Health Promotion
Does birth control help reduce risk for STI's?
No
A client comes to the women's clinic and reports to the nurse that she is having a foul-smelling, thin, grayish-white vaginal discharge. What testing will the nurse prepare the client for? Nonspecific vaginitis Herpes simplex 1 Herpes simplex 2 Trichomoniasis
Nonspecific vaginitis
Family makeup
Nuclear, blended, single
Blended
One parent and fostered/adopted children
Dialysis patient on renal diet to avoid
Overwhelming body with electrolytes
The nurse is educating a client with diabetes on how to better control blood sugar levels and recognize the symptoms associated with both hyperglycemia and hypoglycemia. The client is frequently admitted to the hospital due to elevated blood sugars. This education is an example of which level of health promotion? Primary Secondary Tertiary Chronic
Tertiary
Passed on by penile/vaginal sex Is a bacteria-can be treated with an antibiotic (Flagyl one time dose) and can occur again Greenish/blue/yellow discharge seems foul in women (fishy scent) Most of the time is asymptomatic Discharge from penis in males Painful urination
Trichomoniasis
•Treated with antivirals •Once infected you will always have it •Increased stress = increased symptoms •Ex: HIV, AIDS, Herpes, HPV
Viral STI
Disability, Symptoms, Signs (Preventing worsening of conditions) Awareness, Education, Growth (Preventing development of conditions)
Wellness Paradigm
A client is undergoing a sleep study and appears to be in the stage of rapid eye movement sleep. When assessing the client, which finding would the nurse correlate with this stage of sleep? Select all that apply. slowed pulse rate increased temperature increased respiratory rate decreased blood pressure hyperactive deep tendon reflexes
increased temperature increased respiratory rate
6 Dimensions of Health
intellectual, environmental, spiritual, sociocultural, emotional, physical
Health Promotion Levels
primary, secondary, tertiary
The client being seen in the employee wellness clinic reports difficulty sleeping for the past several months. The most important assessment the nurse could make is: reviewing the client's sleep diary for the past 2 weeks. identifying specific foods that negatively impact sleep. having the client recall the number of sleep hours each night for the past week. asking the client's bed partner to describe the sleep problem.
reviewing the client's sleep diary for the past 2 weeks
The nurse is preparing to provide education to a group of high school students on sexually transmitted infection (STI) prevention. The nurse knows that this age group often uses oral-genital stimulation as a way to prevent pregnancy. Which concept should the nurse make sure to convey to the group? skin-to-skin contact can spread herpes and genital warts oral-genital contact is safe with use of a barrier method use of public restrooms increases the risk of contracting HIV avoid multiple partners to reduce the risk of being infected
skin-to-skin contact can spread herpes and genital warts
A male client presents to the clinic with reports of erectile dysfunction. Which statement by the nurse will assist in identifying the potential cause of the erectile dysfunction? "Do you take any medications such as antihypertensives, antidepressants, or illicit drugs?" "What are you doing immediately prior to your sexual encounters?" "Have you had any discharge or pain with urination? "Have you always had a hard time obtaining an erection?"
"Do you take any medications such as antihypertensives, antidepressants, or illicit drugs?"
A 16-year-old girl tells the nurse that her friend has genital warts and asks the nurse how to make sure that she does not get them. Which of the following should the nurse recommend? "Get the human papillomavirus vaccine." "If your male partner doesn't have genital warts, you will not get them." "Douching will help to prevent them." "Have the Norplant system implanted in your arm."
"Get the human papillomavirus vaccine."
While conducting a sexual history, the nurse asks a client about protection from sexually transmitted infections (STIs). Which question would be most appropriate for the nurse to ask? "Have you had any sexually transmitted infections and if so, which ones?" "Have you or your partner experienced erectile dysfunction?" "Are you comfortable with the way you are currently expressing yourself sexually?" "Do you find sex satisfying?"
"Have you had any sexually transmitted infections and if so, which ones?"
The nurse is teaching a black client about common health conditions. Which statement by the client most directly addresses a health problem with an increased incidence in this population group? "I need to watch the amount of high-density lipids I eat." "It is important to monitor my blood pressure." "Getting a mammogram in my thirties is important." "Increasing dairy will improve my bones."
"It is important to monitor my blood pressure."
A nurse is admitting a client to the unit. Which cultural question is most appropriate? "Will you be able to eat the normal food provided?" "What are your dietary needs and preferences?" "Do you have food restrictions?" "Will you be making requests for special food based on your religion?"
"What are your dietary needs and preferences?"
What is the best prevention for STI's?
