Explain curative factors that occurred in the group. Include how these factors     might impact client progress.

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            Group Processes

Group therapy is an effective treatment option for a wide range of disorders and is much more cost-efficient than individual therapy. As a result, many insurance companies are showing preference for group therapy over individual therapy. This has led to more therapists including group therapy in their practices, making it very likely that you will facilitate group therapy in the future. To successfully develop groups and apply this therapeutic approach, it is essential for you to have an understanding of group processes and formation.

This week, as you examine group processes and stages of formation, you explore curative factors of groups and strategies for managing intragroup conflict. You also assess progress for a client family receiving psychotherapy and develop progress and privileged psychotherapy notes for the family.

 

                         Assignment: Group Processes and Stages of Formation

In your role, you must understand group processes and stages of formation, as this will help you develop groups and determine an individual’s appropriateness for group therapy. Whether you are at the beginning stages of group formation or facilitating a session for a developed group, it is important to consider factors that may influence individual client progress.

For this Assignment, as you examine the video Group Therapy: A Live Demonstration in this week’s Learning Resources, consider the group’s processes, stages of formation, and other factors that might impact the effectiveness of group therapy for clients.

                                                                                To prepare:

· Review this week’s Learning Resources and reflect on the insights they provide

on group processes.

· View the media, Group Therapy: A Live Demonstration, and consider the group

dynamics. (THE VIDEO TRANSCRIPT IS ATTACHED TO THIS ASSIGNMENT)

                                                           

                                               The Assignment

In 3-page paper, address the following:

· Explain the group’s processes and stage of formation.

· Explain curative factors that occurred in the group. Include how these factors

might impact client progress.

· Explain intragroup conflict that occurred and recommend strategies for

managing the conflict. Support your recommendations with evidence-based

literature.

N.B: REMEMBER TO INCLUDE INTRODUCTION, CONCLUSION AND REFERENCES

                                                              Learning Resources

Required Readings

Yalom, I. D., & Leszcz, M. (2005). The theory and practice of group psychotherapy (5th ed.). New York, NY: Basic Books.

The Theory and Practice of Group Psychotherapy, 5th Edition by Yalom, Irvin D. ; Leszcz, Molyn. Copyright 2005 by Hachette Books Group. Reprinted by permission of Hachette Books Group via the Copyright Clearance Center.

Which patient statement reflects a spiritual belief that defines illness?

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Question 1 While caring for a patient from the Chinese culture, the nurse learns that the patient has a specific practice that follows yin and yang. What impact will this have on the patient’s dietary intake?

1. The patient will eat only specified combinations of food.
2. Some foods are only eaten at different times of the year.
3. There are specific foods for specific purposes.
4. Identifies if foods should be eaten hot or cold

Question 2 What would the nurse identify as contributors to illness?

Select all that apply.

1. Imbalance of body, mind, or spirit
2. Imbalance with the family
3. Imbalance with the community
4. Imbalance with the forces of the natural world
5. Imbalance with socioeconomic status

Question 3 While performing a home assessment, the home care nurse identifies traditional practices that the patient uses to protect health.Which are practices used to protect health?

Select all that apply.

1. Picture of a saint hanging on the wall in the bedroom
2. String of garlic hanging in the kitchen
3. Burning a candle on the kitchen table
4. Wearing a purple scarf
5. Chanting prayers

Question 4 Which actions would the nurse categorize as traditional mental HEALTH maintenance?

1. Activities to concentrate and stimulate the mind
2. Avoiding physically demanding hobbies
3. Using medications to preserve chemical balance in the brain
4. Wearing head covering in the cold to preserve head warmth

Question 5 Which action do most people take when experiencing a mild illness?

1. Rely on self-treatment or do nothing.
2. Ingest herbs specific to how they are feeling.
3. Consult a local faith HEALER.
4. Immediately seek medical attention.

Question 6 A patient wants to use a complementary medicine approach for a chronic health problem. Which approaches would the nurse suggest the patient use?

Select all that apply.

1. Hypnotherapy
2. Qi gong
3. Biofeedback
4. Reiki

Question 7 During an assessment, a patient tells the nurse, “An onion a day keeps everyone away.” How does this philosophy protect health?

