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Dimensions of self-concept?
3 dimensions
Self-knowledge- Who am I?- GlobalSelf= A composite of all the basic facts, qualities, traits, image and feelings one holds about themselves.
Self-Expectation- Who or What do I want to Be? Ideal-Self= constitutes the self one wants to be.
Self-Evaluation- How well do I like myself? Self-esteem needs and respect needs or need for esteem from others.
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Formation of Self-Concept
Stages and Development of the Self
- Infancy- No self concept at birth.
- Childhood- Intact body is important, Need to be loved, trusted, and being trust worthy.
- Adolesence- Development of secondary sex characterstics, rapid body changes, sence of self is consolidated, and emphasis on sexual identity and development of own identity.
- AdultHood- Society places expecations on body, Fitness, sexuality, productivity, and beauty. Its important to meet expecatitions.
- Later Years- Declining physical and possibly mental abilities. Losses, increased dependency, diminished choices/options, and death.
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Factors affecting Self-Concept
- Developmental- Criteria marks experiences necessary for positive self-concept change.
- Culture- Value of parents and peers, and culture influences sense of self.
- Internal/External Resources- personal strengths help recognize and develop a powerful and subjective self-concept.
- History of Success and Failure- A history of repeted failure can make a person feel they are a failure. Success helps people succeede.
- Crisis or Life Stressors- Life stressors or crises ( marriage, divorce, illness, job loss, raise, gray hair) can paralize or build self-concept.
- Aging, Illness, or Trauma- An illness or alteration in function positive or negative, can effect the patient's self-concept.
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Nursing Process
Assessing
- Can Successfully identity and resolve self-concept disturbances in patients.
- Self-concept focuses on the patient as a whole.
- Personal Identity- Describes and individual conscious sence of who he or she is.
- Personal Strentghs- Are something they are good at, or are strong in.
- Body Image- Is the subjective view a person has about his or her physical appearence.
- Self-Esteem- The person's precetpions of self, like or dislike, pleased with his or her expectations or progress.
- Role-Performance- Ability to perform in society regarding role-specific behaviors.
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Diagnosing
Disturbances in Self-Concept as the problem
Usually is an disturbed body image, low self-esteem, and ineffective role performance.
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Implementing
Helping Patients identiry and use personal strengths
- Replace self-negation with positive thinking.
- Notice and reinforce strengths.
- Help patients cope with aging and illness.
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Sensory Experience
Components and Conditons
Visceral- Pertaining to inner organs.
Stimulus- Agent, act, or influence that stimulates a nervous system response.
Sensory Reception- The process of recieving data.
Stereognosis- Sense preceiving solidity of an objects.
Kinesthesia- awareness of postioning of the body parts or movement.
Sensory Perception- is the conscious process of selecting, organizing, and interpreting data from the senses into meaningful information.
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Arousal Mechanism
RAS- Reticular Activating System
A network of nerves from the hypothalamus to the medulla, it mediates arousal.
Sensoristais- Optimal arousal state in RAS.
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Disturbed sensory Perception
Disrupted perceptions in color, sound, and touch.
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Sensory Deprivation
The reduction of enviromental stimuli by physical isolation and or loss of eye sight.
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Sensory Overload-
When a person experiences so much sensory stimuli the brain is unable to respond meaningfully or ignores stimuli.
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Presbyopia-
Farsightness due to cilary miscle weakness and loss of elasticity in the crystalline lens.
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Sexual Orientation
- Heterosexual- One who experiences sexual fulfillment with the opposite sex.
- Homosexual- One who experiences sexual fulfillment with the same gender.
- Bisexual- One who experiences sexual fulfillment with the the same gender and opposite sex.
- Transsexual- Is a person of certain biologic gender who has the feeling of the opposite sex.
- Transvestite- An individual who desires to take on the role or wear the clothes of the opposite sex.
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Premenstrual Tension Syndrome- PMS
Characterized by onset and appearance of one or more symptoms several days before the onset on menstruation- irritability, emotion tension, anxiety, mood changes, headache, breast tenderness, and water retension.
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Male
Penis
Erection
- Tublar structure located above scrotum.
- Erection- A destended and rigid state of an organ or part containing erectile tissue, the penis or clitoris.
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Sexually Transmitted Infections
HPV- Human Papillomia Virus
Genital Warts- pail, soft, papillary lesions in, on, or around the genitals.
Women with this are at risk for cervical cancer.
