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NRSG 111 FINAL
OMG. 80/20
| Question | Answer |
|---|---|
| How are STIs transmitted? | sexual contact, mother to infant in pregnancy and childbirth, sharing of needles or tissue transfers |
| What is asymptomatic? | no signs of symptoms |
| What percentage of untreated chlamydia leads to pelvic inflammatory disease? | 10% to 40% |
| What can gnorrhea cause? | spontaneous abortions and premat delivery |
| What is the chance of blindness in babies born to women with chlamydia and gonorrhoea? | 30% |
| What is a sign? | when the health care provider sees on examination |
| What is a symptom? | what the patient feels, ex. pain, irritation |
| What are syndromes? | different pathogens can cause STIs but some give rise to overlapping clinical appearances |
| What are common signs and symptoms? | urethral discharge, genital ulcers, scrotal swelling, inguinal swelling, vaginal discharge, lower ab pain, neonatal eye functions |
| What might STIs lead to? | stertility & infertility, PID, AIDs, Blindness, chronic pelvic pain, cervical cancer, CNS destruction, Ectopic pregnancy, facial disfigurement, death |
| What are some asymptotic STIs | chlamydia, HIV, gnorrhea, syphilis, genital herpes, HPV |
| How can you prevent STIs? | abstain from sex, have intercourse with longterm & mutually monogamous relationship, and condoms |
| What are methods of testing? | swab from urethra, cervix, vagina or anus; urine test; blood test; dan test; syndrom approach; tissue scraping |
| What is the syndrome approach? | looks at signs and symptoms |
| What are three different types of STIs? | bacteria (can be treated and cured), virus (can be treated) and parasites (can be treate and cured) |
| What are some common bacterial STIs? | chlamydia, gonorrhea, and syphilis |
| What is the most common bacterial STI since 1990? | Chlamydia |
| Is chlamydia asymptomatic? | Yes, symptoms may occur 2 to 6 weeks after exposure? |
| What are the female signs and symptoms of chlamydia? | vaginal discharge, painful urination, lower ab pain, vaginal bleeding after intercourse and painful discharge during intercourse |
| What are the male signs and symptoms of chlamydia? | clear, watery or milky urethral discharge, itchy urethra, testicular pain, and painful urination |
| What is the treatment for chlamydia? | antibiotics (single dose or course of a week; if PID or cimplicated infections then long course of texture; hospitalization in some cases |
| What is the second most common bacterial STI reported in Canada since 1924? | Gonorrhea |
| Is gonorrhea asymptomatic? | sort of, women are most often asymptomatic |
| What are the female signs and symptoms of gonorrhoea? | increase of vaginal discharge; lower ab pain; painful urination; pain during intercourse; rectal pain, discharge, or itching; vaginal bleeding after intercourse |
| What are the male signs and symptoms of gonorrhoea? | thick, yellowish, green discharge; painful urination; testicular pain or swelling; rectal pain, discharge, or itching. |
| What is the treatment of gonorrhoea? | antibiotics |
| What are the signs and symptoms of primary syphilis? | three days to three months after exposure a small painless lesion or sore called a chancre is developed. |
| Where does a chancre appear? | where bacteria entered body. It heals on its own but infection remains. |
| If a chancre heals on its own, what does that mean? | it means that the syphilis is entering the CNS |
| What are the signs and symptoms of secondary syphilis? | 2 to 24 weeks after exposure; feeling unwell; rash on body (usually hands and soles of feet); patchy hair loss; flat, smooth warts in genital area |
| What are the signs and symptoms of tertiary syphilis? | 1 to 10 years after primary contact may find tumor-like balls of inflammation (can appear anywhere on the body, can result in gross malformation on local anatomy) |
| What is the treatment of syphilis? | indictable penicillin, tertiary --> antibiotics can stop progression but not rid damage already done |
| What are some viral STIs? | genital herpes, Hep B, HIV, HPV |
| When do people develop symptoms of genital herpes? | not all develop symptoms, but can emerge 2 to 21 days after |
| What might occur prior to a genital herpes outbreak? | may feel tingling or burning sensations |
| What might happen during a genital herpes outbreak? | painful sores, muscular pain, inflammation and redness, tender lymph nodes and fever |
| What are possible complications that come with genital herpes? | blister recurrences; cervical vulvar, vaginal anal, penile and other; obstruction of urethra vaginal opening; depression, sexual dysfunction |
| What is a treatment for genital herpes? | antiviral medications --> acyclovier, famciclovir, valacyvlovir ---> ASAP |
| What are the signs and symptoms for Hep B? | up to 50% are asymptomatic, up to 8 weeks people experience flu like symptoms: tiredness, nausea & vomiting, decreased appetite, yellowing of eyes and skin, rash, joint pain, liver damage |
| What is the treatment for Hep B? | most recover fully withing six months with lifelong immunity, OR antiviral medications or interferon can decrease or remove chronic Hep B from blood and reduce risk of cirrhosis and liver cancer OR liver transplant |
| When do signs and symptoms usually appear for HIV? | two to four weeks after exposure may have mild flu-like symptoms but usually don't emerge until years after exposure |
| What are the signs and symptoms of HIV? | frequent fever/sweats, persistent skin rashes, joint or muscle pain, swollen glands, sore throat, fatigue/lack of energy, headaches, unexplained weight loss, nausea, vomitting, dark uring, pal stools, diarrhea |
| How can you detect HIV? | ONLY by blood tests |
