Health Promotions Chapter 3 Health Illness and Disparities

The nurse is counseling a newly pregnant woman who is concerned about developing infections during her pregnancy. The pregnant woman states, "I'm so afraid something will happen to my baby. My friend developed an infection while she was pregnant and the baby died." Which of the following responses by the nurse would be most appropriate?

"Early prenatal care like you are receiving is very beneficial in reducing chances of infection."

individual perception of wellness

-being: recognizing oneself as separate and individual -belonging: being a part of a whole -becoming: growing and developing -befitting: making personal choices to befit oneself for the future

intellectual dimension

-cognitive abilities -educational backgrounds -past experiences influences the person's response to teaching about health and reactions to nursing care during illness

perceived seriousness

-concerns the persons perception of the threat disease poses to health and its effects on the persons lifestyle - depends on how much the person knows about the disease and can result in a change in health behavior

Dunn

-described his model of high-level wellness as functioning to one's maximum potential while maintaining balance and a purposeful direction in the environment -differentiated wellness from good health, believing that good health is a passive state simply denoting that the person is not ill at this time. wellness is a more active state, regardless of one's level of health.

sociocultural dimension

-economic level -lifestyle -family -culture

health belief model

-focuses on what people perceive or believe to be true about themselves in relation to their health -based on three components of individual perceptions of threat of a disease: 1. perceived susceptibility to a disease 2. perceived seriousness of a disease 3. perceived benefits of action

physical dimension

-genetic inheritance -age -developmental level -race -gender

Current trends that result in an increase in chronic illnesses include

-growing numbers of older adults -lifestyle choices (such as smoking and drug use) -environmental factors (increasing air and water pollution) -AIDS epidemic -effects of increasing obesity

health promotion model

-illustrates how people interact with their environment as they pursue health -incorporates individual characteristics and experiences as well as behavior specific knowledge and beliefs to motivate health promoting behavior

tertiary activities

-medication -medical therapy -surgical treatment -rehabilitation -physical therapy -occupational therapy -job training

what are health disparities influenced by?

-racial and ethnic groups -poverty -gender -age -mental health -educational level -disabilities -sexual orientation -health insurance -access to health care

Self-efficacy

-recommended to be added to the health belief model -one's own belief in the ability to reach goals and complete tasks

secondary activities

-screenings (B/P, cholesterol, glaucoma, HIV, Cancer) -pap smears -mammograms -testicular examination -family counseling

perceived benefits of action

-the persons beliefs about how effectively measures will prevent illness -influenced by the persons conviction that carrying out a recommended action will prevent or modify the disease and by the persons perception of the cost and unpleasant effects of performing the health behavior

health illness continuum

-views health as a constantly changing state, with high level wellness and death at opposite ends of a graduated scale -illustrates the ever changing state of health as a person adapts to changes in internal and external environments to maintain a state of well-being

primary activities

-weight loss -diet -exercise -smoking cessation -reduced alcohol consumption -avoidance of illicit drugs -farm safety -seat belts and child safety seats -immunizations -water treatment -safer sex practices -effective parenting

A 90-year-old woman has a staphylococcus infection in her decubitus ulcer. Staphylococcus is the:

Agent

A nursing student is performing a health risk assessment of an adult patient who admits to living a sedentary lifestyle. The patient states, "If I'm honest, I'd have to say that I just can't be bothered to exercise." What psychological health risk would the student be most justified in identifying?

An underestimation of the risks associated with inactivity

A nursing student is performing an assessment of a patient on a hospital unit. What component of the patient assessment will allow the student to document data relating to a subjective way of knowing?

Asking the patient to describe the character of her abdominal pain

An exacerbation refers to the reactivation of a disease. Which condition is associated with exacerbation?

Chronic illness

Why is health promotion and illness prevention a key responsibility of nurses?

Chronic illnesses are the leading health problem in the world.

A nursing student has developed therapeutic rapport with a patient who is in the third trimester of her pregnancy and who has been on bed rest for the past 10 weeks due to complications. How can the student best promote the patient's emotional wellness?

Dialogue with the patient about how she feels about this limitation on her mobility.

Risk factors for illness are divided into six categories. Working with carcinogenic chemicals is an example of which type of risk factor?

Environmental risk factor

A client has been admitted to the hospital for the treatment of diabetic ketoacidosis, a problem that was accompanied by a random blood glucose reading of 575 mg/dLm (31.91 mmol/L), vomiting, and shortness of breath. This client has experienced which phenomena?

Exacerbation

The nurse in a free clinic caring for clients uses the Health Belief Model, which is based on three components. What is the main focus for this model?

It focuses on what people believe to be true about their health.

A nurse caring for patients with diabetes knows that this is a characteristic of a chronic illness:

It requires special patient education for rehabilitation

A community health nurse is planning a campaign that has the goal of fostering the wellness of older adults in the community. What goal is most appropriate for this campaign?

Older adults will report improved quality of life after the campaign is launched.

The nurse is preparing to talk to a local community group regarding chronic illness. The nurse informs the group that both external and internal factors influence a person's health. When discussing the fact that the male client has a higher chance of developing lung cancer due to his gender, which of the following dimensions is the nurse referring to?

Physical dimension

The nurse's community outreach class is giving a presentation on seat belts and child safety seats at the local firehouse every weekend in October. What level(s) of health promotion is this an example of?

Primary

Which is an example of tertiary health promotion?

Rehabilitation

what are the four stages of illness behaviors?

Stage 1: Experiencing symptoms Stage 2: Assuming the sick role Stage 3: Assuming the dependent role Stage 4: Achieving recovery and rehabilitation

A nurse is caring for a patient who has COPD, a chronic illness of the lungs. The patient is in remission. Which statement best describes a period of remission in a patient with a chronic illness?

