NR 222-Health and Wellness-Exam 1 review
Gordons functional health patterns
-provides a context for collecting data that provide info about the entire person and most life processes -nurses can accurately determine and diagnose actual/potential problems ,intervene more effectively and facilitate movement towards outcomes to promote health and well being -provides strong focus for more effective nursing interventions and outcomes 11 functional health patterns
Secondary prevention
-ranges from providing screening activities and treating early stages of disease to limiting disability by averting or delaying the consequences of advanced disease Goal- identify individuals in early,detectable stages of disease -treating early stages of disease -limiting disability -interventions similar to primary but applied to individuals / populations with disease
WHO definition of health
-state of complete, physical, metal, and social well being not merely the absence of disease or infirmity
Maintenance
-the period beginning 6 months after action has started and continuing indefinitely (sustaining the change over time)
Action
-the person has made a behavior change and it has persisted for a period of 6 months (actively engaged in behavior change)
Pre contemplation
-the person is NOT thinking about or considering quiting or adapting a behavior change within the next 6 months (not intending to make changes)
Contemplation
-the person is seriously considering making a specific behavior change within the next 6 months (considering change)
Planning/prep
-the person who has made a behavior change is seriously thinking about making a change within the next month (making small or sporadic changes)
Goal of educating others
-to achieve the optimal levels of health
variables/risk factors
-variables influence how a person thinks and acts -health beliefs and practices are influenced by internal and external variables and should be considered when planning care
Healthy people 2020
-was a call to action and an attempt to set health goal for US for the next 10 years -national guidelines to promote health -->define national emphasis for health promotion and disease prevention efforts *4 overeaching goals 1. attain high quality,longer lives, free of preventable disease , disability ,injury and pre mature death 2.achieve healthy equity ,eliminate disparities, and improve the health of all groups 3. create social and physical environment that promotes good health for all 4. promote quality of life , healthy development and health behaviors across all life stages
Evidence based practice
-when nurses or other clinicians use research findings and the best evidence possible to make decisions -is defined as the conscientious ,explicit and judicious use of current best evidence in making decisions about the care of individual -means integrating individual clinical expertise from systemic research
environment
-where we live/conditions -air,water, soil -what we eat, ability to adapt, physical environment (work place, where u live) polluted? by factories?
Models of health (4)
1. clinical model 2. role performance model 3. adaptive model 4.eudaimonistic model
Gordon's 11 functional health patterns
1. health perception/health managment 2.nutritional/metabolic (food/fluid concumption/weight/condition of mouth) 3. elimination (extretory function- bowl /bladder/skin) 4.activities/exercise (ADL's,pulse,BP,lessiure,recreation) 5.sleep/rest (too much/too little) 6.cognitive perception (level of consciencous,alertness,orientation) 7. self perception (appearance, body language,eye contact) 8. role relationship (who you live with, support system,employment status) 9. sexual representation (prostate / pap) 10. coping stress (coping/effectness) 11. values/beliefs (religion)
Health education components (3)
1. involves the use of teaching-learning strategies 2.learners maintain voluntary control over the decision to make changes in their actions 3.focuses on behavior changes that have been found to improve health status
6 stages of TTM
1.Pre contemplation 2.Contemplation 3.Planning/prep 4.Action 5.Maintenance 6.Relapse
Health care models
1.health belief model 2.health promotion model 3.basic human needs model 4.holistic health model
eudaimonistic model
-exuberant well being indicates optimal health -emphasizes the interactions b/w physical, social, psychological and spiritual aspects of life and the environment that contribute to goal attainment and create meaning -illness reflected by lack of involvement in life
Relapse
-going back to old habits
Clinical model
-health is defined by the absence and illness by conspicious presence of signs and symptoms of disease -people may not seek preventative health services or they may wait until they are very ill to seek care -absence of disease ,prevention not emphasized
healer
-helps individuals integrate and balance peoples lives -helps person develop own capacity to heal
Definition of health education
-is a vital component in promoting individual and community health -involves not only providing relevant info but also facilitating health related behavior change *is any combination of planned learning ,experiences based on sound theories that provide individuals, groups and communities with the opportunity to aquire the info and skills needed to make quality health decisions
Definition of Illness
-is composed of the subjective experience of the individual and the physical manifestation of the disease -can be described as a responsise characterized by a mismatch b/w a persons needs and the resources available to meet those needs *subjective experience of individual and physical manifestation of disease
Transtheoretical model of change (TTM)
-is useful for determining where a person is in relation to making a behavior chanage;readiness for change -is useful in determining the persons readiness for learning in relation to changing behavior so that health education or behavior change interventions can be matched to the stage -self efficacy is a key construct in this model 6 stages
Definition of Health
-more than an absence of disease -ability to fulfill roles -adaption and rxn to environment -is a state of being that people define in relation to their own values, personality and lifestyle
advocate
-nurse makes sure that all people receive high quality ,appropriate , safe ,cost effective care -want the best for patient
Tertiary prevention
-occurs when a defect or disability is permanent and irreversible -involves minimizing the effects of disease and disability by surveillance and maintenance activities aimed at preventing complications and deterioration -focuses on rehabilitation to help people attain and retain an optimal level of functioning regardless of their disabling condition Objective- is to return the affected individual to a useful place in society , maximize remaing capacities or both
adaptive model
-peoples ability to adjust (+) to social, mental and physiological change in the measure of their health -illness occurs if person fails to adapt
genetic and physiological factors
-physical functioning of body -pregnant/overweight/stress,heredity,age,physical env, and lifestyle
Primary prevention
-precedes disease/dysfunction *interventions --health promotion(ex:health edu about risk factors for heart disease) --health protection( ex:immunizations, reducing exposure to carcinogens,occupational hazards) Purpose-to decrease vulnerability of the individual/pop to disease/dysfunction focus-maintain/improve general/individual/family/community health Passive-not personally involved (public health efforts-clean water/sewer) Active-personally involved-lifestyle changes
care manager
-prevent duplication services ,maintain quality, safety, and reduce cost -help individual avoid care that is ineffective ,unproven or unsafe
educator
-primary prevention technique -help with lack of application
consultant
-provide knowledge about health promotion and disease prevention to individuals and groups
Nursing paradigm
Person Nursing Environment Health
Clinical Model
Person tends to seek healthcare when they really feel sick, avoid doctor when not experiencing symptoms Health is defined by absence of illness
Case manager
Prevent duplication of services Maintain quality and safety Reduce costs Don't provide direct care Help continuity of care
Dorothea Orem
Self-care theory
Examples of tertiary level of prevention
Surgery PT OT
HMO
prepayment plans
PPO
"brokers" between insurers/providers
Culturally competent organizations
- Value diversity - Conduct a cultural self assessment -Manage the dynamics of difference - Institutionalize cultural knowledge - Adapt to diversity
A-assessment
-Collect data about patient's physical, psychological, social, cultural, developmental, and spiritual needs from patient, family, diagnostic tests, medical record, nursing history, and literature
P-planning
-Develop an individualized care plan. Set diagnosis priorities based on patient's immediate needs, expected outcomes, and patient-centered goals. Collaborate with patient on care plan
D-diagnosis
-Identify appropriate nursing diagnoses based on assessment findings
E-evaluation
-Identify success in meeting desired outcomes and goals of nursing care. Alter interventions as indicated when goals are not met
cognitive domain
-refers to the development of new facts and concepts and building on or applying knowledge to new situations
researcher
-researching to deliver best care -evidence based practice
Key Steps in the Resolution of an Ethical Dilemma
1) Ask the ? is this an ethical dilemma 2) Gather info relevant to the case 3) Clarify values; distinguish among fact, opinion, & values. 4) Verbalize the problem 5) Identify possible courses of action 6) Negotiate a plan 7) Evaluate the plan overtime
Nursing process for the family
1) Assess al individuals within their family context 2) Assess the family as patient 3) Assess the family as a system
Five trends as threats or concerns facing families
1) Changing economic status 2) Homelessness 3) Domestic violence 4) Presence of acute or chronic illnesses or trauma 5) End of life care
Family nursing practice has three levels of approaches
1) Family as context 2) Family as patient 3) Family as system
Ten Rules of Performance in a Redesigned Health Care System
1. Care is based on continuous healing relationships 2. Care is individualized based on patient needs and values 3. Patient is the source of control, participates in decision-making 4. Knowledge is shared, info flows freely 5. Decision making is evidence-based 6. Safety is a system property and focused on reducing errors 7. Transparency is necessary through sharing info with patients and families 8. Patients needs are anticipated 9. Waste is continuously decreased 10. Cooperation and communication among clinicians are priorities
Transtheoretical Model of Change
1. Precontemplation 2. Contemplation 3. Preparation 4. Action 5. Maintenance
6 stages of change (TTM)
1. pre-contemplation 2. contemplation 3. planning 4. action 5. maintenance 6. relapse
Virginia Henderson
14 basic needs of patient
maintenance
6 months AFTER action - continuing indefinitely
Six Sigma
A data-driven approach for improving quality by removing defects and variations in processes
Extended Care Facility
A facility that provides health care and help with the activities of daily living to people who may be physically or mentally unable to care for themselves; this type of care may last from days to years
Family as system
A family can be seen as a relatively organized collection of interdependent parts that act together as a whole unit
Family Caregiving
A family process that occurs in response to an illness and encompasses multiple cognitive, behavioral, and interpersonal processes
Oppression
A formal and informal system of advantages and disadvantages tied to our membership in social groups, such as those at work, at school, and in families
Assisted Living
A living arrangement for elderly people that combines privacy and independence with medical supervision
Health disparity
A particular type of health difference that is closely linked with social, economic, and/or environmental disadvantage
Health beliefs
A person's ideas, convictions, and attitudes about health and illness
Value
A personal belief about the worth of a given idea, attitude, custom, or object that sets standards that influence behavior
Adult Day Care
A program for impaired adults that attempts to meet their health, social, and functional needs in a setting away from their homes
Healthy People 2020
A set of disease prevention and health promotion objectives for Americans to meet during the second decade of the new millennium
Code of ethics
A set of guiding principles that all members of a profession accept
Illness
A state in which a person's physical, emotional, intellectual, social, developmental, or spiritual functioning is diminished or impaired
Health
A state of complete physical, mental, and social well-being, not merely the absence of disease or infirmity.
