Unit 2 Exam

The nurse's role as in screening programs as a decision maker:

"Should this condition be screened for or not?" The nurse is responsible for reviewing all the issues concerning, a screen-able disease. Then we must decide what we should do with the information shown from these screenings.

Spirituality:

"The relationship with self and a dimension beyond the self" Cannot be examined through any physical method. Interrelated to culture, RELIGIOUS background education, gender, sexuality, socioeconomic status, etc Appears to be deeply integrated with how people how people derive and live out meaning In and of life. How an individual defines a worlds view. Transcendence: applied to spirituality and connects the self to other. Serves to enrich and derive meaning to relationships that the self touches It is not religion.

Ego Integrity vs. Despair

(Erikson) older adults(65 and older) People in late adulthood either achieve a sense of integrity of the self by accepting the lives they have lived or yield to despair that their lives cannot be relived Change in productivity goals and evaluation of success; development of wisdom ■Ageism: a concern for nurses ■System-wide physical changes ■Cognitive changes due to illness not aging ■Numerous lifestyle changes ■Goals: Remain independent, accept aging, transitions, and loss ■Strategies: Reminiscence or life review (storytelling), exercise, nutrition, sensory stimulation

Gilligan's Theory of Moral Development

(Only Girls) -Preconventional: individual survival -Conventional: self-sacrifice is goodness -Postconventional: principle of non-violence

1. Healthy eating pattern across lifespan · 100 extra calories per day turns into 10 extra pounds per year 2. Variety, nutrient density, and amount · All food groups in recommended amounts. 3. Foods and food components to reduce · Sodium under 2300mg per day. 10% OF CALORIES FROM SF; LESS than 10% from added sugars, alcohol, one drink per day for women 2 for men. As little cholesterol as possible 4. Shift to healthier food and beverage choices · Consider culture and personal preferences. 5. Support healthy eating patterns for all · Everyone has a role to support healthy eating patterns. It is a comprehensive effort

2015 Dietary Guidelines of Americans

Moderate-intensity aerobic activity (e.g., brisk walking) for 150 minutes every week (for example, 30 minutes a day, 5 days a week) and Muscle-strengthening activitieson 2 or more days a week that work all major muscle groups (legs, hips, back, abdomen, chest, shoulders, and arms). Vigorous-intensity aerobic activity(e.g., jogging or running) for 75 minutes (1 hour and 15 minutes) every week AND Muscle-strengthening activitieson 2 or more days a week that work all major muscle groups (legs, hips, back, abdomen, chest, shoulders, and arms). An equivalent mix of moderate- and vigorous-intensity aerobic activityon 2 or more days a week AND Muscle-strengthening activitieson 2 or more days a week that work all major muscle groups (legs, hips, back, abdomen, chest, shoulders, and arms).

Adult physical activity recommendations

•Weight control •Reduce risk of cardiovascular disease •Reduce risk of type 2 diabetes •Reduce risk of some cancers •Strengthen bones and muscles •Improve mental health and mood •Improve ability to perform ADLs •Slows the aging process

Benefits of Physical Activity

•Need for meaning and purpose •Need for love and relatedness •Need for forgiveness

Common Spirituality Needs - - -

Shopping · Purchase refrigerated or frozen items after selecting your non-perishables. · Never choose meat or poultry in packaging that is torn or leaking. · Do not buy food past "Sell-By," "Use-By," or other expiration dates. ´Storage · Always refrigerate perishable food within 2 hours—1 hour when the temperature is above 90 °F (32.2 ºC). · Check the temperature of your refrigerator and freezer with an appliance thermometer. The refrigerator should be at 40 °F (4.4 ºC) or below and the freezer at 0 °F (-17.7 ºC) or below. · Cook or freeze fresh poultry, fish, ground meats, and variety meats within 2 days; other beef, veal, lamb, or pork, within 3 to 5 days. · Perishable food such as meat and poultry should be wrapped securely to maintain quality and to prevent meat juices from getting onto other food. · To maintain quality when freezing meat and poultry in its original package, wrap the package again with foil or plastic wrap that is recommended for the freezer. · Canned foods are safe indefinitely as long as they are not exposed to freezing temperatures, or temperatures above 90 °F. If the cans look ok, they are safe to use. Discard cans that are dented, rusted, or swollen. High-acid canned food (tomatoes, fruits) will keep their best quality for 12 to 18 months; low-acid canned food (meats, vegetables) for 2 to 5 years. ´Preparation · Always wash hands with warm water and soap for 20 seconds before and after handling food. · Don't cross-contaminate. Keep raw meat, poultry, fish, and their juices away from other food. After cutting raw meats, wash cutting board, utensils, and countertops with hot, soapy water. · Cutting boards, utensils, and countertops can be sanitized by using a solution of 1 tablespoon of unscented, liquid chlorine bleach in 1 gallon of water. · Marinate meat and poultry in a covered dish in the refrigerator. ´Thawing · Refrigerator: The refrigerator allows slow, safe thawing. Make sure thawing meat and poultry juices do not drip onto other food. · Cold Water: For faster thawing, place food in a leak-proof plastic bag. Submerge in cold tap water. Change the water every 30 minutes. Cook immediately after thawing. · Microwave: Cook meat and poultry immediately after microwave thawing. ´Cooking Cook all raw beef, pork, lamb and veal steaks, chops, and roasts to a minimum internal temperature of 145 °F (62.8 ºC) as measured with a food thermometer before removing meat from the heat source. For safety and quality, allow meat to rest for at least three minutes before carving or consuming. For reasons of personal preference, consumers may choose to cook meat to higher temperatures. Ground meats: Cook all raw ground beef, pork, lamb, and veal to an internal temperature of 160 °F (71.1 ºC) as measured with a food thermometer. Poultry: Cook all poultry to an internal temperature of 165 °F (73.9 °C) as measured with a food thermometer. ´Serving · Hot food should be held at 140 °F (60 °C) or warmer. · Cold food should be held at 40 °F (4.4 ºC) or colder. · When serving food at a buffet, keep food hot with chafing dishes, slow cookers, and warming trays. Keep food cold by nesting dishes in bowls of ice or use small serving trays and replace them often. · Perishable food should not be left out more than 2 hours at room temperature—1 hour when the temperature is above 90 °F (32.2 ºC). ´Leftovers · Discard any food left out at room temperature for more than 2 hours—1 hour if the temperature was above 90 °F (32.2 ºC). · Place food into shallow containers and immediately put in the refrigerator or freezer for rapid cooling. · Use cooked leftovers within 4 days. · Reheat leftovers to 165 °F (73.9 °C). ´Refreezing Meat and poultry defrosted in the refrigerator may be refrozen before or after cooking. If thawed by other methods, cook before refreezing.