| How does HIV enter your system? | blood, semen, vaginal discharge, breastmilk |
| How does HIV work? | it attacks the immune system at a low level and works up |
| What are the treatments to HIV? | no cure, anti-retroviral thearpy --> slows progression and helps immune system restore itself --> several side effects |
| What are you at risk for after aids has set in? | infections, loss of vision, candidacies (yeast infection in esophagus, lungs, bronchial, vaginal), cancers (cervical, anal, lymphoma, kaposi sarcoma), increased frequency and severoty of herpes outbreaks, chronic intestinal disturbances |
| Is there a cure for HPV? A vaccination? | No cure, but there is a vaccination |
| What are the signs and symptoms of HPV? | many do not have symptoms but can develop: ano-genital warts (on vulva, cervix, penis, scrotum, anus, urethra), itchiness, discomfort and bleeding during intercourse |
| Describe ano-genital warts | small, soft, flesh-coloured growths that are cauliflower like |
| What treatment is used on HPV? | genital warts can be treated (depending on size, #, location) --> strong acids & chemicals, topical cream, liquid nitrogen, elastic currents or laser therapy |
| What are different parasites and fungal STIs? | candidiasis, pubic live, scabies, trichomaniasis |
| What can candiadiasis cause? | vulvovagninites |
| What can candiadiasis affect? | mouth, esophagus or skin |
| What are causes of fungal overgrowth? | pregnancy, medications, weakened immune system, sexual activities, poor controlled diabetes, genital moisture |
| What are the signs and symptoms of candiadiasis in a female? | vaginal itchiness; thick white, clumpy, discharge; pain with intercourse and irratation of vulva; swollen or red vulva and vagina; burning during urination |
| What are the signs symptoms of candiadiasis in male? | men are asymptomatic, men with infection of penis may develop inflammation of head and may experience: itching, red dots, dry peeling skin, burning on urination |
| What is pubic lice? | crab-like insects that nest in pubic hair. bite and feed on blood of host and lay small eggs (nits) that attach to shaft hair |
| What are the signs and symptoms of pubic lice? | skin irritation & inflammation, itchiness & redness; small blue spots where bitten, louse feces undergarments |
| What are some considerations of public lice? | persistent scratching --> secondary bacterial infection; partners from a month prior should be treated; wash things and bag for a week |
| What are some treatments of pubic lice? | affected area washed & use lice-killing product; wash, vacuum & clean |
| What are scabies? | parasitic mites --> burrow under surface of skin and hatch eggs, larvae move to new areas and spread infection. They like warm zones |
| What are the signs and symptoms of scabies? | intense itchiness, reddish rash |
| How is scabies transmitted? | through close contact, can live for 3 days on towels, clothes and bedding |
| What is the treatment of scabies? | creams & lotions; clothes and beddings washed, household contacts and sexual partners within a month prior should be treated |
| What are signs and symptoms of trichomoniasis in women? | half of infected women show signs and symptoms, off white-yellowish green frothy vaginal discharge, sore or itchy vagina, pain during intercourse or urination |
| What are signs and symptoms of trichomoniasis in male? | asymptomatic in men, irritation or redness at urethral opening, burning during urination or ejaculation |
| What is the treatment for trichomoniasis? | medication, usually metroidazole, sexual partners should be treated |
| What does family planning allow individuals to do? | allows individuals and couples to anticipate and attain their desired number of children and the spacing and timing |
| What are three ways family planning is done? | natural family planning methods, contraceptives, treatment of fertility |
| What are the four natural family planning methods? | symptoms, calendar, withdrawal, breastfeeding |
| How does the symptoms/basal body temp method work? | Woman's BT is lowest after waking up each morning, take temp daily and chart |
| What must you keep in mind if you are following the basal body temperature method? | BBT drops slightly before ovulation and rises 24-72 hours after ovulation --> refrain from intercourse from beginning of menstrual cycle after BBT has remained elevated for 3 consecutive days |
| What must you keep in mind for the cervical mucous/billings method? | mucus during ovulation is clear, thin,and slippery |
| What might make charting difficult for the cervical/mucous/billings method? | douching, semen, spermicides, some medications, vaginal infections, and vaginal lubricants |
| What is Coitus interrupts? | withdrawal method |
| What is the failure rate of the withdrawal method? | 4-27% |
| What is another name for the calendar method? | rhythm method |
| How does the calendar method work? | Woman keeps track of her cycle for one year. The length of the shortest cycle minus 19 days is the latest day after onset of menstrual period that woman is likely fertile. |
| Is the calendar method accurate? | No, high failure rate |
| What is the Amenorrhea method? | breast feeding method |
| What does the breastfeeding method say? | it says that breastfeeding can surpass a woman's fertility in the EARLY MONTHS after delivery |
| When can the breastfeeding method be used? | can be used if the menstrual period has not returned since delievery, baby is breastfed on demand (day and night) and no other foods or liquids are given to the baby regularly and baby is less than 6 months |
| Does the breastfeeding method work? | It has a high failure rate |
| What are the benefits of NFP? | accepted by some religions, woman in tune with the body, instantly reversible, can help conceive when ready, supplies inexpensive |