Acute Illness
A sudden illness from which a person is expected to recover
Review of Systems (ROS)
A systematic approach for collecting the patient's self-reported data on all body systems.
Respite Care
A type of care provided for caregivers of homebound ill, disabled, or elderly patients; gives the normal care-takers time off
Which activity represents secondary prevention? A. A home health care nurse visits a patient's home to change a wound dressing. B. A 50-year-old woman with no history of disease attends the local health fair and has her blood pressure checked. C. The school health nurse provides a program to the first-year students on healthy eating. D. The patient attends cardiac rehabilitation sessions weekly.
A. A home health care nurse visits a patient's home to change a wound dressing. Secondary prevention focuses on individuals who are experiencing health problems or illnesses and who are at risk for developing complications or worsening conditions. The home health nurse changing the wound dressing is an activity that is focused on preventing complications. Much of the nursing care related to secondary prevention is delivered in homes, hospitals, or skilled nursing facilities.
While working in a community health clinic, it is important to obtain nursing histories and get to know the patients. Part of history taking is to develop the nurse-patient relationship. Which of the following apply to Peplau's theory when establishing the nurse-patient relationship? (Select all that apply.) A. An interaction between the nurse and patient must develop. B. The patient's needs must be clarified and described. C. The nurse-patient relationship is influenced by patient and nurse preconceptions. D. The nurse-patient relationship is influenced only by the nurse's preconceptions.
A. An interaction between the nurse and patient must develop. B. The patient's needs must be clarified and described. C. The nurse-patient relationship is influenced by patient and nurse preconceptions. The nurse-patient relationship is influenced only by the nurse preconceptions; is incorrect because the focus is only on the nurse.
Which of the following statements apply to theory generation? (Select all that apply.) A. Builds scientific knowledge base of nursing B. Discovers relationships of phenomena to practice C. Tests specific phenomena D. Identifies observations about a phenomenon
A. Builds scientific knowledge base of nursing B. Discovers relationships of phenomena to practice D. Identifies observations about a phenomenon Theory-generating research identifies observations or describes phenomena. It contributes to the scientific knowledge base of nursing. Relationships of the phenomena to practice and testing specific phenomena are part of the theory-testing research activities
Contemporary nursing requires that the nurse has knowledge and skills for a variety of professional roles and responsibilities. Which of the following are examples? (Select all that apply.) A. Caregiver B. Autonomy and accountability C. Patient advocate D. Health promotion E. Lobbyist
A. Caregiver B. Autonomy and accountability C. Patient advocate D. Health promotion E. Lobbyist Each of these roles includes activities for the professional nurse. Each of these is used in direct care or is part of professionalism that guides nursing practice. Some nurses are lobbyists, but being a lobbyist is not expected of all professional nurses
Which of the following is closely aligned with Leininger's theory? A. Caring for patients from unique cultures B. Understanding the humanistic aspects of life C. Variables affecting a patient's response to a stressor D. Caring for patients who cannot adapt to internal and external environmental demands
A. Caring for patients from unique cultures Leininger's theory of transcultural nursing focuses on the patient's culture and the impact of culture heritage on health care needs and interventions.
The client who would be least likely to participate in health teaching activities would choose which model? A. Clinical model B. Adaptive model C. Role performance model D. Eudaimonistic model
A. Clinical model The clinical model of health has the absence of signs and symptoms of disease as indicative of health. People who use this model of health to guide their use of health care services may not seek preventative health services, or they may wait until they are very ill to seek care. Personal responsibility for health may not be a motivating factor for this individual because the provider is responsible for dealing with the health problem and returning the person to a state of health. Attempts at health-promoting activities may not be effective with this person. The role performance model has the ability to perform social roles as indicative of health. This model is the basis for work and school physical examinations and physician-excused absences. The adaptive model of health has the ability to adapt positively to social, mental, and physiological changes indicative of health. The eudaimonistic model of health uses exuberant well-being as indicative of health. This model is also more congruent with integrative modes of therapy.
A nurse is teaching a 27-year-old gentleman how to adjust his insulin dosages based on his blood sugar results. What type of learning is this? A. Cognitive B. Affective C. Adaptation D. Psychomotor
A. Cognitive Cognitive learning requires thinking; learning how to adjust insulin requires analysis, synthesis, and evaluation, which are all types of cognitive learning.
A male patient has been laid off from his construction job and has many unpaid bills. He is going through a divorce from his marriage of 15 years and has been seeing his pastor to help him through this difficult time. He does not have a primary health care provider because he has never really been sick and his parents never took him to the physician when he was a child. Which external variables influence the patient's health practices? (Select all that apply.) A. Difficulty paying his bills B. Seeing his pastor as a means of support C. Family practice of not routinely seeing a health care provider D. Stress from the divorce and the loss of a job
A. Difficulty paying his bills C. Family practice of not routinely seeing a health care provider D. Stress from the divorce and the loss of a job External factors impacting health practices include family beliefs and economic impact. How patients; families use health care services generally affects their health practices. Their perceptions of the serious nature of diseases and their history of preventive care behaviors (or lack of them) influence how patients will think about health. Economic variables may affect a patient;s level of health by increasing the risk for disease and influencing how or at what point the patient enters the health care system
As an art nursing relies on knowledge gained from practice and reflection on past experiences. As a science nursing relies on (select all that apply): A. Experimental research. B. Nonexperimental research. C. Research from other disciplines. D. Professional opinions.
A. Experimental research. B. Nonexperimental research. C. Research from other disciplines. As a science, nursing relies on knowledge gained through research from nursing and other disciplines and scientifically tested knowledge applied in the practice setting.
Match the following components of systems theory with the definition of that component. A. Feedback B. Input C. Content D. Output 1. Data entering the system 2. End product 3. Data related to system functioning 4. Product and information obtained from the system
A. Feedback----3. Data related to system functioning B. Input----- 1. Data entering the system C. Content-----4. Product and information obtained from the system D. Output---- 2. End product
Advanced practice registered nurses generally: A. Function independently B. Function as unit directors C. Work in acute care settings D. Work in the university setting
A. Function independently Advanced practice registered nurse functions independently as a clinician, educator, case manager, consultant, and researcher within his or her area of practice to plan or improve the quality of nursing care for the patient and family.
Match the following theories with their definitions. A. Grand theory B. Middle-range theory C. Descriptive theory D. Prescriptive theory 1. Addresses specific phenomena and reflect practice 2. First level in theory development and describes a phenomenon 3. Provides a structural framework for broad concepts about nursing 4. Linked to outcomes (consequences of specific nursing interventions)
A. Grand theory---- 3. Provides a structural framework for broad concepts about nursing B. Middle-range theory----1. Addresses specific phenomena and reflect practice C. Descriptive theory---- 2. First level in theory development and describes a phenomenon D. Prescriptive theory----4. Linked to outcomes (consequences of specific nursing interventions)
Which of the following agencies or initiatives have been driving forces in health care reform and the prevention of disease in society? (select all that apply) A. Healthy People B. Health Insurance Portability and Accountability Act C. U.S. Department of Health, Education, and Welfare D. Patient Protection and Affordable Care Act E. U.S. Department of Health and Human Services
A. Healthy People C. U.S. Department of Health, Education, and Welfare E. U.S. Department of Health and Human Services Public health has always had the prevention of disease in society as its focus. Over the past 30 years, the promotion of health and individual responsibility moved to the forefront within public health. A key milestone in promoting health was the advent of Healthy People, related to the U.S. Department of Health, Education and Welfare. The U.S. Department of Health and Human Services is now responsible for the Healthy People objectives. The Health Insurance Portability and Accountability Act and the Patient Protection and Affordable Care Acts are not associated with the prevention of disease in society.
When taking care of patients, the nurse routinely asks them if they take any vitamins or herbal medications, encourages family members to bring in music that the patient likes to help the patient relax, and frequently prays with her patients if that is important to them. The nurse is practicing which model? A. Holistic B. Health belief C. Transtheoretical D. Health promotion
A. Holistic The nurse is using a holistic model of care that considers emotional and spiritual well-being and other dimensions of an individual to be important aspects of physical wellness. The holistic health model of nursing attempts to create conditions that promote optimal health. Nurses using the holistic nursing model recognize the natural healing abilities of the body and incorporate complementary and alternative interventions such as music therapy, reminiscence, relaxation therapy, therapeutic touch, and guided imagery because they are effective, economical, noninvasive, nonpharmacological complements to traditional medical care.
A nurse needs to teach a young woman newly diagnosed with asthma how to manage her disease. Which of the following topics does the nurse teach first? A. How to use an inhaler during an asthma attack B. The need to avoid people who smoke to prevent asthma attacks C. Where to purchase a medical alert bracelet that says she has asthma D. The importance of maintaining a healthy diet and exercising regularly
A. How to use an inhaler during an asthma attack It is important to start with essential life-saving information when teaching people because they usually remember what you tell them first.
What are the two overarching goals of Healthy People 2010? (select two that apply) A. Increase quality and years of life B. Eliminate health disparities C. Create access to preventive services for all. D. Increase the span of healthy life
A. Increase quality and years of life B. Eliminate health disparities Healthy People 2010 set out two overarching goals. They are to: increase quality and years of healthy life, and eliminate health disparities. Healthy People 2000 set out three broad goals. They were to: increase the span of healthy life, reduce health disparities, and create access to preventive services for all.