Describe food safety guidelines. ´

An overall dietary pattern that balances caloric intake and physical activity for weight management along with inclusion of a high proportion of plant foods (fruits, vegetables, whole grains, and beans) and limited amounts of processed or red meats, dairy products (for men), and high-calorie/low nutritional value foods and beverages can reduce the risk. Choose most of the foods you eat from plant sources: Choose fewer and smaller portions of high-fat or calorie-dense foods and beverages. Consumption of at least five servings of fruits and vegetables a day.Be physically active: Achieve and maintain a healthy weight.For those who drink alcohol, limit consumption Low sodium diet -Low-fat diet -Choose most of what you eat from plant sources -Good physical activity -For those who drink alcohol, limit consumption -Stop/quit smoking

Describe key dietary and lifestyle interventions for: cancer

well-balanced diet, achieve and maintain a healthy body weight, and reach optimal levles for cholesterol, HGL, LDL, blood pressure, and glucose. -Eat 2 or more servings of fish every week preferably oily varieties -Limit intake of saturated fat to <7% of energy by choosing lean meats and vegetable alternatives, and fat-free or skim milk-When eating food prepared outside of the home: reduce salt intake -Low sodium diet -Low-fat diet -Good physical activity -For those who drink alcohol, limit consumption -Stop/quit smoking

Describe key dietary and lifestyle interventions for: cardiovascular

Ideally, the recommendations are to reduce sodium intake to about 1500 mg but it is very hard with the current prevalence of sodium in packaged and restaurant foods. The following recommended food tips are designed to reduce salt and sodium intake:-Add salt sparingly in home cooking and at the table-Consume fewer foods that have high sodium levels, such as: cheeses, processed meats, most frozen dinners and entrees, most canned soups, etc.-Rinse canned vegetables first before warming-Eat salty, highly processed salty, salt-preserved, and salt-pickled foods infrequently-check labels for the amount of sodium in foods and choose products lower in sodium · Behavior modification, medications, diet and exercise, smoking cessation, stress reduction. Takes a life long commitment to behavior modification, low salt diet (dash diet) · -Low sodium diet -Low-fat die t-Good physical activity -For those who drink alcohol, limit consumption -Stop/quit smoking

Describe key dietary and lifestyle interventions for: hypertension

A balanced diet is important and must include the appropriate serving sizes for the recommended daily intake of each food group. Additionally, exercise is particularly necessary from the outlet, because with exercise there is less need to restrict food intake. Exercise also factors long-term maintenance of body weight. -Low sodium diet -Low-fat diet -Balanced diet with appropriate serving size -Exercise-FDA approved weight loss medication -For those who drink alcohol, limit consumption -Stop/quit smoking

Describe key dietary and lifestyle interventions for: obesity

1.Follow a healthy eating pattern across the lifespan. 2.Focus on variety, nutrient density, and amount. 3.Limit calories from added sugars and saturated fats and reduce sodium intake .4.Shift to healthier food and beverage choices. 5.Support healthy eating patterns for all.

Describe the key dietary guidelines for the general population.

The nurse's role as in screening programs thru follow up:

Did they actually get it done?

· Impacts everything in life · Family · Individual · Also relates to whole of society. · Emotional impact as well as daily activities · Impact on job/ financial impact · Social life · Time planning · Family relationships Economic Impact of chronic diseases: · Personal · Lost wages · Burden on healthcare · Health care workers- increases workload

Discuss the impact chronic illness has on an individual. Impact of chronic illness

•Familiarize the individual or family with spiritual/religious services within the institution. •Respect the need for privacy during prayer or meditation. •Assist to obtain devotional objects and protect them from loss or damage. •Arrange for receiving of sacraments if desired. •Attempt to meet dietary restrictions. •Arrange for a priest, minister, or rabbi to visit if the patient wishes.