Abstinence
Acute or Chronic: Headaches
Acute
An older adult male client is admitted to the cardiac ICU after suffering a heart attack. Upon taking a history after the client is stable, the nurse charts that he weighs over 275 pounds, has a history of heart disease in his family, suffers frequent stress at work, drinks alcohol daily, and smokes two packs of cigarettes daily. What are some modifiable risks factors for this client that has attributed to his heart attack? Select all that apply. Alcohol intake Smoking Stress Age Family history Sex
Alcohol intake Smoking Stress
•Treated with antibiotic-Azithromycin or Doxycycline •Can cure with treatment •Can occur again •Ex: Bacterial vaginosis, chlamydia, gonorrhea, trich, and syphilis
Bacterial STI
Meeting which type of needs is essential for physiological health and survival? Spiritual needs Basic human needs Monetary needs Educational needs
Basic human needs
Which factor is the most important to consider when caring for clients with limited income? Basic human needs going unmet Limited access to reliable transportation Decreased access to healthcare services Risk for increased incidence of disease
Basic human needs going unmet
A 28-year-old male comes to the clinic for an evaluation. The client complains of a penile discharge. After completing an assessment, the nurse suspects that the client has a chlamydia infection based on which finding? Select all that apply. Painful lesion on the penis Burning on urination Swollen testes Testicular pain Painful vesicles around the genitals
Burning on urination Swollen testes Testicular pain
Low-fat, low-sodium, and low-cholesterol
Cardiac Diet
HPV (Genital Warts), Heart disease, Hormonal imbalances, Chronic pain, Depression, Medications (Antidepressants/Antianxiety, Nitrates-Nitro & Cialis, Narcotics), Alcohol
Causes of sexual dysfunction
15-24 population (50% of STI)-Most common STI
Chlamydia
Bacteria Can be passed from mother to baby or from sexual contact S/S: Burning sensation with urinating, pain/swelling in genitalia Treatment: Erythromycin or doxycycline Can cause PID (pelvic inflammatory disease) or ectopic pregnancies in women or infertility in men Refrain from having sex until the antibiotic is finished
Chlamydia
A client is admitted to the hospital with abrupt symptoms of increasing shortness of breath, fever, and a productive cough with green sputum. Upon further exam the client is diagnosed with chronic obstructive pulmonary disease (COPD) exacerbation. The nurse identifies this as which type of illness? Acute Chronic Terminal Contagious
Chronic
Chicken broth
Clear liquid
Post-operative patients go on what diet first
Clear liquid
Sprite
Clear liquid
Advance diet as tolerated
Clear liquid, full liquid, progress into regular diet
•Definition: Group of people who live in the same area/environment •Nursing role: Public health nurse-focus on education and promotion (vaccine clinics, presence in schools-DARE program, businesses-health living/lifestyle, disaster planning/emergency-reporting numbers)
Community
A group of nursing students have been asked to break into groups of four and complete a health-promotion teaching project and present a report to their fellow students. What project most clearly demonstrates the principles of health promotion teaching? Demonstrating an injection technique to a client for anticoagulant therapy Explaining the side effects of a medication to an adult client Discussing the importance of preventing sexually transmitted infections (STI) to a group of high school students Instructing an adolescent client about safe and nutritious food preparation
Discussing the importance of preventing sexually transmitted infections (STI) to a group of high school students
Which interview question would be the best choice for the nurse to use to assess for recent changes in a client's sleep-wakefulness pattern? In what way does the sleep you get each day affect your everyday living? How much sleep do you think you need to feel rested? What do you usually do to help yourself fall asleep? Do you usually go to bed and wake up about the same time each day?
Do you usually go to bed and wake up about the same time each day?
•Roles based on culture •Makeup •Maslow's •Risk factors include environment and genetics
Family
Ice cream
Full liquid
Milk
Full liquid
Yogurt
Full liquid
Bipolar disorder
Genetically tied
What are the good lipids that we want high?
HDL's
The nurse is teaching a client with diabetes how to perform checks of blood glucose level. To optimize learning, it is best for the nurse to Verbally tell the client. Demonstrate to the client. Provide written instructions. Have the client return demonstrate.
Have the client return demonstrate
Does not mean just absence of illness
Health & Wellness
Oral Herpes
Herpes Simplex I
Genital Herpes
Herpes Simplex II
Constipation
High fiber diet
Modifiable or non-modifiable risk factor: Diet
Modifiable
Modifiable vs. Non Modifiable Risk Factors: Can be changed
Modifiable
•Eating habits •Sleeping habits •Exercise habits •Smoking •Drinking alcohol •Stress
Modifiable Risk Factor
Nuclear family
Mom, dad, kids
Stereotyping-ageism Cultural imposition-make everyone else conform to what we believe Cultural blindness-ignoring & continuing cares as if they aren't there Cultural conflict-feel threatened
Factors inhibiting sensitivity to diversity
Best way to deal with cultural conflict
Recognize that it exists (get education on cultures) & offer silence-remain nonjudgmental
Low sodium, low phosphorous, and low protein
Renal Diet
Sexual identity is part of
Self-identity
Ageism
Stereotype
Which nursing activity reflects care given on the tertiary level of healthcare delivery? Educating the client about safe habits Recommending regular exams Assisting with transplant surgery Teaching the client about exercise programs
Assisting with transplant surgery
A parent informs the nurse that immunizations are against the parent's cultural and religious beliefs and the parent does not want the child to receive immunizations. The nurse proceeds to inform the parent that the child will be consistently ill and will not be allowed to start school unless immunized. The nurse also informs the parent that the nurse had all of the nurse's own children vaccinated. The nurse's behavior an example of: stereotyping. cultural blindness. cultural imposition. cultural conflict.
