Nursing III Test I Inherited risk heart disease, depression, diabetes
Healthindividualized definition
Illnessdiminished functioning acute or chronic
Family2 or more who define selves as family, share
emotional bonds of closeness
Individual health effects fam & vice versa
Crisis can make a fam member assume different role
Fam stress theory how a fam will respond to types of
stress by identifying weeknesses and strenghts
All stressors demand a response
Durability intra-familial system of support/stucture
Resilency ability to cope w/ stressors and adapt
Diversity attention to uniqueness
Fam experience stress in passing from one stage to the
next
Transition involves one or more role changes
A functional family copes by communication
A dysfunctional family fights when stressors appear
Coping stratagieshelp fam to adapt to stress /change
Fam resilencedoing well in face of adversity
Denial ignore stressor to make barable
Rationalization use an excuse other than the real
reason
Selective inattentionhear what you want to hear
Isolationseparate self from reality
Intellectualization remove emotion look@logistics
Projection blame someone else
Determine level of functioninglook@ coping skills
and fam resources
Caregivers are usually most organized with
complaints of discomfort
Resources inc; faith, social support, finances, health,
family flexability, coping stratagies
Functional family communication patterns families
with strenghts, resilient, survival needs are met, traits based
on attachment and are affectionate in nature, wnt argue and
will hug and laugh even in hard times
Dysfunctional com patterns noncompliant, resistant,
unmotivated, don’t function well w/ each other or the world,
doesn’t allow change and intervention, very controlling. Will
argue over who has the right to go in
Adaptiveincreased role fallibility, joint problem
solving, passive acceptance of event, communalization,
humor and laughter, social support networks, spiritual
supports
Maladaptive denial, scapegoat, threat or withdrawal
of affection, extreme dominance and submission patterns,
family addictions, domestic violence, threaten, label,
stigmatize,
Fam as structure individual 1st fam 2nd
Fam as the client Fam 1st , individual 2nd
Fam as system fam as one unit that functions
together
Family as component of society how fam functions
w/I society
Health risksdetermine if disease will occur
Life events increase risk for illness and disability
Normative life eventmarriage, kids, etc…expected
Non-normativedivorce, taking care of parent, not
expected
Environmental risks live near factory, where you
work
Economic risk  stock market going down
Behavioral risk smoking, alcohol, sunbathing
Good role modeling increases the risk of substance
abuse in children
Genogramhealth and illness through generations (3)
Ecomap relationships and interactions with social
networks in a family
Family apgar questionaire emotional attachments to
pt., assesses satisfaction with social support from adaptation,
partnership, growth, affection, resolve
Values influence human behavior, ideal that gives
meaning to human life
Individualism and mastery over nature are dominant
American values that permeate many aspects of health care
Maral and ethical foundations ; denounce idleness and
promote hard work
Time is measured in terms of efficiency and
productivity - streamlining and mass producing nursing care
Clarification process of self exploration through
which individuals identify and rank their won personal values
in comparison to those around you., we must be consciously
aware of what our values are and why
Value = an ideal or concept that gives meaning to an
individuals life
Value system = operates as a personal code of
conduct
Attitude = is a feeling of emotion, generally
including positive or negative judgment toward people,
objects, or ideas
Beliefs = refers to special class of intellectual
attitudes based primarily on faith, as opposed to fact
Modeling display behaviors
Moralizing  copying behaviors
Laises=faire anything goes
Rewarding & punishing  time outs
Responsible choice  limit choices, discuss
consequences
Aesthetics qualities of objects, events and people
that provide satisfaction
Altruism concern for the welfare of others
Equality having the same rights, privileges or
status
Freedom capacity to exercise choice
Human dignity inherent worth and uniqueness of
an individual
Truth faithfulness to fact and reality
Justiceupholding of moral and legal principles
Morals PERSONAL standard of right and wrong
Ethics a systematic inquiry into the principles of
right and wrong conduct, of virtue and vie, and of good
an evil as they relate to conduct
Nursing Ethics a system of principles governing
the conduct of the nurse
Ethical dilemmas NO TRUE RIGHT OR
WRONG ANSWER, a puzzling moral problem, requires
a choice between 2 equally unfavorable alternatives,
weather or not u give a med when its against your better
judgement
 Ethical decision making using an orderly process
that considers ethical principles
Ethical distress knowing the right thing to do but
finding it almost impossible to execute, when the doctor
tells you you have to give the med
Ethical uncertainty feeling troubled by a situation
but not knowing if it is an ethical problem
Decision making assess, identify problem, plan,
implementation, evaluation
Do not give personal opnions
Utilitarianism - most amount of good for the
greatest amount of people, health care reform, value is
determines by its usefulness, emphasis on the outcome,
Deontology - traditional theory, it is the principle on
which an action is based that is the morally decisive such
as making and keeping a promise
Princiipalism - primary principle of bioethics,
respect for autonomy, non-malfeasance, beneficence,
distributive justice (social justice)
Communitarianism - hx, tradition and concrete
moral thinking should be the basis of moral thinking and
action 3 theries of this are…virtue ethics, caring and the
ethic of care, feminist ethics.