| What are some contraindictions of NFP? | unwillingness to abstain, irreg menstrual cycle, temp patterns and vaginal discharge, can't keep perfect records |
| Side effects of NFP? | abstinence must be practiced, high failure rates, no protection against STIs |
| What are the different contraception methods? | condoms, transdermal patch, oral, vaginal rings, injectable, IUS, IUD, diaphragms & cervical caps, sponge & spermicide, sterilization |
| What is the difference between Latex/non-latex & polyurethane condoms? | polyurethane condoms breaks easier |
| Do male condoms prevent against herpes and HPV? | not fully |
| Are male condoms Latex/non-latex or polyurethane? What about female condoms? | ALL, only polyurethane |
| What is special about the female condom? | It has two rings, an inner one at the closed end and an outer ring that remains inside the vagina |
| Can a female and male condom be used together? | NO. More prone to breakage |
| What are oral contraceptives? | prescription tablets that are taken once a day |
| What are the different types of oral contraceptives? | combination pill & progesterone only pill |
| What is the combination pill? | contains both estrogen and progesterone |
| How do oral contraceptives work? | they stop the release of a mature egg, thicken cervical mucus making it difficult for sperm to get to the egg & change lining of the uterus so implantation is difficult |
| What is the failure rate of oral contraceptives? | 80 per 1000 |
| What are the advantages for oral contraceptives | reversible, simple & easy, regulates menstrual cycle, reduces cramps, does not interfere with intercourse, decreases acne, reduces risk of endometrial & ovarian cancer |
| What are disadvantages of oral contraceptives? | daily (P-only must be taken daily at the, same time), irreg bleed or spotting, effectiveness can be reduced by other meds, cannot be used by +35 women who smoke, may increase blood clots, no STI protection, may increase headaches, breastfeeding is no |
| What does a transdermal patch do? | releases hormones through skin |
| Where can a transdermal patch be placed? | bum, upper outer arm, lower abs, upper torso (excl. breast) |
| How do you use a transdermal patch? | new patch once a week for three weeks, followed by one week w/o patch |
| What does a transdermal patch do? | stop the release of a mature egg, thicken cervical mucus making it difficult for sperm to get to the egg & change lining of the uterus so implantation is difficult |
| What is the failure rate of oral contraceptives? | 80 per 1000 |
| What are the advantages for transdermal patches? | reversible, highly effective, once-a-wekk, simple & easy, regulates mentrual cycle, reduces cramps, does not interfere with intercourse, expected to provide benefits similar to oral contraceptive |
| Disadvantages of transdermal patch? | irregular bleeding or spotting, breast sensitivity, headache, no STI protection, may detach (less than 2%), skin irritation |
| What is a vaginal ring? | a flexible, nearly transparent ring that measures 54 mm (2 inches) across, it releases a continuous dose of hormones for 3 weeks |
| How does the vaginal ring work? | stop the release of a mature egg, thicken cervical mucus making it difficult for sperm to get to the egg & change lining of the uterus so implantation is difficult |
| What is the failure rate of the vaginal ring? | 80 per 1000 |
| What are the advantages of the vaginal ring? | reversible, highly effective, once a month, regulates menstrual, does not interfere with intercourse, expected to provide benefits |
| What are the disadvantages of the vaginal ring? | does not protect against STIS, Irreg bleeding/spotting, headache, nausea, breast tenderness, ring might come out, vaginal discomfort |
| What is the injectable contraceptive | an injection in the upper arm or bum every 12 to 13 weeks with progesterone |
| How does the injectable contraceptive work? | stop the release of a mature egg, thicken cervical mucus making it difficult for sperm to get to the egg & change lining of the uterus so implantation is difficult |
| What is the failure rate of the injectable contraceptive? | 30 per 1000 |
| What are the advantages of the injectable contraceptive? | reversible, no estrogen, effectiveness not reduced by meds, breastfeeding/smoking ok, menstrual cycle cease after 2 years, improves endometriosis, quick (5 days), reduce risk of endometrial cancer |
| What are the disadvantages of the injectable contraceptive? | initial ireg bleeding, weight gain, decrease in bone mineral density, 9 months after ovaries release again, no STI protection, lack of period might be bothersome |
| What is the Intrauterine System (IUS) | T shaped device with levonorgestrel, hormone released slowly and acts on uterus lining, inserted by physician |
| How does the IUS work? | it goes into the cervix and has hormones inside it |
| What is the failure rate of the IUS? | 1 per 1000 |
| What are the advantages of the IUS? | 5 years, not daily, no estrogen, doesn't interference w/ intercourse, regulates menstrual cycle & reduces cramps, may reduce endometriosis pain, may lower risk of development of precancerous cells in uterus lining, might stop menstrual cycle |
| What are disadvantages of the IUS? | irreg bleeding or spotting, may be expelled (6%), perforation during insertion, no STIs protection, physician must insert and remove |
| What is the Intrauterine Device (IUD)? | T-shape device with a copper wire around it, no medication, inserted by a physician |
| How does the IUD work? | causes changes in the lining of the uterus, prevents sperm from fertilizing egg, decreases activity of sperm to penetrate the cervical mucus |
| What is the failure rate of the IUD? | 8 per 1000 |