cultural imposition
Health includes
culture, community, society
healthy state promoting physical, mental, and emotional health =
wellness
A client has been reporting regularly to the health care unit for blood pressure monitoring. The health care provider diagnoses the client with essential hypertension after analyzing the readings over two or more sessions. What options will the nurse use to inform the client about next steps for blood pressure care? Select all that apply. Advise the client to begin an exercise regimen based on the approval of the health care provider. Remind the client to return back to the health care provider once a year for follow-up. Ask the client to follow a diet that is low in saturated fats and sodium and high in fiber. Advise the client to purchase a self-monitoring cuff or use an automatic cuff at a local pharmacy. Educate the client about the correct position to measure blood pressure, as the position may affect readings.
Advise the client to begin an exercise regimen based on the approval of the health care provider. Ask the client to follow a diet that is low in saturated fats and sodium and high in fiber. Advise the client to purchase a self-monitoring cuff or use an automatic cuff at a local pharmacy. Educate the client about the correct position to measure blood pressure, as the position may affect readings.
Make everyone else conform to what we believe
Cultural imposition
•Beliefs, values, expectations, and behaviors •Shapes an individual •Passed on from generation to generation •Evolve over time •Depends on social and physical environment
Culture
What are the bad lipids that we want low?
LDL's & VLDL's
A nurse is working in a clinic that serves a community with a high population of immigrants. Which nursing assessment is the priority? Language assessment Blood sugar assessment Spiritual assessment Blood pressure assessment
Language assessment
Can heighten sexual experiences
Methamphetamine & Cocaine
Modifiable vs. Non Modifiable Risk Factors: Cannot be changed
Non-Modifiable
Education about STI & Good Sexual Hygiene Nonjudgmental How do you identify? What is your preferred partner? Are you sexually active? Have you had any exposure to STI's? Any STI's in the past? Have you ever been pregnant? How many partners have you had? Have you had any discharge? Are you taking birth control and what is your view on that? Adults-Are you satisfied with your sex life? Have you been seeking out resources? Resources-sex therapist, planned parenthood, student health centers, free clinics, OBGYN/midwives, school nurse Ask about vaccines-Have you had the HPV vaccine? Do you know how to complete a self testicular/breast exam? Have you had a pap smear? Have you had a digital rectal exam? Is sex acceptable in your culture?
Nursing Interventions for Sexual Health
•Development-puberty, menopause, curious •Culture, religion, ethics-unwanted pregnancy •Health conditions/ sexual dysfunction •Childbearing considerations
Factors Affecting Sexuality
The community health nurse is developing a workshop for a group of Native American/First Nation clients. Which topic should the nurse teach? Alcohol use disorder Heart-healthy diets Preventing diabetes Signs of stroke
Alcohol use disorder
•Age •Gender •Race •Family History
Non-Modifiable Risk Factor
A nurse is caring for clients in a predominantly black community. What values or beliefs are commonly shared by members of this culture? Select all that apply. Oriented to the present Frequently highly religious Youth valued over age Praise of self or others considered poor manners Respect given according to sex (male) Clergy members highly respected
Oriented to the present Frequently highly religious Clergy members highly respected
Base/Bottom of Maslow's Hierarchy: Food & shelter
Physiological needs
A nurse is giving a talk to a local community group on the importance of proper diet and regular exercise. This is an example of which type of health promotion? Primary Secondary Tertiary Chronic
Primary
A nurse is giving a talk to a local community group on the importance of proper diet and regular exercise. This is an example of which type of health promotion? Primary health promotion Secondary health promotion Tertiary health promotion Chronic health promotion
Primary health promotion
Family & Community have different roles (HOH-Woman or man)
Provide education to
Does condoms help reduce risk for STI's?
