and effect Collecting; mastering facts Can consider other points of view Thought influenced by social contacts Language is perfected Formal operations 11 to 15 years True logical thought and manipulation of abstract concepts emerge Morality established c. Cognitive Development Theory (Vygotsky) i. proposed that learning precedes development ii. while learning may be similar among children at certain times or phases of development, it is not identical in all children because of their differing social and cultural experiences iii. There are no predetermined levels of development; rather, experience is in the front, leading and expanding development in unlimited ways iv. zone of proximal development is the distance between the actual and potential developmental level, where children are pulled toward new learning through their interaction with others and the environment v. all people need to understand not only the way in which an individual learns and develops but also the social, cultural, and political context in which that learning and development takes place d. Moral Development Theory (Lawrence Kohlberg) i. Based on interviews that focused on hypothetical moral dilemmas (Should a man steal an expensive drug that would save his dying wife?) ii. three stages of moral development (preconventional, conventional, and postconventional) are based on Piaget’s theory of cognitive development and emphasize ethics of justice iii. progression generally takes place during the school-age, adolescent, and young-adult years A. GROWTH AND DEVELOPMENT: Kohlberg’s Stages of Moral Development STAGE GOAL Preconventional Avoiding punishment Gaining reward Conventional Gaining approval Avoiding disapproval Postconventional Agreeing upon rights Establishing personal moral standards Achieving justice e. Moral Development Theory (Carol Gilligan) i. suggests that there is a different process of moral development in women in society ii. women often scored lower in Kohlberg’s subsequent investigations (women were not inferior in their moral development, just different) iii. concluded that the transitions between stages are based on changes in one’s sense of self rather than on changes in cognitive development iv. reported that women think more in terms of caring and relationships than men do, who are more inclined to think in terms of rules and justice B. GROWTH AND DEVELOPMENT: Gilligan’s Stages of Moral Development (for Women) STAGE CHARACTERISTICS GOAL Preconventional What is practical to others and best for self, realizing connection to others Individual survival Conventional Sacrifices wants and needs to fulfill others’ wants and needs Self-sacrifice is goodness Postconventional Moral equal of self and others Principle of nonviolence, do not hurt self or others Edelman: Ch 21 (515-532) 1. Adolescent a. defined as beginning with the onset of puberty, around age 11 to 13 years (many use 10-24 years) b. refers to the psychosocial, emotional, cognitive, and moral transition from childhood to young adulthood c. puberty refers to the development and maturation of the reproductive, endocrine, and structural processes that lead to fertility 2. Biology and Genetics a. experience accelerated growth that dramatically alters their body size and proportions b. most noticeable changes in adolescence involve physical and sexual growth, including the appearance of secondary sexual characteristics c. physical changes are mediated primarily by the hormonal regulatory systems in the hypothalamus (releases gonadotropin-releasing hormone (GnRF), which stimulates the anterior pituitary), pituitary gland (release the gonadotropin hormones luteinizing hormone (LH) and follicle-stimulating hormone (FSH) for ovarian development and estrogen production in females and LH results in testicular enlargement and the development of Leydig cells in the testes to produce testosterone and FSH stimulates the development of the seminiferous tubules of the testes, leading to spermatogenesis), gonads (produce estrogen and testosterone and sperm and egg), and adrenal glands (releases adrenal androgens to stimulate axillary and pubic hair growth) d. Estrogen (for women) produces all secondary sexual characteristics except axillary and pubic hair e. Menarche (the onset of menses in females) usually occurs late in puberty as the growth spurt is subsiding f. Adolescents who do not follow the normal sequence or who have not begun pubertal development by age 14 years, for males, and age 13 years, for females, should have an endocrine evaluation g. Before growth spurt, increase in fat, and then decrease after h. Heart grows in size and strength i. Respiratory rate decreases through childhood (for males: Respiratory volume and vital capacity increase, and larynx and vocal cords grow, producing the characteristic voice changes of puberty) j. Both the sweat and sebaceous glands become more active (sebaceous glands on the face, neck, shoulders, upper back, chest, and genitals can become clogged and inflamed, leading to acne) k. Acne i. sebaceous glands increase production of sebum, a primary factor in the pathogenesis of acne ii. Intervention should include teaching the individual about the pathophysiological nature of acne iii. Washing with soap and water two or three times a day is the best way to remove dirt and oil; Vigorous scrubbing should be discouraged, because the skin can become irritated, leading to follicular rupture; should not attempt to remove the pustules and papules that form; Squeezing the lesion can result in further irritation of the gland and permanent injury to the tissue; benzoyl peroxide cause drying and peeling; make ups with a fat base prevent adequate exposure to air and light; stress can