| What are the advantages of the IUD? | 5 years, no medication, may reduce endomitral cancer, doesn't interfere with intercourse, may be suitable for breastfeeding |
| What are the disadvantages of the IUD? | irreg bleeding ot spotting, perforation of uterus, may increase menstrual bleeding or cramping, may be expelled 2-10%, no STI protection |
| What are diaphragms and cervical caps? | intravaginal barriers that are used with spermicide |
| What is the diaphragm? | a latex dome with flexible steel ring around the edge |
| What is the cervical cap? | a thimble shaped silicone cap |
| How long is the diaphragm or cervical cap left in for? | 6-8 hours after intercourse |
| How do the diaphragm and cervical cap work? | when positioned properly, it blocks entry to uterus so sperm cannot enter and fertilize the egg |
| When using the diaphragm and cervical cap, what should be done in terms of spermicides? | it should be reapplied for each intercourse |
| What is the failure rate of the diaphragm and cervical cap? | 100-320 per 1000 |
| What are the advantages of the diaphragm and cervical cap? | no hormones, inexpensive/reusable, can be used by breastfeeding women |
| What are disadvantages of the diaphragm and cervical cap? | need at time of intercourse, proper insertion technique, no STI protection, spermicides = allergic reaction, diaphragm might increase chance of UTI, may become dislodged, cervical cap can't be used during menstruation & may cause vaginal odour/discharge |
| What is a spermicide? | things that disable sperm and come in several forms, creams, jellies, tablets, suppositories, foams, film |
| What is a sponge? | soft disposable, polyurethane foam device that is impregnated with spermicide |
| How does the sponge work? | fits over cervix, traps & absorbs sperm to augment effect of spermicide, spermicide in sponge disables sperms, effective for up to 12 hours |
| What is the failure rate of sponge and spermicide? | 160-320 per 1000 |
| Advantages of the sponge and spermicide? | no hormones, breastfeeding is okay, smoking is okay, spermicide is added lube |
| Disadvantages of the sponge and spermicide? | need at time of intercourse, no STI protection, spermicide allergies, proper insertion technique, spermicide must be inserted in advance, sponge = vaginal irritation or infection, left long = toxic syndrome shock |
| What are different types of female sterilization? | laparoscopy, mini-laparotomy, hysteroscopy, blocking of the fallopian tube |
| What is laparoscopy? | special instruments inserted through two tiny incisions in abdomen |
| What is mini-laparotomy? | small cut in the abdomen |
| What is hysteroscopy? | use of thin telescope inserted into uterus |
| What are ways the fallopian tube can be blocked? | clip, ring, removing a piece, cautery (electric current), hysteroscopy for insertion of tubal plugs |
| How does female sterilization work? | blocks fallopian tube so sperm & egg cannot meet |
| What is the failure rate of female sterilization? | 5 per 1000 |
| What are the advantages of female sterilization? | no routine, no interference w/ intercourse, private, no significant long term side effects |
| What are the disadvantages of female sterilization? | usually permanent, regret, pregnancy = ectopic pregnancy, no STI protection, short term surgery complications, |
| What is male sterilization? | surgical procedure to close or block the vas deferens --> sperm can't escape |
| What are two common techniques of male sterilization? | conventional vasectomy, no-scalpel vasectomy |
| What is conventional vasectomy? | one or two incisions in the scrotom to reach the vas deferens |
| What is no-scalpel vasectomy? | puncture opening in scrotum --> closed by electric current, mechanical method, removal of small segment of tube |
| What is the failure rate of male sterilization? | 1.5 per 1000 |
| What are the advantages of male sterilization? | no routine, private, no intercourse interference, simple procedure, no sig. longterm effects, less invasive, more cost-effective, males are given responsibility |
| What are the disadvantages of male sterilization? | difficult to revers, regret, short term complications, no STI protection, not effective immediately |
| What are emergency contraceptives? | back up that can be used w/in 5 days --> morning after, plan b, norlevo |
| What do emergency contraceptives do? | prevent ovulation, thickens cervical mucus, thins uterine wall |
| What are side effects of emergency contraceptives? | breast tenderness, irreg bleeding, dizziness, headaches |
| How effective is it? | 60-90% effective |
| Why is understanding normal growth and development important? | it provides a framework for age specific health assessment and promotion throughout a person's lifespan |
| What is development? | increase in complexity of function and skill progression, capacity and skill to adapt to environment |
| What factors might influence growth and development? | genetic, temperament, family, nutrition, environment, health, culture |
| What is are the 8 major components of growth and development? | biophysical, psychosocial, cognitive, behavioural, social, ecological, moral, spiritual |
| What are the 11 stages of growth and development? | neonatal, infancy, toddlerhood, preschool, school age, adolescence, young adulthood, middle adulthoor, young-old, middle-old, old-old |
| What is the biophysical theory? | development and physical changes of the body compared against established norms |
| Give an biophysical theorist | Arnold Gesell (1880 -1961) |
| What is arnold Gesell's theory directed by? | genetics, maturational process based on inborn timetable |
| What are psychosocial theories? | development of personality |