Discuss the nurse's role in promoting spirituality.

Mental Health Prevention Primary: identifying high risk Secondary: early detection and intervention Tertiary: Advanced recovery and reduction of relapse risk Mental Health Promotion •Lifestyle Medicine •Smoking cessation •Decrease alcohol use •Improved diet •Greater physical activity •Weight loss •Stress management •Motivational Interviewing

Discuss the primary focus of mental health prevention strategies.

-Primary Objective: Detection of a disease in its early stages in order to treat it and deter its progression -Secondary Objective: Reduce the cost of disease management by avoiding costly interventions required at later stages -Advantages: simplicity, individual & group, one or multiple test screening, the opportunity for health education

Discuss the purpose of health screenings.

acute care model

Disease-centered Doctor-centered Focus on individuals Secondary care emphasis Reactive, symptom-driven Episodic care Cure focus Single setting: hospital, specialist centers, general practice 1:1 contact through patient visit Diagnostic information provided

Trust vs. Mistrust

Erikson's first stage (0-1) infant, during the first year of life, infants learn to trust when they are cared for in a consistent warm manner ■Rapid steady growth; reflexive to purposeful behavior ■Caregiver-child bonding based on personal interactions ■Environment provides sensory stimulus for learning

identity vs. role confusion

Erikson's stage (13-21_)- young adults during which teenagers and young adults search for and become their true selves Exploration for personal identity and a sense of self; development of fidelity ■Sexual maturation ■Logical decision making ■Internalized moral code ■Needs close peer relationships

Autonomy vs. Shame and Doubt

Erikson's stage 1-3 Toddler, in which a toddler learns to exercise will and to do things independently; failure to do so causes shame and doubt Exploration of the limits of abilities; development of will ■Gross to fine psychomotor skill development ■Egocentric - no right or wrong ■Wants independence; fears separation

Generativity vs. Stagnation

Erikson's stage of social development in which middle-aged people begin to devote themselves more to fulfilling one's potential and doing public service Establishment of career, relationships, family, and societal engagement; development of care ■Physical changes: menopause and andropause ■Focus on family, work, aging parents (sandwich generation)

Initiative vs. Guilt

Erikson's third stage in which the child finds independence in planning, playing and other activities 3-6 Preschool age Development of interpersonal skills through activities with others; development of purpose ■Lower physical growth with increased muscle coordination ■Concrete thinking: Asks why? ■Fears bodily harm ■Pretend play; Moves from parallel play to cooperative play

•Low Exercise. Associated with chronic illness •Poor Nutrition linked to lack of resilliency, poor sleep •Religion positive or negative. •Low self-esteem •Gender . Women have higher rates of anxiety, depression, PTSD. Hormones play a role in mental health. Mens brains are larger. Familt responsibilites for women •ACEs •Environment •Social •Abuse (any form) •Stigma •Culture

Factors associated with mental health conditions

The nurse's role as in screening programs as educator:

Families and communities that they follow through with these screenings. Educate patients about healthy lifestyles and decreased risks, in the ordinary office intake assessment process.

Health Perception - Health Management Pattern -Few acute illness Nutritional - Metabolic Pattern -High need -Vulnerable to eating disorders -Experiment with fads & alcohol -Obesity & Type 2 Diabetes Elimination Pattern Activity - Exercise Pattern -Sports physical Sleep - Rest Pattern -At least 8 hours per night Sexuality - Reproductive Pattern -Pregnancy -Teaching self care -HPV vaccination Cognitive - Perceptual -Piaget - formal operations (logical decision-making) -Erickson - Identity vs role confusion Self - Perception - Self - Concept Pattern -Body image Roles - Relationships Pattern -Peer influence -Needs close peer relationships -Greater independence from family Coping - Stress Tolerance Pattern -Coping mechanisms -Cognitive mastery, conformity, controlling behavior, fantasy, motor activity -Depression & Suicide risk Values - Beliefs Pattern -Kohlberg - Post conventional stage -Internalized moral code Injury -Accidents -Sports injuries -Violence -Sexually Transmitted Infections -Substance Use & Abuse -Tobacco Use

Gordon's Functional Health Patterns- Adolescent

Health Perception - Health Management Pattern -Self-destructive habits = chronic disease -Acceptance of aging, need for exercise, and weight control Nutritional - Metabolic Pattern -Obesity reduction or prevention -Decrease saturated fats -Calcium 1000 mg + Vitamin D -Reduce sodium consumption -Focus on oral health Elimination Pattern -Decreased bowel tone -Kidney function decline -Changes in bladder control Activity - Exercise Pattern -Continuous rhythmic exercise -Brisk physical activity 30 minutes / day total of 3-4 hours / week Sleep - Rest Pattern -Insomnia Cognitive - Perceptual Pattern -Presbyopia (farsightedness) -Glaucoma -Cataracts -Macular degeneration Self - Perception - Self - Concept Pattern -Erickson - Generativity vs stagnation -Roles - Relationships Pattern -Family -Work -Caring for aging parents -Divorce -Death Sexuality - Reproductive Pattern -Satisfactory sexual functioning -Pregnancy prevention Coping - Stress Tolerance -Stress resiliency or hardiness Values - Beliefs Pattern -Deeply rooted -Kohlberg - Post-conventional stage Injuries -Falls -Tobacco -Influenza -Occupational hazards

