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A first-time mother-to-be is taken to the surgi- ily cannot tolerate what she feels is inad- cal unit for an emergency cesarean birth discount keftab 750 mg otc. A mother returns home from the hospi- an example of how each of the following basic tal with a premature baby for whom she needs can be met by the nurse in caring for must provide care buy 750 mg keftab with visa. Physiologic needs: pregnancy tells you she didn’t think she could become pregnant the first time she had sexual relations. Self-actualization needs: cancer finds a lump in her breast during her monthly breast examination. Describe how each tions and explain how each meets the needs family differs from one another. Which fami- of individual family members and society as a lies do you feel have been most effective in whole. Study Guide for Fundamentals of Nursing: The Art and Science of Nursing Care, 7th Edition. Identify their risk factors, and give an example of a character at risk for each of the following: a. List typical questions that should be part of a Scenario: Samuel Kaplan is an 80-year-old man family assessment. Volunteer some of your time at a local home- less shelter or any other service-oriented organization. Explain how you could attempt to provide Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins. Study Guide for Fundamentals of Nursing: The Art and Science of Nursing Care, 7th Edition. What resources might be helpful for and/or ethical/legal competencies are most Mr. Study Guide for Fundamentals of Nursing: The Art and Science of Nursing Care, 7th Edition. Which of the following statements accurately describes a characteristic of a system? A system is an entity in itself and cannot communicate with or react to its Circle the letter that corresponds to the best environment. A theory is based on facts and contains allow energy, matter, or information to absolute or direct proof. Each system is independent of its subsystems that gives meaning to a series of events. When a nursing theorist identifies a specific through which of the following processes? Which of the following theorists believed that a person is a biopsychosocial being who is c. According to Levine’s theory of nursing, nurs- ing practice should focus on which of the d. The human and the complexity of his or when using the quantitative research process? State the research problem as a general to the behavioral system, when illness problem, as opposed to focusing narrowly occurs on the problem being studied. Do not define the purpose of the study stressors, with primary concern for the total until conclusions have been made. The culture of each individual group, or sources, including people, literature, society documents, and findings. Basic research is designed to directly influ- descriptions of nursing theorists and their cen- ence or improve clinical practice. Hildegard Peplau: Nursing is a therapeutic, on the level of current knowledge about a interpersonal, and goal-oriented process. Data that researchers collect from subjects who requires help to reach independence. A hypothesis is based on the independent ill person in the healthcare setting; describes variables that the researcher finds. Martha Rogers: A focus on rehabilitation, conditions that are manipulated or identi- encompassing nursing’s autonomy in the fied to determine the effects of the depend- therapeutic use of cure and care. Instruments are the devices used to collect self-care deficits require nursing actions. Study Guide for Fundamentals of Nursing: The Art and Science of Nursing Care, 7th Edition. Systems are hierarchical in nature and are functions that bring about a desired goal composed of interrelated subsystems that 2. Systems are not separated from each other and construct our perceptions of life by boundaries. A system communicates with and reacts to the common purpose of contributing an its environment through input and output. The theory describes the process by which living matter adjusts to other living 7. Defines a continuously occurring process coercion, or to refuse to participate without that effects change and involves interac- jeopardizing the care he/she will receive.

