NR 222 EXAM 1 STUDY GUIDE
tertiary prevention examples
- enhance rehabilitation from disease, injury, or disability - Provide cardiac rehabilitation - physical and occupational therapy, and rehabilitation
What is Health Education/Wellness?
- includes providing information on topics such as physical awareness, stress management, and self-responsibility to enable individuals to improve their health. -helps people develop a greater understanding of their health and how to better manage their health risks.
Professional Nursing Code of Ethics
-A set of guiding principles that all members of a profession accept -Helps professional groups settle questions about practice or behavior -Includes advocacy, responsibility, accountability, and confidentiality -A code of ethics is a set of guiding principles that all members of a profession accept. It is a collective statement about the group's expectations and standards of behavior.
Examples of LHI (from Healthy People website)
-Children, adolescents, and adults who use the oral health care system (2+ years) -Consumption of calories from added sugars by persons aged 2 years and over (2+ years) -Drug overdose deaths -Exposure to unhealthy air -Homicides -Household food insecurity and hunger -Persons who are vaccinated annually against seasonal influenza -Persons who know their HIV status (13+ years) -Persons with medical insurance (<65 years) -Suicides -infant deaths -Children and adolescents with obesity -Current use of any tobacco products among adolescents -Adults engaging in binge drinking of alcoholic beverages during the past 30 days -Cigarette smoking in adults
Beneficence
-Doing good or causing good to be done; kindly action -Beneficence refers to taking positive actions to help others
illness prevention
-Illness prevention activities such as immunization programs and blood pressure screenings protect people from actual or potential risks to health. - They also help people avoid declines in their level of health or functional ability.
Health promotion model
-Individual characteristics and experiences -Behavior-specific cognitions and affect -Behavioral outcome
preperation stage of change
-Making small changes in preparation for a change in the next month -May have tried to make changes in the past but was unsuccessful. - Patient believes that advantages outweigh disadvantages of behavior change. "I started running once, but I didn't keep it up. I think I might try again in a few weeks."
Why is the SPHM important?
-The use of SPHM techniques is a standard for best practices in the moving, handling, and transfer of patients -reducing injuries to health care providers -SPHM techniques improve patient outcomes. -fewer falls, skin tears, and pressure injuries
What is the Scope and Standards of Nursing Practice and who developed it, maintains it , & revises it?
-When giving care, it is essential to provide a specified service according to standards of practice and to follow a code of ethics. -Professional practice includes knowledge from social and behavioral sciences, biological and physiological sciences, and nursing theories. -ANA
Professional Roles & Responsibility of Nurses Educator
-Your ability to teach effectively improves patients' knowledge, skills, self-care activities, and ability to make informed decisions. -As an educator, you identify patients' willingness and ability to learn, explain concepts and facts about their health, describe the reason for care activities, demonstrate procedures such as self-care activities, reinforce learning or patient behavior, and evaluate the patient's progress in learning.
Critical thinkin in assessment
-deliberate & systematic collection of data about pt -collection, review, analysis of data makes up the process of assessment -goal in assessment is to gather all info necessary to reveal the pt's heal care needs
Factors influencing sleep
-drugs and substances -lifestyle -usual sleep patterns -emotional stress -environment -exercise and fatigue -food and caloric intake
tertiary prevention
-occurs when a defect or disability is permanent and irreversible. (REHAB) -It involves minimizing the effects of long-term disease or disability by interventions directed at preventing complications and deterioration -Activities are directed at rehabilitation rather than diagnosis and treatment
Health Promotion; healthy ways to deal with stress are.....
-regular rest & exercise -have a support system -manage time -guided imagery & visualization -progressive muscle relaxation therapy -assertive training (teach pt ways to comm) -journal writing -mindfulness practice
Autonomy in ethics
-respect rights of patients to make health care decisions -Autonomy refers to freedom from external control. In health care the concept applies to respect for the autonomy of patients
primary prevention
-true prevention -Its goal is to reduce the incidence of disease. -many PP programs are supported by the gvnmt (e.g., federally funded immunization programs). -It includes all health promotion efforts and wellness education activities that focus on maintaining or improving the general health of individuals, families, and communities
Maintenance stage of change
5th stage- work to prevent relapse and to consolidate gains made -Sustained change over time; begins 6 months after action has started and continues indefinitely -Changes integrated into the patient's lifestyle and behaviors adopted to prevent relapse. "I need to avoid people who smoke so I won't be tempted to start smoking again."
The following are steps in the process to help resolve an ethical problem. What is the best order of these steps to achieve resolution? 1. List all the possible actions that could be taken to resolve the problem. 2. Articulate a statement of the problem or dilemma that you are trying to resolve. 3. Develop and implement a plan to address the problem. 4. Gather all relevant information regarding the clinical, social, and spiritual aspects of the problem. 5. Take time to clarify values and identify the ethical elements, such as principles and key relationships involved. 6. Recognize that the problem requires ethics.
6 4 5 2 1 3
Although the United States has made great progress on the LHIs, it falls behind other developed countries on key measures of health and well-being, such as.... (select all that apply) A)life expectancy B) infant mortality C) obesity D) social interactions
A B C
Emotional Factor (internal variable)
A patient's degree of stress, depression, or fear influences health beliefs and practices.
allopathic medicine
A system in which medical doctors and other healthcare professionals (such as nurses, pharmacists, and therapists) treat symptoms and diseases using drugs, radiation, or surgery. Also called biomedicine, conventional medicine, mainstream medicine, orthodox medicine, and Western medicine.
Maslow's Hierarchy
A theory that arranges the five basic needs of people—physiological, security, social, esteem, and self-actualization—into the order in which people strive to satisfy them
Values
A value is a deeply held personal belief about the worth a person holds for an idea, a custom, or an object. The values that a person holds reflect cultural and social influences
Values
A value is a deeply held personal belief about the worth a person holds for an idea, a custom, or an object. The values that a person holds reflect cultural and social influences.
Accountability (professional nursing code of ethics)
Accountability refers to answering for your own actions. You ensure that your professional actions are explainable to your patients and your employer
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 operation to the family and discusses the patient's wishes with them. The nurse is acting as the patient's: 1. Educator 2. Advocate 3. Caregiver 4. Communicator
Advocate
A nurse is caring for a patient with chronic arthritis pain. The patient wants to add some complementary therapies to help with pain management. Which therapies might be most effective for controlling pain? (Select all that apply.) 1. Biofeedback 2. Acupuncture 3. Therapeutic touch 4. Chiropractic therapy 5. Herbal medicines
All are correct
Examples of SDOH include: (Select all that apply) a)Safe housing, transportation, and neighborhoods b)Racism, discrimination, and violence c)Education, job opportunities, and income d)Access to nutritious foods and physical activity opportunities e)Language and literacy skills
All of these are examples of SDOH
What are 3 approaches to ethics?
Approaches to ethics include deontology, utilitarianism, and a relationship-based perspective.
action stage of change
Begins to change behavior through practice, may experience relapse -Actively engaged in strategies to change behavior; lasts up to 6 months Committed to change. Previous habits may become barriers to change. "I am really working hard to stop smoking."
beneficience and nonmaleficence
Beneficence refers to taking positive actions to help others Nonmaleficence refers to the avoidance of harm or hurt.
List the training specific therapies.
Biofeedback Traditional Chinese Medicine Acupuncture Therapeutic touch Pilates Chiropractic care
Confidentiality (professional nursing code of ethics)
Confidentiality refers to the health care team's obligation to respect patient privacy. Confidentiality is a fundamental part of the trusting relationship between a nurse and a patient
You are preparing a presentation for your classmates regarding the clinical care coordination conference for a patient with terminal cancer. As part of the preparation, you have your classmates read the Nursing Code of Ethics for Professional Registered Nurses. Your instructor asks the class why this document is important. Which statement best describes this code? 1. Improves self-health care 2. Protects the patient's confidentiality 3. Ensures identical care to all patients 4. Defines the principles of right and wrong to provide patient care
Defines the principles of right and wrong to provide patient care
What are the social determinant categories?