make worse; dietary restrictions are unnecessary l. Scoliosis i. common skeletal deformity found in adolescents is a lateral S-shaped curvature of the spine ii. Classifications: secondary or functional, congenital, neuromuscular, constitutional, and idiopathic, which has an infantile, juvenile, or adolescent onset iii. curves greater than 15 degrees are abnormal and can progress to significant curvature during the growth spurt iv. Idiopathic scoliosis is most common and is more prevalent in females v. can result in disfigurement, impaired mobility, and cardiopulmonary complications vi. bracing and surgical correction may be necessary and early referral to an orthopedic surgeon is important m. Gender i. Primary sexual characteristics involve the organs necessary for reproduction, such as the penis and testes in boys and the vagina and uterus in girls ii. Secondary sexual characteristics are external features that are not essential for reproduction (breast development, facial and pubic hair growth, and lowering of the voice) iii. Sexual maturity rating (Tanner staging) is used widely to assess and monitor the degree of maturation of an adolescent’s primary and secondary sexual characteristics iv. The first sign of puberty in males is a thinning of the scrotal sac and enlargement of the testicles v. Ejaculation is considered a milestone of male puberty and precedes fertility by several months vi. For females the first sign of puberty is the appearance of breast buds, followed by the growth spurt vii. Menarche occurs approximately 2 years after the appearance of the breast buds and near the end of the growth spurt n. Genetics i. genetic disorders frequently are discovered during the assessment of an adolescent with delayed or irregular pubertal development (family history helps) ii. Turner syndrome (XO) 1. female disorder in which only one X chromosome is present instead of two 2. short stature, a webbed neck, a low posterior hairline, low-set ears, a shield-shaped chest with widely spaced nipples, and gonadal-ovarian dysgenesis, resulting in a lack of sexual development and menses during puberty 3. administration of growth hormone, to increase height, and estrogen therapy to help develop secondary sexual characteristics and menses 4. Always sterile iii. Klinefelter syndrome (XXY) 1. Males have an extra X chromosome 2. typically are tall, initially thin, and do not develop secondary sexual characteristics 3. often have gynecomastia 4. associated with learning or behavior problems during childhood 5. management typically involves androgen therapy and counseling 6. always sterile 7. need ongoing assessment and support to promote development of positive self-esteem 3. Gordon’s functional health patterns a. Health perception- health management pattern i. have fewer acute illnesses than do younger children and fewer chronic illnesses than adults ii. sense of invincibility with experimentation and risk-taking behaviors to produce deleterious health care choices and outcomes iii. in the process of developing health habits and patterns of problem-solving that are likely to last a lifetime iv. cognitive and psychological changes that they experience can affect their adherence to health-promotion and disease-prevention strategies v. treat them as joint partners in planning the care vi. include respect for individual differences, support for the adolescent’s emerging autonomy, a developmental approach, and a focus on the individual’s strengths b. Nutritional-Metabolic Pattern i. may choose dietary intake as a mechanism to gain control over their changing bodies, exert independence, or experiment with a new identity or cause, such as becoming a vegetarian ii. Gymnasts, runners, body builders, rowers, wrestlers, dancers, and swimmers are particularly vulnerable to eating disorders because their sports necessitate weight restriction iii. overwhelming desire to “fit in” with their peers, which often prevails and can lead to unhealthy dietary practices iv. eating disorders 1. anorexia nervosa a. typically female, perfectionists, and high achievers with families that tend to be achievement oriented and experiencing marital discord b. Symptoms include a relentless pursuit of thinness, self-starving with significant weight loss, lack of menstruation (in females) and decreased sexual interests (in males), compulsive physical activity, preoccupation with food, portioning food carefully, eating only small amounts of only certain foods, a distorted body image brittle hair and nails, dry yellowish skin, growth of fine hair over the body, constipation, mild anemia and muscle weakness, and often complains of feeling cold c. response to low self-esteem and real or imagined obesity 2. bulimia nervosa a. affects females more than males b. typically binge on huge quantities of high-caloric foods and then purge by self-induced vomiting and/or laxatives c. Binge episodes may alternate with diets, resulting in dramatic weight fluctuations d. Results in dehydration, sometimes fatal electrolyte imbalances, and erosion of teeth enamel 3. Binge eating disorder (compulsive overeating) a. frequently consumes large amounts of food while feeling a lack of control over eating, but don’t purge 4. Obesity a. consumes too many calories for the amount of energy expended b. strong correlation between inactivity c. depression as one of the strongest predictors d. increases the risk of and occurrence of type 2 diabetes mellitus e. Diabetes is a group of diseases marked by high levels of glucose in the blood, which left unattended lead to blindness, kidney failure, amputations, heart disease, and stroke c. Elimination pattern i. renal and gastrointestinal systems are functionally mature by adolescence, and