A nurse is applying Henderson's theory as a basis for theory based-nursing practice. Which other elements are important for theory-based nursing practice? (Select all that apply.) A. Knowledge of nursing science B. Knowledge of related sciences C. Knowledge about current health care issues D. Knowledge of standards of practice
A. Knowledge of nursing science B. Knowledge of related sciences D. Knowledge of standards of practice Regardless of which particular nursing theory is selected, the nurse must use knowledge from nursing and related sciences, experience, and standards of practice when providing care.
Health care reform will bring changes in the emphasis of care. Which of the following models is expected from health care reform? A. Moving from an acute illness to a health promotion, illness prevention model B. Moving from illness prevention to a health promotion model C. Moving from an acute illness to a disease management model D. Moving from a chronic care to an illness prevention model
A. Moving from an acute illness to a health promotion, illness prevention model Health care reform also affects how health care is delivered. There is greater emphasis on health promotion, disease prevention, and management of illness.
Health is considered to be a metaparadigm for nursing and includes which of the following components? (select all that apply) A. Person B. Health C. Environment D. Nursing E. Psychosocial wellness
A. Person B. Health C. Environment D. Nursing Health is defined as a state of physical, mental, spiritual, and social functioning that realizes a person's potential and is experienced within a developmental context. Health is considered to be part of the metaparadigm for nursing, which includes the four components of person, health, environment, and nursing. Health encompasses spiritual, developmental, and environmental aspects over time. Psychosocial wellness is not considered to be one of the four components of the metaparadigm for nursing.
Nurses in the school setting can participate in health promotion activities through creating nut-free schools. This would protect hypersensitive children from life-threatening allergic reactions to peanuts and other nut products. This type of program is an example of which of the following interventions? A. Primary B. Secondary C. Tertiary D. Emergent
A. Primary Primary prevention interventions are considered health protection when they emphasize shielding or defending the body (or the public) from specific causes of injury or disease. An example is creating nut-free schools to protect hypersensitive children from life-threatening allergic reactions to peanut and other nut products. Such initiatives have largely been the result of grassroots parent organizations working with formal community organizations to adopt policies that protect the health of these children. Nurses may be involved in the parent organizations or the school or public health boards that review the proposed policies. Secondary prevention ranges from providing screening activities and treating early stages of disease to limiting disability by averting or delaying the consequences of advanced disease. Tertiary prevention occurs when a defect or disability is permanent and irreversible. Emergent care is not associated with health promotion activities.
The nurse is participating at a health fair at the local mall giving influenza vaccines to senior citizens. What level of prevention is the nurse practicing? A. Primary prevention B. Secondary prevention C. Tertiary prevention D. Quaternary prevention
A. Primary prevention Primary prevention is aimed at health promotion and includes health-education programs, immunizations, and physical and nutritional fitness activities. It can be provided to an individual and includes activities that focus on maintaining or improving the general health of individuals, families, and communities. It also includes specific protection such as immunization for influenza.
The nurse is teaching a parenting class to a group of pregnant adolescents. The nurse pretends to be the baby's father, and the adolescent mother is asked to show how she would respond to the father if he gave her a can of beer. Which teaching approach did the nurse use? A. Role play B. Discovery C. An analogy D. A demonstration
A. Role play In role play people are asked to play themselves or someone else in a situation to enhance their confidence in handling that situation in the future.
A patient with chest pain is having an emergency cardiac catheterization. Which teaching approach does the nurse use in this situation? A. Telling approach B. Selling approach C. Entrusting approach D. Participating approach
A. Telling approach The telling approach is most appropriate when preparing a patient for an emergency procedure.
Major goals in assessing each person's functional pattern are to determine: (select all that apply) A. ability to manage health-promoting activities. B. herbal medications that promote health. C. knowledge of health promotion. D. the need for physician referral for illness care. E. the value that the person ascribes to health promotion.
A. ability to manage health-promoting activities. C. knowledge of health promotion. E. the value that the person ascribes to health promotion. A major goal in assessing each pattern is to determine the individual's knowledge of health promotion, the ability to manage health-promoting activities, and the value that the individual ascribes to health promotion. The assessment of herbal medications is important to determine potential for interactions with other prescribed medications, and adverse effects produced by the herbal medications. Referral to the physician for illness care would not be part of the assessment of functional health patterns.
Adaptive model
Ability to adapt positively to a change (social, mental, and physiological) Illness occurs when person fails to adapt or becomes maladaptive to changes
Absolute Homelessness vs. Relative Homelessness
Absolute - people without physical shelter who sleep outdoors, in vehicles, in abandoned buildings, or in other places not intended for human habitation Relative - describes those who have a physical shelter but one that does not meet the standards of health and safety
Positive health behaviors
Activities related to maintaining, attaining, or regaining good health and preventing illness
Deliverer of service
Actually providing care Helping with bed pan Taking BP
Sister Callista Roy
Adaption theory Focuses on the process of change
Health Belief Model
Addresses the relationship between a person's beliefs and behaviors
Lateral violence
Aggressive and destructive behavior or psychological harassment of nurses against each other
Fidelity
Agreement to keep promises
Hospice
Allows patient to live with comfort, independence, and dignity while easing the pains of terminal illness
Affective
Alludes tot he recognition of values, religious and spiritual beliefs, family interaction patterns and relationships, and personal attitudes that affect decisions and problem-solving progress
Certified Nurse-Midwife (CNM)
An APRN who is also educated in midwifery and is certified by the American College of Nurse-Midwifes
Clinical Nurse Specialist (CNS)
An APRN who is an expert clinician in a specialized area of practice
Certified Registered Nurse Anesthetist (CRNA)
An APRN with advanced education in a nurse anesthetia accredited program
Cultural encounter
An intervention that involves a nurse directly interacting with patients from culturally diverse backgrounds
Health education
Any combination of planned learning experiences based on sound therories — that provide individuals, groups, and communities the opportunity to acquire information and skills needed to make quality health decisions
Risk Factor
Any situation, habit, or other variable such as social, environmental, physiological, psychological, developmental, intellectual, or spiritual that increases the vulnerability of an individual or group to an illness or accident
Nurse Practioner (NP)
Are prepared to provide direct client care in primary care settings, focusing on health promotion, illness prevention, early diagnosis, and treatment of common health problems
ANA Standards of Nursing Practice
Assessment Diagnosis Outcomes Identification Planning Implementation Coordination of Care Health Teaching + Health Promotion Consultation Prescriptive Authority + Treatment Evaluation
Nursing Process
Assessment Diagnosis Planning Implementation Evaluation
ADPIE
Assessment Diagnosis Planning Implementation Evaluation
Medicare part D
Associated with medications
Culture
Associated with norms, values, and traditions passed through generations It also has been perceived to be the same as ethnicity, race, nationality, and language
Healthy People Initiative overarching goals
Attain longer lives, free of preventable disease, disability, injury Eliminate health disparities Create environment that promotes health Increase quality of life, healthy development, and healthy behaviors
Holistic Health Model
Attempts to create conditions that promote optimal health
When assessing the older adult for sleep quality, the nurse expects to find that the person will state: A. "I continue to be a night owl." B. "I experience difficulty returning to sleep." C. "I experience a night of deep sleep." D. "I rarely wake up during the night."
B. "I experience difficulty returning to sleep." Most difficulties associated with sleep are amenable to nursing therapies. Frequent awakenings do not necessarily imply sleep interruption. Many individuals may awaken numerous times during the night but return to sleep within seconds. This may be especially true of older adults who generally spend most of the night in stages of light sleep. Their normal developmental pattern does not include deep sleep; therefore, awakenings may not affect the sleep cycles and resultant feelings after awakening in the morning. More commonly, older adult individuals experience difficulty returning to sleep because they experience discomfort, fears, or other variables.
The nurse is developing a health promotion program on healthy eating and exercise for high school students using the health belief model as a framework. Which statement made by a nursing student is related to the individual's perception of susceptibility to an illness? A. "I don't have time to exercise because I have to work after school every night." B. "I'm worried about becoming overweight and getting diabetes because my father has diabetes." C. "The statistics of how many teenagers are overweight is scary." D. "I've decided to start a walking club at school for interested students."
B. "I'm worried about becoming overweight and getting diabetes because my father has diabetes." The statement indicates that the patient is concerned about developing diabetes and believes that there is a risk or susceptibility based on recognition of a familial link for the disease. Once this link is recognized, the patient may perceive the personal risk for diabetes.
A patient comes to the local health clinic and states: "I've noticed how many people are out walking in my neighborhood. Is walking good for you?" What is the best response to help the patient through the stages of change for exercise? A. "Walking is OK. I really think running is better." B. "Yes, walking is great exercise. Do you think you could go for a 5-minute walk next week?" C. "Yes, I want you to begin walking. Walk for 30 minutes every day and start to eat more fruits and vegetables." D. "They probably aren't walking fast enough or far enough. You need to spend at least 45 minutes if you are going to do any good."
B. "Yes, walking is great exercise. Do you think you could go for a 5-minute walk next week?" The patient's response indicates that the patient is in the contemplative state, possibly intending to make a behavior change within the next 6 months. The nurse's statement reinforces the behavior and provides a specific goal for the patient to begin a walking plan.
A nurse is planning a teaching session about healthy nutrition with a group of children who are in first grade. The nurse determines that after the teaching session the children will be able to name three examples of foods that are fruits. This is an example of: A. A teaching plan. B. A learning objective. C. Reinforcement of content. D. Enhancing the children's self-efficacy.