Economic Stability Education Access and Quality Health Care Access and Quality Neighborhood and Built Environment Social and Community Context
Which SDOH has a Goal: Increase educational opportunities and help children and adolescents do well in school.
Education Access & quality
The nurse spends time with a patient and family reviewing a dressing change procedure for the patient's wound. The patient's spouse demonstrates how to change the dressing. The nurse is acting in which professional role? 1. Educator 2. Advocate 3. Caregiver 4. Communicator
Educator
What is the 7th standard of practice?
Ethics: The registered nurse integrates ethics in all aspect of practice.
T/F: The Affordable Healthcare Act initiative provides evidence-based, 10-year national objectives for promoting health and preventing disease.
False: Healthy People
T/F: Healthy People 2020, promotes a society in which all people live long, healthy lives
False: Healthy People 2030
t/f Nurses use one health model to understand patients' unique attitudes and values about health and illness and to provide effective health care
False: Nurses use several health models
T/F: People who are free from disease are always healthy.
False: People who are free from disease are not necessarily healthy
t/f Herbal medicines are approved for use as drugs and are not regulated by the FDA.
False: they are not approved by FDA
T/F: Individual perceptions and definitions of health always stay the same as individuals change.
False: Individual perceptions and definitions of health change with age and are affected by a person's health beliefs
fidelity
Fidelity refers to faithfulness or the agreement to keep promises -As a nurse you have a duty to be faithful to the patients you care for, to the health care agency you work for, and to yourself
Professional Nursing Code of Ethics
Guiding principles that all members of a profession accept: Advocacy responsibility accountability confidentiality
What are the models of health that we have learned in class? (4)
Health Belief Health Promotion Holistic Maslow
what does safe patient handling & mobility involve?
In the case of safe patient handling and mobility (SPHM), it involves improved assessment, the use of mechanical equipment, and safety procedures to lift and move patients. Many states have laws mandating SPHM in health care agencies
Developmental stage, intellectual background, perception of functioning, and emotional and spiritual factors are examples of ________ __________.
Internal Variables
__________ & _____________ variables influence how a person thinks and acts
Internal and external
Justice
Justice refers to fairness and the distribution of resources
Nurses use which model of health to understand the interrelationships of basic human needs. Basic human needs (e.g., food, water, safety, and love) are necessary for human survival and health
Maslow's hierarchy of needs
-marriage or the birth of a child requires new coping styles. - crises occur as a person moves through the stages of life. what type of crisis are the examples?
Maturational or developmental
What type of holistic therapy sometimes helps patients cope with the difficult side effects of chemotherapy
Meditation
What do models of health do?
Models help explain complex concepts or ideas, such as health and illness. Models help you understand the relationships between these concepts and a patient's attitudes toward health and health behaviors.
Morals
Morals usually refer to judgment about behavior, based on specific beliefs, and ethics refers to the study of the ideals of right and wrong behavior.
Morals are:
Morals usually refer to judgment about behavior, based on specific beliefs, and ethics refers to the study of the ideals of right and wrong behavior.
Which SDOH has a Goal: Create neighborhoods and environments that promote health and safety.
Neighborhood & Built Environment
Define Nonmodifiable Risk Factors
Nonmodifiable risk factors such as age, gender, genetics, and family history cannot be changed.
Professional Roles & Responsibility of Nurses Manager
Nurse managers direct groups of nurses by establishing an environment for collaborative patient-centered care and safe, evidence-based quality care with positive patient outcomes. -manager coordinates the activities of members of a nursing staff in delivering nursing care and has personnel, policy, and budgetary responsibility for a specific nursing unit or agency -uses appropriate leadership styles to create a nursing environment for patients and staff that reflects the mission and values of the health care organization
objective data
Objective data are the findings resulting from observation of patient behavior and clinical signs as well as direct measurement, including what you see, hear, and touch (Ball et al., 2019). Inspecting the condition of a wound, observing a patient walk down the floor, measuring blood pressure (BP), and describing specifically an observed behavior (patient seizure) are examples of objective data.
What is standard 3 and what is involved?
Outcomes Identification (smart goals) - written outcome statement goals- the desired physiological, psychological, social, developmental, or spiritual responses that indicate resolution of a patient's health problems. -(Specific, Measurable, Attainable, Realistic, Timed)
What is standard 4 and what is involved?
Planning -develops a plan encompassing strategies to achieve expected outcomes.
________ health behaviors maintain, attain, or regain health and prevent illness.
Positive
PTSD
Posttraumatic stress disorder (PTSD) begins when a person experiences or witnesses a traumatic event and responds with intense fear or helplessness. PTSD is common among military personnel, veterans and police.
progressive relaxation
Progressive relaxation training teaches the individual how to effectively rest and reduces tension in the body. The person learns to detect subtle localized muscle tension sequentially, one muscle group at a tim
Professional Roles & Responsibility of Nurses Advocate
Protect pts human & legal rights & provide assistance in asserting those rights if needed. Act on behalf of pt, such as safeguarding their case against errors, suggesting alternative care, securing pt healthcare rights and facilitating personal & cultural preferences.
What is Provision 1- in the ANA Code of Ethics?
Relates to compassion, patient autonomy, and professional behaviors *just remember A, B , C*--> autonomy,behavior,compassion
______ helps individuals develop cognitive skills to reduce the negative ways in which they respond to situations within their environment
Relaxation
List nursing accessible therapies
Relaxation Meditations & Breathing Imagery
What are research objectives?
Research objectives represent public health issues with a high health or economic burden or significant disparities between population groups — but they aren't yet associated with evidence-based interventions.
Professional Roles & Responsibility of Nurses Accountability
Responsibility professionally & legally for the type & quality of nursing care provided. Must remain current & competent in nursing scientific knowledge & technical skills
secondary traumatic stress
Secondary traumatic stress is the stress that health care providers experience when witnessing and caring for others who are suffering.
There are some religions and faiths that discourage followers from having blood transfusions. This is an example of which internal variable?
Spiritual Factor
precontemplation stage of TTM
Stage of change in the TTM where individuals do not intend to change their high-risk behaviors in the foreseeable future. -No intent to make changes within the next 6 months Patient is unaware of, not interested in, or underestimates the problem. May be defensive. "There is nothing I really need to change."
What is stress?
Stress is described as an actual or alleged hazard to the balance of homeostasis. It is often described as a physical, chemical, or emotional factor that produces tension in the body or the mind
Subjective Data
Subjective data are your patients' verbal descriptions of their health problems gathered during interviews (informal and formal). Subjective data include patient feelings, perceptions, and self-reported symptoms.
Define the nursing code of ethics
The nursing code of ethics is a statement of philosophical ideals of right and wrong that define the principles you will use to provide care to your patients.
responsibility (professional nursing code of ethics)
The word responsibility refers to a willingness to respect one's professional obligations and to follow through. As a nurse you are responsible for your actions, the care you provide, and the tasks that you delegate to others.
What are the three types of crisis?
There are three types of crises: (1) maturational or developmental crises, (2) situational crises, and (3) disasters or adventitious crises
Social determinants
They are the conditions in the environments in which people are born, live, learn, work, play, worship, and age that affect health, functioning, and quality-of-life outcomes and risks
Health Promotion (stress & coping) What are three primary modes of intervention for stress?