elimination patterns are consistent with those found in adults ii. Abnormal variation can occur in teens with eating disorders d. Activity-Exercise Pattern i. alterations in body composition and growth of lean muscle mass allow the teen to experience increased physical strength and endurance ii. Frequent injuries, stress fractures, secondary amenorrhea, extreme dietary measures to gain or lose weight, exclusion of other activities, deteriorating school work, and chronic pain are a few of the signs of overuse, overexertion, or overinvestment e. Sleep-Rest Pattern i. amount of time needed each night for sleep declines in comparison to earlier childhood needs ii. need at least 8 hours of sleep per night iii. Too little sleep also might contribute to mood swings and behavioral problems f. Cognitive-perceptual pattern i. Piaget’s Theory of Cognitive Development 1. Formal operations 2. used the term formal to represent the emergence of ability to focus on the “form” of thoughts, objects, and experiences rather than on the exact content, which in turn lays the groundwork for abstract thinking 3. because of their new ability to “think about their thinking,” adolescents become highly introspective 4. As introspection increases, they develop an internalized audience that provides them with a means to evaluate questions such as “Who am I?” “How do others see me?” and “Where am I going?” 5. Introspection also combines with a reemergence of egocentrism, leading to their sense of being the primary focus 6. Being exceptional to the adolescent means being the exception, giving rise to the risk-taking behaviors for which they are well-known 7. intolerance of things as they are (able to conceptualize things as they might or could be, rather than how they are, and can think of elaborate means for achieving these changes) 8. constantly challenge the ways things are and challenge themselves [Show Less]
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NR 222 Unit 3 Exam 1 Questions
NR 222 Unit 3 Exam 1 Questions NR222 Unit 3 Exam 1 Questions NR 222 1. Question: A nurse prepares the budget and policies for an intensive care unit. Wh... [Show More] ich role is the nurse implementing? 2. Question : A patient is scheduled for surgery. When getting ready to obtain the informed consent, the patient tells the nurse, “I have no idea what is going to happen. I couldn’t ask any questions.” The nurse does not allow the patient to sign the permit and notifies the health care provider of the situation. Which role is the nurse displaying? 3. Question : A nurse attends a workshop on current nursing issues provided by the American Nurses Association. Which type of education did the nurse receive? 4. Question : A nurse is using the Healthy People 2020 to establish goals for the community. Which goal is priority? 5. Question : A nurse is providing screening at a health fair. Which finding indicates a person may be more likely to develop health problems? 6. Question : A nurse is using the holistic approach to care. Which goal is the priority? 7. Question : A nurse is teaching a patient about the use of biofeedback. Which goal should the nurse add to the care plan? 8. Question : Which patient will cause the nurse to question an order for acupuncture? 9. Question : The nurse questions a health care provider’s decision to not tell the patient about a cancer diagnosis. Which ethical principle is the nurse trying to uphold for the patient? 10. Question : The nurse has become aware of missing narcotics in the patient care area. Which ethical principle obligates the nurse to report the missing medications? 11. Question : A state of physical, mental, spiritual, and social functioning that realizes a person’s potential and is experienced within a developmental context is known as: 12. Question : Which of the following represents a method of primary prevention? 13. Question : A nurse is planning to deliver an educational program to individuals with diabetes. Which of the following should be the initial action taken by the nurse to ensure the success of the program? 14. Question : Which nurse is at risk of making a medical error? 15. Question : Which person is at highest risk for being uninsured? 16. Question : Patient care emphasis on wellness, rather than illness, begins as a result of: 17. Question : The nurse caring for a patient in the acute care setting assumes responsibility for a patient’s care. What is this legally binding situation? 18. Question : What are the universal guidelines that define appropriate measures for all nursing interventions? 19. Question : A nurse fails to irrigate a feeding tube as ordered, resulting in harm to the patient. This nurse could be found guilty of: 20. Question : Acupuncture is a complementary therapy that uses fine needles placed in acupoints. What is the believed purpose of these acupoints? 21. Question : A nurse examines whether patient interventions have been appropriate and expected outcomes have been met. The nurse is demonstrating which step in the nursing process? 22. Question : The patient’s son requests to view documentation in the medical record. What is the nurse’s best response to this request? 23. Question : Which of the following represents a method of secondary prevention? 24. Question : When professionals work together to solve ethical dilemmas, nurses must examine their own values. What is the best rationale for this step? 25. Question : A patient is admitted to a rehabilitation facility following a stroke. The patient has right-sided paralysis and is unable to speak. The patient will be receiving physical therapy and speech therapy. Which level of preventive care is the patient receiving? 