Symptoms are not experienced

A nurse refers an HIV-positive client to a local support group. This is an example of what level of preventive care?

Tertiary

Which model is most useful in examining the cause of disease in an individual, based upon external factors?

The Agent-Host-Environment Model

health risk assessments

_____ are an important part of primary health promotion and preventative care

health disparity

a specific difference that is closely linked to social, economic and or emotional disadvantage

illness

abnormal process in which any aspect of the persons functioning is altered (in comparison to the previous condition of health)

direct nursing care interventions at the secondary level include

administering medications and caring for wounds

What is the definition of wellness?

an active state of being healthy

wellness

an active state of being healthy including living a lifestyle that promotes good physical mental and emotional health

adolescents and young adults are at greater risk for

automobile crashes for excessive speed

tertiary health promotion and illness prevention

begins after an illness is diagnosed and treated with the goal of reducing disability and helping rehabilitate patients to maximum level of functioning

health protection

behavior motivated by a desire to avoid or detect disease or to maintain functioning within the constraints of an illness or disability

health promotion

behavior of an individual motivated by a personal desire to increase well being and health potential

To be an effective change agent for wellness, the nurse must:

consume a diet low in fat.

holistic care

health care that takes into account the whole person interacting with the environment

A community health nurse arranges for a dental checkup camp for the local children in the school district. Which of the following would most likely be the nurse's goal for this health camp?

health promotion

patient protection and affordable care act 2010

helped reduce disparities so that underserved groups can reach their full health potential

The body's attempt to restore balance through self-regulatory mechanisms is termed:

homeostasis.

emotional dimension

how the mind affects body functions and responds to body conditions

self concept

how they feel about themselves (self esteem) and the way they perceive their physical self (body image)

most people define health according to

how they feel, the absence or presence of symptoms of illness, or their ability to carry out activities of daily living.

secondary preventative care

identify an illness, reverse or reduce its severity or provide a cure and thereby return the person to maximum health as quickly as possible

chronic illness

irreversible illness that causes permanent physical impairment and requires long term health care

mortality

number of deaths

The nurse is explaining primary and secondary care to the client. Which nursing activity reflects secondary care as provided by the nurse?

ordering a mammography

disease

pathologic changes in the structure or function of the body or mind

remission

period in a chronic illness when disease is present but the person does not experience symptoms of the disease

exacerbation

period in chronic illness when symptoms of the disease reappear

health integrates which human dimensions?

physical intellectual emotional sociocultural spiritual and environmental

acute illness

rapidly occurring illness that runs its course allowing a person to return to one's previous level of functioning

The client is admitted with a gastrointestinal bleed (GI). The physician ordered a colonoscopy. Which level of care encompasses this procedure?

secondary

what is a basic human need?

something essential that must be met for emotional and physiological health and survival

risk factor

something that increases a persons chance for illness or injury

health

state of optimal functioning or well being, not merely the absence of disease or infirmity

The nurse is preparing a plan of care for a client with nutritional deficits. Which is the priority intervention for this client?

teaching about intake of food and vitamins

perceived susceptibility

the belief that one either will or will not contract a disease

modifiable risk factor

things a person can change such as quitting smoking

nonmodifiable risk factor

things that cant be changed such as family history of cancer

The nurse is addressing primary prevention with a group of college students. Which is an example of a primary prevention measure?

use of condoms and safer sex practices

each person defines health in terms of one's own ____ and _____

values and beliefs

the agent -host-environment model

views the interaction between an external agent, a susceptible host, and the environment as causes of disease in a person

Common causes for disease

•Inherited genetic defects •Developmental defects resulting from exposure to such factors as virus or chemicals during pregnancy •Biologic agents or toxins •Physical agents such as temperature, chemicals, and radiation •Generalized tissue responses to injury or irritation •Physiologic and emotional reactions to stress •Excessive or insufficient production of body secretions (hormones, enzymes, and so forth)

chronic illness

•It is a permanent change. •It causes, or is caused by, irreversible alterations in normal anatomy and physiology. •It requires special patient education for rehabilitation. •It requires a long period of care or support.

what percent of people with chronic illnesses have one or more daily activity limitations?

25 percent

illness

This response is unique for each person and is influenced by self-perceptions, others' perceptions, the effects of changes in body structure and function, the effects of those changes on roles and relationships, and cultural and spiritual values and beliefs

A nurse has chosen to characterize a new initiative as "wellness promotion" rather than "health promotion." Which statement best describes the difference between the concept of wellness and the concept of health?

Wellness is an active state, whereas health is a more passive state dependent on the absence of disease.

spiritual dimension

-baptisms for stillborn and live births -kosher dietary laws -prohibiting the intake of pork and shellfish -opposition to blood transfusion

environmental Dimension

-Housing -sanitation -climate -pollution of air, food, and water

primary health promotion and illness prevention

-aim to promote health and prevent development of disease processes or injury -may focus on people or groups -immunization clinics, family planning services, providing poison control info, accident prevention education, teaching about healthy diet, safe sex, exercise, seat belts etc.

When caring for a client who has just been diagnosed with a chronic illness, the nurse understands the importance of promoting health by highlighting which of the following concepts?

Focus on what is possible.

A client experiencing symptoms of cold is referred to the specialist for diagnosis and consultation. Consultation and diagnostic tests are included in which level of the health care system?

Secondary care

Nurses promote the needs of clients as an integral part of each person's human dimension. Which needs are being met when a nurse recommends a senior citizen community centre for an older client who is living alone?

Sociocultural needs

toddlers are at greater risk for

drowning

the persons ____, ______, ______, and _____ also influence this personal perception of health

family culture community society

morbidity

frequency that disease occurs