Three primary modes of intervention for stress are to decrease stress-producing situations, increase resistance to stress, and learn skills that reduce physiological response to stress
A nurse is assigned to care for an 82-year-old patient who will be transferred from the hospital to a rehabilitation center. The patient and her husband have selected the rehabilitation center closest to their home. The nurse learns that the patient will be discharged in 3 days and decides to make the referral on the day of discharge. The nurse reviews the recommendations for physical therapy and applies the information to fall prevention strategies in the hospital. What discharge planning action by the nurse has not been addressed correctly? 1. Patient and family involvement in referral 2. Timing of referral 3. Determination of discharge date
Timing of referral
Current evidence supports that many people go through a series of five stages when they make a change, described by which model?
Transtheoretical Model of Change
second victim syndrome
When a medical error occurs that inflicts significant harm on a patient and the patient's family
Cultural Background (exercise & activity)
When developing a physical fitness program for culturally diverse populations, consider their education and beliefs regarding the value of exercise and their access to resources to exercise, and learn about what motivates individuals to exercise and which activities are appropriate and enjoyable.
The Health Promotion Model (HPM) defines health as .....
a positive, dynamic state, not merely the absence of disease
ethical dilemma
a situation in which you have to decide whether to pursue a course of action that may benefit you or your organization but that is unethical or even illegal -An ethical problem is called a dilemma when two opposing courses of action can both be justified by ethical principles
Define illness
a state in which a person's physical, emotional, intellectual, social, developmental, or spiritual functioning is diminished or impaired -A person can feel ill in the presence or absence of a disease such as cancer or multiple sclerosis
Internal variables include a person's ...... a) developmental stage, intellectual background, perception of functioning, and emotional and spiritual factors. b)family practices, psychosocial and socioeconomic factors, and cultural background.
a) developmental stage, intellectual background, perception of functioning, and emotional and spiritual factors.
External variables influencing a person's health beliefs and practices include a)family practices, psychosocial and socioeconomic factors, and cultural background. b)developmental stage, intellectual background, perception of functioning, and emotional and spiritual factors.
a) family practices, psychosocial and socioeconomic factors, and cultural background.
Health-promoting behaviors result in...... (select all that apply) a)improved health b)enhanced functional ability c) less stress for the nurse d) better quality of life at all stages of development
a)improved health b)enhanced functional ability d) better quality of life at all stages of development
How does the World Health Organization (WHO) define health ?
as a "state of complete physical, mental, and social well-being, not merely the absence of disease or infirmity"
Nonmaleficence
avoidance of harm or hurt; core of medical oath and nursing ethics
examples of modifiable risk factors
cigarette smoking, obesity, physical inactivity, diet, alcohol, stress
Which SDOH has a Goal: Help people earn steady incomes that allow them to meet their health needs.
economic stability
What are the goals of Healthy People 2030?
eliminate health disparities, achieve health care equity, and attain health literacy to improve the nation's health and well-being
In an _______ ________, a nurse faces two equally justifiable courses of action
ethical dilemma
Issues in healthcare
importance of nurses self care health care reform and cost demographic changes medically undeserved
What is Provision 6- in the ANA Code of Ethics?
includes responsibilities for the environment and the moral milieu during practice
Health Belief Model (HBM)
individual perceptions modifying factors likelihood of action
Discharge planning
is a coordinated, interprofessional process that develops a plan for continuing care after a patient leaves a health care agency.
What is a risk factor?
is any attribute, quality, environmental situation, or trait that increases the vulnerability of an individual or group to an illness or accident. -Risk factors and behaviors, risk factor modification, and behavioral modification are integral components of health promotion, wellness, and illness prevention.
Healthy People 2030 identifies __________ __________ __________ (e.g., household food insecurity and hunger; homicides; suicides; children and adolescents with obesity), which are high-priority health issues in the United States
leading health indicators (LHIs)
Examples of complementary therapy
relaxation; exercise; massage; reflexology; prayer; biofeedback; creative therapies, including art, music, or dance therapy; meditation; and herbs/supplements
What is health promotion?
the process of enabling people to increase control over, and improve their health helps individuals maintain or enhance their present health. It motivates people to engage in healthy activities such as routine exercise and good nutrition to reach more stable levels of health.
What type of complementary therapy requires special training?
therapeutic touch, hypnotherapy, and chiropractic therapy, contain diagnostic and therapeutic methods that require special training
t/f Most Healthy People objectives measure progress towards a target over time, but some aren't measurable or have other limitations.
true
t/f Providing care to patients at the end of life and to those with serious illness who may be nearing end of life is a frequent source of ethical problems.
true
t/f Public health focuses on health promotion, wellness, and illness prevention
true
t/f Risk-factor modification, health promotion, illness prevention activities, or any program that attempts to change unhealthy lifestyle behaviors is a wellness strategy.
true
t/f Situational stressors in the health care workplace that affect nurses and other health care professionals include high-acuity patient load, job environment, constant distractions, responsibility, conflicting priorities, and intensity of care (e.g., trauma, emergency, or critical care areas) (Mealer et al., 2017; Ueno et al., 2017). In addition, changing shifts increases fatigue and work-related stress.
true
t/f The HPM describes the multidimensional nature of people as they interact within their environment to pursue health
true
t/f The process is not linear; instead, it is an ongoing process that evolves as you care for a patient.
true
t/f Where we live and the condition of that area (its air, water, and soil) determine how we live, what we eat, the disease agents to which we are exposed, our risk factors, our state of health, and our ability to adapt.
true
t/f when applying the model, focus your care on a patient's needs rather than on strict adherence to the hierarchy
true
t/f Maintaining healthy lifestyles can prevent hospitalizations and potentially lower the cost of health care.
true
t/f Two common ethical problems that nurses encounter are ethical dilemmas and moral distress
true
t/f: Nurses use holistic therapies either alone or in conjunction with conventional medicine
true
Continuing care types (2)
• Long-term care: assisted living, nursing centers • Psychiatric and older-adult day care
Health Promotion Model The model focuses on which 3 areas?
(1) individual characteristics and experiences; (2) behavior-specific cognitions and affect; and (3) behavioral outcome, in which the patient commits to or changes a behavior
Primary prevention examples
* health education programs, nutritional programs, and physical fitness activities. -Providing immunizations Attention to personal hygiene Use of environmental sanitation Protection from occupational hazards Protection from accidents and carcinogens
According to Healthy People what is LHI?
- (LHIs) are a small subset of high-priority Healthy People 2030 objectives selected to drive action toward improving health and well-being. -LHIs cover the life span. -address important factors that impact major causes of death and disease in the United States, and they help organizations, communities, and states across the nation
Causes of sleep deprivation
-illness (e.g., fever, difficulty breathing, or pain) -emotional stress, -medications, -environmental disturbances (e.g., frequent interruptions in sleep during nursing care, noisy neighbors or pets), -variability in the timing of sleep as a result of shift work. -Sleep disorders such as sleep apnea or insomnia can cause sleep deprivation
Resolution of an ethical problem involves discussion with the patient, the patient's family, and participants from appropriate health care disciplines. Which statement best describes the role of the nurse in the resolution of ethical problems? 1. To articulate the nurse's unique point of view, including knowledge based on clinical and psychosocial observations 2. To study the literature on current research about the possible clinical interventions available for the patient in question 3. To hold a point of view but realize that respect for the authority of administrators and health care providers takes precedence over personal views 4. To allow the patient and the health care provider private time to resolve the dilemma on the basis of ethical principles
1
What are the 5 levels of Maslow's Hierarchy of Needs?
1)Self-actualization; 2)Self-esteem; 3)Love and belonging needs; 4)Safety and security( including physical and psychological safety) 5)Physiological: Oxygen, fluids, nutrition, body temperature, elimination, shelter, and sex.