26. Question : The nurse is caring for a patient who has been trying to quit smoking. The patient has been smoke free for 2 weeks but had two cigarettes last night and at least two this morning. What should the nurse anticipate? 27. Question : The nurse is working in a drug rehabilitation clinic and is in the process of admitting a patient for “detox.” What should the nurse do next? 28. Question : A female patient has been overweight for most of her life. She has tried dieting in the past and has lost weight, only to regain it when she stopped dieting. The patient is visiting the weight loss clinic/health club because she has decided to do it. She states that she will join right after the holidays, in 3 months. Which stage is the patient displaying? 29. Question : Upon completion of the assessment, the nurse finds that the patient has quit drinking and has been alcohol free for the past 2 years. Which stage best describes the nurse’s assessment finding? 30. Question : If a nurse decides to withold a medication because it might further lower the patient's blood pressure, the nurse will be practicing the principle of : 31. Question : A nurse is caring for a client who is from a different culture than himself. When beginning the cultural assessment. which of the following acitons should the nurse take first. 32. Question : A nurse is assessing the family unit to determine the family’s ability to adapt to the change of a member having surgery. Which area is the nurse monitoring? 33. Question: A nurse reviews the current trends affecting the family. Which trend will the nurse find? 34. Question: A nurse is using the family as context approach to provide care to a patient. What should the nurse do next? 35. Question: A nurse is caring for an immigrant with low income. Which information should the nurse consider when planning care for this patient? 36. Question : A nurse is assessing the health care disparities among population groups. Which area is the nurse monitoring? 37. Question: The nurse is caring for a patient of Hispanic descent who speaks no English. The nurse is working with an interpreter. Which action should the nurse take? 38. Question: A nurse is assessing a patient’s ethnohistory. Which question should the nurse ask? 39. Question : A nurse is using a guide that provides principles of right and wrong to provide care to patients. Which guide is the nurse using? 40. Question : A nurse is teaching about the goals of Healthy People 2020. Which information should the nurse include in the teaching session? 41. Question : A nurse is using Maslow’s hierarchy to prioritize care for an anxious patient that is not eating and will not see family members. Which area should the nurse address first? 42. Question : A nurse is teaching about the transtheoretical model of change. In which order will the nurse place the progression of the stages from beginning to end? 43. Question : A nurse is using the problem-oriented approach to data collection. Which action will the nurse take first? 44. Question : The nurse is gathering data on a patient. Which data will the nurse report as objective data? 45. Question : A patient expresses fear of going home and being alone. Vital signs are stable and the incision is nearly completely healed. What can the nurse infer from the subjective data? 46. Question : A nurse has already set the agenda during a patient-centered interview. What will the nurse do next? 47. Question : A nurse is conducting a nursing health history. Which component will the nurse address? 48. Question : The nurse is interviewing a patient with a hearing deficit. Which area should the nurse use to conduct this interview? 49. Question : Which nurse most likely kept records on sanitation techniques and the effects on health? 50. Question: A patient asks the nurse for a nonmedical approach for excessive worry and work stress. Which therapy should the nurse recommend? [Show Less]
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NR 222 ATI Nurses Touch Stress Causes Effects and Management Dictation Notes
NR 222 ATI Nurses Touch Stress Causes Effects and Management Dictation Notes NR222 ATI Nurses Touch Stress Causes Effects and Management Dictation Notes ... [Show More] Touch Stress Causes Effects and Management Dictation Notes Nurse’s Touch: Wellness and Self-Care Module: Stress, Effects, and Management Introduction Stress causes effects and management this module teaches you about the basics of stress it defines stressed he tells the three main components of stress and explains the mind body connection when it comes to dealing with stress next this module delves into the physiological stress response In other words how your body reacts to different stressors and what effect stress has on your body overtime you'll learn about Hans Selye general adaptation syndrome along with the fighter flight response what happens to your body if you consistently live in a state of elevated stress it may have more of a lasting effect than you think this module teaches you how stress can lead to illness and disease along with signs that intervention is necessary as a nurse what types of stressors do you experience this module presents in detail some of the workplace stressors inherent in the profession and shows you how they could eventually lead to compassion or career burnout with all this talk about stress this module would not be complete without presenting some coping strategies and relaxation techniques you or your clients may use to help eliminate or manage your stress there is a lot of material ahead of you in this module so taking deep cleansing breath inhale and exhale letting your worries and stress release from your body on your exhalation OK Are you ready it's time to talk about stress The