Chamberlain College of Nursing - NURSING
NR 222H+W exam 2 Study Guide
Make sure we’re not unconsciously biased

Evaluate our own values
Therapeutic communication





Purposeful use of communication
Build+ maintain helping relationships with patients, families, significant others
Purpose to our conversation
Patient-centered/ planned/ goal directed
Factors
o Trust
o Reliance on pt to carry out responsibilities + prmises
o Proxemics
 Personal space
 Intimate: 0-1.5 ft

https://browsegrades.com/documents/3002/chamberlain-college-of-nursing---nursing-nr-222hw-exam-2-study-guide

techniques
o active listening
health promotion/ sensitivity to each pt. goals + values

goals to have pt adopt health promoting behaviors
therapeutic effectiveness





self-awareness + self-reflection
ability to empathize
sensitivity
acceptance
creativity

ability to focus + confront
Emotional/ spiritual/ physical care

Listen/ silence/ touch/ convey acceptance
Health people 2020

Improve health literacy
o Health promotion requires effective communication
o Read, comprehend, + follow through on health info.
Values clarification


Method discovering 1’s values + importance of these values
Own values + biases
interventions
Steps in self-awarenesshttps://browsegrades.com/documents/3002/chamberlain-college-of-nursing--nursing-nr-222h-w-exam-2-study-guide





Listening to oneself
Self-disclosure
https://browsegrades.com/documents/3002/chamberlain-college-of-nursing---nursing-nr-222hw-exam-2-study-guide
o disclosure in another
Practical reflection
o Understand 1’s own thoughts + actions to take action in future
Need self awareness + clarifications of values
o Therapeutic use of self impaired
Relationship stages

Orientation/ introductory phase/ RN + pt meet
 Conveying concern + warmth
 Pay attention to comfort + control

Working phase
o RN + pt work together to promote pt’s health
Ethical communication



How receiver getting message
Treat people with respect
Barriers
o Sender
 RN matches nuances of pt style + behavior, pt interpret RN as
active listening increase, misinterpretations decrease
o Flexibility
o Silence
o Humor
o Touch
o space
Forms of communication



Verbal
o Using words/ spoken, written
Non-verbal
o Messages not spoken, written
https://browsegrades.com/documents/3002/chamberlain-college-of-nursing---nursing-nr-222hw-exam-2-study-guide
o
o
o
o
o
o

Facial expressions
Eye contact
Gestures
Sounds
Territoriality + personal space
Personal appearance
https://browsegrades.com/documents/3002/chamberlain-college-of-nursing---nursing-nr-222hw-exam-2-study-guide
Non-therapeutic communication
o Is it inspiring

N
o Is it necessary

K
o Is it kind
Communication techniques





Open-ended ?
o Describe the problem
o . Tell me more about that
Closed-ended ?
o Do you eat healthy food
o Do you exercise
o Do you follow a particular diet
o When do you shop for food
o Do you sleep well
o Very specific
Special needs
o Can’t speak clearly
o Are cognitively impaired
R
o Respond to pt
E
o Empower pt
Holistic health: taking care of whole person
Complementary


Using healing practices
Products that work in conjunction with traditional western medicine
Alternative

No western medicine
American holistic rn association

Support pt natural healing



Consider whole person
Consider environment
Connect pt spirit/ thoughts/ body
Rn healer

Rn presence can contribute to healing
Holistic principles for rn



Examine own thoughts about healing + rn
Be aware of effect of thoughts, voice, words
Incorporate holistic healing in own life
Holistic health




Acupuncture
Cupping
 Treats whole person
 Symptoms body’s effect to rid itself of disease
o Ayruvedic/ india
Biological based
o Herbal
 Treat of enhance body systems
o Probiotics
 Live microorganisms in gut
 + controlled breathing
 Move qi energy through energy channels + increase vital energy
o Tai chi
 Physical movement, breath control, meditation/ slow
o Yoga
 Postures, controlled breathing, medication
Meditation
o Transcendental
o Mindfulness
o Walking
o Breathing

 images
o Music therapy
 Impact limbic system/ emotions
o Hypnosis
Energy-based
o Acupuncture/ stimulate mapped points on skin
 Manipulates life energy
o Healing touch
o Reiki/ japanese
Health promotion/ holistic technique