| Who are some psychosocial theorists? | Robert Havighurst (1990-1991), Sigmund Freud (1856-1939), Erik Erikson (1902-1994), Robert Peck (1919-2002), Roger Gould (B. 1935) |
| Explain Robert Havighurt's theory | learning is basic & continuous, occurs in 6 stages, faced with a development task at each stage |
| Explain Sigmund Frued's theory | introduced concepts of the unconscious mind, defence mechanisms & id, ego and super-ego |
| What is the unconscious mind? What are defense mechanisms? | mental life (unaware of it); result of conflict because of environmental/social restrictions |
| What is id? | source of intrinsic & unconscious urges (source of all pleasure) |
| What is ego? (Freud) | formed by person to make effective contact with social and physical needs --> satisfies id impulses |
| What is super-ego? (Freud) | conscience (do nots) and ego ideal (standards of perfection) |
| What is libido? (Freud) | motivation to human development |
| How many stages are in Sigmund Freud's theory? | 5: oral, anal, phalic, latency, genital |
| What is Erik Erikson's theory? | an expansion of Frued's theory that includes all lifespan |
| What is ego (Erikson)? | conscious core of personality |
| How many stages are in erikson's theory? | 8: infancy, early childhood, late childhood, school age, adolescence, young adulthood, adulthood, maturity |
| What is infancy in Erikson's theory? | trust vs mistrust |
| What is early childhood in Erikson's theory? | autonomy vs. shame & doubt |
| What is late childhood in Erikson's theory? | initiative vs. guilt |
| What is school age in Erikson's theory? | industry vs. inferiority |
| What is adolescence in Erikson's theory? | identity vs. role confusion |
| What is young adulthood in Erikson's theory? | intimacy vs. isolation |
| What is adulthood in Erikson's theory? | generatively vs. stagnation |
| What is maturity in Erikson's theory? | integrity vs. despair |
| What is Robert Peck's theory? | physical capabilities decrease but mental & social capacities increase with age |
| According to Robert Peck, what are the three developmental tasks in old age? | ego differentiation vs. work-role preoccupation, body transcendence vs. body preoccupation, ego transcendence vs. ego preoccupation |
| What is Robert Gould's theory? | transformation is central during adulthood |
| What are the seven stages of Gould's theory? | 16/18 part of family, wants freedom; 18/22 autonomy in jeopardy; 22/28 autonomy established must prove self; 28/34 marriage & career, questions life; 34/43 self reflection, questions values & life; 43 to 50 personality set, time finite; 50 to 60 mortality |
| What is temperament? | response to environment |
| Who are the temperament theorists? | Stella Chess (1914-2007) and Alexander Thomas (1914-2003) |
| What do Stella Chess and Alexander Thomas say about temperament? | goodness of fit btwn temperamental qualities and demands of environment contributes to positive interaction and growth/development |
| What is goodness of fit? | parent's expectation of childs behaviour consistent with temperament of the child |
| How many characteristics are there in temperament? What are they? | 9: activity, sensitivity, intensitiy, adaptability, distractability, approach/withdrawal, mood, persistence, regularity |
| Who is the attachment theorist? | John Bowlby (1907- 1990) |
| What is John Bowlby's theory? | early childhood experience has strong influence on child's development & later behaviour, humans have essential need for attachment |
| Who is the Cognitive theorist? | Jean Piaget (1896-1980) |
| What is cognitive development? | orderly, sequential process |
| What are the five major phases of cognitive development (piaget) | sensorimotor, preconceptual, intuitive thought phase, concrete operations, formal operations |
| What is the sensorimotor phase? | actions reflexive, object extension of self, acknowledges external environment, goal and attainment, new goals, pretend play |
| What is the preconceptual phase? | egocentric approach, words with objects |
| What is the intuitive thought phase? | one idea at a time, words express thought |
| What is the concrete operations phase? | solves concrete problems |
| What is the formal operations phase? | rational thinking |
| What three primary abilities are used in each stage? | assimilation accomodation, adaption |
| What is assimilation? | process of humans encounter & react to new situations by mechanisms already processed |
| What is accommodation? | process of change |
| What is adaption | coping behaviour |
| What is the social learning theory? | based on the principle that individuals learn by observing and thinking about behaviour of self and others and seen as spanning both behaviourist and cognitive learning theories |
| Who are the social learning theorists? | albert bandura (b.1925) and Lev Vygotsky (1896 - 1934) |
| What is Albert Bandura's social learning theory? | learn by imitation and practice -> requires self awareness, self motivation and self regulation, individual actively interacts with environment to learn |
| What is Lev Vygotsky's social learning theory? | cognitive development within social, historical and cultural contexts --> adults guide children to learn & development depends on use of language, play and extensive social interaction |
| Who is the ecological systems theorist? | Urie Bronfenbrenner |
| What is the ecological systems theory? | child interacts with environment at different levels and systems |
| How many levels are there in the ecological systems theory? | 5: microsystem (close daily relationships), Mesosystem (relationships of microsystems), Exosystem (settings that might influence a child but no daily contact), Macrosystem (attitudes/beliefs of culture), chronosystem (period child grows up in) |
| Who are the two Moral Development theorists? | Lawrence Kholberg (1927-1987) and Carol Gilligan (B.1936) |