1. An onion protects the person from coming in contact with those who might be ill.
2. This philosophy affirms the belief in the power of onions to prevent disease.
3. This philosophy recognizes the special antibiotic properties contained within onions.
4. This philosophy advertises that onions have special healing abilities.

Question 8 Which action does the nurse recognize as essential for maintaining health?

1. Having a strong familial and social support system
2. Practicing moderation in all activities
3. Ensuring proper balance in all aspects of life
4. Taking a daily multivitamin

Question 9 During a health history, a patient tells the nurse about following traditional epidemiological practices. What is the purpose of these practices?

1. Preserve a heritage
2. Used as a part of the patient’s religion.
3. Cure an illness
4. Uses folk medicine herbal remedies

Question 10 Which activities does the nurse recognize as being used by a patient to restore health?

Select all that apply.

1. Drinking herbal tea
2. Using massage
3. Prayer
4. Meditation
5. Purging

Question 11 A patient tells the nurse that an illness was caused by the evil eye. What are common beliefs about this cause of illness?

Select all that apply.

1. Power comes from the eye and strikes a victim.
2. The onset of illness is sudden.
3. The person who cast the evil eye may not be aware of the power.
4. The illness may be cured with rituals.
5. The illness will become chronic.

Question 12 Which statement would the nurse utilize to define HEALTH?

1. The balance of a person within the outside world
2. A continuous struggle between balance and imbalance
3. Recovering from an illness
4. Physical wholeness for activity

Question 13 While assessing a patient from the Jewish culture, the nurse learns that the patient believes that an illness is being caused by another soul. What is this health belief considered?

1. Aberglobin

2. Kayn aynhoreh

3. Szatan

4. Dybbuk

Question 14 While working with community members of different cultures, the nurse learns a variety of beliefs about the evil eye. What are the consistent variables of this cause of illness?

Select all that apply.

1. How it is cast
2. Who can cast it
3. Who receives it
4. Degree of power it has
5. What body part is afflicted

Question 15 The nurse is trying to determine if a treatment that a patient has been taking for an illness is considered a homeopathic remedy. Which are criteria of homeopathy?

Select all that apply.

1. The person, and not the disease, is being treated.
2. Does not conform to scientific standards
3. A substance used would cause symptoms in a healthy person.
4. Spinal manipulation realigns mental impulses.

Question 16 The nurse notes that a patient’s religion is identified as being Christian Science. How will this religious belief impact the health care that the patient will want?

1. The patient will choose the method of health care that is the most effective.
2. The patient will use similar treatments for healing disease.
3. The patient uses aromas for healing.
4. The patient will ask for spinal manipulation.

Question 17 The nurse notes that a patient’s religion is identified as being Christian Science. How will this religious belief impact the health care that the patient will want?

1. The patient will choose the method of health care that is the most effective.
2. The patient will use similar treatments for healing disease.
3. The patient uses aromas for healing.
4. The patient will ask for spinal manipulation.

Question 18 In some cultures, spitting is a health protection activity done after giving someone else a compliment. What is the purpose of this action?

1. Prevents the recipient of the compliment from receiving an evil spell
2. Avoids direct speech afterwards with the person who receives the compliment
3. Prevents the recipient of the compliment from being too flattered
4. Makes the air better to take in the compliment

Question 19 Which patient statement reflects a spiritual belief that defines illness?

1. “I am being punished for breaking a religious code.”
2. “It is a necessary part of my religious culture.”
3. “I failed to wear special amulets to ward it off.”
4. “I am sick because I violated dietary practices.”

Question 20 The nurse learns that a patient used to follow homeopathic medicine but now only uses allopathic medicine approaches. What is the significance of allopathic medicine?

1. Espouses empiric methods for treating disease
2. Accepts other forms of therapy as valid for treating disease
3. Is practiced only where it is accepted
4. Encompasses different treatment modalities within its framework

Analyze important information about Erikson’s Stages of Development.

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N3325 Holistic Care of Older Adults

image1.jpg

Submit by 2359 Saturday of Week 2.

Name: Date:

Overview: Life Review – Ego Integrity Research (Erikson)

In preparation for the Life Review interview, you will research the theories of Erik Erikson. This assignment will help you record, organize, and analyze important information about Erikson’s Stages of Development.