Manipulative/ body based
o Chiropractic medicine
 Spine + joints
 Spinal alignment for optimal nervous system function
o Spinal/ bone manipulation
o Massage
o Cranio-sacral therapy/ originally osteopathy/ skull
o Physical therapy
 Massage, manipulation, hot+cold, movement, electrical impulses
Nurturing self
Environmenthttps://browsegrades.com/documents/3002/chamberlain-college-of-nursing---nursingnr-222h-w-exam-2-study-guide




Sleep
Aromatherapy
Love + healing
Accessible therapies



Relaxation
Meditation+breathing
Guided imagery
Specific



Need training for
Biofeedback
Movement
Nutrition


Previously on disease of deficiency + inadequate intake
Now with food excess + food intake imbalances
Health people 2020



Reduce chronic disease + premature death by eating healthy diet
Achieve + maintain healthy body weight/ adults + kids
o Obese kids often remain obese into adults
Food safety
Stats




2/3 adults overweight/ obese
1 in 5 kids overweight/ obese by 6 y
Adults 2x daily Na
15% adults, 10% kids eat recommended fruits, veggies per day
BMI


< 18.5 underweight
obese
Unhealthy diet/ health risks





Coronary heart disease
o Hypertension
o Blood lipid imbalances
Metabolic syndrome
Obesity
Insulin resistance/ diabetes
Cancer risk
Dietary reference intakes






Latest understanding about nutrient requirements based on optimizing health in
individuals + groups
Replaces RDA ranges
Prevent nutrition deficiency + avoid nutrition access
Estimated average requirements
o Estimate nutritional needs ½ of person in particular life stage, group
Recommended dietary allowances
o Minimum amount to stay healthy
o mean nutrient intake eaten by group
Tolerable upper intake levels
o Highest average daily intake safely eaten
Recommendations


Us dietary guidelines for americans
MyPlate
Dietary guidelines/ recommendations for prevention

Increase food variety from all food groups staying within energy intake needs
Supplements


Billion $ us market
Not regulated by FDA
o , bone health
Safety


Food-borne illness/ 1 in 6 sick
Practices
o Clean
 Wash hands, utensils, cutting boards before + after contact with raw
meat, poultry, seafood, eggs
o Separate
Disordershttps://browsegrades.com/documents/3002/chamberlain-college-of-nursing---nursing-nr222h-w-exam-2-study-guide

Risks
o
o
o
o
Poverty
Knowledge deficit
Emotion/ stress-related
Eating disorders
Diets


Ask if pt following specific diet for weight loss/ taking pills
Be aware of side effects of some diet pills
ADPIE

Assessment/ screening
o Identify risk factors associated with dietary/ nutrition problems
o Older adults disproportionate risk
Assess impact of problems/ recognize risk from factors/ interventions
D

disease

multiple medications
E
M
fitness
healthy people 2020

increase in activity increase with education level


aerobic
o use large muscle groups in repetitive rhythmic fashion over extended period to
improve body
increase leisure time physical activity
fintensity
t

time/ 20 min
t
Exercise impact




aging
o keeps balance
o keeps independent
o prevent disability/ hospitalization
cardiovascular system
o correlation between decrease in physical activity + coronary heart disease
o decrease chd, increased activity
triglyceride levels
o increase hdl, decrease chd
low back pain
o increase muscular +aerobic fitness decrease risk
o , improve strength + flexibility, decreased joint vulnerability, delay dysfunction
o reduce pain + joint stiffness, reduce fatigue, improve function
considerations




coronary heart disease
o dr consult/ specific exercise needs
diabetes
o dr consult/ special exercise needs
chronic conditions/ injury/ age
o dr consult/ special exercise needs
o determine proposed course of action
implementation
o implement interventions

