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NUR 326 Exam 1/259 Questions with Accurate Answers
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NUR 326 Exam 1/259 Questions withAccurate Answers
A patient has been prescribed a selective serotonin reuptake inhibitor (SSRI)
antidepressant. After taking the new medication, the patient states, "This
medication isn't working. I don't feel any different." What is the best
response by the nurse? - -"It usually takes a few weeks for you to notice
improvement from this medication."
- Seeing a response to antidepressants takes 3 to 6 weeks
-A patient coming to the health clinic for a blood pressure check reports to
the nurse that she just does not have the energy to go out much in winter
but looks forward to gardening in summer. The nurse realizes that this
patient is describing a major symptom of what condition? - -Seasonal
affective disorder
-seasonal affective disorder - -Decreased exposure to sunlight in winter
months can reduce the production of serotonin in the brain, leading to a type
of depression
- tends to resolve with the longer days and increased exposure to sun of
spring and summer
-A patient who is at a health clinic with complaints of a sore throat is
exhibiting signs of depression. The nurse administers a basic screening for
depression. What level of prevention is the nurse performing? - -Secondary
prevention
-Secondary prevention - -aimed at early detection of problems, I.e.
identification of depression for early intervention
-Primary prevention for mood disorders - -focuses on stress reduction and
societal issues such as reducing poverty and racism
-Tertiary prevention - -aims to reduce disability from a diagnosed condition;
for mood disorders, this includes prevention of relapse and protection from
harm
-A family member of a patient diagnosed with bipolar disorder asks what
behaviors would indicate the beginnings of a manic phase. What is the best
response by the nurse? - -"The person may have excess energy, talk a lot,
feel restless, and spend too much money."
, -Signs that a person is cycling into a manic phase include - -sleeping and
eating less and having increased energy and racing thoughts, increased
impulsivity, and increased spending behaviors
-A patient has been admitted with major depressive disorder. What typical
signs and symptoms would the nurse expect to assess? - -Poor eye contact
Appetite changes
Slowed speech
-Typical signs of depression include - -sleep disturbance; poor eye contact;
loss of interest in events; guilt; decreased energy, speech, and
concentration; appetite changes; and slowed motor movements
-Denial stage - -In this stage, grieving people are unable or unwilling to
accept that the loss has taken (or will shortly take) place
- It can feel as though they are experiencing a bad dream, that the loss is
unreal, and they are waiting to "wake up" as though from a dream,
expecting that things will be normal
-Anger stage - -at the loss and the unfairness of it
They may become angry at the person who has been lost (or is dying).
Feelings of abandonment may also occur.
-Bargaining stage - -In this stage, people beg their "higher power" to undo
the loss, saying things along the lines of, "I'll change if you bring her (or him)
back to me".
This phase usually involves promises of better behavior or significant life
changes which will be made in exchange for the reversal of the loss
-Grief - -subjective feeling and affect that follows a loss
- Powerful emotional state
- Universal reaction
- Involves stress, pain and suffering
-Mourning - -the process by which grief is resolved
-Types of Grief - -- Uncomplicated grief
- Complicated (dysfunctional) grief
- Anticipatory
- Disenfranchised
, -Depression stage - -stage where they confront the inevitability and reality
of the loss and their own helplessness to change it
- During this period, grieving people may may cry, experience sleep or eating
habit changes, or withdraw from other relationships and activities while they
process the loss they have sustained
- People may also blame themselves for having caused or in some way
contributed to their loss, whether or not this is justified
-Acceptance stage - -where they have processed their initial grief emotions,
are able to accept that the loss has occurred and cannot be undone, and are
once again able to plan for their futures and re-engage in daily life
-Situations That Precipitate Grieving - -- Loss of body parts, function
- Loss of status/groups
- Failures
- Changes
- Loss of home
- Loss of job, profession
- Loss of pets
-Usual Pattern of Response to grief - -- Shock and disbelief
- Somatic distress
- Preoccupation
- Guilt
- Anger
- Change in behavior
- Reorganization
-Stages of Mourning - -- Shock and Disbelief
- Awareness of Loss
- Restitution
-Factors That Influence Outcome of grief - -- Importance of deceased as
source of support
- Degree of ambivalence toward deceased
- Age of the lost object and the mourner
- Number and nature of previous grief reactions
- Degree of preparation for the loss
- Physical and psychological health of the mourner
- Culture and ethnicity
- Spiritual beliefs
-The following can be present in dysfunctional grieving: - -Changes in
emotions, behaviors and thoughts are more exaggerated than expected.
, These changes may include sleeplessness, poor appetite, anger, rage,
despair, depression, anxiety, self-blame, guilt and feelings of loneliness.
Difficulty moving out of a state of grief
Emotional numbness for a prolonged period
Grief response is out of proportion to the loss.
Withdrawn from family and friends, work, school and other activities.
Engage in inappropriate or risky behavior.
Use of alcohol in excess or misuse prescription or illegal drugs.
If the severity or duration of your symptoms begins to disturb your life and
normal functioning,
-Nursing Interventions for grief and loss - -Goal: assist person with process
and accept the discomfort
Maintain accepting attitude
- Facilitates process
- Encourages crying
- Verbalization of feelings
- Reviewing relationship with deceased
- Seek support from family and friends
- Anticipate and accept anger and rage
Discourage maladaptive coping
- Alcohol/drugs
- Promiscuity
- Prolonged denial
Discourage drastic moves or changes
Lasts 6-12 months
Self limited process of realization
-Guidelines for Nurses for grief and loss - -Seek basic understanding of
clients' spiritual needs, resources, and preferences
Follow clients' expressed wishes regarding spiritual care
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