Gordon's Functional Health Patterns- Middle adulthood

Health Perception - Health Management Pattern -Abstract understanding of health Nutritional - Metabolic Pattern -1200 - 1600 calories per day -Milk group - 3 cups fat free milk -Meat group - 5 oz lean meat or beans -Vegetable group - 2-2 ½ cups daily -Fruit group - 1 ½ cups daily -Grains group - 4 - 6 oz daily -Obesity prevention / nutrition education Elimination Pattern -Full bladder/bowel control -Enuresis -Encopresis Activity - Exercise Pattern -Significant motor skill change (Fine tuning of body systems) -Group / team activities -Promotes social, personal, and cognitive development Sleep - Rest Pattern -Adult sleep requirements -Disorders of arousal -Immediately before REM -1 -2 hours after going to sleep -Family history -Reflect CNS immaturity -Influenced by fatigue and stress Cognitive - Perceptual Pattern -Intense cognitive development -Abstract thinking evolving to concrete operations -Develop problem solving skill; What if? -Move from egocentric to cooperative interactions Self - Perception - Self - Concept Pattern -Erikson - Industry vs inferiority Roles - Relationships Pattern -Family structure important -Associates with same sex peers -Vulnerable to physical, emotional, and sexual abuse Sexuality - Reproductive Pattern -Gender identification -Physical changes of puberty Coping - Stress Tolerance Pattern -Real and perceived stressors -Depression -Anorexia, sleeplessness, lethargy, changed affect, aggressive behavior, frequent crying, or withdrawal Values - Beliefs Pattern -Kohlberg - preconventional level (self-interest) -Developing moral code of right and wrong -Moral behavior problems Injuries Fatal: Motor Vehicle Accidents Nonfatal: Head injuries Health/Safety Promotion -Bicycle safety -Street safety -Motor vehicle safety -Pool safety -Firearm safety -Playground safety -Fire safety -Stranger safety -Sport safety -Animal safety

Gordon's Functional Health Patterns- School aged

Health Perception - Health Management Nutritional - Metabolic Pattern -Breastfeeding acceptable -Limit whole cows milk -Iron supplementation / fortification --Limit fruit juice consumption -Reduced appetite Elimination Pattern -Toilet training Activity - Exercise Pattern -Developing coordination and independence -Gross to fine psychomotor skill development Sleep - Rest Pattern -12 hours per night w/ 1-2 naps Cognitive - Perceptual Pattern -Develop receptive and expressive language -Object permanence Role - Relationships Pattern -Egocentric - no right or wrong "terrible twos" -Wants independence; fears separation Self Perception - Self Concept Health Concerns: -Unintentional Injuries -Accidental injury, drowning, burns, - MVA injury -Overdose, poisoning, toxin exposure

Gordon's Functional Health Patterns- Toddlers

Health - Perception - Health -Management Pattern -Preventative care -Female - annual screening -Male - biannual screening -Self care Immunizations -Hepatitis B, Meningococcal, HPV Nutrition - Metabolic Pattern -Male - 1600 - 1800 calories per day -Female - 1200 - 1500 calories per day -Calcium 1200 mg per day -Iron supplementation -Folic Acid 0.4 mg daily during pregnancy Elimination Pattern Activity - Exercise Pattern -Aerobic exercise for 30 minutes or more five times per week Sleep - Rest Pattern -7-8 hours each night Cognitive - Perceptual Pattern -Piaget - Formal Operational thought -Erickson - Intimacy vs Isolation -Kohlberg - Post-conventional moral reasoning Self - Perception - Self - Concept Pattern -Explore and Experiment -Commitment oriented Roles - Relationships Pattern -Friendships characterized by giving rather than receiving -Interpersonal / Intimate relationships -Independence from family of origin -Separation & Divorce = emotional strain Sexuality - Reproductive Pattern -Infertility -Unintended pregnancy -Sexually transmitted infections Coping - Stress Tolerance Pattern -Situational stress -Achievement oriented stress -Depression & suicide Values - Beliefs Pattern Injuries -Motor vehicle accidents -Occupational hazards -Substance use -Alcohol use -Tobacco use

Gordon's Functional Health Patterns- Young Adult

Health Perception - Health Management Pattern -Personal motivation and buy in Nutritional - Metabolic Pattern -Obesity -Malnutrition Elimination Pattern -Constipation -Urinary incontinence Activity - Exercise Pattern -Weight-bearing activity -Strength training Sleep - Rest Pattern -Increases physical endurance -Improves cognition Cognitive - Perceptual Pattern -Dementia -Multi-infarct dementia -Alzheimer's disease -Mini-Mental State Examinations (MMSE) -Sensory factors -Changes in taste, sight, smell, hearing Self - Perception - Self - Concept Pattern -Erickson - Ego Integrity vs Despair Roles - Relationships Pattern -New roles -Downsizing -Loss of independence -Loss of loved ones Sexuality - Reproductive Pattern -Physical changes -Need for expression Coping - Stress Tolerance Pattern -Depression -Suicide Values - Beliefs Pattern -Spirituality Injuries -Falls -Seniors Driving Safety Course -Elder Abuse -Influenza -Pneumonia -Cancer -Drug use -Alcohol use -Tobacco use