| What does Lawrence Kohlberg focus on? | why an individual makes a decision |
| What is the first level of Kohlberg's moral development theory? | Premoral/Preconventional --> responsive to cultural rules & label of good/bad, physical terms (punishment vs. reward); STAGES: Punishment & Obedient, Instrumental relativist (egocentric) |
| What is the second level of Kohlberg's moral development theory? | Conventional: maintain expectations of fam, group, nation --> loyalty/conformity; STAGES: Interpersonal concordance orientation (approval, concerns of others), Law & Order |
| What is the third level of Kohlberg's moral development theory? | Postconventional/Autonomous/Principled -->define valid values w/o regard to outside authority/expectations; STAGES: social contract legalistic orientation (social rules are not sole basis), universal ethical principle orientation (internalized rules) |
| What is Carol Gilligan's Moral development theory? | moral development must include caring and responsibility |
| What are the three stages of Gilligan's moral development theory? | Caring for self (survival,selfish); Caring for others (approach causes difficulties with relationships b/c lacks balance); Caring for self & others (self needs not met, others might suffer) |
| Who are the Spiritual Development theorists? | James Fowler (B. 1940) and John Westerhoff (B. 1933) |
| What is James Fowler's take on faith? | a force that gives meaning to life --> form of knowing, way of being in relation to an ultimate environment, Development of faith = interactive process between persona and environment |
| What is John Westerhoff's take on faith? | a way of being and behaving that evolves from experienced faith guided by parents & others during infancy & childhood to an own faith |
| What is self concept? | mental image of oneself |
| What are the four dimensions of self concept? | self-knowledge, self-expectation, social self, social evaluation |
| What is self awareness? | relationship between person's perception of self in comparision with other's perceptions of him or her |
| What is Erik Erikson's take on self-concept? | development of healthy self concept is dependent on success of accomplishing developmental tasks |
| How does self-concept develop? | 3 steps: infant learns physical self is separate and different from environment, child internalizes other's' attitudes towards self, child and adult internalize standards of society, |
| What is global self? | colletive beliefs and images a person holds about the self |
| What is self-concept thought to be based on? | vocational performance, intellectual functioning, personal appearance & physical attractiveness, being liked by others, ability to cope & resolve problems, particular talents |
| What is perceived self? | how they see themself vs. how others see them |
| What are the components of self concepts? | personal identity; Body image; Role performance; Self-esteem; |
| What is role ambiguity? | when people are unclear of role responsibility and do not know what to do or how to do it |
| What is role strain? | when people feel inadequate or unsuited to a role |
| What is role conflict? | comes from opposing or incompatible expectations of a role or position |
| What factors affect self concept? | stage of development, family & culture, stressors, resources, history of success and failure, illness |
| What can lead to access, communication and compliance problems? | If a person's culture, ethnicity, traditions and genetic factors conflict with mainstream medical practices |
| How many languages are spoken in Canada? | over 200 |
| How many languages in Canada? | 33 |
| When did Canada introduce policies on multiculturalism? What did this policy say? | 1971 ---> encouraged to retain cultural beliefs and practices |
| When was the Canadian Charter of Rights and Freedoms signed? what did it say? | 1982 --> no discrimination |
| When was the employment Equity Act? | 1986 --> no person denied employment for reasons unrelated to abilty |
| What is a culture? | learned, shared, transmitted values, beliefs, norms & lifeway practices of a particular group that guid thinking, decisions and actions |
| What is a subculture? | people who have a distinct identity and are also related to a larger cultural group |
| What is bi-culture? | crosses of two cultures, lifestyles, and sets of values |
| What are the seven characteristics of culture? | learned, taught, social, adaptive, shared, difficult to articulate, exists at many levels |
| What is ethnicity? | people who identify with one another on the basis of a common social and cultural heritage --> race, skin color, bone structure, facial features, hair, texture |
| What is cultural vulnerability? | a person or group is vulnerable for greater health risks because of communication difficulties, different beliefs, customs, values and/or prejudice |
| What is cultural awareness? | conscience and informed recognition of difference and similarities between cultural and ethnic groups -- not derived solely from myths and stereotypes |
| What is cultural sensitivity? | knowing that cultural differences and similarities exist without assigning values to those cultural differences, respect and appreciation for different cultural behaviors, beliefs, experiences & perspectives & willingness to explore differences |
| What is cultural competence? | an ability to interact effectively with people of different cultures |
| What are the four components of cultural competence? | awareness of one's own cultural worldview, attitude towards cultural differences, knowledge of different cultural practices & worldviews, willingness to accept differences |
| What does cultural safety require? | nurses be respectful of nationality, culture, age, sex, political and religious beliefs |