Yes
The nurse is providing client education for the parents of an obese child diagnosed with obstructive sleep apnea. What treatment measures would the nurse explain during the education session? Select all that apply. a weight loss plan treatment with intranasal antibiotics treatment with sleeping pills use of a continuous passive airway pressure (CPAP) machine counseling for depression use of a mandibular advancement device (MAD)
a weight loss plan use of a continuous passive airway pressure (CPAP) machine use of a mandibular advancement device (MAD)
•Avoid ethnocentrism focus on therapeutic communication •Perform a cultural assessment •Develop your own cultural self-awareness •Develop cultural knowledge-Take courses, listen to your patients, observe patients and families, and self-study different cultures •Accommodate and respect practices and family/cultural roles •Avoid mandating change-don't force to comply •Seek assistance
Cultural Guidelines for Nurses
Don't recognize culture/Ignore & continue cares as if they aren't there (i.e. gender assignments, male nurse with male)
Cultural blindness
An adolescent female is in the community health clinic seeking contraception since becoming sexually active. The community health nurse demonstrates effective health promotion and prevention with the client when what is included in the health education teaching plan? Contraception plans prior to initiation of sexual activity. Correct use of the contraception method selected. The importance of using a barrier method to prevent risk of HIV transmission. The need for a back-up contraceptive method when using antibiotics.
Contraception plans prior to initiation of sexual activity
Do you have heat/water-quality? Pollution-Air? Access to healthcare?
Environmental risk factors
Thinking that your way is the best (i.e. my way is the highway)
Ethnocentrism
Assessment of cultural consideration with values, beliefs, and expectations (may vary)
Evolves overtime based on social and physical environmental
Bacteria Can affect cervix spread through sexual contact Puss like discharge (White to yellow/greenish), Abd or pelvic pain, bleeding Can be treated with antibiotics (uncomplicated) or Rocephin (ceftriaxone) shot Education: Condoms, limit sexual partners
Gonorrhea
Virus Spread through sexual contact, blood (sharing needles/blood transfusion), delivery (mom to baby) S/S: Headaches, muscle ache, night sweats/chills (Flu-like symptoms) Antiviral medications-ART Education: Limit partners There are rapid tests/screenings for this now (come back within 15 minutes-false positives possible, can create worry) ELSA-screening tool Most definitive screening tool-Western Blot test CD4 count hits 200-diagnosis with AIDS (below 500 is high risk)
HIV/AIDS
Virus Can get it from vaginal, anal or oral sex or from skin to skin contact (open sores/warts) S/S: Most are asymptomatic, warts, can cause cancer No cure, but can take antiviral medication to minimize exacerbations Prevention: HPV vaccine Teaching: Avoid multiple partners, vaccine, pap smears at 21 and every 3 years
HPV
A lot of people are asymptomatic Open sores that are crusted or draining (oral, around genitalia) Virus that can be treated with antivirals Once diagnosed, will always have this You can spread even with no sores present Simplex I can be spread to Simplex II or from Simplex II to Simplex II If pregnant with current flare-up (sores present), will have c-section Spread via saliva, sore that is open, or skin to skin contact Health Promotion: condoms, abstinence
Herpes
Oncology patients (chemotherapy/radiation) + Wound/Burn patients needing wound healing
High protein diet
(Signs, Symptoms, Disability)-Treatment Paradigm, Pre-Mature Death Neutral Point: No discernable illness or wellness Awareness, Education, Growth, High-Level Awareness
Illness-Wellness Continuum
BRCA gene
Indicates risk for developing ovarian cancer
Health is determined
Individually
The public health nurse is preparing a presentation about disparities in health care in the community. What key concept(s) will the nurse include? Select all that apply. Information regarding minorities within the community Identifying groups that are disadvantaged within the community Pointing out groups within the community that possess less power Differences in beliefs within a particular culture Ethnic identities within subcultures in the community
Information regarding minorities within the community Identifying groups that are disadvantaged within the community Pointing out groups within the community that possess less power
2nd level Maslow's Hierarchy: Choking hazards? Water temperature?
Safety & Security
Includes the physical body, emotional, intellectual, and social aspects
Self-identity
Spread through sexual contact through skin or mucous membrane Sores on genitalia, recum, or mouth STAGES: Primary-sore on original site of infection Secondary-skin rash with swollen lymph nodes with mild fever Latent-no S/S present Tertiary-severe medical problems that can affect heart, brain, or other organs (diagnosed at this phase) Bacterial-take antibiotics Teaching-you can recontract, practice safe sex Increased risk for developing dementia if untreated
Syphilis
When chronic illnesses and disabilities are present, individuals benefit most from activities that: help them eat well. help them maintain independence. preserve their social interactions. accomplish financial stability.
help them maintain independence
An 82-year-old client is newly admitted to an assisted living facility. Which intervention promotes safety at night for the client? using a night light in the bathroom leaving a bright light on in the bathroom administering diuretics at bedtime leaving the door open to the nursing hallway
using a night light in the bathroom