B. A learning objective. A learning objective describes what the learner will do after the teaching session.
A nurse is caring for a patient with end-stage lung disease. The patient wants to go home on oxygen and be comfortable. The family wants the patient to have a new surgical procedure. The nurse explains the risk and benefits of the surgery to the family and discusses the patient's wishes with the family. The nurse is acting as the patient's: A. Educator B. Advocate C. Caregiver D. Case manager
B. Advocate An advocate protects the patient's human and legal right to make choices about his or her care. An advocate may also provide additional information to help a patient decide whether or not to accept a treatment or find an interpreter to help family members communicate their concerns.
A patient is admitted to an acute care area. The patient is an active business man who is worried about getting back to work. He has had severe diarrhea and vomiting for the last week. He is weak, and his breathing is labored. Using Maslow's hierarchy of needs, identify this patient's immediate priority. A. Self-actualization B. Air, water, and nutrition C. Safety D. Esteem and self-esteem needs
B. Air, water, and nutrition The immediate priority is air, water, and nutrition. The patient needs to have sufficient air exchange, which might require oxygen administration. In addition the patient needs to have appropriate fluid balance and some nutritional supplement.
When a nurse is teaching a patient about how to administer an epinephrine injection in case of a severe allergic reaction, he or she tells the patient to hold the injection like a dart. Which of the following instructional methods did the nurse use? A. Telling B. Analogy C. Demonstration D. Simulation
B. Analogy Analogies use familiar images when teaching to help explain complex information.
A patient who is hospitalized has just been diagnosed with diabetes. He is going to need to learn how to give himself injections. Which teaching method does the nurse use? A. Simulation B. Demonstration C. Group instruction D. One-on-one discussion
B. Demonstration Demonstration is used to help patients learn psychomotor skills.
Which of the following theories describe the life processes of an older adult facing chronic illness? A. Systems theories B. Developmental theories C. Interdisciplinary theories D. Health and wellness models
B. Developmental theories Developmental theories describe and predict behavior and development at various phases of the life continuum, as in the phase of older adulthood.
The nurse is preparing education on prevention of urinary tract infections. A principle emphasized in the teaching plan would be: A. Decreasing oral intake facilitates urinary dilution. B. Empty the bladder at the first sensation of fullness. C. Frequency is a common symptom that can be ignored. D. Increasing time between urinations decreases the risk of infection.
B. Empty the bladder at the first sensation of fullness. The nurse uses evidence-based practice to guide his or her practice. Emptying the bladder as soon as bladder sensation of fullness occurs is a practice that decreases the time the urine remains in the bladder, thus decreasing the chance for bacterial growth to occur. Decreasing oral intake will cause the urine to become concentrated. Urinary frequency is a symptom seen with urinary tract infections. Research indicates that delayed time between urinations is associated with increased incidence of urinary tract infection.
A theory is a set of concepts, definitions, relationships, and assumptions that: A. Formulate legislation. B. Explain a phenomenon. C. Measure nursing functions. D. Reflect the domain of nursing practice.
B. Explain a phenomenon. Theories are designed to explain a phenomenon such as self-care or caring. A theory is a way of seeing through a "set of relatively concrete and specific concepts" and the propositions that describe or link the concepts.
A patient needs to learn how to administer a subcutaneous injection. Which of the following reflects that the patient is ready to learn? A. Describing difficulties a family member has had in taking insulin B. Expressing the importance of learning the skill correctly C. Being able to see and understand the markings on the syringe D. Having the dexterity needed to prepare and inject the medication
B. Expressing the importance of learning the skill correctly Patients are ready to learn when they understand the importance of learning and are motivated to learn.
The nurse assesses the following risk factors for coronary artery disease (CAD) in a male patient. Which factors are classified as genetic and physiological? (Select all that apply.) A. Sedentary lifestyle B. Father died from CAD at age 50 C. History of hypertension D. Eats diet high in sodium E. Elevated cholesterol level F. Age is 44 years
B. Father died from CAD at age 50 C. History of hypertension E. Elevated cholesterol level F. Age is 44 years Genetic and physiological risk factors include those related to heredity, genetic predisposition to an illness, or those that involve the physical functioning of the body. Certain physical conditions such as being pregnant or overweight place increased stress on physiological systems (e.g., the circulatory system), increasing susceptibility to illness in these areas. A person with a family history of coronary artery disease is at risk for developing the disease later in life because of a hereditary and genetic predisposition to the disease.
The nurse is teaching about primary prevention and includes which educational statement in the instructions? A. Everyone should participate in colorectal cancer screening. B. Health teaching about the risk factors of heart disease should be performed. C. Limiting disability is a vital role of nursing since preventive measures are therapeutic. D. The nurse is involved in minimizing the effects of disease and disability by surveillance and maintenance.
B. Health teaching about the risk factors of heart disease should be performed. Primary prevention precedes disease or dysfunction. Primary prevention intervention includes health promotion, such as health teaching about risk factors for heart disease, and specific protection, such as immunization against hepatitis B. Its purpose is to decrease the vulnerability of the individual or population to disease or dysfunction. People are taught to use appropriate primary preventive measures. Screening is secondary prevention because the principle goal is to identify individuals in an early, detectable stage of the disease process. Delayed recognition of disease results in the need to limit future disability in late secondary prevention. Tertiary prevention occurs when a defect or disability is permanent and irreversible. The process is minimizing the effects the disease and disability by surveillance and maintenance activities aimed at preventing complications and deterioration.
When illness occurs, different attitudes about it cause people to react in different ways. What do medical sociologists call this reaction to illness? A. Health belief B. Illness behavior C. Health promotion D. Illness prevention
B. Illness behavior Illness behavior involves how people monitor their bodies, define and interpret their symptoms, take remedial actions, and use the resources in the health care system. Personal history, social situations, social norms, and past experiences can affect illness behavior.
Which of the following nursing roles may have prescriptive authority in their practice? (Select all that apply.) A. Critical care nurse B. Nurse practitioner C. Certified clinical nurse specialist D. Charge nurse
B. Nurse practitioner Nurse practitioners and certified clinical nurse specialists encompass the role and preparation of the advanced practice registered nurse. According to the American Nurses Association standards of practice, prescriptive authority may be granted to these nurses.
A patient with diabetes is controlling the disease with insulin and diet. The nursing health care provider is focusing efforts to teach the patient self-management. Which of the following nursing theories is useful in promoting self management? A. Neuman B. Orem C. Roy D. Peplau
B. Orem Orem's theory of self-care provides a solid theoretical background for self-management for a variety of diseases. This theory shows the nurse how to direct the patient toward self-management to promote health and/or sustain wellness.
A nurse is caring for an older-adult couple in a community-based assisted living facility. During the family assessment he notes that the couple has many expired medications and multiple medications for their respective chronic illnesses. They note that they go to two different health care providers. The nurse begins to work with the couple to determine what they know about their medications and helps them decide on one care provider rather than two. This is an example of which Quality and Safety in the Education of Nurses (QSEN) competency? A. Patient-centered care B. Safety C. Teamwork and collaboration D. Informatics
B. Safety Helping the patients understand the consequences and complications of multiple medications helps to build the competency in safety.
The nurse is conducting a home visit with an older adult couple. She assesses that the lighting in the home is poor and there are throw rugs throughout the home and a low footstool in the living room. She discusses removing the rugs and footstool and improving the lighting with the couple. The nurse is addressing which level of need according to Maslow? A. Physiological B. Safety and security C. Love and belonging D. Self-actualization
B. Safety and security The teaching addresses the need for safety and security. The throw rugs, low lighting, and low stool are hazards that can cause falls in the elderly. Preventing falls is a priority safety issue for older adults.
The nurse assesses a community for evidence of health-promotion strategies. Which of the following are health-promotion strategies? (select all that apply) A. Seeking primary care in the acute care hospital B. Self-care for minor illness C. Entry into acute care facilities to manage chronic illness D. Environmental changes to enhance clean air E. Supporting Habitat for Humanity house construction
B. Self-care for minor illness D. Environmental changes to enhance clean air E. Supporting Habitat for Humanity house construction Health-promotion strategies go beyond providing information. It is proactive decision making at all levels of society. Strategies identified within this decision-making process are screening, self-care for minor illness, readiness for emergencies, successful management of chronic illness, environmental changes to enhance positive behaviors, and health-enhancing policies within an organizational setting. Health-promotion efforts focus on maintaining or improving the general health of individuals, families, and communities through support of housing at the public and community level; and at the personal level by voting and volunteering for improved low-income housing.
The nurse is performing an initial antepartal assessment on a woman who has missed two periods. Assessment of this woman for alcohol consumption is best determined by the: A. CAGE test. B. T-ACE test. C. non-stress test. D. protein dipstick test.
B. T-ACE test. The T-ACE test provides a much more sensitive measure of alcohol intake patterns than that derived from the CAGE test. The T-ACE test considers the following assessment criteria: • How many drinks does it Take to make you feel high? • Have you ever been Annoyed by people criticizing your drinking? • Have you ever felt you ought to Cut down your drinking? • Have you ever had a drink first thing in the morning (Eye Opener) to steady your nerves or get rid of a hangover? The CAGE test considers data collected from the client on Cutting down on drinking, being Annoyed by criticism of drinking, feeling Guilty about drinking, and using alcohol as an Eye opener. The non-stress test evaluates the fetal heart rate response to fetal movement, which is assessed after the fetus is 20 weeks or more. The protein dipstick is performed at each prenatal visit and measures the amount of protein in the client's urine. Proteinuria is a symptom seen with pre-eclampsia.