body’s Three Stage Reaction to Stress – General Adaptation Syndrome From an anonymous author comes these words of wisdom stresses like an iceberg we can see 1/8 of it above but what about what's below Hansel yay an endocrinologist and researcher identified a specific pattern of physiological adaptations in rats after repeated exposure to stress these adaptations included an increase in the production of stress hormones and an enlargement of the adrenal cortex which produces stress hormones a decrease in infection fighting white blood cells leading ulcers atrophy of the lymphatic glands and death Selye called these progressive stress related changes and he called the body's attempt to adapt to the changes that general adaptation syndrome Stages of the General Adaptation Syndrome The general adaptation syndrome has three stages alarm resistance and exhaustion in the first stage alarm you activate the fight or flight response you put several body systems primarily the nervous and endocrine systems on alert and activate them they remain in that activated state unless you deal with or remove the stressor in the second stage resistance your body tries to recover by adapting to the continued stress it produces more epinephrine or adrenaline increases blood pressure and alertness suppresses your immune system and tenses your muscles remaining in the stage can cause a higher metabolic rate in some organs and eventually you deplete your ability to resist leading to the third and final stage exhaustion during exhaustion one or more of your body's organs fails to function properly due to the increased demands overtime the result is illness or death Selye’s research led to a further understanding of the strong correlation between stress and disease and laid the groundwork for the use of relaxation techniques in an effort to reduce stress Fight or Flight Educator author and stress expert doctor George Everly stated to understand the stress response we must possess a fundamental knowledge not only of psychology but a Physiology as well well then what happens to the body during stress to find out take a closer look at the fighter flight response in 1914 Harvard physiologist Walter cannon introduced the concept of the fight or flight response in his research he noted that when presented with a stressor the body prepares itself for immediate action in one of two ways fight and defend based on an emotion of anger or aggression or run an escape based on an emotion of fear Connection Between Mind and Body in Periods of Stress The Toll of Stress Takes What is stress and how does it affect you some health experts speculate that stress is the cause of as much as 85% of all illnesses and diseases 85% as a health care professional when it makes sense for you to focus your efforts on the one thing responsible for such a huge percentage of society's health care problems The Concept of Stress There are many definitions of stress the important concept to keep in mind is that stress is the inability to cope with the threat or disruption you perceive to your physical mental emotional and spiritual well-being this triggers a series of physiological responses and adaptations the stress response is unique to each individual as its basis is that person's perception of the stressor Stress – Variations and Components Now that you know it stresses take a look at the variations in what constitutes stress there are three main components of stress environmental or physical mental and emotional Stress – The Environmental or Physical Component The environmental or physical component includes situations that become obstacles to the achievement of our goals or to having positive experiences examples of these obstacles are the death of a loved one theft unpleasant interactions with others job or school problems or major disasters such as war fires floods or other severe weather related catastrophes Stress – More About the Environmental or Physical Component Some common acute stressors of the environmental or physical component are noise hunger danger and infection some common chronic stressors are long-term relationship problems loneliness and lack of control Stress – The Mental Component The mental component of stress is your appraisal of the severity of the situation and your unique ability to cope with a potential stressor your psychological makeup is the basis for how you react what could be a significant stressor to someone else might not stress you at all The Mental Component of Stress Mr Sherwood I'm going to go over your discharge instructions now do you have all the information the rehab team left with you earlier today yes think so papers around here somewhere here there it looks like you have everything set up and you're ready to go remember all your exercises and will briefly go over the signs and symptoms of infection that you want to lookout for at home wish my son could hear all this information to know he can't fly it until tomorrow I'm afraid I'm gonna fall again the doctors in rehab team have cleared you I think you'd be happy to be going home the client is demonstrating the mental component of stress although it seems the health care team is taking care of everything for the client he's thinking about his son not being present and his fears about falling the discharge planner doesn't make it any easier with her non therapeutic communication style meeting discharge criteria is a relief from any clients but in this case it's a stressor for Mr Sherwood Stress – The Emotional Component Finally the emotional component of stress consists of the actual emotions or feelings that arise from your mental assessment of the stressor such as anger fear anxiety or depression The Emotional