Nursing Level I

  1. Self-Concept
    • what a person thnks about themselves
    • subjective
    • un/conscious thoughts, attitudes, and perceptions about one's self
    • directly affects self-esteem
    • affects management of all situations and relationships
  2. Factors of Self-Concept
    • ever-changing
    • influenced by family, caregivers, culture
    • low in adolescents/geriatrics
    • high in childhood/adulthood
    • physical appearance
    • vocational performance
    • intellectual functioning
    • being liked by others
    • ability to cope and resolve
  3. Self-Reflection
    • thoughts/feelings about lifestyle, health, and illness
    • Awareness ie the effects of non-verbal communication
    • personal values and expectations
    • ability to convey non-judgmental attitude
    • attitudes about cultural differences
  4. Self-Esteem
    • emotional assessment of self-concept that reflects the overall sense of being capable, worthwhile, & competent
    • foundation for self-esteem is established during early life experiences
    • dependent upon stress day to day, high to low
  5. Nursing Objective of Self-Concept
    recognize: personal identity, body image, role performance
  6. Personal Identity
    • individuality
    • wholeness
    • consistency over time and in different situations
    • what makes a perosn different
    • necessary for intimate relationships
    • racial & cultural identity
    • (vulnerable at adolescence)
  7. Body Image
    • physical appearance
    • structure/function
    • sexuality
    • youthfulness
    • health/strength
    • aging
    • race/ethnicity
    • culture
  8. Body Image affected by 
    • cognitive growth
    • devaluing others
    • physical development
  9. Cultural Body Image factors
    • Western Culture= Youth
    • Eastern Culture= Age
  10. Role-Performance
    • Reinforcement-extinction
    • Inhibition
    • Substitution
    • Imitation
    • Identification
  11. Reinforcement-Extinction
    Behavior becomes common or avoided depending on whether approved or punished
  12. Inhibition
    learn to refrain even when tempted
  13. Substitution
    Replace one behaviorwith another, same gratification
  14. Imitation
    Acquire knowledge, skill, etc. from other members
  15. Identification
    Internalize values, behavior of role models
  16. Self-Concept Factors
    • Stage of Development
    • Family & Culture
    • Resources
    • -internal/external
    • History of Success/Failure
    • Illness
    • Stressors
  17. Body image stressors
    • loss of body part
    • unrealistic body ideal
  18. Role-performance stressors
    • conflict
    • ambiguity
    • strain
    • development
    • mastery
    • overload
  19. Role Conflict
    • caregiver
    • or child
    • or parent
  20. Role ambiguity
    no defining lines
  21. Role strain
    feel inadequate to full fill the role
  22. Role development
    • under or over developed
    • unevenly developed
  23. Role Mastery
    • difficulty reaching mastery
    • only master one role
  24. Role overload
    unmanageable amount of responsibility
  25. Self-Esteem Stressors
    • lack of positive feedback from significant other
    • repeated failures
  26. Identity stressors
    • declining physical, mental or sensory abilities
    • identity confusion-unrealistic ideal self
  27. Stressors for Adults/Geriatric Clients
    • multiple roles
    • role ambiguity
    • developmental tasks
    • caring for others
    • empty nest
    • beginning physical decline
  28. Stressors in Older Adults
    • Dependence
    • Devaluation
    • Depersonalization
    • Functional Impairments
    • Lack of Control
    • Multiple Losses
    • -finances, loved ones, health status
  29. Adaptive Coping
    • Physical or behavioral response that preserves integrity and stability of a person
    • protects from harm
    • strengthens ability to deal with challenging situations
    • mobilizing resources
    • emowerment
  30. Maladaptive Coping
    • Physical or behavioral response that causes disruption of integrity or persistent instability
    • overuse of soem mechanisms
    • conflict continues on unresolved or intensifies
    • self-destructive behaviors: alcohol/drugs, tobacco, indiscriminate sexual behaviors
  31. Alter & Adapt Coping
    • effort to manage psychological stress of daily living
    • may differ from one time of stress to another
    • may use combination of strategies
    • goal to use strategies/mechanisms that decrease unnecessary stress
  32. Altruism
    • emotional conflicts and stressors are dealt with by meeting the needs of others
    • Dennis Quaid example
  33. Sublimation
    taking drives or impulses that are personally or socially unacceptable into activities that are constructive
  34. Suppression
    voluntarily blocking awareness of unpleasant feelings and experiences
  35. Denial
    avoiding emotional conflicts by refusing to consciously acknowledge anything that causes intolerable emotional pain