___1. You see an open medical record on the computer and close it so that no one else can read the record without proper access. ___2. You administer a once-a-day cardiac medication at the wrong time, but nobody sees it. However, you contact the provider and your nurse manager and follow agency procedure. ___3. A patient at the end of life wants to go home to die, but the family wants every care possible. The nurse contacts the primary care provider about the patient's request. ___4. You tell your patient that you will return in 30 minutes to give him his next pain medication. a. Advocacy b. Responsibility c. Accountability d. Confidentiality
1-d 2-c 3-a 4-b
The nurse recognizes that which statements made by a patient indicate an understanding of behaviors that will promote sleep? (Select all that apply.) 1. "I will not watch television in bed." 2. "I will not drink caffeine later in the day." 3. "A short nap late in the evening will lead to a more restful night of sleep." 4. "I am going to start eating dinner closer to my bedtime." 5. "I will start to exercise regularly during the day."
1. "I will not watch television in bed." 2. "I will not drink caffeine later in the day." 5. "I will start to exercise regularly during the day."
A nurse is conferring with another nurse about the care of a patient with a Stage 2 pressure injury. The two decide to review the clinical practice guideline of the hospital for pressure injury care. The use of a clinical practice guideline achieves which of the following? (Select all that apply.) 1. Allows nurses to act more quickly and appropriately 2. Sets a level of clinical excellence for practice 3. Eliminates the need to create an individualized care plan for the patient 4. Incorporates evidence-based interventions for stage II pressure injury 5. Provides for access to patient care information within the electronic health record
1. Allows nurses to act more quickly and appropriately 2. Sets a level of clinical excellence for practice 4. Incorporates evidence-based interventions for stage II pressure injury
Steps of the Nursing Process (ADPIE)
1. Assessment 2. Diagnosis 3. Planning 4. Implementation 5. Evaluation
List the ANA scope & standards of Practice in order:
1. Assesssment 2.DX 3.Outcomes Identification (SMART goals) 4.Planning 5. implementation 6. evaluation 7. ethics 8. advocacy
Contemporary nursing requires that the nurse have knowledge and skills for a variety of professional roles and responsibilities. Which of the following are examples of these roles and responsibilities? (Select all that apply.) 1. Caregiver 2. Autonomy 3. Patient advocate 4. Health promotion 5. Genetic counselor
1. Caregiver 2. Autonomy 3. Patient advocate 4. Health promotion
Which measures does a nurse follow when being asked to perform an unfamiliar procedure? (Select all that apply.) 1. Checks scientific literature or policy and procedure 2. Determines whether additional assistance is needed 3. Collects all necessary equipment 4. Delegates the procedure to a more experienced nurse 5. Considers all possible consequences of the procedure
1. Checks scientific literature or policy and procedure 2. Determines whether additional assistance is needed 3. Collects all necessary equipment
A 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 praying daily 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 a physician when he was a child. Which external variables influence the patient's health practices? (Select all that apply.) 1. Difficulty paying his bills 2. Praying daily 3. Age of patient (46 years) 4. Stress from the divorce and the loss of a job 5. Family practice of not routinely seeing a health care provider
1. Difficulty paying his bills 5. Family practice of not routinely seeing a health care provider
The nurse is caring for a patient who is suffering from posttraumatic stress disorder (PTSD) after a motor vehicle accident. What assessment findings reported by the patient provide cues to validate the diagnosis of PTSD? (Select all that apply.) 1. Frequent feelings of anxiety 2. Need to be around people 3. Frequent nightmares 4. Flashbacks to the accident 5. Feelings of sadness
1. Frequent feelings of anxiety 3. Frequent nightmares 4. Flashbacks to the accident 5. Feelings of sadness
Which sleep-hygiene actions at bedtime can the nurse delegate to assistive personnel? (Select all that apply.) 1. Giving the patient a back rub 2. Turning on quiet music 3. Dimming the lights in the patient's room 4. Giving a patient a cup of coffee 5. Monitoring for the effect of the sleeping medication that was given
1. Giving the patient a back rub 2. Turning on quiet music 3. Dimming the lights in the patient's room
Which cognitive skills can a patient develop while practicing relaxation? (Select all that apply.) 1. Increasing an ability to focus attention for an extended period of time 2. Limiting stimuli that come into one's field of vision 3. Stopping a focus on unnecessary goal-directed activity 4. Being able to tolerate experiences that are uncertain 5. Building relationships with significant others
1. Increasing an ability to focus attention for an extended period of time 3. Stopping a focus on unnecessary goal-directed activity 4. Being able to tolerate experiences that are uncertain
Which of the following are common barriers to effective discharge planning? (Select all that apply.) 1. Ineffective communication among providers 2. Lack of role clarity among healthcare team members 3. Number of hospital beds to manage patient volume 4. Patients' long-term disabilities 5. The patient's cultural background
1. Ineffective communication among providers 2. Lack of role clarity among healthcare team members
The nurse manager of a community clinic arranges for staff in-services about various complementary therapies available in the community. What is the purpose of this training? (Select all that apply.) 1. Nurses play an essential role in the safe use of complementary therapies. 2. Nurses are often asked for recommendations and strategies that promote well-being and quality of life. 3. Nurses learn how to provide all of the complementary modalities during their basic education. 4. Nurses play an essential role in patient education to provide information about the safe use of these healing strategies. 5. Nurses appreciate the cultural aspects of care and recognize that many of these complementary strategies are part of a patient's life.
1. Nurses play an essential role in the safe use of complementary therapies. 2. Nurses are often asked for recommendations and strategies that promote well-being and quality of life. complementary modalities during their basic education. 4. Nurses play an essential role in patient education to provide information about the safe use of these healing strategies. 5. Nurses appreciate the cultural aspects of care and recognize that many of these complementary strategies are part of a patient's life.
A nurse is conducting a home visit with a new mom and her three children. While in the home the nurse weighs each family member and reviews their 3-day food diary. She checks the mom's blood pressure and encourages the mom to take the children for a 30-minute walk every day. The nurse is addressing which level of need, according to Maslow's Hierarchy of Needs? 1. Physiological 2. Safety and security 3. Love and belonging 4. Self-actualization
1. Physiological
Transtheoretical Model of Change stages
1. Precontemplation 2. Contemplation 3. Preparation 4. Action 5. Maintenance
Which of the following approaches are recommended when gathering assessment data from an 82-year-old male patient entering a primary care clinic for the first time? (Select all that apply.) 1. Recognize normal changes associated with aging. 2. Avoid direct eye contact. 3. Lean forward and smile as you pose questions. 4. Allow for pauses as patient tells his story. 5. Use the list of questions from the clinic assessment form to complete all data.
1. Recognize normal changes associated with aging. 3. Lean forward and smile as you pose questions. 4. Allow for pauses as patient tells his story.
A crisis intervention nurse is working with a mother whose child with Down syndrome is hospitalized with pneumonia and who has lost her child's disability payment while the child is hospitalized. The mother worries that her daughter will fall behind in her classes during hospitalization. Which strategies are effective in helping this mother cope with these stressors? (Select all that apply.) 1. Referral to social service process reestablishing the child's disability payment 2. Sending the child home in 72 hours and having the child return to school 3. Coordinating hospital-based and home-based schooling with the child's teacher 4. Teaching the mother signs and symptoms of a respiratory tract infection
1. Referral to social service process reestablishing the child's disability payment 3. Coordinating hospital-based and home-based schooling with the child's teacher 4. Teaching the mother signs and symptoms of a respiratory tract infection
A nurse is developing a plan for a patient who was diagnosed with narcolepsy. Which interventions should the nurse include on the plan? (Select all that apply.) 1. Take brief naps, no longer than 20 minutes, no more than twice a day. 2. Drink a glass of wine with dinner. 3. Eat a large meal at lunch rather than dinner. 4. Establish a regular exercise program. 5. Teach the patient about the side effects of modafinil.
