Test Bank Of Family Health Care Nursing Theory Practice 5 Ed by Joanna Rowe Kaakinen, Deborah Padgett Coehlo

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Test Bank Of Family Health Care Nursing Theory Practice 5 Ed by Joanna Rowe Kaakinen, Deborah Padgett Coehlo

 

Chapter 1

 

Family Health Care Nursing: An Introduction

 

This chapter provides an introduction to and broad overview of family health care nursing, explaining why this information is important to nurses who care for today’s families. Family nursing is a scientific discipline based in theory, and Chapter 1 introduces theoretical concepts important to the nurse’s understanding of how to care for groups. It also provides definitions of family, family health, family health care nursing, and traits healthy families exhibit. It describes the evolution in the past few decades of family nursing as its own specialty as well as the many roles for nurses within this discipline. The concepts of family structure, function, and process are reviewed, as are family roles. Chapter 1 emphasizes both the historical and evolving value of family as a basic unit of human society and as a unit of analysis. It approaches health and illness as family events, with changes in the individual affecting the entire family’s functioning. This chapter lays the foundational knowledge of the nature of interventions in family nursing.

 

Critical Concepts

 

  • Family health care nursing is an art and a science that has evolved as a way of thinking about and working with families.

 

  • Family nursing is a scientific discipline based in theory.

 

  • Health and illness are family events.

 

  • The term family is defined in many ways, but the most salient definition is, The family is who the members say it is.

 

  • An individual’s health (on the wellness–illness continuum) affects the entire family’s functioning, and in turn, the family’s ability to function affects each member’s health.

 

  • Family health care nursing knowledge and skills are important for nurses who practice in

 

 

 

 

 

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generalized and in specialized settings.

 

  • The structure, function, and processes of families have changed, but the family as a unit of analysis and service continues to survive over time.

 

  • Nurses should intervene in ways that promote health and wellness, as well as prevent illness risks, treat disease conditions, and manage rehabilitative care needs.

 

  • Knowledge about each family’s structure, function, and process informs the nurse in how to optimize nursing care in families and provide individualized nursing care tailored to the uniqueness of every family system.

 

Review of Key Terms

 

Contemporary family: Generally refers to the changing structure and function of today’s families, including single-headed households, cohabitating couples and parents, blended families, same-sex couples and parents, and grandparents raising grandchildren. Family functions have expanded from a focus on reproduction, socialization of the young, economic survival, and health care functions. The functions have shifted to include intimate relationships, communication, and shared responsibilities with the larger society.

 

Family: Two or more individuals who depend on one another for emotional, physical, and economic support. The members of the family are self-defined (Hanson, 2005).

 

Family as a component of society: Care that views the family as one of many institutions in society, similar to the health, economic, educational, or religious institutions.

 

Family as a system: Care that focuses on the interaction between and among family members, including subsystems within the family (e.g., dyads such as mother–father and parent–child) and outside the family (e.g., schools, churches, and community agencies).

 

 

 

 

 

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Family as client: Care that focuses on the family members as a unit rather than any one individual.

 

Family as context: Care that focuses on the individual but considers the family’s influence on the individual.

 

Family functions vs. family functioning: Family functions are all the ways that families serve their members, related to prescribed social and cultural obligations and roles of family in society. Denham (2003) described family functioning as “individual and cooperative processes used by developing personas to dynamically engage one another and their diverse environments over the life course” (p. 277).

 

Family health: A dynamic, changing state of well-being that includes the biological, psychological, spiritual, sociological, and cultural factors of individual members and the whole family system.

 

Family health nursing: The process of providing for health care needs of families within the scope of nursing practice. Nursing care can be designed with the family as context, the family as a whole, the family as a system, or the family as a component of society.

 

Family process: The ongoing interaction between family members through which they accomplish their instrumental and expressive tasks (Denham, 2005).

 

Family structure: The ordered set of relationships within the family and between the family and other social systems. Genograms and ecomaps are tools used for the assessment of who comprises the family unit and the interactions between family members and other systems. Health function of families: Refers to historical and contemporary tasks of family members providing care for the health and illness of one another; vitally important as a resource to the larger society.