| How do you show cultural sensitivity? | adress by last name unless given permission, introduce self, ask permission for tasks, be honest, no discriminating language, find out what client knows, no assumptions, show respect for clients support system, learn about their culture |
| What is Ethnocentrism? | view that one's own culture is superior to others |
| What is stereotyping? | assumption that all members of a culture or ethnic group are alike (all black people are good at dancing) |
| What is prejudice? | strongly held opinion about some topic or group |
| What is discrimination? | differential treatment of individuals or groups based on: race, ethnicity, gender, social class, exceptionality |
| What models Guide Nursing practice? | scientific, clinical or biomedical; holistic, traditional medicine |
| What is the Scientific, Clinical or Biomedical Model? | belief that life and life processes are governed by physical and biomedical processes that can be manipulated --> things can be fixed |
| What is the holistic health beliefs model? | forces of nature must be maintained in balance and harmony --> natural balance disrupted, illness results |
| Example of holistic health beliefs model? | Medicine Wheel in First Nations communities --> need physical, mental, emotional and spiritual balance |
| What is the traditional medicine model? | derived from cultural traditions not science (like chicken noodle soup when sick), usually in home or community, less expensive, health problem identified through conversations with client or family rather than testing |
| What are pharmacogentics? | a client's response to a drug which is influenxed by genetics |
| What is ethnopharmacology | the study of the effect of ethnicity on responses to medications |
| What is othering? | identifying those that are thought to be different from oneself or mainstream --> results in marginalization |
| What does sexuality include? | biological sex, gender identity & roles, sexual orientation, sensuality, eroticism, intimacy, reproduction |
| How is sexuality expressed? | through thoughts, fantasies, desires, beliefs, attitudes, values, behaviors, practices, roles, relationships |
| How does family influence sexuality? | children observe parent's behaviour and often model selves after parents |
| How does culture infleunce sexuality? | how you dress, rules of marriage, attitudes about premarital sex, polygamy or monogamy |
| How does religion influence sexuality? | acceptable & prohibited behaviour, premarital sex, save sex marriage |
| How does health and illness influence sexuality? | heart disease, diabetes, spinal cord injury, chronic pain or joint disorders, STIs |
| Gay/lesbian | attraction to same sex |
| Homophobia | negative attitudes and feelings towards gay, lesbian, bisexual, transgendered |
| Heterosexism | attitudes, biases, and discrimination towards those who are not in favor of heterosexual relationships. |
| Heteronormative | belief that heterosexuality is the normal sexual orientation |
| Transgender | strong and persistent feelings of discomfort with their assigned gender – sexual anatomy is not consistent with sexual identity |
| Bi-sexual | attracted to both men and women |
| Cross-dresser | males who dress to express their feminine side but who are not uncomfortable with their anatomy. |
| Asexual | lack of sexual attraction or interest in or desire for sex |
| Up until what year was homosexuality considered a mental illness? | 1970s |
| What are lesbian woman at risk for? | greater risk of breast and ovarian cancer |
| Different Mental Illnesses | Depression, Bipolar, Schizophrenia, OCD, ADD/ADHD, Eating disorders: anorexia, bulimia and binge |
| What is depression? | unhappiness and temporary depression are normal, it becomes a clinical disorder when these feelings are severe, last for several weeks and interfere with work and social life. |
| Causes of depression? | Distressing life event, Biochemical imbalance, Negative or pessimistic view of life, Genetic predisposition |
| Treatment for Depression | medication, psychological counselling, support! |
| What is bipolar disorder (manic depression)? | Periods of serious depression, followed by episodes of elevated or irritable moods (“highs”) --> shifts in our moods and missing sense of control --> No known cause |
| Treatment of Bipolar disorder | recognize signs and triggers to prevent recurrences from becoming severe, treat depression (medication & therapy), electroconvulsive therapy |
| What is schizophrenia | alteration in behavior, thinking, speech or socializing (16 to 30) (affects 1 in 100) |
| Positive (excess) symptoms of Schizophrenia? | delusions; hallucinations; disorganized or confusing thoughts and speech |
| Negative (lacking) symptoms of schizophrenia? | avoiding eye contact, apathy, lack of emotion, slowed speech, monotone, long pauses, reduction and slowing of movements, not interest in social participation |
| Causes of Schizophrenia? | combination of genetics, environmental factors (urban area = high risk), problems to or during pregnancy (flu, malnutrition, diuretics, father older than 50), brain abnormalities (head injury, ab structure or function) |
| Treatment of schizophrenia? | medications to decrease hallucinations & delusions, psychotherapy, support from family and other loved ones |
| What is OCD? | isorder affecting thoughts, behaviors, emotions, and sensations --> worries become obsessions and compulsive rituals take over life --> obsessions intrusive and illogical |
| Cause of OCD? | neurological imbalance, genetics, can happen in any age and gender |
| Coping/Treatment of OCD? | early diagnosis and treatment can avoid depression and relationship problems, Medication & cognitive behavioral therapy |