1. Take brief naps, no longer than 20 minutes, no more than twice a day. 4. Establish a regular exercise program. 5. Teach the patient about the side effects of modafinil.
The nurse is caring for a patient who needs a liver transplant to survive. This patient has been out of work for several months, does not have health insurance, and cannot afford the procedure. Which of the following statements speaks to the ethical elements of this case? 1. The health care team should select a plan that considers the principle of justice as it pertains to the distribution of health care resources. 2. The patient should enroll in a clinical trial of a new technology that can do the work of the liver, similar to the way dialysis treats kidney disease. 3. The social worker should look into enrolling the patient in Medicaid, since many states offer expanded coverage.
1. The health care team should select a plan that considers the principle of justice as it pertains to the distribution of health care resources.
A nurse is caring for a patient who is expressing pain. The patient has two analgesics ordered prn for pain and has been using cold applications on his surgical site for pain relief. The last time an analgesic was given was 4 hours ago. The patient is scheduled for a physical therapy visit in 2 hours. Which of the following demonstrate good clinical decision making during intervention? (Select all that apply.) 1. The nurse reviews the options for pain relief for the patient. 2. The nurse assesses whether the prn medication, ordered every 4 to 6 hours and given 4 hours ago, is effective and whether a newmedication is needed. 3. The nurse reviews the policy and procedure for the cold application. 4. The nurse considers how the patient might react if the pain medication is held until an hour before physical therapy. 5. The nurse delegates the assistive personnel to prepare the patient's medication.
1. The nurse reviews the options for pain relief for the patient. 2. The nurse assesses whether the prn medication, ordered every 4 to 6 hours and given 4 hours ago, is effective and whether a new medication is needed. 4. The nurse considers how the patient might react if the pain medication is held until an hour before physical therapy.
When assessing an older woman who is recently widowed, the nurse suspects that the woman is experiencing a developmental crisis. Which questions provide information about the impact of this crisis? (Select all that apply.) 1. With whom do you talk on a routine basis? 2. What do you do when you feel lonely? 3. Tell me what your husband was like. 4. I know this must be hard for you. Let me tell you what might help. 5. Have you experienced any changes in lifestyle habits, such as sleeping, eating, smoking, or drinking?
1. With whom do you talk on a routine basis? 2. What do you do when you feel lonely? 5. Have you experienced any changes in lifestyle habits, such as sleeping, eating, smoking, or drinking?
Secondary prevention examples
1. communicable disease screenin, case finding. 2. early detection and tx of DM 3. exercise program for older adults who are already frail 4. screenings--cholesterol, etc. 5. medication therapy
Health Belief Model What are the 3 components to this model?
1. first component of this model involves an individual's perception of susceptibility to an illness 2. The second component is an individual's perception of the seriousness of the illness. 3.The third component is the likelihood that a person will take preventive action.
A nurse is conducting a patient-centered interview. Place the statements from the interview in the correct order, beginning with the first statement a nurse would ask. 1. "You say you've lost weight. Tell me how much weight you've lost in the past month." 2. "My name is Terry. I'll be the nurse taking care of you today." 3. "I have no further questions. Is there anything else you wish to ask me?" 4. "Tell me what brought you to the hospital." 5. "So, to summarize, you've lost about 6 pounds in the past month, and your appetite has been poor—correct?"
2 4 1 5 3
A nurse observes a patient walking down the hall with a shuffling gait. When the patient returns to bed, the nurse checks the strength in both of the patient's legs. The nurse applies the information gained to suspect that the patient has a mobility problem. This conclusion is an example of: 1. Reflection 2. Clinical inference 3. Cue 4. Validation
2 Clinical inference
A 72-year-old patient asks the nurse about using an over-the-counter antihistamine as a sleeping pill to help her get to sleep. What is the nurse's best response? 1. "Antihistamines are better than prescription medications because prescription medications can cause a lot of problems." 2. "Antihistamines should not be used because they can cause confusion and increase your risk of falls." 3. "Antihistamines are effective sleep aids because they do not have many side effects." 4. "Over-the-counter medications when combined with sleep-hygiene measures are a good plan for sleep."
2. "Antihistamines should not be used because they can cause confusion and increase your risk of falls."
An 80-year-old female patient is admitted to the hospital through the emergency room with acute chest pain. Initial testing shows that the patient had a myocardial infarction. Her current vital signs are BP 156/90; HR 88; respirations 20; she is afebrile. The patient has osteoarthritis, causing chronic pain in both knees. She also has glaucoma. The patient is Bosnian and has been in the United States for 3 years. She requires a professional interpreter at bedside when explanations of treatment are provided. Which of the following factors might require you to adapt the way you assist this patient with ambulation? (Select all that apply.) 1. Patient is Bosnian 2. Had a recent myocardial infarction 3. Respirations 20 4. Osteoarthritis of both knees 5. Needs an interpreter 6. Patient is afebrile
2. Had a recent myocardial infarction 4. Osteoarthritis of both knees 5. Needs an interpreter
Which nursing interventions are appropriate to include in a plan of care to promote sleep for patients who are hospitalized? (Select all that apply.) 1. Give patients a cup of coffee 1 hour before bedtime. 2. Plan vital signs to be taken before the patients are asleep. 3. Turn television on 15 minutes before bedtime. 4. Have patients follow at-home bedtime schedule. 5. Close the door to patients' rooms at bedtime.
2. Plan vital signs to be taken before the patients are asleep. 4. Have patients follow at-home bedtime schedule. 5. Close the door to patients' rooms at bedtime.
The school nurse has been following a 9-year-old student who has shown behavioral problems in class. The student acts out and does not follow teacher instructions. The nurse plans to meet with the student's family to learn more about social determinants of health that might be affecting the student. Which of the following potential social determinants should the nurse assess? (Select all that apply.) 1. The student's seating placement in the classroom 2. The level of support parents offer when the student completes homework 3. The level of violence in the family's neighborhood 4. The age at which the child first began having behavioral problems 5. The cultural values about education held by the family
2. The level of support parents offer when the student completes homework 3. The level of violence in the family's neighborhood 5. The cultural values about education held by the family
A home health nurse is visiting a 62-year-old Hispanic woman diagnosed with type 2 adult-onset diabetes mellitus following a 2-day stay at a local hospital. The physician ordered home health with placement of the patient on a diabetic protocol for education about diabetes mellitus and a new medication and diet counseling. The patient lives with her 73-year-old husband, who has progressive dementia. Their daughter checks on her parents daily, buys groceries, and helps with home maintenance. The nurse conducts an initial history to gather information about the patient's condition. Which of the following data cues combine to reveal a possible health problem? (Select all that apply.) 1. First time hospitalized 2. Unable to describe diabetes 3. Takes antiinflammatory for arthritis 4. Has limited health literacy 5. Husband is able to perform self-bathing 6. Patient unable to identify food sources on prescribed diet 7. Patient has reduced vision and wears glasses 8. Patient prescribed an oral hypoglycemic drug
2. Unable to describe diabetes 4. Has limited health literacy 6. Patient unable to identify food sources on prescribed diet 7. Patient has reduced vision and wears glasses
Which statement most accurately describes intervention(s) offered by TCM providers? 1. Uses acupuncture as its primary intervention modality 2. Uses many modalities based on the individual's needs 3. Uses primarily herbal remedies and exercise 4. Is the equivalent of medical acupuncture
2. Uses many modalities based on the individual's needs
Contemplation stage of change
2nd stage - aware of problem, thinking about making a change -May be ambivalent about the change or is thinking about making a change. "I have a problem that I think I need to work on."