 

 

 

 

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Healthy families: Optimally functioning families have the ability to negotiate; communicate in clear, open, and spontaneous ways; have respect for each other; encourage autonomy; accept responsibility; demonstrate warmth; and express optimism and enjoyment of shared experiences. Traditional family: Usually refers to a more traditional concept of family structure including a husband, wife, and biological children.

 

U.S. Census definition of family: A group of persons united by ties of marriage, blood, or adoption, constituting a single household; interacting and communicating with each other in their respective social roles of husband and wife, mother and father, son and daughter, brother and sister; and creating and maintaining a common culture.

 

 

Terms Used to Describe Family Nursing Roles

 

“Case finder” and epidemiologist: The family nurse gets involved in case finding and becomes a tracker of disease. For example, consider the situation in which a family member has been recently diagnosed with a sexually transmitted disease. The nurse would engage in sleuthing out the sources of the transmission and in helping get other sexual contacts in for treatment. Screening of families and subsequent referral of the family members may be a part of this role. Case manager: Included in the contemporary understanding of this nursing role is coordination and collaboration between a family and the health care system. The case manager has been formally empowered to be in charge of a case. For example, a family nurse working with seniors in the community may become assigned to be the case manager for a patient with Alzheimer disease.

 

“Clarify and interpret”: The nurse clarifies and interprets data to families in all settings. For example, if a child in the family has a complex disease, such as leukemia, the nurse clarifies and

 

 

 

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interprets information pertaining to diagnosis, treatment, and prognosis of the condition to parents and extended family members.

 

Consultant: The family nurse serves as a consultant to families whenever asked or whenever necessary. In some instances, he or she consults with agencies to facilitate family-centered care. For example, a clinical nurse specialist in a hospital may be asked to assist the family in finding the appropriate long-term care setting for their sick grandmother. In this role the nurse comes into the family system by request for a short period and for a specific purpose.

 

Coordinator, collaborator, and liaison: The family nurse coordinates the care that families receive, collaborating with the family to plan care. For example, if a family member has been in a traumatic accident, the nurse would be a key person in helping families access resources—from inpatient care, outpatient care, home health care, and social services to rehabilitation. The nurse may serve as the liaison among these services.

 

Counselor: The family nurse plays a therapeutic role in helping individuals and families solve problems or change behavior. An example from the mental-health arena is a family that requires help with coping with a long-term chronic condition, such as when a family member has been diagnosed with schizophrenia.

 

“Deliverer” and supervisor of care and technical expert: The family nurse either delivers or supervises the care that families receive in various settings. To do this, the nurse must be a technical expert both in terms of knowledge and in skill. For example, the nurse may be the person going into the family home daily to consult with the family and help take care of a child on a respirator.

 

“Environmental specialist”: The family nurse consults with families and other health care professionals to modify the environment. For example, if a man with paraplegia is about to be

 

 

 

 

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discharged from the hospital to home, the nurse assists the family in modifying the home environment so that the patient can move around in a wheelchair and engage in self-care. Family advocate: The family nurse advocates for families with whom he or she works; the nurse empowers family members to speak with their own voices, or the nurse speaks out for the family. An example is the nurse who is advocating for family safety by supporting legislation that requires wearing seat belts in motor vehicles.

 

Health teacher: The family nurse teaches about family wellness, illness, relations, and parenting, to name a few topics. The teacher–educator function is ongoing in all settings in both formal and informal ways. Examples include teaching new parents how to care for their infant and giving instruction about diabetes to a newly diagnosed adolescent boy and his family members.

 

Researcher: The family nurse should identify practice problems and find the best solution for dealing with these problems through the process of scientific investigation. An example might be collaborating with a colleague to find a better intervention for helping families cope with incontinent elder adults living in the home.

 

Role model: The family nurse is continuously serving as a role model to other people through his or her activities. A school nurse who demonstrates the right kind of health practices in personal self-care serves as a role model to parents and children alike.

 

Surrogate: The family nurse serves as a surrogate by substituting for another person. For example, the nurse may stand in temporarily in the role of a loving parent to an adolescent who is giving birth to a child alone in the labor and delivery room.