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Female Primary Sexual Dysfunction
Inhibited sexual Desire
Consists of an inhibition in sexual arousal so that congestion and vaginal lubrication are absent or minimal.
Dyspareunia= Painful Intercourse.
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Hypertensive Medications
Methyldopa, Clonidine, Reserpine can decrease sexual desire, increase erectile failure, and increase erectile and ejaculatory dysfunction.
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Nursing Process
Physical Assessment
- Reproductive history, std's history of sexual dysfunction, sexual performance, self-care behaviors, etc.
- How do you feel about? sexual identity, sexual functioning, sexual image, sexual selfesteem, and sexual role performance.
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Implementing
Teaching about Sexuality and Sexual Health
Nursing Interventions pretaining to patient's sexuality involving teaching to promote sexual health.
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What is circadian rhythm?
Complete a full cycle every 24 hours.
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NREM
What occurs with the PNS Parasympthetic nervous system?
Dominates and decreases pulse, respirations, blood pressure, metabolic rate, and temperature.
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Medications
Effects-
- Sleep quality is effected and influenced by certain drugs.
- Decreased REM sleep with barbituates, amphetamines, and antidepressants.
- Also diuretics, steroids, caffine, asthma, and antihypertensives.
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Narcolepsy-
Is a condition characterized by an uncontrolled desire to sleep, can't be controlled by self.
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Sleep Apnea-
CPAP- Continous Positive Airway Pressure
A mask and an air pump delivers air that keeps airway open during sleep.
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Somnambulism-
Sleep walking, sleep talking, night terrors, and bruxism (grinding Teeth).
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Who determines pain?
The patient or person experiencing it.
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Types of Pain-
Chronic- pain can be limited, intermittent, or persistent, and last beyond normal healing time.
Referred- Is in one part of the body, but is manifest or precieved in another part.
Phantom- Pain from a non-existent limb or part that is no longer attached to the body.
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Modulation of Pain
Endorphins
Endorphins-They are powerful pain blocking chemical that have prolonged analgesic effects and produce euphoria.
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Nursing Process
Common Misconceptions
Components of a Pain Assessment
Addiction to medication, given routinely, better to deal with the pain that the side effects of the drug, better to wait til the pain gets bad, and I don't want to bother anyone.
Duration, location, quantity and intensity, quality, time, aggravation, allevaiting, physiolocic indacatiors, behavioral responses, and effect on activity and life style.
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Nonpharamacological Relief Measures of Pain
10 Types
- Distraction
- Humor
- Music
- Imagery
- Cutaneous Stimulation
- Acupuncture
- Hypnosis
- Biofeedback
- Therpeutic Touch
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Pharmacological Relief Measures
Analesics=
Is a pharmaceutical agent that relieves pain.
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Metabolic Requirements
Basal Metabolism=
Is the energy required to carry on the involuntary activities of the body at rest.
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Water Requirements
2000-3000 mL/Day for adults. Usually equals water output.
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Decreased Food Intake
Anorexia=
Limiting food intake or calorie intake.
The lack of appetite, may be related to systemic and local diseases and numerous psychosocial causes, fear, anxiety, depression, and pain.
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Nursing Process: Implementation
Stimulating Appetite=
Serve fresh frequent meals, provide encouragment, (Control pain, nausea, and depression with medications), provide comfortable postion, etc.
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Providing Nutrition in Special Situation
Clear Liquid Diet=
They are a variety of normal and modified diets available.
Clear Liquid Diet- Contains only foods that are clear liquids at room or body temperature: gelatin, fat-free broth, bouillon, ice pops, clear juices, carbonated beverages, coffee, and tea.
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Providing Enteral Nutition
Tube Feeding Administration
Oral feeding is the most preferred and most effective method for feeding patients.
NG tube & NI tube- puts food in stomach or in in intestines.
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Feeding Schedule
Based on patients physical, medical, and nutritional condition.
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Nursing Considerations with Tube Feedings
Promoting Patient Saftey
- CHECK Tube Placement: Xray, external marking, PH test, and aspirate.
- Check residual- Gastric Contents.
- Assess abdomen.
- Patient sit in upright position.
- Prevent contamination during feedings.
- Medications may be given through feeding tube.
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Providing Parenteral Nutrition
Total Parenteral Nutrition=
Is the administration of nutritional support via the intravenous route.
TPN- Is highly concentrated, hypertonic nurtient solution.
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