Gordon's Functional Health Patterns- older adults

Health Perception-Health Management -Recognize role in own health Nutrition - Metabolic Pattern -50% CHO -50% protein and fat -Calcium 700 -1000mg -Adequate iron intake -Salt and sugar in moderation Elimination Pattern -Independent toileting Activity - Exercise Pattern -Explore intently -Lower physical growth with increased muscle coordination -Increased coordination and confidence in motor activities -Interactive/cooperative play Sleep - Rest Pattern -8-12 hours per night -Naps abandoned Cognitive - Perceptual Pattern -Concrete thinking: Asks why? -Piaget - Preoperational stage -Preschool Readiness -Pretend play; Moves from parallel play to cooperative play Self-Perception - Self-Concept Pattern -Sense of initiative (Erikson) -Struggle for autonomy -Fears bodily harm Roles - Relationships Pattern -Peer influence begins -Gender role expectations Sexual - Reproductive Pattern -Gender role identification Coping - Stress Pattern -Play approaches -Coping mechanisms Values - Beliefs Pattern Unintentional Injuries -Safe sleep environment -Safe, well-ventilated play environment -Burn prevention -Aspiration prevention -Poison ingestion prevention -Water safety -Home safety

Gordon's Functional Health Patterns- preschooler

Health Perception - Health Management Nutritional - Metabolic Pattern -Essential nutrients - water, protein, -CHO, fat, vitamins, & minerals -Breast milk vs Formula feeding -Solid foods - 6 months of age Activity - Exercise Pattern -Rapid steady growth; reflexive to purposeful behavior -Sleep - Rest Pattern -SIDS - "Back to Sleep" campaign Cognitive - Perceptual Pattern -Vision, hearing, taste, smell, language Role - Relationships Pattern -Caregiver-child attachment and bonding based on personal interactions

Gordon's Functional Health Patterns-Infant

Qualified Health Claims- How to spot ´Relationship between food/food substance and reduced disease risk ´Includes, foods, components of foods and dietary supplements Examples of qualified health claims: ´Calcium and osteoporosis ´Dietary fat and cancer ´Sodium and hypertension ´Folate and neural tube defects Nutrient Content Claim ´Nutrition claims on packages must conform to FDA standard definitions ´Example: ´Low fat: ≤ 3 g fat/serving ´Lean: < 10 g fat, 4.5 g saturated and trans fat, and 95 mg How to Spot False Claims ´Too good to be true? ´Cure-all for a wide variety of ailments ´Can treat or cure diseases ´Limited availability (Hurry!) ´Undocumented case histories or personal testimonials ´No risk / Money-back guarantee ´Impressive sounding terms - "hunger stimulation point" ´Melts away fat Consider the Source (do they provide contact info) ´.gov www.choosemyplate.gov ´.edu www.psu.edu ´.org www.eatright.org ´.com www.webmd.com Structure/Function Claims- How claims are marketed ´Describes the effect a supplement may have on body structure or function ´Can't claim to diagnose, cure, mitigate, treat, or prevent disease ´If claim must have the following statement on the label: ´This statement has not been evaluated by the FDA. This product is not intended to diagnose, treat, cure or prevent disease. Has to be on labels

How to spot qualified health claims/ how to spot false claims

•Lack of information, incorrect information, lack of concern regarding health condition being addressed. •Fear, anger, other strong emotions about diagnosis. •Physical inability to make necessary changes. (cant lose weight due to arthritis) •Psychological or cultural barriers to making necessary changes. •Low or absent motivation to make needed changes. •Low or absent familial/social support for making needed changes. •Lack of personal control over health circumstances. •Reluctance to engage with nurse in developing and implementing health promotion plan.

Identifying Obstacles To Physical Well being

The nurse's role as in screening programs as a planner:

If we decide to screen, it is essential in the development of the patients care plan. It is an important referral system to enhance continuity of care and to ensure follow-up

conventional stage

Kohlberg's moral development stage where your behavior is influence by peer pressure/society Gaining approval, avoiding disapproval

Preconventional

Kohlberg's stage of moral development in which rewards and punishments dominate moral thinking avoid punishment gaining reward

Congenital & Genetic Disorders -Phenylketonuria (PKU) (metabolic disorder) -Hypothyroidism (endocrine) -Sickle Cell Anemia (hemoglobin) -Cystic Fibrosis

Newborn: screenings

•Develop and implement screening programs •To support Decision maker and be a decision maker about what types of screening to implement •Planner: how to promote screenings •Education •Follow-up on education

Nurse's Role In screening

-Moderate intensity (150 minutes) 30 minute brisk walk 5x/week Weight training 2x/week -Vigorous intensity (75 minutes) 25 minute jog 3x/week Weight training 2x/week -Mix of moderate & vigorous(150 minutes) 30 minute brisk walk 3x/week 25 minute jog 2x/week Weight training 2x/week