The nurse is evaluating how well a patient newly diagnosed with multiple sclerosis and psychomotor impairment is coping. Which statements indicate that the patient is beginning to cope with the diagnosis? (Select all that apply.) 1. "I'm going to learn to drive a car, so I can be more independent." 2. "My sister says she feels better when she goes shopping, so I'll go shopping." 3. "I'm going to let the occupational therapist assess my home to improve efficiency." 4. "I've always felt better when I go for a long walk. I'll do that when I get home." 5. "I'm going to attend a support group to learn more about multiple sclerosis."
3. "I'm going to let the occupational therapist assess my home to improve efficiency." 5. "I'm going to attend a support group to learn more about multiple sclerosis."
A nurse is taking a sleep history from a patient. The nurse recognizes that which statement made by the patient needs further follow-up? 1. "I feel refreshed when I wake up in the morning." 2. "I use soft music at night to help me relax." 3. "It takes me about 45 to 60 minutes to fall asleep." 4. "I take the pain medication for my leg pain about 30 minutes before I go to bed."
3. "It takes me about 45 to 60 minutes to fall asleep."
Based on the Transtheoretical Model of Change, what is the most appropriate response to a patient who states: "Me, stop smoking? I've been smoking since I was 16!" 1. "That's fine. Some people who smoke live a long life." 2. "OK. I want you to decrease the number of cigarettes you smoke by one each day, and I'll see you in 1 month." 3. "What do you think is the greatest reason why stopping smoking would be challenging for you?" 4. "I'd like you to attend a smoking-cessation class this week and use nicotine replacement patches as directed."
3. "What do you think is the greatest reason why stopping smoking would be challenging for you?"
When assessing an older adult who is showing symptoms of anxiety, insomnia, anorexia, and mild confusion, what is the first assessment the nurse conducts? 1. The amount of family support 2. A 3-day diet recall 3. A thorough physical assessment 4. Threats to safety in her home
3. A thorough physical assessment
Which principle is most important for a nurse to follow when using a clinical practice guideline for an assigned patient? 1. Knowing the source of the guideline 2. Reviewing the evidence used to develop the guideline 3. Individualizing how to apply the clinical guideline for a patient 4. Explaining to a patient the purpose of the guideline
3. Individualizing how to apply the clinical guideline for a patient
While planning care for a patient, a nurse understands that providing integrative care includes treating which of the following? 1. Disease, spirit, and family interactions 2. Desires and emotions of the patient 3. Mind-body-spirit of patients and their families 4. Muscles, nerves, and spine disorders
3. Mind-body-spirit of patients and their families
A nurse initiates a brief interview with a patient who has come to the medical clinic because of self-reported hoarseness, sore throat, and chest congestion. The nurse observes that the patient has a slumped posture and is using intercostal muscles to breathe. The nurse auscultates the patient's lungs and hears crackles in the left lower lobe. The patient's respiratory rate is 22 breaths/min compared with an average of 16 breaths/min during previous clinic visits. The patient tells the nurse, "It's hard for me to get a breath." Which of the following data sets are examples of subjective data? (Select all that apply.) 1. Heart rate of 22 breaths/min and chest congestion 2. Lung sounds revealing crackles and use of intercostal muscles to breathe 3. Patient statement, "It's hard for me to get a breath" 4. Slumped posture and previous respiratory rate of 16 breaths/min 5. Patient report of sore throat and hoarseness
3. Patient statement, "It's hard for me to get a breath" 5. Patient report of sore throat and hoarseness
A nurse working the evening shift has five patients and is teamed up with an assistive personnel. One of the assigned patients has just returned from surgery, one is newly admitted, and one has requested a pain medication. The patient who has returned from surgery just minutes ago has a large abdominal dressing, is still on oxygen by nasal cannula, and has an intravenous line. One of the other patients has just called out for assistance in setting up a meal tray. Another patient is stable and resting comfortably. Which patient is the nurse's current greatest priority? 1. Patient in pain 2. Patient newly admitted 3. Patient who returned from surgery 4. Patient requesting assistance with meal tray
3. Patient who returned from surgery
Which complementary therapies are most easily learned and applied by a nurse? (Select all that apply.) 1. Therapeutic massage therapy 2. Traditional Chinese medicine 3. Progressive relaxation 4. Breathwork and guided imagery 5. Therapeutic touch
3. Progressive relaxation 4. Breathwork and guided imagery
A patient discharged a week ago following a stroke is currently participating in rehabilitation sessions provided by nurses, physical therapists, and registered dietitians in an outpatient setting. In what level of prevention is the patient participating? 1. Primary prevention 2. Secondary prevention 3. Tertiary prevention 4. Transtheoretical prevention
3. Tertiary prevention
A 34-year-old single father who is anxious, tearful, and tired from caring for his three young children tells the nurse that he feels depressed and does not see how he can go on much longer. Which statement would be the nurse's best response? 1. "Are you thinking of suicide?" 2. "You've been doing a good job raising your children. You can do it!" 3. "Is there someone who can help you during the evenings and weekends?" 4. "Tell me what you mean when you say you can't go on any longer."
4. "Tell me what you mean when you say you can't go on any longer."
When planning patient education, it is important to remember that patients with which of the following illnesses may find relief in complementary therapies? 1. Lupus and diabetes mellitus 2. Ulcers and hepatitis 3. Heart disease and pancreatitis 4. Chronic back pain and arthritis
4. Chronic back pain and arthritis
You are preparing a presentation for your classmates regarding the clinical care coordination conference for a patient with terminal cancer. As part of the preparation, you have your classmates read the Nursing Code of Ethics for Professional Registered Nurses. Your instructor asks the class why this document is important. Which statement best describes this code? 1. Improves self-health care 2. Protects the patient's confidentiality 3. Ensures identical care to all patients 4. Defines the principles of right and wrong to provide patient care
4. Defines the principles of right and wrong to provide patient care
The nurse is caring for a patient with an abdominal obstruction. The nurse irrigates the patient's nasogastric tube and reports the amount of fluid aspirated from the patient's stomach to the health care provider. The patient has an IV infusing; the nurse changes the transparent dressing over the IV site and instructs the patient to report any tenderness at the site. Which of these interventions is an indirect care measure? 1. Irrigation of nasogastric tube 2. Changing of transparent dressing 3. Instructing patient to report tenderness at IV site 4. Report of the amount of fluid aspirated
4. Report of the amount of fluid aspirated
How many social determinant categories are there? Where can you find this information?
5 Healthy People 2030
. In preparing to collect a nursing history for a patient admitted for elective surgery, which of the following data are part of the review of present illness in the nursing health history? 1. Current medications 2. Patient expectations of planned surgery 3. Review of patient's family support system 4. History of allergies 5. Patient's explanation for what might be the cause of symptoms that require surgery
5. Patient's explanation for what might be the cause of symptoms that require surgery
Environmental Issues (exercise & activity)
A common barrier for physical activity is a lack of time needed to engage in a daily exercise program. -home & work sites -schools -community
What is a concept map?
A concept map is a tool to assist in the planning of care. It shows the relationship between multiple nursing diagnoses and planned interventions.
Crisis
A crisis implies that a person is facing a turning point in life. This means that previous ways of coping are ineffective, and the person must change.
Define Disease
A medical condition that causes distress for a person in the form of its symptoms is referred to as a disease. It is a generic term that includes all disorders, infections, disabilities, and deformities that can afflict human beings
advocacy ethics (professional nursing code of ethics)
Advocacy refers to the application of one's skills and knowledge for the benefit of another person
What is the 8th standard of practice?
Advocacy: The registered nurse demonstrates advocacy in all roles and settings
The __________ ___________ _____________ established its first Code of Ethics for Nursing
American Nurses Association (ANA)
acute disease
An acute disease is usually reversible and has a short duration. The symptoms appear abruptly, are intense, and subside after a relatively short period.