At the completion of the interview, you may be able to determine the degree to which the client has achieved ego integrity as defined by Erikson (1986). Failure to achieve ego integration may manifest itself in disgust and/or fear of death. Nurses can encourage elders to write about their life experiences by assigning topics which can be shared with a group or can use a guided interview to provide a sense of continuity and experience the human need for connectedness. Life that can be viewed across years may balance the highs and lows with a sense of completeness, as opposed to remembering the regrets.

Performance Objectives:

· Apply gerontologic nursing principles and standards in nursing practice across the continuum of elder care.

· Use current evidence and theories in care of older adults.

Rubric

Use this rubric to guide your work on the assignment, “Ego Integrity Research.”

Levels of Achievement
Criteria Novice Competent Proficient
Week 1- Assignment 2 Conduct research and list sources consulted regarding Erikson’s Stages of Development

Weight 33.00%

 0 %

Less than 2 sources included

 50 %

APA formatted list of 2 sources or APA formatting incorrect

 100 %

APA formatted list of 3 or more sources included
Record Key Ideas. Documentation of Important information

Weight 50.00%

 0 %

Information was cut and pasted directly from other sources

 50 %

Key ideas recorded but no evidence of synthesis

 100 %

Ideas show synthesis of information gathered
Spelling punctuationa and grammar

Weight 17.00%

 0 %

More than 2 errors

Or APA not used

 50 %

APA format

1-2 errors

 100 %

APA format

No errors

A. Conduct research: List sources of information regarding Erikson’s theories that you used during your research. Be sure to follow APA format.

B. Key ideas: Use this space to record and organize the information you discover during your research. Focus on key ideas, examples, and applications that will relate to your interview with your Life Review elder. (This information should not exceed two pages.). DO NOT COPY AND PASTE FROM YOUR REFERENCES. Please supply a synthesis of what you have learned about the last stage of development (ego integrity vs despair). Please do not discuss the other developmental stages. Pretend that your instructor knows nothing about this stage of development and how it affects older adults – teach us! Please write in paragraph format rather than bullet points.

Week 2 – Assignment 2: Ego Integrity Research (Erikson)

Which of the following statements best reflects an aspect of the platelets that would constitute part of the CBC? 

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Question 21

During a flu shot clinic, one of the questions the student nurse asks relates to whether the patient has had Guillain-Barré syndrome in his medical history. The patient asks, “What is that?” How should the nursing student reply?

Answers:

A. “A type of paralysis that affects movement on both sides of the body that may even involve the respiratory muscles”

B. “Influenza-like illness where you had fever and chills for 2 to 3 days after your last flu shot”

C. “A degenerative disease where you have trouble walking without the help of a cane or walker”

D. “Swelling of your arm where you got your flu shot, and maybe your eyes and lips had some swelling as well”

Question 22

A 22-year-old female college student is shocked to receive a diagnosis of myasthenia gravis. What are the etiology and most likely treatment for her health problem?

Answers:

A. Excess acetylcholinesterase production; treatment with thymectomy

B. A decline in functioning acetylcholine receptors; treatment with corticosteroids and intravenous immunoglobulins

C. Cerebellar lesions; surgical and immunosuppressive treatment

D. Autoimmune destruction of skeletal muscle cells; treatment with intensive physical therapy and anabolic steroids

Question 23

A baseball player was hit in the head with a bat during practice. In the emergency department, the physician tells the family that he has a “coup”injury. How will the nurse explain this to the family so they can understand?

Answers:

A. “It’s like squeezing an orange so tight that the juice runs out of the top.”

B. “When the bat hit his head, his neck jerked backward causing injury to the spine.”

C. “Your son has a contusion of the brain at the site where the bat hit his head.”

D. “Your son has a huge laceration inside his brain where the bat hit his skull.”

Question 24

Which of the following glycoproteins is responsible for treating such diseases as bone marrow failure following chemotherapy and hematopoietic neoplasms such as leukemia? Answers:

A. Growth factors and cytokines

B. T lymphocytes and natural killer cells

C. Neutrophils and eosinophils

D. Natural killer cells and granulocytes

Question 25

While being on subcutaneous heparin injections for deep vein thrombosis during her latter pregnancy, a patient begins to experience major side effects. Her OB-GYN physician has called in a specialist who thinks that the patient is experiencing heparin-induced thrombocytopenia. The nurse should anticipate which of the following orders?