Older Adult physical activity recommendations

chronic care model

Person-centered Team-centered Population health approach Primary care emphasis Proactive, planned intervention Ongoing care Prevention/management focus Community setting, collaboration across primary & secondary care 1:1 or group contact Support for self-management

· Preschool-aged children (ages 3 through 5 years) should be physically active throughout the day for growth and development. · Adult caregivers should encourage preschool-aged children to be active when they play. Aiming for 3 hours a day

Recommended Levels for Preschool-Aged Children (ages 3 through 5 years)

· Children and adolescents ages 6 through 17 years should do 60 minutes (1 hour) or more of moderate-to-vigorous intensity physical activity each day, including daily aerobic - and activities that strengthen bones (like running or jumping) - 3 days each week, and that build muscles (like climbing or doing push-ups) - 3 days each week.

Recommended Levels for School-Aged Children and Adolescents (ages 6 through 17 years)

Industry vs. Inferiority (Erikson)

School aged 6-11 years - Children busily learn to be competent and productive or feel inferior and unable to do anything well. Self-esteem based on feedback from others; development of competence ■Fine tuning of body systems ■Intense cognitive development ■Abstract thinking evolving ■Develop problem solving skill; What if? ■Independence; Associates with same sex peers ■Developing moral code of right and wrong

The nurse's role as in screening programs as a developer and implementer:

Screening programs for a particular individual, community, or targeted groups.

AI - Adequate Intakes:

The recommended average daily intake based on observed or experimentally determined approximates or estimates of nutrient intake by group

intamacy vs isolation

The sixth of Erikson's eight stages Young adults (late teens to mid 30s) of development. Adults seek someone with whom to share their lives in an enduring and self-sacrificing commitment. Without such commitment, they risk profound loneliness and isolation. (young adulthood): Development of happy relationships and a sense of commitment, safety, and caring; development of love ■Physical growth completed ■Focus on personal and social tasks such as career choice, social and personal relationships, self-concept, and adult relationship with family

Adolescent/ young adult Many behaviors that can affect health and well-being later in life start during adolescence. Healthy People 2030 focuses on helping adolescents stay safe and healthy. Adolescents are at risk for many preventable health problems, including substance use disorders, sexually transmitted infections, and injuries from motor vehicle crashes. And there are disparities by race/ethnicity and family income. Adolescents also experience many developmental changes that can affect their physical and mental health. Encouraging positive health behaviors — like getting preventive care, using birth control, and getting enough sleep — can help adolescents stay safe and healthy.

adolescent/ young adult healthy people 2030 objectives

Adults -Pap test (after age 21) -Mammography (after age 40) -Cholesterol (after age 40) -Colonoscopy (after age 50) -Fecal occult blood (after age 50) -Diabetes or Prediabetes (after age 50)

adults recommended screenings

•Nutrition •Lifestyle modifications •Secondary prevention •Pharmacologic interventions •Preventing and managing: -Hypertension -Lipid disorders -Orthostatic hypotension

age related cardiovascular changes nursing interventions

•Diminished sense of smell and taste •Less efficient chewing •Decreased saliva secretion •Reduced or limited ability to procure, prepare, & enjoy food •Weight changes •Slower motility •Constipation

age related changes GI changes

•Nutrition interventions •Assess for dysphagia •Assess medications for side effects •Evaluate weight •Monitor BMs •Promote oral and dental health

age related changes GI changes nursing intervetnions

•Decreased myocardial contractility •Changes in neuroconduction •Arteries and veins less elastic •Reduced circulation

age related changes cardiovascular changes

•Decreased cell turn over •Dermis thins and flattens •Decrease moisture content •Decreased sweat & sebaceous gland production •Decreased wound healing •Decreased sweating, shivering, & tactile sensitivity •Increased susceptibility to burns, bruises, and breakdown •Increased susceptibility to skin cancer

age related changes integumentary system

•Teach self-care for healthy skin •Teach about detection of skin cancer •Prevent pressure ulcers •Prevent skin tears

age related changes integumentary system nursing interventions

Age-related changes •Degenerative changes of bones, muscles, joints, and connective tissue •Decrease muscle strength and endurance •Increased difficulty performing ADLs •Diminished bone mass => osteopenia & osteoporosis •Increased risk for falls & fractures •Slowed reaction time •Fear of falling

age related changes musculoskeletal system

•Prevent falls & fall-related injuries •Use safety monitoring devices in inpatient settings •Encourage weight bearing exercises •Teach about osteoporosis

age related changes musculoskeletal system nursing interventions

•Degenerative changes in brain •Slower reaction time •Reasoning and abstract thinking declines •Some memory functions decline •Vision & hearing changes

age related changes nervous system

•Physical exercise •Mental stimulation •Challenging leisure activities •Socialization •Teaching concentration and attention strategies (imagery)

age related changes nervous system nursing interventions

•Decreased nephron function •Decreased renal blood flow •Decreased bladder elasticity •Increased urine production at night •Decreased clearance of medications •Decreased bladder capacity •Urgency & incontinence •Chronic residual urine