Component of Stress Hey Julie guess what it's across all day yesterday and most of last night but I stayed up late and I finished the holiday scheduling you are going to be so happy you have Christmas off this year what why I know you didn't request it but I'm sure you'd want to spend the time with you next time don't assume you know I work every holiday you should ask me first Julie is demonstrating the mental and emotional components of stress the emotion that arises from her assessment is anchor which she directs tord Courtney Courtney doesn't know that Julie does not like to be alone on the Holidays and that her family lives far away and usually can't be with her to avoid disappointment Julie chooses to work because it's less stressful for her than being alone The Severity of the Situation As you can see although a stressor may originate from the environment it's truly your mind that interprets the severity of the situation it's from that point that you decide how to deal with the stress are based on your perception your experience and the resources you have available for protection Stress – The Physiological Response Now that you know an environmental situation can in the shape stress it's time to learn how the mind interprets the stress that elicits emotions where does the body come in can the mind's interpretation of a situation actually cause a physiological response in the body what do you think The Physiological Response to Stress Better get started passing out medications what's that noise who's that yelling call you can you come and help me out here something's wrong all right guys got another 5 yards Wisconsin just store the nurse is interpreted the sound coming from the client's room as he possible threat or danger be stressful situation for sure both nurses experienced physiological changes due to the anticipated stress as indicated by colleen's racing heart and Claudia sweaty palms calling use her available resources namely Claudia for added protection from the proceeds stressor Processing the Stress Response As you probably guessed the answer to the earlier question is yes the minds interpretation of a situation can cause a physiological response in the body you will learn about the response in the body in detail shortly when your mind stresses your heart rate can increase and your palms may sweat this is because you must first process the stress response at the mental level before it can continue on the pathway toward a physiological response on the other hand you can also use your mind to calm down your body or even to help you recover from illness Your Mind, Your Body There is now actual proof that your mind is your body and your body is your mind biofeedback hypnosis image visualization guided imagery autogenic training meditation and progressive muscle relaxation all provide evidence of the very real connection between the mind and body now it's time to briefly introduce these modalities Biofeedback Biofeedback is a technique that uses an electronic monitoring device to amplify the electrochemical energy the bodies organs produce that feedback facilitates learned self-control of physiological responses biofeedback demonstrates success in treating more than 150 medical problems including headaches asthma high blood pressure and back pain Hypnosis Hypnotism was originally called mesmerism after Viennese physician Franz Anton mesmer who introduced the technique in the late 18th century the method has changed throughout the years however the result is the same hypnosis accesses the unconscious mind through relaxation this creates a state of increased suggest ability that directly affects the biochemical mechanisms responsible for healing hypnosis has been successful in treating wars asthma seasonal rhinitis that's hay fever and other allergies along with modifying behaviors such as smoking and overeating Image Visualization Image visualization is the use of mental images to change behavior or promote healing and relaxation by using this technique you can actually reprogram a negative image that elicits the stress response this can lead to changes in unhealthy behaviors such as smoking gambling or drinking alcohol image visualization can also change heart rate blood pressure body temperature and hormone production Guided Imagery Guided imagery is similar to image visualization and practicing guided imagery instructor therapist or counselor suggests the imagery to invoke a spontaneous flow of thoughts that originate from the unconscious mind image visualization is usually a conscious choice with intentional instructions and with a purpose of changing yourself in some way Autogenic Training The word autogenic means self-regulation autogenic training uses autosuggestion to reprogram the mind to override the stress response this is true control of the body through the mind by concentrating on such phrases as my heartbeat is calm and regular or my lungs breathe for me you can slow down your heart rate or relieve anxiety this technique also demonstrates success in improving the quality of life for people who have chronic conditions such as emphysema asthma or cancer click ahead to see an example of autogenic training in action Meditation Meditation is the quieting of the mind by using focused awareness to reflect on internal stimuli as opposed to external stimuli you can calm the mind from sensory overload meditation has many proven health benefits such as lower blood pressure decreased heart rate reduced pain and relief from some chronic health problems such as asthma and arthritis [Show Less]
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NR 222 Unit 2 Graded Discussion Topic 1 - Scope and Standards of Nursing Practice graded.