 

 

 

 

 

 

 

 

 

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Quiz and Exam Questions

 

  1. Which of the following statements is true about family nursing practice?

 

  1. Family care is concerned with the experience of the family over time.

 

  1. Family nursing is directed at families whose members are both healthy and ill.

 

  1. The family nurse is responsible with the family itself for defining who is the family.

 

  1. If family nursing practice is successful, the family members will simultaneously achieve maximum health.

 

  1. All of the above

 

  1. Which of the following nursing specialties has historically focused on the quality of family health?

 

  1. Maternity nursing

 

  1. Pediatric nursing

 

  1. Public health nursing

 

  1. All of the above

 

  1. Family health care nursing is a specialty that started near the end of the 20th century.

 

  1. True

 

  1. False

 

  1. The most appropriate time for the nurse to collaborate with a family regarding realistic and culturally appropriate outcomes is before addressing interventions.

 

  1. True

 

  1. False

 

  1. Select four traits that are common in healthy families. a. Develops suspicion amongst members

 

 

 

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  1. Exhibits a sense of shared responsibility

 

  1. Admits to and seeks help with problems

 

  1. Enforces participation in rituals and tradition

 

  1. Shares leisure time

 

  1. Updates each other through social media about daily happenings g. Maintains unchangeable rules

 

  1. Teaches respect for others

 

 

 

 

Reflection Questions

 

Note: All chapters of the instructor’s manual include reflective questions as means of evaluating learning. A deep understanding of family requires more than simply choosing an answer in a multiple-choice format. Reflective writing or in-depth thought about one’s assumptions, values, and belief systems can result in both personal and professional growth for students and nurses alike.

 

  1. Describe the difference between family as a client and family as a system.

 

Answer: The family as a client centers on the assessment of all individual family members where the family is in the foreground and individuals are in the background. The family is the sum of individual family members with a focus on each and every individual such as one may see in a family medical practice office. The family as system views the family as an interactional system whereby the interactions between family members become the target for nursing interventions. The nurse focuses on the individual and family simultaneously.

 

 

 

 

 

 

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  1. Discuss three traditional functions families performed over history that still exist today. What are two family functions that have become more meaningful in modern times?

 

Answer:

 

  • Families existed to achieve economic survival.

 

  • Families existed to reproduce the species.

 

  • Families existed to provide protection from hostile forces.

 

  • Families passed along the religious faith (culture).

 

  • Families educated their children (socialization).

 

  • Families conferred social status on their children.

 

  • In modern times, the building of relationships and health care function of families have received more attention.

 

 

Student Learning Activities

 

  1. Have students working in a clinical site ask their patients who is in their family, and suggest including this information on the patient record.

 

  1. In Chapter 1, family is defined as “two or more individuals who depend on one another for emotional, physical, and economical support. The members of the family are self-defined” (Kaakinen et al., 2010, p. 5). Have students discuss this definition in small groups and then report back to the larger class how they feel about this definition versus others (U.S. Census, each state, province, etc.) when applied to their own personal or professional lives, or both.

 

 

 

 

 

 

 

 

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  1. List five traits that are common in healthy families. Give examples of how the family nurse would assess these. Have students do an assessment on their own families according to the criteria for healthy families found in the text (Box 1-1).

 

Answer: Answers from the following are acceptable: communicates and listens to one another, affirms and supports one another, teaches respect for others, develops a sense of trust in members, displays a sense of play and humor, exhibits a sense of shared responsibility, teaches a sense of right and wrong, has a strong sense of family in which rituals and traditions abound, has a balance of interaction among members, has a shared religious core, respects the privacy of one another, values service to others, fosters family table time and conversation, shares leisure time, or admits to and seeks help with problems.

 

  1. Have students learn how agencies in which they are assigned clinical experiences define family. Have students interview nurses in assigned units to learn what kinds of ethical dilemmas or legal considerations regarding family members the nurses have faced in their practice.

 

  1. Have students discuss the implications for nursing care when the agency’s definition of family is not congruent with those of the patient or nurse, or both. Alternatively, students may be able to describe and reflect on their own experiences as a student nurse, depending on where they are at in their program of study.

 

  1. Have students explore the history of families, choosing a specific topic to follow across time. Topics of interest include child abuse, domestic violence, unwed mothers, women and work, child labor, alcohol dependency, juvenile delinquency, and mental health (particularly depression and suicide). This exercise emphasizes that contemporary

 

 

 

 

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families have improved many of the conditions most damaging to individuals (child abuse, child labor, etc.) but have increased other areas (i.e., depression and suicide rates).

 

 

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