Four distinct models have been used to describe concepts of health. Which of the following statements accurately describes some of the models used? (select all that apply) A. In the clinical health model, health and illness are defined by signs and symptoms of disease. B. The role performance model of health defines health in terms of individuals' ability to perform social roles. C. The clinical model is the basis for occupational health evaluations. D. In the adaptive model of health, people's ability to adjust positively to social, mental, and physiological change is the measure of their health. E. In the eudaimonistic model, exuberant well-being indicates optimal health.
B. The role performance model of health defines health in terms of individuals' ability to perform social roles. D. In the adaptive model of health, people's ability to adjust positively to social, mental, and physiological change is the measure of their health. E. In the eudaimonistic model, exuberant well-being indicates optimal health. The role performance model of health defines health in terms of individuals' ability to perform social roles. Role performance includes work, family, and social roles, with performance based on societal expectations. Illness would be the failure to perform roles at the level of others in society. In the adaptive model of health, people's ability to adjust positively to social, mental, and physiological change is the measure of their health. Illness occurs when the person fails to adapt or becomes maladaptive to these changes. In the eudaimonistic model, exuberant well-being indicates optimal health. This model emphasizes the interactions between physical, social, psychological, and spiritual aspects of life and the environment that contribute to goal attainment and create meaning. In the clinical model, health is defined by the absence, and illness by the conspicuous presence, of signs and symptoms of disease. The role performance model of health defines health in terms of individuals' ability to perform social roles. This model is the basis for occupational health evaluations.
The nurse is planning to teach a patient about the importance of exercise. When is the best time for teaching to occur? (Select all that apply.) A. When there are visitors in the room B. When the patient's pain medications are working C. Just before lunch, when the patient is most awake and alert D. When the patient is talking about current stressors in his or her life
B. When the patient's pain medications are working C. Just before lunch, when the patient is most awake and alert Plan teaching when the patient is most attentive, receptive, alert, and comfortable
A person reports his exercise pattern is one golf game per week. The nurse evaluates this pattern and teaches the individual that: A. exercise should include jogging. B. exercises should be repetitive. C. golfing one time per week is adequate. D. weekly workouts at the gym should be included.
B. exercises should be repetitive. Exercise is a type of physical activity that is planned, structured, and repetitive, and performed to improve or maintain physical fitness. Active social activities such as backyard softball or golf would be considered physical activity. Activities such as jogging, walking, or gym workouts would be considered exercise. Sedentary social activities such as bingo, reading, knitting, stamp collection, cards, or participation in discussion groups would not be considered physical activity.
The nurse, teaching a class on primary prevention at a women's health club, emphasizes participation in: A. physician visits during illness. B. recommended immunization schedules. C. taking antibiotics at the first sign of symptoms. D. water aerobics to develop muscle building.
B. recommended immunization schedules. Primary prevention is a concept central to nursing and includes generalized health promotion and specific protection from disease. Health promotion connotes an active process involving specific protections, including immunizations, occupational safety, and environmental control, along with a set of behaviors that enhances health. Physician visits that promote health promotion focus on screening and wellness visits that include teaching on preventative health practices. Antibiotics should only be taken when there is evidence of an infection. Water aerobics focuses on flexibility, not muscle building.
Role performance model
Based on whether the person can perform their societal roles Illness = failure to perform roles at the level of others in society
Based on the transtheoretical model of change, what is the most appropriate response to a patient who states: "Me, exercise? I haven't done that since junior high gym class, and I hated it then!" A. "That's fine. Exercise is bad for you anyway." B. "OK. I want you to walk 3 miles 4 times a week, and I'll see you in 1 month." C. "I understand. Can you think of one reason why being more active would be helpful for you?" D. "I'd like you to ride your bike 3 times this week and eat at least four fruits and vegetables every day."
C. "I understand. Can you think of one reason why being more active would be helpful for you?" The patient's response indicates that the patient is in the precontemplation stage and does not intend to change his behavior in the next 6 months. In this stage the patient is not interested in information about the behavior and may be defensive when confronted with it. Asking an open-ended question may stimulate the patient to identify a reason to begin a behavior change. Nurses are challenged to motivate and facilitate change in health behavior when working with individuals.
Evidence-based practice is defined as: A. Nursing care based on tradition B. Scholarly inquiry of nursing and biomedical research literature C. A problem-solving approach that integrates best current evidence with clinical practice D. Quality nursing care provided in an efficient and economically sound manner
C. A problem-solving approach that integrates best current evidence with clinical practice Evidence-based practice integrates best current evidence with clinical expertise and patient/family preferences and values for delivery of optimal health care.
An 18-year-old woman is in the emergency department with fever and cough. The nurse obtains her vital signs, auscultates her lung sounds, listens to her heart sounds, determines her level of comfort, and collects blood and sputum samples for analysis. Which standard of practice is performed? A. Diagnosis B. Evaluation C. Assessment D. Implementation
C. Assessment Assessment is the collection of comprehensive data pertinent to the patient's health and/or the situation.
The school nurse is about to teach a freshman-level high school health class about nutrition. What is the best instructional approach to ensure that the students meet the learning outcomes? A. Provide information using a lecture B. Use simple words to promote understanding C. Develop topics for discussion that require problem solving D. Complete an extensive literature search focusing on eating disorders
C. Develop topics for discussion that require problem solving Adolescents learn best when they are able to use problem solving to help them make choices.
Nurses at a community hospital are in an education program to learn how to use a new pressure-relieving device for patients at risk for pressure ulcers. This is which type of education? A. Continuing education B. Graduate education C. In-service education D. Professional Registered Nurse Education
C. In-service education In-service education programs are instruction or training provided by a health care agency or institution. An in-service program is held in the institution and is designed to increase the knowledge, skills, and competencies of nurses and other health care professionals employed by the institution.
To practice in today's health care environment, nurses need a strong scientific knowledge base from nursing and other disciplines such as the physical, social, and behavioral sciences. This statement identifies the need for which of the following? A. Systems theories B. Developmental theories C. Interdisciplinary theories D. Health and wellness models
C. Interdisciplinary theories As the health system evolves and the health care needs of the patient focus on health promotion, illness prevention, and treatment, more disciplines are involved in patient care. To be effective in practice nurses need to be aware of theoretical approaches of care arising from other disciplines and from nursing.
Which of the following statements about theory-based nursing practice is incorrect? A. Contributes to evidence-based practice B. Provides a systematic process for designing nursing interventions C. Is not linked to nursing outcomes D. Guides the nurse's assessment
C. Is not linked to nursing outcomes Theory-based nursing practice does reflect nursing outcomes. For example, prescriptive theories address specific nursing interventions and predict the patient response.
A patient newly diagnosed with cervical cancer is going home. The patient is avoiding discussion of her illness and postoperative orders. What is the nurse's best plan in teaching this patient? A. Teach the patient's spouse B. Focus on knowledge the patient will need in a few weeks C. Provide only the information that the patient needs to go home D. Convince the patient that learning about her health is necessary
C. Provide only the information that the patient needs to go home This patient is in denial; thus it is appropriate to only give her information that is needed immediately.
A patient experienced a myocardial infarction 4 weeks ago and is currently participating in the daily cardiac rehabilitation sessions at the local fitness center. In what level of prevention is the patient participating? A. Primary prevention B. Secondary prevention C. Tertiary prevention D. Quaternary prevention
C. Tertiary prevention Tertiary prevention involves minimizing the effects of long-term disease or disability by interventions directed at preventing complications and deterioration following the myocardial infarction. Tertiary-prevention activities are directed at rehabilitation rather than diagnosis and treatment. Care at this level aims to help patients achieve as high a level of functioning as possible, despite the limitations caused by illness or impairment. This level of care is called preventive care because it involves preventing further disability or reduced functioning.
A nurse is going to teach a patient how to perform breast self-examination. Which behavioral objective does the nurse set to best measure the patient's ability to perform the examination? A. The patient will verbalize the steps involved in breast self-examination within 1 week. B. The nurse will explain the importance of performing breast self-examination once a month. C. The patient will perform breast self-examination correctly on herself before the end of the teaching session. D. The nurse will demonstrate breast self-examination on a breast model provided by the American Cancer Society.
C. The patient will perform breast self-examination correctly on herself before the end of the teaching session. Return demonstration provides an excellent source of feedback and reinforcement to evaluate learning.
In addition to changes in ethnic and racial distribution within the population, it is expected that changes in _______ distribution will affect health promotion practice. A. geographic B. environmental C. age D. social
C. age In addition to changes in the ethnic and racial distribution within the population, the projected changes in age distribution will affect health promotion practice. Considerable growth is expected in the proportion of the population that is 25 years of age and older. Analysis of population trends and projections helps health professionals determine changing needs. Additionally, analysis of the social and economic environment is necessary for developing social policy concerning health. Geographic, environmental, and social aspects are not expected means of impacting health promotional practices although social and environmental concerns determine health outcomes.
The individual's perceived health and well-being and how health is managed describes the: A. cognitive-perceptual pattern. B. coping-stress tolerance pattern. C. health perception-health management pattern. D. self-perception-self-concept pattern.
C. health perception-health management pattern. The health perception-health management pattern provides an overview of the individual's health status and the health practices that are used to reach the current level of health or wellness. The focus is on perceived health status and the meaning of health, along with the individual's level of commitment to maintaining health. The cognitive-perceptual pattern focuses on sensory perceptual and cognitive patterns. The coping-stress tolerance pattern identifies the general coping pattern and effectiveness on stress tolerance. The self-perception-self-concept pattern describes the individual's perception of self to include body comfort, body image, and feeling state as well as self-conception and self-esteem.
In assessing the nutritional-metabolic pattern, the nurse performs an examination of: A. attention span. B. blood pressure. C. mucous membranes. D. urine color.