age related changes renal system

•Promote hydration •Encourage toileting every 2 hours •Promote perineal hygiene •Maintain dignity •Teach S & S of urinary tract infection

age related changes renal system nursing interventions

•Upper airway stiffens •Diminished cough and gag reflex •Chest wall stiffness •Weakening of chest muscles •Diminished vital capacity •Diminished gas exchange •Increased susceptibility to lower respiratory infections

age related changes respiratory system

•Decrease risk of choking •Smoking cessation •Identify factors that increase risk for infection •Respiratory infection prevention •Influenza and pneumonia vaccinations > 65 years of age

age related changes respiratory system nursing interventions

•Decreased time in deep sleep •Increased time in light sleep •Decreased time dreaming •Increased time to fall asleep •Frequent arousals •Difficulty returning to sleep •Poor quality of sleep

age related changes sleep and rest

•Day time physical exercise •Day time mental stimulation •Promote leisure activities •Promote Socialization •Observe for sleep apnea •Evaluate medications •Non pharmacological interventions to promote sleep •Modify sleeping environment

age related changes sleep and rest nursing interventions

•Decreased SQ tissue •Decreased shivering •Decreased ability to acclimate to heat •Decreased sweating •Decreased peripheral circulation •Inefficient vasoconstriction •Decreased febrile response to illness

age related changes thermoregulation

•Maintain optimal environmental temperature •Comfort measures •Prevent hypothermia •Prevent hyperthermia

age related changes thermoregulation nursing intervetnions

-Lead -Iron deficiency anemia -Obesity -Diabetes

children screenings

-Developmental considerations -Family -Ethnic background -Formal Religion -Life events

factors affecting spirituality - - - - -

•Falls •Frailty •Malnutrition •Urinary incontinence •Functional decline •Pressure ulcers •Cognitive impairment

geriatric syndromes - - - - - - - -

•Disease management •Optimal health outcomes •More pleasant (for everyone!) -Helps eliminate unnecessary energy drain. -Maintains stored resiliency. -Impatience, irritability, anger decrease -.Improves physical and mental health. -Greater access to intuition. -Memory, focus, other brain functions improve.

health benefits of managing stress

Infants: · Reduce the rate of infant deaths — MICH‑02 · Increase the proportion of infants who are breastfed exclusively through age 6 months — MICH‑15 Increase the proportion of infants who are breastfed at 1 year — MICH‑16 Reduce infections caused by Listeria — FS‑03 Reduce cases of pertussis among infants — IID‑05 Reduce preterm births — MICH‑07 Increase the proportion of newborns who get screened for hearing loss by age 1 month — HOSCD‑01 Increase the proportion of infants who didn't pass their hearing screening who get evaluated for hearing loss by age 3 months — HOSCD‑02 Increase the proportion of infants with hearing loss who get intervention services by age 6 months — HOSCD‑03 Reduce the rate of mother-to-child HIV transmission — HIV‑06 Reduce congenital syphilis — STI‑04 Increase the proportion of infants who are put to sleep on their backs — MICH‑14 Increase the proportion of infants who are put to sleep in a safe sleep environment — MICH‑D03 Reduce the proportion of children who get no recommended vaccines by age 2 years — IID‑02 Baseline only Maintain the vaccination coverage level of 1 dose of the MMR vaccine in children by age 2 years — IID‑03 Baseline only Increase the coverage level of 4 doses of the DTaP vaccine in children by age 2 years — IID‑06 Increase the number of states where a child fatality team reviews external causes of death in children — IVP‑D01

healthy people 2030 infant objectives

-Can cause heart disease & increase BP -Overeating-Stress eating -Smoking-Alcohol & drug abuse -Sleep problems -Headaches -Fatigue

impact of stress on physical well-being

Mental -Anxiety -Lack of motivation or focus -Irritability or anger -Sadness or depression -Low self-esteem

impact of stress on psychological well being

social withdrawal

impact of stress on social well being

preoperational stage

in Piaget's theory, the stage (from about 2 to about 6 years of age) during which a child learns to use language but does not yet comprehend the mental operations of concrete logic The child uses symbols (words and images) to represent objects but does not reason logically. The child also has the ability to pretend. During this stage, the child is egocentric

sensorimotor stage

in Piaget's theory, the stage (from birth to about 2 years of age) during which infants know the world mostly in terms of their sensory impressions and motor activities The infant explores the world through direct sensory and motot contact. Object permanence and separation anxiety devleop during this stage

concrete operational stage

in Piaget's theory, the stage of cognitive development (from about 7 to 12 years of age) during which children gain the mental operations that enable them to think logically about concrete events The child can think logically about concrete objects and can thus add and subtract. The child also understands conservation

formal operational stage

in Piaget's theory, the stage of cognitive development (normally beginning about age 12- adult) during which people begin to think logically about abstract concepts The adolescent can reason abstractly and think in hypothetical terms