NR 222 Unit 2 Graded Discussion Topic 1 - Scope and Standards of Nursing Practice NR222 Unit 2 Graded Discussion Topic 1 - Scope and Standards of Nursing... [Show More] Practice NR 222 NR 222 Unit 2 Graded Discussion Topic 1 - Scope and Standards of Nursing Practice (graded, 25 points) The American Nurses Association's Nursing: Scope and Standards of Practice (3rd ed.) discusses integrating the art and science of nursing. Describe how science and art are synthesized in the practice of nursing. How is art and science synthesized in the nursing practice? Well, ideally a well-rounded nurse is one who can weigh both equally. Often, you need the art to get to the science. With regard to the professional nursing practice, a nurse should build on the art by establishing their clients trust, showing compassion, being responsive to their needs. The art of nursing is all about the qualities you enact on to your patient. Generally, the science aspect falls along the line of critical thinking; this helps to obtain the patients goal you are seeking. Its premise evolves around questions like what's wrong with your client? Why are they here? What information do you have to support your plan of care? Evolving around treating and making nurses diagnoses to the human response (ANA, 2010), the art and science of nursing both work hand in hand and is essential with patient care. For instance, I work with cancer patients, these particular clients sometimes don't have the greatest prognosis (of course sometimes great). Nonetheless, all aspects of their treatment plan is important e.g radiation/chemotherapy. A nurse takes all aspects of their care seriously, i.e. explain their plan of care in a way that they are going to understand. It is about being responsive, putting one's self in the background and focus solely on how you are going to put a plan of care into action. (Johnson,2016) further indicates the key components of information, education and support to the person with who has been diagnosed with cancer and the barriers a nurse may cross in diverse practice settings. So, incorporating the integral aspects of both the art and science in your standards of practice again are the key components to the scope and standards. American Nurses Association. (2010). Nursing's social policy statement: The essence of the profession (3rd ed.). Silver Spring, MD: Author. American Nurses Association. (2015b). Code of ethics for nurses with interpretative statements. Washington, DC: Author. Johnson, C. (2016). Celebrating the science and art of cancer nursing through inspirational leadership. Australian Journal Of Cancer Nursing, 17(1), 2-3. NR 222 Unit 2 Graded Disussion Topic 2 - Discuss where your personal values and beliefs are most or least aligned. Discuss where your personal values and beliefs are most or least aligned with the ethics of nursing as described in one of the position statements from the American Nurses Association listed below. According to (Hooten, Shipman, 2013) Society has allowed lethal injections to be one of the primary resources to execute prisoners. As most may know Lethal injections acquire medical knowledge and skill. Hence, it places ethical conflicts amongst the nursing profession with regard to our participation in the act. In many instances aside from the code of ethics of nursing it can also conflict with our personal values and beliefs. Additionally, Nurses are supposed to alleviate pain and suffering and help clients or society in general to maintain and restore optimal health, not solidify undignified death. Nurses participation in capital punishment is a contradiction to all things we stand for and by and our fundamental goals. My personal values and beliefs are most aligned with the ethics of nursing as described in “Nurses role in Capital Punishment." That is to say that I too feel nurses should not have any participation in lethal injection. Capital punishment is a tough subject to discuss. However, aside from the pros and cons one may mention on the subject, whether it be they feel they deserve Capital punishment for the crime they committed. I feel no one should play GOD. I feel in the professional nursing practice, there is an ethical code to advocate, care, and protect regardless of the circumstances. To add on, The ANA (2015b) Code of Ethics for Nurses with Interpretative Statements provides decision-making tools that are essential with regard to the professional nursing practices, to help guide nurses when they come across ethical dilemmas. ANA's position statement elaborates that capital punishment is in fact a contradiction to the ethical code that is set forth in the nursing profession. Furthermore, ethically, is taking someone's life for the crime they committed, any different from their own? From my standpoint we are simply perpetuating the same crime against the perpetrator. American Nurses Association. (2015b). Code of ethics for nurses with interpretative statements. Washington, DC: Author. Edelman, C. L., Kudzma, E. C., & Mandle C. L. (2014). Health promotion throughout the life span. (8th ed.). St. Louis, MO: Mosby. Hooten, J., & Shipman, D. (2013). Comment: The ethical dilemmas of nurses’ participation in prisoner executions. Nursing Ethics, 20(4), 491-492. NR 222 Unit 2 Content Question Discuss the steps in the teaching-learning process. Why is it important to follow all of these steps? The first step in the teaching-learning process is assessment. In this first step there are several factors to consider such as age, health beliefs, health risk, and external/internal barriers. During the assessment, the questions to ask yourself are what does the individual know about his or her illness, and if the individual is motivated enough to make a behavioral change. The next step is development of expected outcomes, in this step there are three goals to