What is standard 1 and what is involved?
Assessment: The registered nurse collects pertinent data and information -gathering data, ANALYZING DATA
autonomy
Autonomy refers to freedom from external control. In health care the concept applies to respect for the autonomy of patients. It can also apply to agency respect for the autonomy of health care professionals. A commitment to respect the autonomy of others is a fundamental principle of ethical practice.
What are the Professional Roles & Responsibility of Nurses
Autonomy, Accountability, Advocate, Educator, Communicator, Manager, Caregiver
What are the barriers to effective discharge of patients?
Barriers to effective discharge planning include ineffective communication, lack of role clarity among health care team members, and lack of resources.
Contemporary nursing requires that the nurse have knowledge and skills for a variety of professional roles and responsibilities. Which of the following are examples of these roles and responsibilities? (Select all that apply.) 1. Caregiver 2. Autonomy 3. Patient advocate 4. Health promotion 5. Genetic counselor
Caregiver Autonomy Patient Advocate Health promotion
Professional Roles & Responsibility of Nurses Communicator
Communicating allows you to know your patients, including their preferences, strengths, weaknesses, and needs. - routinely communicate with patients and families, other nurses and health care professionals, resource people, and the community. -Effective communication strategies are fundamental to providing high-quality care, coordinating and managing patient care, assisting patients in rehabilitation, advocating for patients, assisting patients and families in decision-making, providing patient education
compassion fatigue
Compassion fatigue is a term used to describe a state of burnout and secondary traumatic stress.
complementary therapy
Complementary therapies are therapies used together with conventional treatment recommended by a person's health care provider. As the name implies, complementary therapies complement conventional treatments.
Define coping
Coping is a person's cognitive and behavioral efforts to manage a stressor (Buchanan, 2021). It is important to physical and psychological health because stress is associated with a range of psychological and health outcomes
what are the objectives for healthy people 2030? (3)
Core objectives Developmental objectives Research objectives
What are core objectives ?
Core objectives reflect high-priority public health issues and are associated with evidence-based interventions.
When does a crisis occur?
Crisis occurs when stress overwhelms a person's usual coping mechanisms and demands mobilization of all available resources. A crisis creates a turning point in a person's life because it changes the direction of life in some way
________ influences our values, how we define health, what we believe about illness, where we seek health care, and the treatments we prefer. a) life b) beliefs c) finances d) culture
D. Culture
Developmental changes (exercise & activity)
Developmental changes. Throughout the life span the appearance and functioning of the body undergo changes affecting movement. (age)
what are developmental objectives?
Developmental objectives represent high-priority public health issues that are associated with evidence-based interventions but don't yet have reliable baseline data.
What is standard 2 and what is involved?
Diagnosis: The registered nurse uses the assessment data to determine the actual or potential diagnoses, problems, and issues. -IDENTIFY THE PROBLEM
Disparities can be related to what variables? (6)
Disparities can be related to many variables, such as race, ethnicity, gender, location, disability, or social determinants
Ethics
Ethics is the study of what is right and wrong with our conduct. It concerns our obligations to individuals, groups, and society
ethics
Ethics is the study of what is right and wrong with our conduct. It concerns our obligations to individuals, groups, and society.
What is standard 6 and what is involved?
Evaluation: The registered nurse evaluates progress toward attainment of goals and outcomes.
Poverty, food insecurity, no primary health care in a community, culture, exposure to violence, and access to green spaces are examples of _______.
Examples of SDOH
A child whose parents believe in the importance of physical activity and eating healthy foods may continue to practice these health beliefs. This is an example of which variable & factor?
External Variable Family role and practices
Family practices, psychosocial and socioeconomic factors, and cultural background are examples of _______ _____.
External variables
T/F Illness and Disease are the same
False
t/f The Health Belief Model empowers patients to engage in their own recovery and assume some responsibility for health maintenance
False Holistic Health Model
The first component of which model involves an individual's perception of susceptibility to an illness?
Health Belief Model
Use of this model helps you understand factors influencing patients' perceptions, beliefs, and behaviors to plan care so that you can more effectively help patients maintain or restore health and prevent illness.
Health Belief Model
A patient whose family history includes one parent and two siblings who have died from a myocardial infarction (MI) recognizes the familial link for coronary artery disease and perceives a personal risk of heart disease. This is an example of which model of health & which component of that model?
Health Belief Model Individual Perceptions Component
Which SDOH has a Goal: Increase access to comprehensive, high-quality health care services.
Health Care Access & Quality
Define Health Beliefs & what are they based on?
Health beliefs are a person's ideas, convictions, and attitudes about health and illness. They can be based on reality or false expectations, facts or misinformation, common sense or myths, or good or bad experiences.
Healthcare Disparities (definition)
Health care disparities are the differences in health care outcomes and dimensions of health care, including access, quality, and equity, among population groups
____________, ____________, & ____________help individuals, groups, and communities improve their health, decrease the incidence of disease and disability, and improve their quality of life.
Health education, legislation, and policy
________, the initiative's ______ iteration, builds on knowledge gained over the first __________.
Healthy People 2030 5th 4 decades
Healthy People 2030 aims to.........
Healthy People 2030 aims to promote the nation's health and create a society in which all people throughout the life span can achieve their fullest potential for health and well-being.
Healthy People
Healthy People identifies public health priorities to help individuals, organizations, and communities across the United States improve health and well-being.
risk factor example
Impaired gait, reduced vision, and lower extremity weakness are examples of risk factors for falls
What is standard 5 and what is involved?
Implementation- work to fix pt problem When implementing patient care, you must consider an organization's efficiency and cost control goals while still focusing on competently providing timely, thoughtful, safe, patient-centered care.
self-actualization
Self-actualization is the highest expression of one's individual potential and allows for continual self-discovery
Which SDOH has a Goal: Increase social and community support.
Social & Community Context
_______________ ____________ have a major impact on people's health, well-being, and quality of life.
Social determinants of health (SDOH)
__________include a variety of social, commercial, cultural, economic, environmental, and political factors that affect health disparities. a) LHI b) SDOH c) Code of ethics
Social determinants of health (SDOH)
Issues in healthcare ethics
Social media Quality of life Care at the end of life Access to healthcare
Family and social support (exercise & activity)
Social support is one very important motivational tool to encourage and promote exercise and physical fitness.
Why are herbal medications not safe?
Some herbal medicines can be contaminated with prescribed medications, and it is important to understand the actions of herbal medicines and any potential interactions with patients' prescribed medications.
List some common holistic interventions: (6)
Some of the most widely used holistic interventions include meditation, music therapy, reminiscence, relaxation therapy, therapeutic touch, and guided imagery
Define modifiable risk factors
Some risk factors such as lifestyle practices and behaviors can be modified.
Does the code of ethics list the provisions or the standards of practice?
The Code of Ethics for Nurses with Interpretive Statements lists the nine succinct provisions and interpretive statements that establish the ethical framework for RNs' practice across all roles, levels, and settings.
T/ F: Discharge planning begins at admission to a health care agency, helps determine the best place for a patient to go after discharge from the hospital, and creates a smooth transition of a patient's care from the acute care or post-acute care agency to the patient's next environment
True
T/F: Health is the actualization of inherent and acquired human potential through goal-directed behavior, competent self-care, and satisfying relationships with others
True
T/F: Nurses promote patient satisfaction through providing patient- and family-centered care and applying good interpersonal skills, including courtesy, respect, and good communication skills.