C. mucous membranes. Assessment of the mucous membranes determines hydration status, which is part of the nutrition-metabolic pattern. Other specific assessment findings for the nutritional-metabolic pattern may point to an individual who is overweight, underweight, overly hydrated, dehydrated, or experiencing difficulties in skin integrity, such as skin breakdown or delayed healing. The attention span is part of the self-perception-self-concept pattern. Measurement of blood pressure is part of the activity-exercise pattern. Urine color is part of the elimination pattern.
The nurse is preparing a class on wellness and health promotion for a group of middle school students. Developmental tasks of early adolescence include a learning focus emphasis on: A. coping with life events and problems. B. economic responsibility. C. risk taking and its consequences. D. social responsibility for self and others.
C. risk taking and its consequences. Early adolescence developmental focus is on industry verses inferiority as identified by Erikson. The wellness tasks identified include: • learning that health is an important value. • learning self-regulation of physiological needs—sleep, rest, food, drink, and exercise. • learning risk taking and its consequences (injury prevention). The other three options define adolescent (identity verses role confusion) wellness developmental tasks, which include learning to cope with life events and problems, learning economic responsibility, and learning social responsibility for self and others.
C-LARA
Calm Listen Affirm Respond Add
Culturally congruent care
Care that fits a person's life patterns, values, and system of meaning
Restorative Care
Care that helps persons regain their health, strength, and independence
CHAPTER 10
Caring for Families
Casuistry
Case-based reasoning, turns away from conventional principles of ethics as a way to determine best actions and focuses instead on an "intimate understanding of particular situations"
Domains of learning
Cognitive Affective Psychomotor
Vulnerable populations
Collection of individuals who are more likely to develop health problems as a result of excess risks, limits in access to health care services, or being dependent on others for care
CHAPTER 9
Cultural Awareness
Meaning of Disease and Illness
Culture affects how an individual defines the meaning of illness
A patient with a 20-year history of diabetes mellitus had a lower leg amputation. Which statement made by the patient indicates that he is experiencing a problem with body image? A. "I just don't have any energy to get out of bed in the morning." B. "I've been attending church regularly with my wife since I got out of the hospital." C. " My wife has taken over paying the bills since I've been in the hospital." D. "I don't go out very much because everyone stares at me."
D. "I don't go out very much because everyone stares at me." The amputation resulted in a change in physical appearance that caused a change in body image. Reactions of patients and families to changes in body image depend on the type of changes (e.g., loss of a limb or an organ), their adaptive capacity, the rate at which changes take place, and the support services available. When a change in body image such as results from a leg amputation occurs, the patient generally adjusts in the following phases: shock, withdrawal, acknowledgment, acceptance, and rehabilitation. The patient's statement indicates he is in the stage of withdrawal.
The patient states she joined a fitness club and attends the aerobics class three nights a week. The patient is in what stage of behavioral change? A. Precontemplation B. Contemplation C. Preparation D. Action
D. Action The patient is in the action stage of behavioral change. In this stage the patient is actively engaged in strategies to change behavior. This stage may last up to 6 months.
An older adult is being started on a new antihypertensive medication. In teaching the patient about the medication, the nurse: A. Speaks loudly. B. Presents the information once. C. Expects the patient to understand the information quickly. D. Allows the patient time to express himself or herself and ask questions.
D. Allows the patient time to express himself or herself and ask questions. When teaching older adults, it is important to establish rapport, involve them in their care, and allow them to progress at their own pace.
You are participating in a clinical care coordination conference for a patient with terminal cancer. You talk with your colleagues about using the nursing code of ethics for professional registered nurses to guide care decisions. A nonnursing colleague asks about this code. Which of the following statements best describes this code? A. Improves self-health care B. Protects the patient's confidentiality C. Ensures identical care to all patients D. Defines the principles of right and wrong to provide patient care
D. Defines the principles of right and wrong to provide patient care When giving care, it is essential to provide a specified service according to standards of practice and to follow a code of ethics. The code of ethics is the philosophical ideals of right and wrong that define the principles you will use to provide care for your patients. The code serves as a guide for carrying out nursing responsibilities to provide quality nursing care and the ethical obligations of the profession.
A nurse is teaching a group of young college-age women the importance of using sunscreen when going out in the sun. What type of content is the nurse providing? A. Simulation B. Restoring health C. Coping with impaired function D. Health promotion and illness prevention
D. Health promotion and illness prevention Health promotion and illness prevention are the focus when nurses provide information to help patients improve their health and avoid illness.
A patient in the emergency department has developed wheezing and shortness of breath. The nurse gives the ordered medicated nebulizer treatment now and in 4 hours. Which standard of practice is performed? A. Planning B. Evaluation C. Assessment D. Implementation
D. Implementation Implementation is completing coordinating care and the prescribed plan of care.
A critical care nurse is using a computerized decision support system to correctly position her ventilated patients to reduce pneumonia caused by accumulated respiratory secretions. This is an example of which Quality and Safety in the Education of Nurses (QSEN) competency? A. Patient-centered care B. Safety C. Teamwork and collaboration D. Informatics
D. Informatics Using decision support systems is one example of using and gaining competency in informatics.
ID: 514968103 The nurses on an acute care medical floor notice an increase in pressure ulcer formation in their patients. A nurse consultant decides to compare two types of treatment. The first is the procedure currently used to assess for pressure ulcer risk. The second uses a new assessment instrument to identify at-risk patients. Given this information, the nurse consultant exemplifies which career? A. Clinical nurse specialist B. Nurse administrator C. Nurse educator D. Nurse researcher
D. Nurse researcher The nurse researcher investigates problems to improve nursing care and to further define and expand the scope of nursing practice. He or she often works in an academic setting, hospital, or independent professional or community service agency.
A patient at the community clinic asks the nurse about health promotion activities that she can do because she is concerned about getting diabetes mellitus since her grandfather and father both have the disease. This statement reflects that the patient is in what stage of the health belief model? A. Perceived threat of the disease B. Likelihood of taking preventive health action C. Analysis of perceived benefits of preventive action D. Perceived susceptibility to the disease.
D. Perceived susceptibility to the disease. The health belief model addresses the relationship between a person's beliefs and behaviors. It provides a way of understanding and predicting how patients will behave in relation to their health and how they will comply with health care therapies. In the perceived susceptibility to the disease phase, the patient recognizes the familial link to the disease.
The examination for registered nurse licensure is exactly the same in every state in the United States. This examination: A. Guarantees safe nursing care for all patients B. Ensures standard nursing care for all patients C. Ensures that honest and ethical care is provided D. Provides a minimal standard of knowledge for a registered nurse in practice
D. Provides a minimal standard of knowledge for a registered nurse in practice Registered nurse (RN) candidates must pass the NCLEX-RN® that the individual State Boards of Nursing administer. Regardless of educational preparation, the examination for RN licensure is exactly the same in every state in the United States. This provides a standardized minimum knowledge base for nurses.
A patient needs to learn to use a walker. Which domain is required for learning this skill? A. Affective domain B. Cognitive domain C. Attentional domain D. Psychomotor domain
D. Psychomotor domain Using a walker requires the integration of mental and muscular activity.
A nurse works in a special care unit for children with severe immunology problems and is caring for a 3-year-old boy from Greece. The boy's father is with him while his mother and sister are back in Greece. The nurse is having difficulty communicating with the father. What action does the nurse take? A. Care for the boy as she would any other patient B. Ask the manager to talk with the father and keep him out of the unit C. Have another nurse care for the boy because maybe that nurse will do better with the father D. Search for help with interpretation and understanding of the cultural differences by contacting someone from the local Greek community
D. Search for help with interpretation and understanding of the cultural differences by contacting someone from the local Greek community The nurse needs to understand how the Greek culture impacts the father's health beliefs and communication with health care providers. Cultural variables must be incorporated into the child's plan of care. Cultural background influences beliefs, values, and customs. It influences the approach to the health care system, personal health practices, and the nurse-patient relationship. Cultural background may also influence an individual's beliefs about causes of illness and remedies or practices to restore health. If nurses are not aware of their own and other cultural patterns of behavior and language, they may not be able to recognize and understand a patient's behavior and beliefs and may have difficulty interacting with the patient.
Which of the following are components of the paradigm of nursing? A. The person, health, environment, and theory B. Health, theory, concepts, and environment C. Nurses, physicians, health, and patient needs D. The person, health, environment/situation, and nursing
D. The person, health, environment/situation, and nursing The nursing paradigm focuses on person, health, environment/situation, and nursing. All the elements interact with one another, with the patient being central.
Theory-based nursing practice uses a theoretical approach for nursing care. This approach moves nursing forward as a science. This suggests that: A. One theory will guide nursing practice. B. Scientists will decide nursing decisions. C. Nursing will only base patient care on the practice of other sciences. D. Theories will be tested to describe or predict patient outcomes
D. Theories will be tested to describe or predict patient outcomes There are multiple theories for the practice of nursing; these theories are tested to develop the evidence to describe or predict patient outcomes.
When teaching about proper nutrition to a person with congestive heart failure, which affective component should be included in the educational plan? A. Eating with someone B. Food preparation techniques C. Knowledge of dietary restrictions D. Values of adhering to the diet
D. Values of adhering to the diet The affective component of education addresses the attitudes and values the person believes regarding the education and how it will apply to his or her life beliefs. If the person values the education, it will be more likely to be followed as opposed to if the person finds that the education is not congruent with his or her values. Even when the person possesses the knowledge base, assessment of whether the individual also values the importance of adhering to the modifications in lifestyle is vital.
Public health nurses are involved in supporting active health promotion strategies such as: A. supporting clean water. B. advocating for vitamin D in all milk. C. supporting sanitary sewage systems. D. participating in an individual daily exercise program.