look for, and they are program goals, learning goals, and learning objectives. Program goals are long term goals that provide a sense of direction, learning goals are meant to see the changes an individual will make at the end of the program. Learning objectives are the steps that an individual will take towards meeting the learning goals. The third step is the development of a teaching plan. In this step the main idea is to figure out what effective method will be easier for the individual to comprehend the information being provided. Learning can be divided into three categories: cognitive, psychomotor, and effective. The fourth step is implementing the teaching plan whether it is in a lecture format, role-playing, or even in a practice-based setting. The last step in teaching-learning process is the evaluation of the expected outcomes. In this step the nurse will look to see what the individual has achieved with the program, and what teaching method was most effective for the individual. It is important to follow these steps in the process, without the first step, which is assessment the program would fail to start. The nurse would not know where to address the patients needs, and where to set goals for the patient. So the teaching-learning process is very unique since one step clearly leads to another. There are many ways of educating the patient, and if learning process doesn’t work an individual has many more options to choose from. Lots of valuable information can be loss, if a section were to be skipped in the learning process. Therefore when implementing valuable information to a patient, always refer back to the teaching-learning process. Reference Edelman, C. & Mandle, C. L. (2014). Health promotion throughout the life span. (8th ed.). St. Louis, MO: Mosby. Unit 2 Content Questions Student Version Directions: Content Question answers are to be posted no later than 11:59 p.m. mountain time (MT) on Wednesday to allow everyone time to utilize answers posted by all students when studying for exams. Refer to the Content Question Assignments document in the Course Announcements to find which question you have been assigned to answer. Review the grading rubric for content questions located in the Assignment link. Compose the answer to your question and post the answer in the Week 2 Content Questions Answers discussion. Your answer should be posted directly in the dialogue box on the discussion. Do not post your answer as an attachment. Your answer must be in your words and cited with a reference using APA format. Keep in mind that answers should be succinct. The typical length of an answer is one paragraph, two at the most. Focus on identifying the essential concepts for everyone in your class. Although many of the questions could be addressed as an entire term paper, that is not the focus of this assignment. 1. What is health literacy? Please provide an example. 2. Please describe the different models of health (Clinical, Role Performance, Adaptive, and Eudaimonistic) 3. Please define and provide examples of the three domains of learning. Why are these important to patient teaching? 4. What are the two major goals of Health People 2020? Why are theses important to healthcare? 5. Define and discuss the levels of prevention. Please give examples of each. 6. Define and discuss the different levels of care. Please provide an example for each. . 7. Please define and discuss the Transtheoretical model of change. Provide an example for each stage. 8. Discuss the following roles of a nurses: educator, role model, researcher, advocate, consultant, and provide an example of each. 9. Define evidence-based research and its importance to nursing. Please provide an example. 10. Please discuss cultural sensitivity and communication. Why is this important in nursing? Please provide an example? 11. Describe the health belief model and include an example of how a nurse can use this model to help someone improve his or her health choices. 12. Discuss the steps in the teaching-learning process. Why is it important to follow all of these steps? Please provide an example. See answer on a separate sheet in this folder 13. Discuss health education as a method for improving the health of individuals and communities. 14. Define and discuss the meaning of alteration in health and wellness. Please provide an example. 15. Discuss strategies for evaluation of the teaching-learning process. How do learning objectives relate to the evaluation process? 16. Describe three teaching strategies you would use to promote health education. What would be the primary domain of learning for each of the three strategies that you included? 17. Discuss and define one of Gordon’s Functional Health Patterns. Please provide an example. 18. Please explain the family as a set of relationships and please provide examples. 19. Discuss the different meanings of the term family. Please use in an example. 20. Discuss the primary purpose of social marketing in relationship to health education. 21. When the nurse is educating patients and families, what must the nurse first assess? Please discuss your rationale. 22. What are the nurse’s four central concepts when delivering care? Why are these imporatnt. Please provide an example of each. 23. Describe teaching strategies that are most effective for learning in the psychomotor domain of learning. 24. To prevent the onset of hypertension, Tom has decided to make some lifestyle changes. He eats a very healthy diet, has stopped smoking, and exercises daily. What level of prevention is Tom using? Please explain your answer and some test taking strategies you use. a. Primary b. Secondary c. Tertiary d. sub-acute 25. What are the steps in the nursing process? Apply the nursing process to a patient education situation. [Show Less]
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