True
Patient's behavior (exercise & activity)
Understanding how human behavior influences a patient's motivation and willingness to be active and exercise is critical to your success in creating a patient-centered exercise program.
integrative therapy
Use of a combination of techniques from different therapies based on the therapist's judgement of which particular methods will provide the greatest benefit for the client.
chronic disease
a disease that develops gradually and continues over a long period of time -A chronic disease usually lasts more than 6 months, is irreversible, and affects functioning in one or more systems. - person with a chronic disease is like a person with a disability in that both have varying degrees of functional limitations
What does the Health Belief Model address?
addresses the relationship between a person's beliefs and behaviors
examples of nonmodifiable risk factors
age, gender, race, heredity
which therapy replaces biomedical care?
alternative therapy
A major natural disaster, man-made disaster, or crime of violence What type of crisis is listed?
an adventitious crisis.
What type of health problems can sleep deprivation cause?
both chronic sleep deprivation and long sleep duration are associated with obesity, type 2 diabetes mellitus, poor memory, depression, digestive problems, and the development of cardiovascular disease
What is sleep deprivation?
decrease in the amount, consistency, or quality of sleep
-How do some older adults define health? -How do others define their health?
define health by the health practices they use regularly as the absence of disease and disability, the maintenance of physical and cognitive functioning, and having connections with others
Health Belief Model: What variables influence this model? (2)
demographic variables (age, gender, race, ethnicity) sociopsychological variables (personality, social class, peer and reference group pressure)
Factors influencing activity and exercise
developmental changes, behavior, lifestyle, environmental issues, family and social support, cultural and ethnic factors.
When does discharge planning start?
discharge planning with coordination of services must begin the moment a patient is admitted to a hospital
t/f When nonpharmacological therapies such as exercise, chiropractic, and herbal supplements are used in place of conventional pharmacological or other medical procedures, they are considered complementary therapies
false: alternative therapy
secondary prevention
focuses on preventing the spread of disease, illness, or infection once it occurs. -Activities are directed at dx & prompt intervention, thereby reducing the severity and enabling the patient to return to a normal level of health as early as possible
In a continuing care setting, you will apply __________ nursing principles to help patients adapt to permanent health changes so that they can remain active and engaged.
gerontological
Considering a patient's ______ & _______stage helps you predict a patient's response to an actual illness or the threat of a future illness.
growth and developmental
Use which model to help identify risky behaviors and implement the change process will help you motivate patients and facilitate health behavior changes
health promotion mode
Nurses play a key role in promoting access to health care and in providing appropriate education to patients and families to promote ______________, ________________, and _________________ to all individuals across the lifespan.
healthy development, healthy behaviors, and well-being to all individuals across the life span.
illness prevention
help protect people from actual or pot threats to their health
Professional Roles & Responsibility of Nurses Caregiver
help pts maintain & regain health, manage disease & symptoms, and attain a maximal level of function & independence through the healing process
health educations
helps individuals develop a greater understanding of their health and how to better manage
health promotion
helps individuals maintain or enhance their health
List common positive health behaviors: (6)
immunization scheduled screenings (e.g., colonoscopy) proper sleep patterns adequate exercise stress management nutrition.
Professional Roles & Responsibility of Nurses Autonomy & Give example
in nursing, it involves the initiation of independent nursing interventions WITHOUT medical orders EX: Independently advise pt to cough & suggest deep breathing exercises to clear lungs of pt
Health Belief Model Cues to action in this model include.....
including mass media campaigns, advice from others, illness of family member or friend, newspaper or magazine article, etcetera lead to perceived threat of disease X.
What is integrative healthcare?
integrative health care emphasizes the importance of the relationship between practitioner and patient; focuses on the whole person; is informed by evidence; and makes use of appropriate therapeutic approaches, health care professionals, and disciplines to achieve optimal health
In ____ _____the nurse feels unable to take the action that is correct.
moral distress
Healthy People sets ___________ to help the United States increase its focus on health promotion and disease prevention (instead of illness care) and encourages cooperation among individuals, communities, and other public, private, and nonprofit organizations to improve health
objectives
moral distress
occurs when the individual knows the right thing to do but organizational constraints make it difficult to take the right course of action
passive relaxation
passive relaxation is to still the mind and body intentionally without the need to tighten and relax any particular body part. One effective passive relaxation technique incorporates slow abdominal breathing exercises while imagining warmth and relaxation flowing through specific body parts such as the lungs or hands
What are the 3 levels of prevention?
primary, secondary, tertiary
What is the holistic health model?
promotes a patient's optimal level of health by considering the dynamic interactions among the emotional, spiritual, social, cultural, and physical aspects of an individual's wellness
The ___________ of the Code of Ethics describe the nurse's obligation to the patient, the role of the nurse as a member of the health care team, and the duties of the nurse to the profession and to society
provisions
Nurses' knowledge and use of complementary therapies such as mindfulness, relaxation, and breathing techniques aid in reducing ______ and improving ______.
reduce pain improve comfort
What is Provision 3- in the ANA Code of Ethics?
relates to advocacy for patients rights and confidentiality
What is Provision 7- in the ANA Code of Ethics?
relates to life-long learners as nurses -the requirement to follow standards.
What is Provision 2- in the ANA Code of Ethics?
relates to the nurses' commitment: includes information about conflict of interest
What is Provision 5- in the ANA Code of Ethics?
relates to the nurses' duty to self physically, mentally, and morally -includes directions on maintaining competency
What is Provision 4- in the ANA Code of Ethics?
relates to the nurses' professional obligations & decision making
What type of holistic therapy sometimes helps relieve anxiety for older patients dealing with memory loss
reminiscence
What does SPHM stand for?
safe patient handling and mobility (SPHM),
External sources such as a job change, a motor vehicle crash, or severe illness what type of crisis is listed?
situational crises.
Which standards of practice are part of the Nursing Process?
standards 1-6
Negative health behaviors include practices that are harmful to health. What are some examples? (5)
such as smoking, drug or alcohol abuse, risky sexual behaviors, poor diet, and refusing to take necessary medications
maleficence
the act of committing harm or evil
Patients benefit most from instructions based on information about their homes and lifestyles, such as which types of activities promote sleep when a person must work during the night shift or how to make the home environment more conducive to sleep. t/f
true
T/f: Health beliefs usually influence health behaviors or health practices, which positively or negatively affect a patient's level of health
true
T/f: Risk factors can be modifiable or nonmodifiable
true
t/f A commitment to respect the autonomy of others is a fundamental principle of ethical practice.
true
t/f A patient's subjective experience is relevant in maintaining health or assisting in healing. This is part of the Holistic Health Model.
true
t/f Access to health care is an ethical issue of justice
true
t/f An individual's daily lifestyle greatly influences engagement with exercise.
true
t/f Complementary therapies accessible to nursing include relaxation, meditation and mindfulness techniques, and imagery. Evidence supports their use to decrease the effects of stress and improve overall patient well-being.
true
t/f Critical thinking attitudes foster the exploration of all data sources in detail to ensure a thorough patient database.
true
t/f Evidence-based research has shown that safe patient handling and mobility interventions significantly reduce overexertion injuries by replacing manual patient handling with safer methods guided by ergonomic principles
true
t/f In community health and home, settings help patients develop behaviors conducive to rest and relaxation.
true
Important nursing interventions for promoting sleep in the hospitalized patient are to establish periods for ________ _______ &________ _______ _________.
uninterrupted sleep and rest and to control noise levels.
Health is a state of being that people define in relation to their own ________, ____________, and ________________.
values, personality, and lifestyle
What is involved in discharge planning?
• Determining the appropriate post-hospital destination for a patient usually done by case manager or social worker • Identifying a patient's needs for a smooth and safe transition from the acute care hospital/post-acute care agency to the patient's discharge destination • Beginning the process of meeting a patient's needs while the patient is still hospitalized, with approaches such as early mobility protocols, health education, and new medication regimens.