  36. Displacement
    Transferring emotions, ideas, or wishes from a stressful situation to a less anxiety-producing substitute
  37. Intellectualization
    attempting to avoid expressing emotions of a stressful situation by using logic, reasoning, and analysis
  38. Projection
    • seeing your own unwanted feelings in other people
    • projecting one's feelings or impulses that one finds unacceptable to himself/herself onto another person
  39. Introjection
    Taking on the beliefs and values of someone else
  40. Isolation
    separating feelings or emotions from a thought or memory
  41. Rationalization
    making a behavior acceptable as a way of dealing with stressors
  42. Reaction Formation
    • overcompensation
    • prevents unacceptable behaviros by exaggerating opposite thoughts or behaviors
  43. Regression
    returning to behaviors that were once acceptable but are no longer acceptable in the current stage of development
  44. Repression
    involuntary, unconscious blocking of unpleasant feelings/experiences
  45. Conversion reaction
    • somataziation
    • changing the anxiety into a physical symptom
  46. Undoing
    actions that psychologically undo wrongdoings for the wrongdoer
  47. compensation
    making up a real or imagined deficiency by emphasizing an asset
  48. identification
    assuming another's qualities, actions, characteristics
  49. Idealization
    focusing on the good things and ignoring the limitations or the reality of a thing or an issue
  50. Dissociation
    • subjective sense of numbing, and a reduced awareness of one's surroundings
    • separating thoughts activities from conscious awareness
  51. Immature Defenses
    • Passive-aggressive behavior: defense of rights by expressing resistance to social/occuptational demands
    • Acting-out behaviors: not coping-giving in to the pressure to misbehave
  52. Intervention Goals
    • decrease stress producing situations
    • increase resistance to stress
    • learn skills that reduce physiological response to stress
  53. Interventions
    • exercise
    • support systems
    • time management
    • guided imagery/visualization
    • progressive muscle relaxation
    • assertiveness training
    • journal writing
    • workplace stress management
  54. Stress
    State created by a change in the environment that is perceived as challenging, threatening, or damaging to one's well being
  55. General Adaptation Syndrome
    • alarm reaction
    • resistance stage
    • recovery or exhaustion stage
  56. Anxiety
    • perceived threat to body or psyche
    • mild, moderate, severe, panic
  57. Mild Anxiety
    • sympathetic nervous system: fight or flight
    • Psych/Cognition: increased alertness, sharper observations, grasps increased sensory input
    • Behavioral: irritable, restless, repeated questions
  58. Moderate Anxiety
    • physical: increased SNS response
    • Psych: perceptual field constricted, focused on specific details
    • Behavioral: increased movement, more intense irritability
  59. Severe Anxiety
    • Pronounced Fight or Flight
    • Processing scattered, disorganized, purposeless activity
    • Hyperactive behavior
  60. PANIC
    • can be a disorder
    • s/s may mimic heart attack
    • perceptions grossly distorted
    • intense urge to escape or fight
    • may be a danger to self or others
    • speech difficulties
    • inability to sleep, delusions, and hallucinations
  61. Anxiety Disorders
    • panic disorder
    • generalized anxiety disorder
    • post-traumatic stress disorder
    • social phobia
    • specific phobia
    • obsessive-compulsive disorder
  62. Reducing Anxiety Interventions
    • sense of caring
    • therapeutic self
    • respect
    • active listening
  63. Psychological Stress
    person is under stress only if he/she evaluates event/circumstance as personally significant (subjective)
  64. Eustress
    stress that is deemed healthful or giving one the feeling of fulfillment; protects health
  65. Distress
    state of extreme necessity or misfortune; damaging stress
  66. Effect of Stress/Anxiety on healing
    • increased pain perception
    • decreased or abnormal immune response
    • causes disease
    • decreased compliance with treatment programs
    • interferes with learning if severe and/or prolonged
  67. Reducing Anxiety
    • Permission to feel/validate emotion
    • Spiritual Support
    • Teaching
    • Modify the Environment
    • Empower the patient
    • Medications
  68. Crisis Intervention
    • old coping mechanisms
    • aware of unrecognized strengths & resources or functioning deteriorates
    • situation for danger or opportunity; decline or growth
    • focus on problem; approach w/ problem solving
    • mental connection between event and response is imperative
    • awareness of feelings
    • explore/identify coping mechanisms
    • facilitate social interactions/contacts
Card Set
Nursing Level I
Self-Concept & Anxiety