Infants -Iron deficiency anemia -Lead poisoning

infants screenings

Excess weight High BP High cholesterol

modifiable biomedical factors in chronic illness - - -

Tobacco smoking Excess alcohol use Physical inactivity Poor diet

modifiable- behavioral factors in chronic illness - - - -

Age Gender Indigenous status Ethnic background Family history Genetic make-up

nonmodifiable factors in chronic illness - - - - - -

Older adult By 2060, almost a quarter of the U.S. population will be age 65 or older.1Healthy People 2030 focuses on reducing health problems and improving quality of life for older adults. Older adults are at higher risk for chronic health problems like diabetes, osteoporosis, and Alzheimer's disease. In addition, 1 in 3 older adults fall each year, and falls are a leading cause of injury for this age group.2 Physical activity can help older adults prevent both chronic disease and fall-related injuries. Older adults are also more likely to go to the hospital for some infectious diseases — including pneumonia, which is a leading cause of death for this age group. Making sure older adults get preventive care, including vaccines to protect against the flu and pneumonia, can help them stay healthy.

older adult healthy people 2030 objectives

· Self image: · Self control: not having self discipline which plays into self image · Social competence: social norms, meeting social expectations · Childhood risk: there is a link between prenatal and early childhood conditions to later adult diseases. Prenatals have a higher rate of hypertension later in life, as well as diabetes, strokes, etc. · Risk accumulation: a person who has a risk factor has a higher risk of developing another risk factor, then when you develop a chronic illness those risk factors begin to multiply more. Accumulate over life because of some of the age related factors · Underlying determinants: sociodeterminates of health, poverty, environment, economics, social life, · Poverty: poverty cycle causes risk factors to multiply. Poverty causes chronic illnesses, chronic illnesses causes increased poverty, risk factors, etc

other risks associated with chronic illness

Socio-environment factors Psychosocial factors Political factors

possibly modifiable factors in chronic illness - - -

· Pregnant or postpartum women should do at least 150 minutes (for example, 30 minutes a day, five days a week) of moderate-intensity aerobic physical activity per week, such as brisk walking, during and after their pregnancy. It is best to spread this activity throughout the week. · Women who already do vigorous-intensity aerobic physical activity, such as running, can continue doing so during and after their pregnancy.

pregnant women physical activity recommendation guidelines

Person - centered, they need to be involved in the decision making Collaborative decision-making Supported self-management Holistic care / Healing partnerships Empowerment This is cognitive Our role is to be supportive in their ability to self-manage The key is to empower them to achieve their highest level of functioning, by giving them the tools they need

psychosocial needs of individuals with chronic illness

Thorough assessment ListeningImplement a range of interventions :Praying, reading inspirational texts, reminiscing, providing music, empathetic manner, symptom management, emotional presence Chaplain referral Holding a hand, talking with that individual, means the world to them, it helps meet a spiritual need You can implement a variety of strategies by being present and attentive with that individual

spiritual needs of individuals with chronic illness

RDA-Recommended Dietary Allowances:

the average daily nutrient level that is sufficient to be the nutrient requirement of all, 97-98% of people in a particular life stage and gender group

UL - Tolerable Upper Intake Levels:

the highest average daily nutrient intake level that is likely to pose no risk or adverse health effects to almost all individuals in a general pop

postconventional morality

third level of Kohlberg's stages of moral development in which the person's behavior is governed by moral principles that have been decided on by the individual and that may be in disagreement with accepted social norms agreeing on rights establish personal moral standards achieving justice

Toddler/ children Childhood is a critical period of growth and development — and a child's experiences, behaviors, and health problems can have long-term impacts. Healthy People 2030 focuses on ways to directly and indirectly improve children's health, safety, and well-being. Making sure children get timely developmental screenings and recommended health care services is key to finding health problems early, when they're usually easier to treat. In addition, positive health behaviors — like getting enough sleep and eating healthy — can help prevent diseases and injuries in children. But there are important racial/ethnic and income disparities in these healthy behaviors and related health outcomes. Safe, stable, and supportive relationships are critical for children's health, development, and well-being. Family-level interventions can help keep children safe and healthy. Strategies focused on children's health and safety in early childhood education programs, at school, and in their neighborhoods can also help improve health outcomes for children.

toddler/children healthy people 2030 objectives

EAR - Estimated Average Requirements:

use to be used to determine the RDA values. The average daily nutrient intake level estimated to meet the nutrient needs of half of healthy individuals in aParticular life stage or gender group

Dietary Reference Intakes (DRIs) Defined

´Replaced the RDA's ´Developed and published by the Institute of Medicine (IOM) ´Represent the most current scientific knowledge on nutrient needs of healthy populations ´Used in planning diets for individuals and groups ´DRIs include four reference values Revised every 5 years Helps us form federal nutrition policies and improve public education and establish nutritional standards for federal programs like WIC. We want to message to the consumer to balance calories, identify foods to increase and foods to reduce Focus on optimizing health and reducing chronic diseases with nutrition

The Interdisciplinary Team in chronic care

•Nurse •Dietitian •Medical practitioner •Occupational therapist •Physical therapist •Speech pathologist •Respiratory therapist •Social worker

Stress Management Techniques

•Physical exercise •Meditate •Deep breathing •Be present/slow down •Connect socially •Tune into your body •Decompress •Laugh out loud •Listen to loud music •Reduce toxic relationships •Alternative Therapy •Hypnosis •Acupuncture •Healthy diet •Consistent sleep •Be assertive •Connect spiritually examples of ____