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In one of the earliest social psychology experiments purchase keftab 500 mg without prescription, [7] Ringelmann (1913; reported in Kravitz & Martin buy 250 mg keftab, 1986) had individual men, as well as groups of various numbers of men, pull as hard as they could on ropes while he measured the maximum amount that they were able to pull. In fact, the loss was so large that groups of three men pulled at only 85% of their expected capability, whereas groups of eight pulled at only 37% of their expected capability. This type of process loss, in which group productivity decreases as the size of the group increases, has been found to occur on a wide variety of tasks. Group process losses can also occur when group members conform to each other rather than expressing their own divergent ideas. Groupthink is a phenomenon that occurs when a group made up of members who may be very competent and thus quite capable of making excellent decisions nevertheless ends up, as a result of a flawed group process and strong conformity Attributed to Charles Stangor Saylor. Groupthink is more likely to occur in groups whose members feel a strong group identity, when there is a strong and directive leader, and when the group needs to make an important decision quickly. The problem is that groups suffering from groupthink become unwilling to seek out or discuss discrepant or unsettling information about the topic at hand, and the group members do not express contradictory opinions. Because the group members are afraid to express opinions that contradict those of the leader, or to bring in outsiders who have other information, the group is prevented from making a fully informed decision. Analyses of the decision-making processes in these cases have documented the role of conformity pressures. The group members begin to feel that they are superior and do not need to seek outside information. Although many other countries rely on judges to make judgments in civil and criminal trials, the jury is the foundation of the legal system in the United States. The notion of a ―trial by one‘s peers‖ is based on the assumption that average individuals can make informed and fair decisions when they work together in groups. But given the potential for group process losses, are juries really the best way to approach these important decisions? As a small working group, juries have the potential to produce either good or poor decisions, depending on the outcome of the characteristics of the individual members as well as the group process. In terms of individual group characteristics, people who have already served on juries are more likely to be seen as experts, are more likely to be chosen to be the jury foreman, and give more input during the deliberation. It has also been found that status matters; jury members with higher status occupations and education, males rather than females, and those who talk first are more likely be chosen as the foreman, and these individuals also contribute more to [9] the jury discussion (Stasser, Kerr, & Bray, 1982). However, although at least some member characteristics have an influence on jury decision making, group process plays a more important role in the outcome of jury decisions than do member characteristics. Like any group, juries develop their own individual norms, and these norms can have a profound impact on how they reach their decision. Analysis of group process within juries shows that different juries take very different approaches to reaching a verdict. Some spend a lot of time in initial planning, whereas others immediately jump into the deliberation. Some juries base their discussion around a review and reorganization of the evidence, waiting to make a vote until it has all been considered, whereas other juries first determine which decision is preferred in the group by taking a poll and then (if the first vote does not lead to a final verdict) Attributed to Charles Stangor Saylor. These two approaches are used quite equally but may in some [10] cases lead to different decisions (Davis, Stasson, Ono, & Zimmerman, 1988). Perhaps most importantly, conformity pressures have a strong impact on jury decision making. This does not mean that minorities can never be persuasive, but it is very difficult for them to do so. The strong influence of the majority is probably due to both informational conformity (i. When the majority of the 6 initially favored voting guilty, the jury almost always voted guilty; when the majority of the 6 initially favored voting innocent, the jury almost always voted innocent. The juries were frequently hung (could not make a decision) when the initial split was 3–3. However, despite these concerns, the evidence suggests that juries may not do as badly as we would expect. The deliberation process seems to cancel out many individual juror biases, and the importance of the decision leads the jury members to carefully consider the evidence itself. Using Groups Effectively Taken together, working in groups has both positive and negative outcomes. On the positive side, it makes sense to use groups to make decisions because people can create outcomes working together that any one individual could not hope to accomplish alone. In addition, once a group makes a decision, the group will normally find it easier to get other people to implement it, because many people feel that decisions made by groups are fairer than are those made by individuals. Yet groups frequently succumb to process losses, leading them to be less effective than they should be. Furthermore, group members often don‘t realize that the process losses are occurring around them. For instance, people who participate in brainstorming groups report that they have been more productive than those who work alone, even if the group has actually not done that [11] well (Nijstad, Stroebe, Lodewijkx, 2006; Stroebe, Diehl, & Abakoumkin, 1992). The tendency for group members to overvalue the productivity of the groups they work in is known as theillusion of group productivity, and it seems to occur for several reasons. For one, the productivity of the group as a whole is highly accessible, and this productivity generally seems quite good, at least in comparison to the contributions of single individuals.

