Phelp LPNtoRN 6e

78 Unit I • The Transition Process

The NCLEX-RN Might Ask 3.3 The nurse is caring for a client who has had a radical mastectomy. The client refuses to look at the operative site and be involved in dressing changes. This client’s behavior best describes which stage of grieving? a. Depression b. Denial

c. Bargaining d. Acceptance ••See Appendix A for correct answer and rationale.

RESONANCE The term resonance is generally used to define the reflection or reverberation of sound. However, it also describes the response of a system to changes from inside or outside the system. For example, if an individual has a cold, not only are the nasal passages affected but malaise, fever, and general discomfort also occur. Likewise, the individual who is depressed will also be fatigued and disengaged from day-to-day activities. An entire system is affected by what is happening to a part or parts. General systems theory is often used to explain the interrelatedness of parts of a system and the resonance response. When one part of a system experiences change, the whole system responds. The system can be a human, a family, an organization, or a community. Although the parts may be defined as separate, each part has a function that contributes to the total function of the system. A change in one part resonates throughout the system. The nursing profession has always held a holistic view of wellness and illness. Within this holistic view, change within one part affects the entire system. The whole is considered greater than and different from its parts. In using the holistic perspective, a person constantly experiences change internally and externally. These changes resonate within the entire system. An open system must be maintained for the exchange of energy, information, and matter to occur. Following are examples of changes that occur to a part in which the entire system responds. EXAMPLE 3.1 Juana dives into a cold pool. She experiences a sense of shock as she hits the cold water. She also feels other sensations related to internal changes, such as blood vessel constriction, an inability to focus on anything except the immediate sensations, and a feeling of discomfort. Juana will also experience other changes, depending on how long she remains in the pool. Her internal environment responds to the changing external environment. EXAMPLE 3.2 There are four members of the Allen family. The parents work outside the home. Their two teenage daughters go to the local high school. The father has not been home from work on time for many weeks. When he arrives home, it is obvious that he has been drinking. The parents frequently fight about this situation. The oldest daughter frequently has headaches and stomachaches. Her grades at school have dropped. Her teachers are concerned about the change in her demeanor—she is withdrawn, quiet, and inattentive.

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