evaluation
o ongoing
 focus on outcomes + goals
stress managementhttps://browsegrades.com/documents/3002/chamberlain-college-of-nursing--nursing-nr-222h-w-exam-2-study-guide


intervention
o health promotion
distress
sources


stress
o state of threatened homeostasis triggers adaptive responses
stressor
o what triggers stress
o requires change, adaption
responses




behavioral
spiritual
chronic/ more risk + more frequent infections
revert to old behaviors
assessing stress


effects
primary
o perceived actual, potential positive, negative outcome
o how pt perceived it
secondary
o pt identifies choices to cope with actual, potential harm, threat, challenge


depression
psychocutaneous disease
o psoriasis
management

what does it mean to pt
coping
o of threat
crisis intervention


specific to pt/ internal
https://browsegrades.com/documents/3002/chamberlain-college-of-nursing---nursing-nr-222hw-exam-2-study-guide
adpie

diagnosis
o ineffective coping
o anxiety
o feat
o insomnia
o spiritual distress
culture






custom
music
food
traditions
values
ethnicity
values

beliefs
o worth something to someone
melting pot


voluntary migration
 Still choosing to leave
o Sojourner
 Temporary
 Studying for school
Involuntary migration
o Fleeing, being forced out of homeland
o Natural disaster/ war
Cultural competence

Disregard personal biases + treat every person with respect
o Reduce disparities in healthcare
Race

https://browsegrades.com/documents/3002/chamberlain-college-of-nursing---nursing-nr-222hw-exam-2-study-guide

Physical/ biological characteristics
Ethnicity


Individuals who identify with common traits
Customs
Minority group



Group with disadvantages in relation to power/ control
Blacks
Women
Ethnic group


Location
Religion
Madeleine Leininger


Transcultural rn
Care/ helps with recovery, growth, development
Cultural iceberg


See + hear
Going deeper to understand culture
Asian americans/ pacific islandershttps://browsegrades.com/documents/3002/chamberlain-collegeof-nursing---nursing-nr-222h-w-exam-2-study-guide


Issues
o Heart disease
o Cancer
o Highest rate of tuberculosis
Family network/ rely on family to support sick member
Blacks


Issues
o
o
o
Issues
o
o
Hypertension
High bp
Stroke
Highest # of uninsured
Rely on natural/ folk remedies only
Native americans



issues
o Alcoholism
o Cirrhosis/ liver disease
o Smoking
o Substance abuse
Sharing resources
Peace+harmony with nature/ health
Arab americans

Issues



o Diabetes
o Smoking/ kids
o Heart disease
Males dominate
Woman care from woman only
Woman covered
https://browsegrades.com/documents/3002/chamberlain-college-of-nursing---nursing-nr-222h-wexam-2-study-guide
Homeless

Issues
o Hygiene
o Nutrition
o Poverty
HIV/AIDS


Black/ most affected
50+/ faster growing
RN role

Showing pt we care
o Actively listening
o Speaking up for pt
Rn cultural assessment

Systematic + comprehensive examination of cultural care values, beliefs, practices of
individuals, families, communities
o Taboos, myths
o Worldviews
 Ethnocentrism
 1’s own cultural belief + way of life are better than another’s
 Medio centrism

https://browsegrades.com/documents/3002/chamberlain-college-of-nursing---nursing-nr-222hw-exam-2-study-guide
Acculturation

Process of adapting to + adopting parts of a new culture
Assimilation

Process of acquiring social, psychological characteristics of dominant culture
Life points



Newborn
Postpartum period
Grief, loss
Maslow’s Hierarchy





physiological needs basic needs
safety needs basic needs
belongingness and love needs psychological needs
esteem needs physiological needs
self-actualization self-fulfillment
functional health pattern framework
 health perception - health management
 nutritional-metabolic
 Elimination
https://browsegrades.com/documents/3002/chamberlain-college-of-nursing---nursing-nr-222h-wexam-2-study-guide