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There’s one bone in the entire skeleton that doesn’t articulate with any other bones but nonetheless is considered part of the axial skeleton buy discount keftab 250 mg on-line. Chapter 5: A Scaffold to Build On: The Skeleton 79 Appendicular Skeleton: Reaching Beyond Our Girdles Whereas the axial skeleton lies along the body’s central axis best 750 mg keftab, the appendicular skele- ton’s 126 bones include those in all four appendages — arms and legs — plus the two primary girdles to which the appendages attach: the pectoral (chest) girdle and the pelvic (hip) girdle. The pectoral girdle is made up of a pair of clavicles, or collar bones, which attach to the sternum medially and to the scapula laterally articulating with the acromion process, and a pair of scapulae, better known as shoulder blades. Each scapula has a depression in it called the glenoid fossa where the head of the humerus (upper arm bone) is attached. The lower end of the humerus articulates with the forearm’s long ulna bone to form the elbow joint. The process called the olecranon forms the elbow and is also referred to as the funny bone, although banging it into something usually feels anything but funny. The forearm also contains a bone called the radius; together the ulna and radius articulate with the eight small carpal bones that form the wrist. The carpals articulate with the five metacarpals that form the hand, which in turn con- nect with the phalanges (finger bones), which are found as a pair in the thumb and as triplets in each of the fingers. During early developmental years, the os coxa consists of three separate bones — the ilium, the ischium, and the pubis — that later fuse into one bone sometime between the ages of 16 and 20. Posteriorly, the os coxa articulates with the sacrum, forming the sacroiliac joint, the source of much lower back pain; it’s formed by the connection of the hip bones at the sacrum. Toward the front of the pelvic girdle, the two os coxae join to form the symphysis pubis, which is made up of fibrocartilage. A cup-like socket called the acetab- ulum articulates with the ball-shaped head of the leg’s femur (thigh bone). Also inside each lower leg is the fibula bone, which joins with the tibia to connect with the seven tarsal bones that make up the ankle. The tarsals join with the five metatarsals that form the foot, which in turn connect to the phalanges of the toes — a pair of phalanges in the big toe and triplets in each of the other toes. Use the terms that follow to identify the bones and structures of the appendicular skeleton shown in Figure 5-10. The structure of the humerus that articulates with the head of the radius is the a. Hands Arthrology: Articulating the Joints Arthrology, which stems from the ancient Greek word arthros (meaning “jointed”), is the study of those structures that hold bones together, allowing them to move to vary- ing degrees — or fixing them in place — depending on the design and function of the joint. The term articulation, or joint, applies to any union of bones, whether it moves freely or not at all. Chapter 5: A Scaffold to Build On: The Skeleton 83 Inside some joints, such as knees and elbows, are fluid-filled sacs called bursae that help reduce friction between tendons and bones; inflammation in these sacs is called bursitis. Some joints are stabilized by connective tissue called ligaments that range from bundles of collagenous fibers that restrict movement and hold a joint in place to elastic fibers that can repeatedly stretch and return to their original shapes. The three types of joints are as follows: Fibrous: Fibrous tissue rigidly joins the bones in a form of articulation called synarthrosis, which is characterized by no movement at all. Cartilaginous: This type of joint is found in two forms: • Synchondrosis articulation involves rigid cartilage that allows no move- ment, such as the joint between the ribs, costal cartilage, and sternum. Synovial: Also known as diarthrosis, or freely moving, joints, this type of articula- tion involves a synovial cavity, which contains articular fluid secreted from the synovial membrane to lubricate the opposing surfaces of bone. The synovial membrane is covered by a fibrous joint capsule layer that’s continuous with the periosteum of the bone. Ligaments surrounding the joint strengthen the capsule and hold the bones in place, preventing dislocation. In some synovial joints, such as the knee, fibrous connective tissue called meniscus develops in the cavity, dividing it into two parts. There are six classifications of moveable, or synovial, joints: Gliding: Curved or flat surfaces slide against one another, such as between the carpal bones in the wrist or between the tarsal bones in the ankle. Hinge: A convex surface joints with a concave surface, allowing right-angle motions in one plane, such as elbows, knees, and joints between the finger bones. Pivot (or rotary): One bone pivots or rotates around a stationary bone, such as the atlas rotating around the odontoid process at the top of the vertebral column. Condyloid: The oval head of one bone fits into a shallow depression in another, allowing the joint to move in two directions, such as the carpal-metacarpal joint at the wrist, or the tarsal-metatarsal joint at the ankle. Saddle: Each of the adjoining bones is shaped like a saddle (the technical term is reciprocally concavo-convex), allowing various movements, such as the car- pometacarpal joint of the thumb. Ball-and-socket: The round head of one bone fits into a cup-like cavity in the other bone, allowing movement in many directions so long as the bones are nei- ther pulled apart nor forced together, such as the shoulder joint between the humerus and scapula and the hip joints between the femur and the os coxa. Use the terms that follow to identify the structures that form a synovial joint shown in Figure 5-11. The structure in the knee that divides the synovial joint into two separate compartments is the a.