Virtue Ethics - goal; enable persons to flourish as
human beings
Caring and Ethic of care - 2 voices in caring the
express 2 distinct concepts of morality and the methods of
expression
Feminist Ethics - supports critical thinking and a
focus on gender, power and socioeconomic status, men
and woman are equal
Advocacy is too promote and encourage the pt to
have a voice
In pa you are not obligated to stop at an accident
Culture is a shared system of beliefs values and
behaviors and an integral component of health and illness
Race  shared biological features
Ethnicity shared culture (american)
So america would be the ethnicity and the with
different races in the ethnicity
Enculturation - process of becoming a member of a
cultural group, assimulating into a culture, can create
conflict w/I a family
Migration - people migrate from state to state as
well as across county borders
Immigrants - name given to people who cross
national borders
Cultural Diversity - individuals exposed to multiple
world views
Culture shock - feeling of panic, anger, depression,
and denial and a sense of separation from others
Assimilation - when minority groups living within a
dominant group lose the cultural characteristics that once
made them different
Prescriptive - things the individual should do to have
harmony
Restrictive - things the individual should not to do
have a positive outcome
Things that if done will have significant negative
outcomes
Linear time - straight line that can be divided into
parts with a begning and end. Western health care
providers see time as linear
Circular time - time is a never ending enitiy, space is
linked with issues of territoriality, living, work, with
health care arrangements, touch, sound and smell
Space - encompases the concepts of territoriality,
density, and distance
Territoriality - to own space
Density - the number of people within a given
environmental space
Distance - the way cultures use space to
communicate
Intimate Zone  0 - 18 inches
Personal Zone  18 inches to 3 feet
Social Zone  3 feet to 6 feet
Rite - an event that marks change in status from
lower to higher level, such as a confirmation, bar mitzvah,
baptism
Ritual - prescribed manner or process closely related
to a cultures ideology, such as high school graduation,
wedding, admission to school
Practices that interfere with a persons spiritual life can
hinder physical recovery and promote physical illness
Spiritual healing - healing energy from spiritual
sources
Traditional oriental - complete system of diagnostic
and therapuetic approaches
Naturopathic medicine - supports natural healing
capacity of the individual
Chiropractic - adjustment and manipulation of
musculoskeletal articulations to treat functional disorders
Orthomolecular - rebalance of individual
biochemistry
African americans higher risk for sickle cell disease,
htn, amy time desease process ins well advanced before
seeking medical help, have a difficulty metabolizing
immunosuppresants, betablockers, Ace inhibitors, genetic
defects results in less effective HAART (aids med), initially
seek info from family, high teen pregnancy rate, sti’s and hiv
are high, diet is high in fat, cholesterol and sodium, being
overweight is seen as positive, lactose intolerant 75% of
them. Feed babies mashed potatoes and cereal at a younger
age, parents are very involved in child raising, high incidence
of high bp, only take meds when needed. End of life
decisions are made by the family, burial survice is 5-7 days
after death, are usually baptist or Methodist, laying on of
hands, use farmers almanac
Amish - hemophelia and dwarfism are common,
Appalacian - serpent services, high risk of CAD, SIDS
Arab - high risk for epilepsy, pku, sickle cell disease,
thalasemia, difficulty metabolizing antiarrhythmics,
antidepressants, beta-blockers, neuroleptics, opiod agents,
mostly all meds that take care of the heart, head and pain,
don’t eat pork, don’t make eye contact, males make all
decisions, will prefer a caregiver of own sex and race if
possible
Asians - require lower doeses of CNS depressants, have
a lower tolerance for alcohol, and are more sensitive to
adverse effects of alchohol, lactose intolerant often, , often do
not recognize mental health illness, smoke, balanced diet is
essential for physical and emotional harmony (yin and yang),
no ice, death is part of the natural cycle of life, eat lots of
rice, veggies, #4 is unlucky, white is a symbol of death, close
family ties, Buddhism, islam, christian, faiths, life forces are
sources of strenght, traditional Chinese medicine vs. western
medicine
Jewish - higher rate of side effects with clozapine
(schizophrenia drug)
Irish - stoic when dealing with pain
Italian - older woman very vocal with pain,
Hindue - does not show any signs of pain
Greeks - family gathers pt is expected to be verbal
 Navahoe Indians - most are stoic,
Northern European americans - cigarette smoking, high
risk sexual behavior, typical diet is high in fats and
cholesterol and low in fiber (fast foods), burried or cremated
within 3 days of death, dying person should not be left alone,
many recognized religions, clergy available, health
promotion and wellness, full sidclosure of health condition to
client who then describes the info to family (England,
Ireland, france, is the dominant culture in america)
Native Americans - alcohol, adolescence suicide, eat
lots of sheep, fry bread and mutton cooked in lard, lactose
intolerant, taboo to talk with client about fatal illness, body
must go into the afterlife as whole as possible, spirituality is
based on harmony with nature, healing ceremonies restore
balance mentally, physically and spiritually, do not
understand theory of germs, pain is to be endured, Herbal
medicine is used
Latin American - smoke, alcohol, obesity is seen as
positive, the evil eye, rice breans and tortillas are staples in
diet, sweetened fruit drinks are popular, extended family
affair with death, may want candles at the bedside, autopsy is
not welcome, roaman catholic with some Indian influences,
family is considered most credible source of health care info.
Herbal medicines and teas are used frequently, hot and cold
therapies are used, will close legs during labor to keep out
cold, use lead as med which can cause brain damage