Answers:

A. Immediately discontinue the heparin therapy

B. Switch to Coumadin 2.5 mg once/day

C. Decrease the dose of heparin from 5000 units b.i.d to 3000 units b.i.d

D. Infuse FFP stat

Question 26

Which of the following individuals would most likely experience global ischemia to his or her brain?

Answers:

A. A woman who is being brought to hospital by ambulance following suspected carbon monoxide poisoning related to a faulty portable heater

B. A male client who has just had an ischemic stroke confirmed by CT of his head

C. A woman who has been admitted to the emergency department with a suspected intracranial bleed

D. A man who has entered cardiogenic shock following a severe myocardial infarction

Question 27

A new mother and father are upset that their 2-day-old infant is requiring phototherapy for hyperbilirubinemia. The pediatrician who has followed the infant since birth is explaining the multiplicity of factors that can contribute to high serum bilirubin levels in neonates. Which of the following factors would the physician be most likely to rule out as a contributor?

Answers:

A. Transitioning of hemoglobin F (HbF) to hemoglobin A (HbA)

B. Hepatic immaturity of the infant

C. Hypoxia

D. The fact that the infant is being breast-fed

Question 28

A 14-year-old boy has been diagnosed with infectious mononucleosis. Which of the following pathophysiological phenomena is most responsible for his symptoms?

Answers:

A. Viruses are killing some of his B cells and becoming incorporated into the genome of others.

B. The Epstein-Barr virus (EBV) is lysing many of the boy’s neutrophils.

C. The virus responsible for mononucleosis inhibits the maturation of myeloblasts into promyelocytes.

D. The EBV inhibits the maturation of white cells within his peripheral lymph nodes.

Question 29

A 16-year-old female has been brought to her primary care physician by her mother due to the girl’s persistent sore throat and malaise. Which of the following facts revealed in the girl’s history and examination would lead the physician to rule out infectious mononucleosis?

Answers:

A. Chest auscultation reveals crackles in her lower lung fields bilaterally.

B. Her liver and spleen are both enlarged.

C. Blood work reveals an increased white blood cell count.

D. The girl has a temperature of 38.1°C (100.6°F) and has enlarged lymph nodes.

Question 30

A 30-year-old woman who has given birth 12 hours prior is displaying signs and symptoms of disseminated intravascular coagulation (DIC). The client’s husband is confused as to why a disease of coagulation can result in bleeding. Which of the nurse’s following statements best characterizes DIC?

Answers:

A. “The same hormones and bacteria that cause clotting also cause bleeding.”

B. “Massive clotting causes irritation, friction, and bleeding in the small blood vessels.”

C. “So much clotting takes place that there are no available clotting components left, and bleeding ensues.”

D. “Excessive activation of clotting causes an overload of vital organs, resulting in bleeding.”

Question 31

A 20-year-old has been diagnosed with an astrocytic brain tumor located in the brain stem. Which of the following statements by the oncologist treating the client is most accurate?

Answers:

A. “Our treatment plan will depend on whether your tumor is malignant or benign.”

B. “This is likely a result of a combination of heredity and lifestyle.”

C. “The major risk that you face is metastases to your lungs, liver, or bones.”

D. “Your prognosis will depend on whether we can surgically resect your tumor.”

Question 32

A patient diagnosed with low-risk chronic lymphocytic leukemia (CLL) has recently developed thrombocytopenia. One of the medications utilized to treat this would be Answers:

A. cisplatin, a chemotherapeutic.

B. vincristine, a Vinca alkaloid.

C. dexamethasone, a corticosteroid.

D. doxorubicin, a cytotoxic antibiotic.

Question 33

Two nursing students are attempting to differentiate between the presentations of immune thrombocytopenic purpura (ITP) and thrombotic thrombocytopenic purpura (TTP). Which of the students’ following statements best captures an aspect of the two health problems? Answers:

A. “ITP can be either inherited or acquired, and if it’s acquired, it involves an enzyme deficiency.”

B. “Both of them involve low platelet counts, but in TTP, there can be more, not less, hemostasis.

C. “TTP can be treated with plasmapheresis, but ITP is best addressed with transfusion of fresh frozen plasma.”

D. “Both diseases can result from inadequate production of thrombopoietin by megakaryocytes.”

Question 34

A physician is explaining to a 40-year-old male patient the importance of completing his course of antibiotics for the treatment of tuberculosis. The physician explains the damage that could occur to lung tissue by Mycobacterium tuberculosis. Which of the following phenomena would underlie the physician’s explanation?

