Exam three study guide PDF

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Exam 3 Study Guide Chapter 3 Culture How is culture defined? is an umbrella term which encompasses the social behavior and norms found in human societies, as well as the knowledge, beliefs, arts, laws, customs, capabilities, and habits of the individuals in these  Define: race is a grouping of humans based on shared physical or social qualities into categories generally viewed as distinct by society. heritage is the legacy of cultural resources and intangible attributes of a group or society that is inherited from past generations. ethnicity the fact or state of belonging to a social group that has a common national or cultural tradition. ethnocentrism evaluation of other cultures according to preconceptions originating in the standards and customs of one's own culture. acculturation assimilation to a different culture, typically the dominant one. diversity the practice or quality of including or involving people from a range of different social and ethnic backgrounds and of different genders, sexual orientations, etc. assimilation the process in which a minority group or culture comes to resemble a society's majority group or assume the values, behaviors, and beliefs of another group whether fully or partially.  Review cultural competence and how it relates to healthcare. Describes ability of sustems to provide care to patients with diverse views, beliefs, and behaviors  How can aspects of one’s culture impact their healthcare? For example, diet, family patterns, etc.  Discuss situations when an interpreter may be needed.  What does it mean to be culturally sensitive?  Are religion and spirituality different? If so, how? Religion- organized system of beliefs as a shared experience that can assist in meeting ones individual spiritual needs Spirituality- encompasses something larger than ones own existance with belief in transcendence Something in world is bigger than you  Review manifestations of spiritual distress in patients. Seek spiritual guidance Interruption in value system or beliefs Question meaning of life or death

Feelings of anger or embarresment Feelings of emptiness Changes of mood or behavior, anger, depression, periods of crying  What should be included in a cultural assessment? Heritage, health practices & communication, nutrition & pregnancy, birth/child rearing, spirituality/ religion, death & health providers

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Chapter 11 Psychosocial What are dimensions of psychosocial health and examples of each? Mental (thinking) Social (relating) Spiritual (being) Emotional (Feeling) Give examples of internal factors that influence psychosocial health. Genetics, physical health, emotional stress What are examples of external factors? Family, culture, geography, economic status What is self-concept and how does it affect mental health? Someone with low self-esteem has negative feelings about themselves, believing that they are not worthy of love, happiness or success.

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What effects psychosocial health in teenagers? Review eating disorders and assessment findings that may be seen. Review stress and coping. Recognize unhealthy coping. Risk factors for substance abuse: Assessment tools for substance abuse Screening, brief intervention, and referral to treatment (S B I R T) make up an approach that can be used for the nursing management of substance use The three components of (S B I R T) include: o Assessment for substance use concerns by using a standardized screen. o A brief intervention by the nurse. o Referring patients who screen positive for treatment services The C A G E Substance Abuse Screening Tool The T A P S tool Single-question screenings or tests.

 What are the stages of the cycle of abuse and what occurs in each stage?

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Phase 1: Tension building Phase 2: acute /battering incident Phase 3:calm, loving (honeymoon phase) Review the 4 main categories of intimate partner violence (IPV). o Physical violence: force resulting in injury or death o Sexual violence: attempted or completed acts without permission o Stalking: repeated unwanted attention through various methods Psychological aggression: emotional abuse of an aggressive nature What type of behaviors does the abuser usually have? Victim? Abuser- Low self-esteem and a need to maintain control Common traits of perpetrator: o pathological jealousy and o limited ability to cope Possessive behavior Seeks power through intimidation/ isolation May use threats of suicide or homicide

• Victim- Women and men of all ages, races, religions, cultures, and socioeconomic groups - May be married or single - Two common characteristics in women who are abused: o low self-esteem and o willingness to accept the blame abuser’s actions - Grew up in violent/ abusive homes - Victims who are chronically exposed to violence can develop a “learned helplessness”  -

Review the assessment for IPV. Observe the patient’s general appearance, speech patterns, posture, gait, and body language General appearance: dress, personal hygiene, and grooming Speech patterns should be assessed for content, tone, pace, and volume Appropriate for the situation? Observe facial expression and affect

 Review documentation of IPV. o Provide detail o Non-biased progress notes, injury maps, and photographic evidence o Transcribe verbatim information received from individual o Physical exam Thorough documentation using forensic technology terms o Provide digital photographic documentation in the medical record  -Obtain consent o May have to separate The patient from the parent, spouse, and/or caregiver —follow protocol  Review factors that increase the risk of suicide.

Chapter 17 Breast  Review the lymph nodes relating to their purpose and the flow of drainage of lymph nodes in the breast and axilla. Central Axillary, Pectoral (anterior axillary), Subscapular (posterior axillary), Lateral  Review teaching and assessment techniques of self-breast exams compared to the breast exam performed by the nurse. - Teach woman to do this in front of a mirror while she is disrobed to waist. - At home, she can start palpation in shower, where soap and water assist palpation. - Then palpation should be performed while lying supine. - Encourage woman to palpate her own breasts while you monitor her technique. - Use of model for return demonstration as well as pamphlets may be helpful. Vertical strip pattern From nipple palpating out as if spokes on a wheel  Documenting a breast lump in relation to location, size, shape, etc. - Location: Ever noticed lump or thickening in breast? Where? - Onset: When did you first notice it? Changed at all since then? - Appearance: Does lump have any relation to your menstrual period?

