nursing actions/responses when caring for pt who says they are agnostic
view that the existence of God, of the divine or the supernatural is unknown or unknowable
-assess for sense of meaning or purpose in life and how health care can maintain that
how to assess spiritual needs
love, identity, meaning, forgiveness, hope, love, isolation, disconnection from family, critical of/paranoid of family
forgiveness: anger, guilt, refuse care
BE AWARE OF NEEDS
interventions to help a pt meet spiritual needs
- empathy
- mindful of restrictions associated w beliefs/customs
- aware of significant clothing, jewelry or other apparel, read religious literature
factors affecting communication/blocks
appropriate, privacy, comfort, equal treatment, encourage, focus, aware of pt’s and own feelings
socioeconomic status, language, gender, health status, developmental level, emotions, falsely reassume, defensive, disapproval, stereotype, ask why, changing subject, belittle, give opinion, pet names
examples of facilitators of communication
open/closed-ended questions, summarizing, focusing, promote social interaction, paraphrase, listen, use silence, touch, gentle humor, assertiveness
appropriate therapeutic nsg response to decrease pt’s anxiety R/T upcoming treatment
reiterate their feelings
be honest but provide comfort
Principles of G/D
quantitative/qualitative (ht, wt, emotion, psychosocial), continuous & orderly regular trends, environmental influences, rates, individualized, patterns predictable, critical periods, chephalocaudal, proximodistal, general to specific
interventions R/T G/D issues
understand behavior, don’t mistake G/D changes c dz or vice versa
most accurate indicators of fluid balance
- I/O
- urinary out
- daily weights
pts at risk for fluid imbalance
surgery, v/d, diaphoresis, hemorrhage, burns, ascites, DM, other dz
-young and old
Electrolyte ranges
- sodium: 135-145 mEq/L
- potassium: 3.5-4.5 mEq/L
- calcium: 8.5-10.5 mg/dL
- magnesium: 1.2-2.1 mEq/L
assessment R/T sleeping difficulties
usual amount of sleep, usual bedtime routine/time, naps, meds, environment, exercise pattern perception of need for sleep; assess as much at one time (combo therapy)
interventions/teaching R/T promoting sleep
- decrease noise
- turn off lights
- provide comfort
- temp in room
- usual routine
- emotional support
- increased activity during the day
- decreased day-dozing
- get as much done when assessing
- bed time snack 1 hr before bed (teach pt to eat snacks high in protein & tryptophan)
insomnia
- trouble falling asleep
- wake up during sleep
- shorter overall period of sleep
normal sleep cycle
I, II, II, IV, III, II, REM
4-5 cycles per night
awakened, begin w stage II
as night progresses: NREM III & IV decrease; REM incr.