D. participating in an individual daily exercise program. Health-promotion strategies are either active or passive. Passive strategies involve the individual as an inactive participant or recipient. Examples of passive strategies include public health efforts to maintain clean water and sanitary sewage systems, and efforts to introduce vitamin D in all milk to ensure that children will not be at risk for rickets when there is little sunlight. Active strategies depend on the individual becoming personally involved in adopting a proposed program of health promotion. Examples of lifestyle changes are daily exercise as part of a physical fitness plan and a stress-management program as part of daily living.
Assessment
Data Subjective - verbal description
Coping-Stress Tolerance Pattern
Describes patient's ability to manage stress; sources of support; effectiveness of the patterns in terms of stress tolerance
Nutritional-Metabolic Pattern
Describes patient's daily/weekly pattern of food and fluid intake (e.g., food preferences or restrictions, special diet, appetite); actual weight; weight loss or gain.
Role-Relationship Pattern
Describes patient's patterns of role engagements and relationships
Sexuality-Reproductive Pattern
Describes patient's patterns of satisfaction and dissatisfaction with sexuality pattern; patient's reproductive patterns; premenopausal and postmenopausal problems
Self-Perception-Self-Concept Pattern
Describes patient's self-concept pattern and perceptions of self (e.g., self-concept/worth, emotional patterns, body image)
Health perception-health management pattern
Describes patient's self-report of health and well-being; how patient manages health (e.g., frequency of health care provider visits, adherence to therapies at home); knowledge of preventive health practices
Elimination Pattern
Describes patterns of excretory function (bowel, bladder, and skin)
Activity-Exercise Pattern
Describes patterns of exercise, activity, leisure, and recreation; ability to perform activities of daily living
Sleep-Rest Pattern
Describes patterns of sleep, rest, and relaxation.
Value-Belief Pattern
Describes patterns of values, beliefs including spiritual practices, and goals that guide patient's choices or decisions
Cognitive-Perceptual Pattern
Describes sensory-perceptual patterns; language adequacy, memory, decision-making ability
Pay for performance programs
Designed to promote quality, effective, and safe patient care by physicians and health care organizations Quality improvement strategies that reward excellence through financial incentives to motivate change to achieve measurable improvements
Evaluation
Determine whether goals were met Assess why goals were not met Modify plan as needed
World view
Determines how people perceive others, how they interact and relate to reality, and how they process information
Psychomotor
Developing physical skills from simple to complex actions
Cognitive
Development of new facts or concepts, and building on or applying knowledge to new situations
Internal Variables that Influence Health
Developmental stage, intellectual background, perception of functioning, emotional factors, spiritual factors
Health Promotion Model
Directed at increasing a patient's level of well-being
Concomitant Symptoms
Does the patient experience other symptoms along with the primary symptom? For example, does nausea accompany pain?
Social Learning/Cognitive Theory
Emphasizes influence of self-efficacy on Health Behavior (Bandura) "People with high assurance in their capabilities approach difficult tasks as challenges to be mastered rather than threats to be avoided."
Autonomy
Essential element of professional nursing that involves the initiation of independent nursing interventions without medical orders.
ANA Standards of Professional Performance
Ethics Education Evidence-Based Practice Quality of Practice Communication Leadership Collaboration Professional Practice Resources Environmental Health
CHAPTER 22
Ethics and Values
Passive Health Promotion Strategies
Ex. Fluoride in water, fortified foods
Active Health Promotion Strategies
Ex. weight reduction, smoking-cessation
ETHNIC
Explanation Treatment Healers Negotiate Intervention Collaboration
External Variables that Influence Health
Family practices, socioeconomic factors, cultural background
Family as patient
Family processes and relationships are the primary focuses of nursing care
Mary Mahoney
First professionally trained African American nurse
Mary Adelaide Nutting
First professor of nursing at Columbia University Teachers College in 1906.
Primary Health Care
Focuses on improved health outcomes for an entire population; includes primary care and health education, proper nutrition, maternal/child health care, family planning, vaccines, and control of diseases
Secondary Prevention
Focuses on individuals who are experiencing health problems or illnesses and are at risk for developing complications or worsening conditions
Continuing Care
For people who are disabled, functionally dependent, or suffering a terminal disease
Blended family
Formed when a single parent marries another person, who may or may not have children
Single-parent family
Formed when one parent leaves the nuclear family because of death, divorce, or desertion or when a single person decides to have or adopt a child
Florence Nightingale
Founder of modern nursing; started first organized program to train nurses; first practicing nurse epidemiologist; connected sanitation with cholera and dysentery
Teach Back technique
Have patient repeat directions observe that message is understood restate directions speak louder speak slower use a translator
Theoretical Models of Health Promotion/Beliefs
Health Belief Model Transtheoretical Model of Change Pender's Model of Health Promotion Social Learning/Cognitive Theory
CHAPTER 2
Health Care Delivery System
CHAPTER 6
Health and Wellness
Illness Prevention
Health education programs or activities directed toward protecting patients from threats or potential threats to health and minimizing risk factors
Gordon's 11 functional health patterns
Health perception-Health management Nutritional-Metabolic Elimination Activity-Exercise Sleep-Rest Cognitive-Perceptual Self-Perception/Self-Concept Roles-Relationships Sexuality-Reproductive Coping-Stress Tolerance Values-Beliefs
Family resiliency
Helps to evaluate healthy responses when individuals and families experience stressful events
Systems theory
How one person is doing can effect how family is doing How they relate to each other What is the flow of information/values' How they cope with different things
Skilled Nursing Facility (SNF)
Includes administration of IV fluids, wound care, long term ventilator management, and rehab
Extended family
Includes the nuclear family plus grandparents, aunts, uncles, and cousins
Negative health behaviors
Inculde practices actually or potentially harmful to health such as smoking, drug or alcohol abuse, poor diet and refusal to take necessary medications
Components of Health Belief Model
Individual perceptions or readiness for change The value of health to the individual compared with other aspects of living Perceived susceptibility to a health problem, disease, or complications Perceived seriousness of the disease level threatening the achievement of certain goals or aims Risk factors to a disease attributed to heredity, race, or culture, medical history etc Perceived benefits of health action Perceived barriers to promotion action
Health perception-Health management
Individual's perceived health and well-being Assess current and past health practices
Cue
Information that you obtain through use of the senses
Family
Interacting individuals related by blood, marriage, cohabitation, or adoption
Family Health System (FHS)
Interactive Developmental Coping Integrity Health
Family hardiness
Internal strengths and durability of the family unit; characterized by a sense of control over the outcome of life events and hardships, a view of change as beneficial and growth-producing, and an active rather than passive orientation in responding to stressful life events
Action
Involved in change for 6 months
Telemedicine
Involves the use of video, audio, and computer systems to provide medical and/or health care services
Core measures
Key quality indicators that help health care institutions improve performance, increase accountability, and reduce costs
LEARN
Listen Explain Acknowledge Recommend Negotiate
Rural Hospitals
Located in a county that has a low population density
Feminist ethics
Looks to the nature of relationships to guide participants in making difficult decisions, especially relationships in which power is unequal or in which a POV has become ignored or invisible
Health Services Pyramid
Managing health instead of illness Emphasis on wellness Injury prevention programs
Advanced Practice Registered Nurse (APRN)
Most independently functioning nurse; has masters degree in nursing
Nuclear family
Mother, father and children living as a unit
Benner's Model of Novice to Expert
Novice Advanced beginner Competent Proficient Expert
Clara Barton
Nurse during the Civil War; founder of the American Red Cross
CHAPTER 16
Nursing Assessment
CHAPTER 1
Nursing Today
Interview Techniques
Observation Open-ended questions Leading question Back channeling Probing Direct close-ended questions
Tertiary Prevention
Occurs when a defect or disability is permanent or irreversible; involves minimizing the effects of long-term disease or disability by interventions directed at preventing complications and deterioration
Burnout
Occurs when perceived demands outweigh perceived resources
Nursing Quality Indicators
Outcomes of nursing care, identified by the American Nurses Association, that address patient safety and quality of care
Intersectionality
Overlapping of social categories such as race, class, gender as they apply to a given individual or group. Creates interdependent systems of discrimination/ disadvantage
Health Belief Model
Paradigm used to predict and explain health behavior Explain responses to symptoms, disease, prescribed treatments, and potential health problems
IOM Competencies
Patient Centered Care Work in Interdisciplinary Teams Use Evidence-Based Practice Apply Quality Improvement Use Informatics
Nursing-sensitive outcomes
Patient outcomes and nursing workforce characteristics that are directly related to nursing care such as changes in patients' symptom experiences, functional status, safety, psychological distress, registered nurse job satisfaction, total nursing hours per patient day, and costs
Intensive Care
Patients receive close monitoring and intensive medical care
Psychiatric Facilities
Patients who suffer emotional and behavioral problems such as depression, violent behavior, and eating disorders often require special counseling and treatment in psychiatric facilities
Chronic Illness
Persists longer than 6 months, is irreversible, and affects functioning in one or more systems
Maslow's Hierarchy of Needs
Physiological Safety Love + Belonging Self Esteem Self-actualization
Wellness
Positive state in which incremental increases in health can be made beyond the midpoint
Level of prevention (3)
Primary secondary tertiary
Family as context
Primary focus is on the health and development of an individual member existing within a specific environment
Levels of Preventive Care
Primary, secondary, tertiary
Maintenance
Processing effects of change, continuation of behaviors
Deontology
Proposes a system of ethics that comes from the work of an eighteenth century philosopher, Immanuel Kant Deontology defines actions as right or wrong on the basis of their "right-making characteristics" such as fidelity to promises, truthfulness, and justice
Home Care
Provision of medically related professional and paraprofessional services and equipment to patients and families in their homes for health maintenance, education, illness prevention, diagnosis and treatment of disease, palliation, and rehabilitation
PQRST
Provokes Quality Radiate Severity Time
Implementation
Put plan and interventions into practice Adjust plan based on patient's continually changing condition Include patient/family in planning and implementing interventions
RESPECT
Rapport Empathy Support Partnership Cultural competence Trust