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Proper assessment techniques for clinical breast examination. Subjective data related to abnormal breast findings. Pain, lump, and discharge Rash, swelling, trauma History of breast disease Surgery or radiation Medications Patient-centered care Perform breast self-examination/last mammogram

 Compare and contrast normal and abnormal breast changes, subjective data to be collected relating to breast pain. Chapter 16 Thorax and Lungs  Know the appropriate technique to perform a complete assessment of the lungs, palpation. - Palpate for symmetric chest expansion. - Assess tactile (vocal) fremitus. - Palpate anterior chest wall. - Palpation - Tactile fremitus—using hands to assess for palpable vibrations - Repetition of phrases by patient (“99” or “blue moon”) - Be aware of factors that can influence normal intensity.

 Abnormal findings and causes of decreased breath sounds and tracheal deviation. - Increased tactile fremitus - Decreased tactile fremitus

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 Compare and contrast normal and abnormal AP to transverse diameter and disease processes that could cause abnormal changes.

 Expected findings related to breath sounds with auscultation of the lungs.

Abnormal sounds

Compare and contrast the various normal and abnormal breathing patterns: Hypoventilation, hyperventilation, Cheyne-Stokes, Biot’s, Bradypnea, Tachypnea.

Chapter 24 Neurologic System  The nurse knows that cranial nerves enter and exit the brain rather than the spinal cord. What is the type and function of each cranial nerve? I. Olfactory-sensory-smell II. Optic- sensory-vision III. Ocular motor:mixed Motor- extra ocular movement, opening of eyelids Parasympathetic-pupil construction, lens shape IV. Trochlear: motor- down and inner movement of eyes V. Trigeminal- mixed Motor- muscles of mastication Sensory- sensation of face & scalp, cornea, mucus membranes mouth and nose VI. Abducens: motor- lateral movement of eyes VII. Facial: mixedMotor- facial muscles, closed eyes, labial speech, close mouth Sensory- taste of anterior 2/3 of tongue Parasympathetic- saliva and tear secretion VIII. Acoustic: sensory- hearing & equilibrium IX. Glossopharygneal: mixedMotor- pharynx (pronation and swallowing) Sensory- taste on posterior 1/3 of tongue, gag reflex Parasympathetic- paratoid gland, caratoid reflex X. Vagas: mixed-

Motor- pharynx & larynx (talking & swallowing) Sensory- general sensation from caratiod body, carotid sinus pharynx, viscera Parasympathetic- carotid reflex XI. Spinal accessory: motor- movement of trapezius & sternocleoid mastoid muscles XII. Hypoglossal-: motor-movement of tongue  Balance tests for gait dysfunction: o Tandem walk and possible causes of abnormal findings Tests for cerebellar function Walk heel-toe Abnormal: stiff and staggering, lack of arm swing ataxic & gate, hemiparesis, parkinsonian gait o Romberg test, what would indicate positive vs negative outcome? Test balance with eyes closed Positive- patient able to maintain balance for a minimum of 20 seconds w/ minimum swaying Negative- patient sways, falls, widens stance to maintain balance  Diabetic Neuropathy screening- normal vs abnormal. Test of sensory function, touch tests sharp and dull, light touch, vibration position sense Normal- patient is able to identify and feel sensations Abnormal- patient unable to identify these sensations Stereognosis- ability to recall above Graphesthesia- when a number is drawn on a hand with eyes closed and you can recall it Tophonosis- identifying part of body touched Kinesthesia- ability to sense joint movement  Normal vs. abnormal superficial (cutaneous) reflexes. Testing biceps, triceps, brachioradialis, patellar, & achilleas Normal- reflex bilaterally equal & less than 2+ Abnormal- +3 and sometimes +4 4+ hyperactive 3+brisk, above normal 1+ diminished 1 No response  Neurologic Recheck including Glasgow coma scale. 1) Mental status 2) Motor function and balance

3) Sensory exam 4) Newborn & infant reflexes 5) Tendon reflexes 6) Evaluation 12 cranial nerves 7) Coordination exam

Glasgow Coma Scale

 Define the following: 8) Dysdiadochokinesia- impaired ability to perform rapid, alternating movements 9) Dysmetria- he inability to control the distance, speed, and range of motion necessary to perform smoothly coordinated movements 10) Ataxia a lack of muscle control or coordination of voluntary movements, such as walking or picking up objects 11) Hypoesthesia numbness is a common side effect of various medical conditions which manifests as a reduced sense of touch or sensation, or a partial loss of sensitivity to sensory stimuli. In everyday speech this is generally referred to as numbness. 12) Hyperesthesia excessive physical sensitivity, especially of the skin. 13) Neuropathy disease or dysfunction of one or more peripheral nerves, typically causing numbness or weakness. 14) Stereognosis the mental perception of depth or three-dimensionality by the senses, usually in reference to the ability to perceive the form of solid objects by touch. 15) Astereognosis the inability to identify an object by active touch of the hands without other sensory input, such as visual or sensory information. 16) Graphesthesia is the ability to recognize writing on the skin purely by the sensation of touch

17) Tactile discrimination is the ability to differentiate information through the sense of touch....