Answers:

A. Tissue destruction results from neutrophil deactivation.

B. Neutrophils are ineffective against the Mycobacterium tuberculosis antigens.

C. Macrophages form a capsule around the Mycobacterium tuberculosis bacteria, resulting in immune granulomas.

D. Nonspecific macrophage activity leads to pulmonary tissue destruction and resulting hemoptysis.

Question 35

A teenager, exposed to West Nile virus a few weeks ago while camping with friends, is admitted with headache, fever, and nuchal rigidity. The teenager is also displaying some lethargy and disorientation. The nurse knows which of the following medical diagnoses listed below may be associated with these clinical manifestations?

Answers:

A. Encephalitis

B. Lyme disease

C. Rocky Mountain spotted fever

D. Spinal infection

Question 36

A patient has been diagnosed with anemia. The physician suspects an immune hemolytic anemia and orders a Coombs test. The patient asks the nurse what this test will tell the doctor. The nurse replies,

Answers:

A. “They are looking for the presence of antibody or complement on the surface of the RBC.”

B. “They will look at your RBCs under a microscope to see if they have an irregular shape (poikilocytosis).”

C. “They will wash your RBCs and then mix the cells with a reagent to see if they clump together.”

D. “They will be looking to see if you have enough ferritin in your blood.”

Question 37

A 29-year-old construction worker got a sliver under his fingernail 4 days ago. The affected finger is now reddened, painful, swollen, and warm to touch. Which of the following hematological processes is most likely occurring in the bone marrow in response to the infection?

Answers:

A. Phagocytosis by myelocytes

B. Increased segmented neutrophil production

C. High circulatory levels of myeloblasts

D. Proliferation of immature neutrophils

Question 38

A surgeon is explaining to the parents of a 6-year-old boy the rationale for the suggestion of removing the boy’s spleen. Which of the following teaching points would be most accurate?

Answers:

A.“We think that his spleen is inhibiting the production of platelets by his bone marrow.”

B.“We believe that your son’s spleen is causing the destruction of many of his blood platelets, putting him at a bleeding risk.”

C.“Your son’s spleen is holding on to too many of his platelets, so they’re not available for clotting.”

D.“Your son’s spleen is inappropriately filtering out the platelets from his blood and keeping them from normal circulation.”

Question 39 A nurse practitioner is providing care for a client with low levels of the plasma protein gamma globulin. The nurse would recognize that the client is at risk of developing which of the following health problems?

Answers:

A. Anemia

B. Blood clots

C. Jaundice

D. Infections

Question 40

A 32-year-old woman presents at her neighborhood health clinic complaining of weakness and a feeling of abdominal fullness. She reports that 6 months earlier she noticed that she had difficulty in maintaining the high level of energy she has relied on during her aerobic workouts over the past few years. Because she felt that she was in overall good health, but knew that women often need additional iron, she added a multiple vitamin with iron and some meat and leafy greens to her diet. She followed her plan carefully but had no increase in energy. Upon examination, her spleen is noted to be enlarged. Which of the following is most likely to be the cause?

Answers:

A. CLL

B. Accelerated CML

C. Infectious mononucleosis

D. Stage A Hodgkin disease

Question 41

A nurse is providing care for several patients on an acute medical unit of a hospital.Which of the following patients would be most likely to benefit from hematopoietic growth factors?

Answers:

A. A 61-year-old female patient with end-stage renal cancer

B. A 55-year-old obese male patient with peripheral neuropathy secondary to diabetes

C. A 51-year-old female patient with liver failure secondary to hepatitis

D. A 44-year-old man with a newly diagnosed brain tumor

Question 42

Misinterpreting her physician’s instructions, a 69-year-old woman with a history of peripheral artery disease has been taking two 325 mg tablets of aspirin daily. How has this most likely affected her hemostatic status?