Magnet Recognition Program
Recognition by the American Nurses Credentialing Center that an organization provides quality nursing care
Patient-Centered Care
Recognize the patient or designee as the source of control and full partner in providing compassionate and coordinated care based on respect for patient's preferences, values, and needs
Clara Barton
Red cross
Beneficence
Refers to taking positive actions to help others
Nonmaleficence
Refers to the avoidance of harm or hurt
Autonomy
Refers to the freedom from external control
Advocacy
Refers to the support of a particular cause
Theory
Related concepts to help explain a phenomenon
Alternative family
Relationships include multi-adult households, "skip-generation" families (grandparents caring for grandchildren), communal groups with children, "nonfamilies" (adults living alone), and cohabitating partners
Utilitarianism
Relies on the application of a certain principle; focuses on outcomes Proposes the value of something is determined by it's usefulness Also known as consequentialism
Patient-Centered Interview
Requires: courtesy, comfort, connection, confirmation
Rehabilitation
Restores a person to the fullest physical, mental, social, vocational, and economic potential possible
Preparation
Seriously thinking of making change, actions identified, within the next month
Planning
Set plan with patient Identify outcomes/goals
Advocate
Speaking up for someone Help individuals obtain what they are entitled to receive thru the health care system
Developmental theory
Stages of family life cycle Critical family developmental tasks
Ethics of care
Strives to address issues beyond individual relationships by raising ethical concerns about the structures within which individual caring occurs (structures such as hospitals or universities)
Genomics
Study of whole genomes, including genes and their functions
Nursing Assessment
Systematic and continuous collection and analysis of information about the client Two Steps: 1. Collect info from primary source (pt) and secondary sources (family, friends, health prof, records) 2. Interpret and validate data to ensure complete database
Theoretical foundations (frameworks) for assessing family
Systems theory Developmental Risk-Factor
Linguistic competence
The ability of an organization and its staff to communicate effectively and convey information in a manner that is easily understood by diverse audiences
Social determinants of health
The conditions in which people are born, grow, live, work, and age, shaped by the distribution of money, power, and resources at global, national, and local levels
Quality Health Care
The degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge
Healthcare literacy
The degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions
Cultural Competency
The enabling of health care providers to deliver services that are respectful of and responsive to the health beliefs, practices, and cultural and linguistic needs of diverse patients
Cultural desire
The motivation of a health care professional to "want to" not "have to" engage in the process of becoming culturally competent
Pre-contemplation
The person is not thinking about or considering quitting or adopting a behavior change within the next 6 months
Health promotion
The process of enabling people to increase control over, and to improve, their health
Jean Watson
Theory of Human Caring
Subjective Data
Things a person tells you about that you cannot observe through your senses; symptoms Includes patient's feelings, perceptions, and self-reported symptoms
Contemplation
Thought of making change within the next 6 months
Goal of cultural assessment
To obtain accurate information from a patient that allows you to formulate a mutually acceptable and culturally relevant plan of care for each health problem of a patient
Primary Prevention
True prevention, precedes disease or disfunction and applied to patients considered physically and emotionally healthy Includes: health education, vaccines, nutritional programs, fitness activities
Transtheoretical Model of Change
Useful for determining where a person is in relation to making a behavior change Pre-contemplation Contemplation Planning or preparation Action Maintenance
Nursing informatics
Uses information and technology to communicate, manage knowledge, mitigate error, and support decision making
Illness Behavior
Ways in which people monitor their bodies, define and interpret their symptoms, take remedial actions, and use the health care system.
Three questions patients and families should ask
What is my main problem What do I need to do Why is it important for me to do this
Inference
Your judgement or interpretation of these cues
Explanatory model
a patient's views about health and illness and its treatment
Clinical Models of Health
absence of signs and symptoms of the disease - prevention is not emphasized, not getting annual checkups or shots - person thinks they are 100% healthy because they don't have signs or symptoms
Emic
approach of studying a culture's behavior from the perspective of an INSIDER
Etic
approach of studying a culture's behavior from the perspective of an OUTSIDER
Nursing process (ADPIE)
assessment diagnosis planning implementation evaluation
Nurse Researcher
conducts evidence-based practice and research to improve nursing care and further define and expand the scope of nursing practice
Risk-Factor theory
considers families a pivotal part of the environment and also an important support system used to decrease health risks for individuals
Compassion fatigue
described as physical, emotional, and spiritual exhaustion resulting from seeing patients suffer, leads to a decreased capacity to show compassion or empathize with suffering people
risk factors include: (4)
genetic and physiological factors age environment life style
Validation of assessment data
is the comparison of data with another source to determine data accuracy
action
made a change persisted for 6 months
Nurse Administrator
manages patient care and the delivery of specific nursing services within a health care agency
pre- contemplation
people in this stage are not even thinking about a new behavior pattern. Unmotivated, resistant and engage in avoidance tactics
transtheoretical model of health
stages of change- where the person is in relation to change self-efficacy- the key construct in the model 6 stages partner with individuals regarding behavior change respect the persons right to choose to change or not
planning
starting to change or making changes in next 30 days
contemplative
studying, thinking, reflecting on an issue. seriously considering change in the next 6 months
ANA definition of nursing
the protection, promotion, and optimization of health and abilities, prevention of illness and injury, alleviation of suffering through the diagnosis and treatment of human response, and advocacy in the care of individuals, families, communities, and populations
Nurse Educator
works primarily in schools of nursing, staff development departments of health care agencies, and patient education departments
Medicare
Federal program Taxes Qualifications - 65+ Multiple parts (A, B, D)
Lillian Wald
Founded school nursing Public health
health promotion model
-directed at increasing a patients level of well being -complimentary counterpart to models of health protection Focuses on 3 areas -individual characteristics and experiences -behavior specific knowledge and effect -behavioral outcomes
age
-effects persons suseptibility to certain illness -infants more suseptible to infections -older ppl,cancers and heart disease -family history/personal habits
psychomotor domain
-envolves developing physical skills from simple to complex actions
I-implementation
-Perform nursing care therapies. Include patient as active participant in care. Involve family/significant other in care as appropriate
life style
-activites/habits/ practices -lifestyle choices ex: sunbathing, poor diet, smoking, overweight
health belief model
-addresses the relationship between the persons beliefs and behaviors -helps understand factors influencing patients perceptions,beliefs and behavior to plan care that will be most effective 3 componenets -perception of illness -seriousness of illness -likelyhood the person will take preventative actions
affective domain
-alludes to the recognition of values ,religious and spiritual beliefs, family interation pattern and relationships and personal attitudes that affect decision and problem solving process
holistic health model
-attempts to create conditions that promote optimal health -patients are involved in their healing process
basic human needs model
-attempts to meet the patients basic needs
Domains of learning (3)
-cognitive -psychomotor -affective
Social marketing
-defined as the application of commercial marketing technologies to the analysis, planning, execution and evaluation of programs designed to influence to volunatry behavior of target audiences in order to improve their personal welfare and that of their society Primary objective- is to change behavior *key attributes 1. offering of benefits 2. the reduction of barriers to influence target groups behavior -consumer oriented -culturally sensitive -info about target pop can improve development of effective educational interventions
role performance model
-defines health in terms of individuals ability to perform social roles -role performance includes work,family , social roles with performance based on societal expectations -model is basis for occupational health evaluations, school physicals, physician excused absences
deliverer of services
-delivery of direct services such as health education ,flu shots, counceling and health promotion -visible ,direct delivery=foundation of public image of nursing
Roles of the nurse
Advocate Case manager Consultant Deliverer of service Educator Healer Researcher
Healthcare settings and services
Hospital based Clinical based Restorative Rehabilitation Home care Extended care Assisted living Respite care Hospice Adult day care
Medicare part A
Hospital, short term care, home health
Models of health
Clinical Role performance Adaptive Eudaemonistic
Illness
Composed of the subjective experience of the individual and the physical manifestation of the disease
Consultant
Consult with other nursing specialties to provide best care for patients
Medicaid
Federal and state managed/funded State determines eligibility No age requirement Low income
Florence Nightingale
Described and explained what nursing is/is not Focused on the environment
Secondary level of prevention
Early diagnosis Prompt treatment Disability limitation
Educator
Educate patients on health components
Medicare part B
Have to buy supplemental insurance
Primary level of prevention
Health promotion Specific protection Before disease happens
Healer
Nebulous Helping people integrate and balance various parts of their lives Being with a patient, not just there for them Active listening
Levels of prevention
Primary, secondary, and tertiary
Eudaemonistic model
Really into health, go above and beyond Seek out herbs, meditation, chiropractors etc Go in for wellness checks/look to avoid illness or disease
Tertiary level of prevention
Restoration Rehabilitation Disease has already occurred
Examples of secondary level of prevention
Screening (mammogram, colonoscopy etc) Health fair (BP, BS, screening blood work etc)
Health
Total functioning of a person's living experience; complete physical, mental, and social well being. Not just absence of disease and infirmity within a developmental context
Madeline Leininger
Transcultural theory Emphasis on culturally competent care
Examples of primary level of prevention
Using helmets Using seat belts Prenatal care/visits Healthy diet presentation Immunizations
Researcher
Ways to reduce infection Ways to screen better Looking to improve outcomes
Nursing roles (7)
advocate care manager consultant deliverer of services educator healer researcher
internal/external variables
internal- includes a persons development stage, intelectual background, perception of functioning and emotional/spiritual factors external- influencing a persons health beliefs and practices include family practices, socioeconomic factors and cultural background