| ADD and ADHD emotional effects | aggressive/violent behaviour, withdrawal, anxiety, depression, low self-esteem, avoiding activities where they are unsure of success |
| ADD and ADHD goals? | improve relationships and performance at school, decrease disruptive behaviours, promote safety, increase independence |
| Treatment of ADD and ADHD? | medications and behavioural therapy |
| Which mental illness as the highest mortality rate? | eating disorders |
| What is Anorexia nervosa? | Severe weight loss due to extreme food reduction |
| What is bulimia nervosa? | person binges on food or has regular episodes of overeating and feels a loss of control, then uses various methods -- such as vomiting or laxative abuse --> to prevent weight gain -->Many (but not all) people with bulimia also have anorexia nervosa |
| What is Binge-eating? | compulsive over eating --> Often triggered by chronic dieting and involves periods of overeating, often in secret and often carried out as a means of comfort |
| Causes of eating disorders? | Low self-esteem, feelings of inadequacy, lack of control, depression, anger, loneliness, relationship problems, difficulty expression emotions and feelings, media promotion of unrealistic images and goals |
| Treatment of eating disorders | thorough medical assessment, nutritional guidance, support, individual, group and family therapy |
| What can you do to stop hurting people with mental illnesses? | Use the STOP acronym |
| What is the S of STOP | stop stereotyping people with mental illness --> not alike, they are individuals, influence others constructively |
| What is the T of STOP | stop trivializing or belittling people with mental illness --> educate people on it |
| What is the O of STOP | Stop offending people with mental illness by insulting them --> be careful of words, be sensitive |
| What is the P of STOP | stop patronizing people with mental illness by treating them as if they were not as good as other people --> positive attitude |
| What factors affect the health care system? | growth and demographic changes, uneven distribution of services, access to health care, climate change, population aging, woman's health, homeless populations, political and other leaders |
| What is health? | a fundamental human right and therefore the attainment of global health is socially desirable objective on which to focus |
| What is global health? | the optimal well-being of all humans on the planet considered from an individual and collective perspective |
| What does global health take into account? | principles of primary health care, epidemiology, health promotion and high speed technology |
| What is globalization? | the flow of information, good, capital and people across political and geographic boundaries |
| What are the positive impacts of globalization? | shared knowledge and resources, allows poor countries and citizens to develop economically and raise their standards of living |
| What are the negative impacts of globalization? | increase health risks due to world travel, may exacerbate & reinforce health inequity b/c knowledge & resources not shared equally, burdens developing countries with debt, benefits western world at expense of low income countries |
| What are other impacts of globalization? | common language, reeduces competitive edge, spread of infectious disease, brain drain, lowers capacity of the ecological system to keep up, difficult to maintain food security |
| What is social justice? | the concept of a society in which justice is achieved in every aspect of society rather than merely the administration of law |
| What is social justice in health care? | every body having the same type of health care |
| What was the Millennium Development Summit? | A UN meeting in New York in Sept 2000 that set goals for 2015 |
| What are the 8 Millennium Development Goals? | Eradicate extreme poverty & hunger, Universal primary education, gender equality & empower women, Reduce Child Mortality, Improve maternal health, Combat HIV/AIDS, maleria & other disease, Ensure enviornmental sustainability, global partnership for dvlpmt |
| Where does most of population occur? | in the developing world |
| What are the fertility rates of the developed world? | 1.7 children per women |
| What are the fertility rates of the developing world? | 4.63 children per woman |
| What is the life expectancy for the developed world? | 76.5 years |
| What is the life expectancy for the developing world? | 65.4 |
| Where is are most of the world's resources consumed? | in North America --> North americans consume more energy and resources per person than people from other regions of the world |
| ___% of world income goes to ___% of the world's people | 94%, 40% |
| Half of the world live on $___ per day | $2 |
| Almost a _______ people live on less than $___ per day | $1 |
| What are some environmental contaminants? | air pollution, household chemicals, water & pollution, noise pollution, radiation, food quality |
| What is climate change? | long term change weather patterns |
| What is pollution? | the changes quality, composition of water, soil and air that could make it less able to serve life |
| What are pollutants? | waste product that pollutes the air |
| What are mutations? | A change in DNA |
| What are teratogens? | anything that can cause a birth defect |
| What is a carcinogen? | a substance that can cause cancer |
| What are the 4 Rs of environmental awareness? | reduce, reuse, recycle, recover |
| What does accreditations canada do? | e provide national and international health care organizations with an external peer review process to assess and improve the services they provide to their patients and clients based on standards of excellence |
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