Answers:

A. The binding of an antibody to platelet factor IV produces immune complexes.

B. The patient’s prostaglandin (TXA2) levels are abnormally high.

C. Irreversible acetylation of platelet cyclooxygenase activity has occurred.

D. She is at risk of developing secondary immune thrombocytopenic purpura (ITP).

Question 43 Which of the following teaching points would be most appropriate with a client who has a recent diagnosis of von Willebrand disease?

Answers:

A. “Make sure that you avoid taking aspirin.”

B. “Your disease affects your platelet function rather than clot formation.”

C. “Clotting factor VIII can help your body compensate for the difficulty in clotting.”

D. “It’s important that you avoid trauma.”

Question 44

A nurse at a long-term care facility provides care for an 85-year-old man who has had recent transient ischemic attacks (TIAs). Which of the following statements best identifies future complications associated with TIAs? TIAs

Answers:

A. are caused by small bleeds that can be a warning sign of an impending stroke.

B. are a relatively benign sign that necessitates monitoring but not treatment.

C. are an accumulation of small deficits that may eventually equal the effects of a full CVA. D. resolve rapidly but may place the client at an increased risk for stroke.

Question 45

Following a motor vehicle accident 3 months prior, a 20-year-old female who has been in a coma since her accident has now had her condition declared a persistent vegetative state. How can her care providers most accurately explain an aspect of her situation to her parents?

Answers:

A. “If you or the care team notices any spontaneous eye opening, then we will change our treatment plan.”

B. “Your daughter has lost all her cognitive functions as well as all her basic reflexes.”

C. “Though she still goes through a cycle of sleeping and waking, her condition is unlikely to change.”

D. “Your daughter’s condition is an unfortunate combination with total loss of consciousness but continuation of all other normal brain functions.”

Question 46

A couple who is expecting their first child has been advised by friends to consider harvesting umbilical cord blood in order to have a future source of stem cells. The couple has approached their caregiver with this request and is seeking clarification of exactly why stem cells are valuable and what they might expect to gain from harvesting it. How can their caregiver best respond to the couple’s enquiry? Stem cells can

Answers:

A. “be used as source of reserve cells for the entire blood production system.”

B. “help treat some cancers and anemias, but they must come from your child himself or herself.”

C. “be used to regenerate damaged organs should the need ever arise.”

D. “help correct autoimmune diseases and some congenital defects.”

Question 47 A surgeon is explaining to the parents of a 6-year-old boy the rationale for the suggestion of removing the boy’s spleen. Which of the following teaching points would be most accurate?

Answers:

A. “Ferritin is a protein–iron complex that allows your red blood cells to make use of the iron that you consume in your diet.”

B. “Ferritin is the activated and usable form of iron that your red blood cells can use to transport oxygen.”

C. “Ferritin is the form of iron that is transported in your blood plasma to red blood cells that need it.”

D. “Ferritin is a stored form of iron that indirectly shows me whether you would benefit from iron pills.”

Question 48

A 13-year-old African American boy comes to the ER complaining of fatigue and a rapid heartbeat. In conversation with the father, it becomes apparent to you that the boy has grown 2 inches in the previous 5 months. What is the first problem the health care team would attempt to rule out?

Answers:

A. Aplastic anemia

B. Sickle cell anemia

C. Thalassemia

D. Iron deficiency anemia

Question 49

In which of the following patients, would diagnostic investigations least likely reveal increased thrombopoietin production?

Answers:

A. A 55-year-old man with dehydration secondary to Crohn disease

B. An 81-year-old woman with diagnoses of rheumatoid arthritis and failure to thrive

C. A 66-year-old woman with a diagnosis of lung cancer with bone metastases

D. A 21-year-old woman awaiting bone marrow transplant for myelogenous leukemia

Question 50

A hospital laboratory technologist is analyzing the complete blood count (CBC) of a patient. Which of the following statements best reflects an aspect of the platelets that would constitute part of the CBC?

Answers:

A. New platelets are released from the bone marrow into circulation.

B. The half-life of a platelet is typically around 8 to 12 days.

C. Platelets originate with granulocyte colony–forming units (CFU).

D. The α-granules of platelets contribute primarily to vasoconstriction.