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In other parts of Colombia such as the Páez and Inga pueblos cheap 500mg keftab with mastercard, and other ethnic groups in the Putumayo area buy keftab 375mg without prescription, the plant is known as yajé. Resguardo Peñas Caquéta medio, Amazonas, Negras, Caquéta medio, Amazonas, Colombia, Colombia, 10 January 1992. The variety of yajé shown in the photograph is cielo (sky) ayahuasca or cielo yajé. It is called this because when the ritual is carried out with this variety of yajé it is possible to travel to infinity. Uses Yajé and other entheogenic plants are used in the realisation of powerful and dangerous shamanic journeys of recognition. In the state of trance when people move from normal conscience to altered conscience by means of taking, inhaling or bathing in entheogenic substances, or using other methods under the effect of entheogens, especially yajé or ayahuasca, conscience and sensations are activated, including: intuition, visionary capacity and amplified sensorial perception, among others; spiritual forms are ‘seen’ and ‘felt’ and strange odours and surroundings are experienced. During these journeys the shaman is exposed to a struggle between good and evil which he must overcome using his skills and wisdom. The indi- vidual’s fears are brought to the surface in such a way that, on returning from the entheogenic trance to the normal state of conscience, the memory of the trance remains. For Uitoto and Muinane ethnic groups the use of yaje is used only as a last resource for the solution of problems or illnesses that cannot be resolved using other more commonly used ritual plants such as coca or tobacco or minerals. They have their own methods of identification, which they describe as identifying the energy of the plant – its power to heal. The location, identification and collection of the plants require great concentration. An infinite number of curative plants can be collected from the forest, but the most commonly used are planted very near to the houses to be avail- able for frequent use; others are planted together with the ritual and edible plants in the chagras. The time of collection of medicinal plants is considered to be important and depends on when the plants are sensed to be more powerful or have positive energy to heal. In general the ethnic groups in Amazonia use their medicinal plants fresh because they consider them to have more healing power than when dried. When available the indigenous groups will use western medicine to treat fractures. However, due to the remote location of many of the communities, the sabedores use the bark of certain trees as a splint which they say heals the bone as well as acting as an analgesic. Examples of traditional curative plant medicines Among the enormous number of plants, below are included a few of those used by sabedores from different tribes in the Amazon forest. Amori (Uitoto language) Preparation The Amori tree, which has not been botanically identified, is found in primary forest. The sabedores record it as having hallucinogenic effects and it is also known as ambil de monte. It is cura- Araracuara, Caquéta medio, Amazonas, tive for nervous conditions, high Colombia, 26 June 1991. In the Caquetá Media geographical area Albahaca is known in the Uitoto language as Jaibikie. According to Sabedor Oscar Román, the plant is used to bathe children to improve their mood and to lower fevers caused by influenza and cough. To treat diarrhoea the plant is prepared in hot water with cinnamon and lemon (see interview 3 in the addendum). As a comparison, we include an example of use of the same plant, Alba- haca (Ocimum micranthum), used by the Quichua ethnic group, Amazon forest, Ecuador. In this case, Sabedor Gabriel Tapuy explains that the plant can be used to treat ‘mal aire’. The plant is collected and passed over the person repeatedly in the form of a cross in order to extract negative energies or ‘clean’ them. According to Sabedor Gabriel, the person who carries out the treatment will feel the arm become heavy if he or she is successful at extracting the ‘mal aire’ (see interview 4 in the addendum). Traditional medicine used in the Colombian Amazon forest | 77 Badea (Passiflora quadrangularis) Sabedor Hilario Rivero Yukuna, originally from Mirití said in an interview in, Leticia, Amazonas, Colombia (see interview 5 in the addendum): Seven leaves of Badea are collected and cooked in water. The plant is used to clean the stomach when suffering painful cramps and diarrhoea. Members of other ethnic groups or pueblos such as Muinas (Uitotos), Muinanes, Andokes, Yukunas and others use the young Badea leaves to cure hepatitis A and B in the early stages: on the first day of treatment, the juice of one leaf is taken, and each following day the juice of another leaf is added until nine leaves are being used; the plant is then suspended for 3 days. On resuming the treatment, the number of leaves taken is reduced by one leaf each day until returning to one leaf (see interview 6 in the addendum). It is also used topically as an anti-inflammatory and to control haemorrhage from a wound; the cold leaf is applied directly to the affected area. Internally it can be taken as an infusion made with the leaves, or taken as the pure juice to lower blood pressure. In order to increase hair growth the leaf is crushed and applied to the head without bathing. The fresh fungus is red in colour, and at this stage is 78 | Traditional medicine Figure 4. After 3 or 4 days the fungus begins to turn white in colour and at this stage of ageing is highly toxic (see interview 8 in the addendum).

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