3803 Final
Identify physical and behavioral signs of child maltreatment?
multiple fractures, burn patterns, scars, welts, bite marks, reluctance to return home
proteins
muscle and making hormones
How does exercise benefit the aging population?
neuromuscular function, osteoporosis, low back pain, immune function, mental health
nitrogen balance
nitrogen input = nitrogen output
Health/Wellness- Illness Continuum
the depiction of the relationship btw the concepts of health and illness
What are the risk factors for Cardiovascular Disease? Non-modifiable: Modifiable:
Non-modifiable - age, gender, race, family history, personal medical history Modifiable - hypertension, high cholesterol, obesity, diabetes mellitus, diet, physical inactivity, alcohol intake, smoking
(Briefly) How do each of the following dietary habits increase cancer risk? a. Obesity: b. Red or processed meat intake: c.Salt-preserved foods:
Overweight or Obese: Breast. Colon, endometrium, esophagus, kidney Red or processed meat(heterocyclic amines - HCAs- from cooking at high temps): colon, prostate Alcohol (>circulating estrogens): breast, kidney, larynx, liver, oral, pharynx Salt-preserved foods: pharynx, stomach
What are the dietary components that need to be monitored and controlled in a renal diet?
Renal diet limits/controls intake of potassium, fluid, protein, phosphorus (vit. D and calcium) and sodium.
What is the DASH diet? How/why is it helpful in reducing cardiovascular health?
Whole grains (7-8 servings/day) Fruits (4-5/day) Vegetables (4-5/day) Low/non-fat dairy (2-3/day) Meat/poultry/fish (2 or less) Nuts, seeds, legumes ( 4-5/week) Monounsaturated fats & oils only (2.5 teaspoons/day)
What is Allostatic load? What impact (long and short term) does it have on health outcomes
"the wear and tear on the body" which accumulates as an individual is exposed to repeated or chronic stress
non-essential amino acids
(11) body can synthesize them
Pre-hypertension
(120-139/80-89)
essential amino acids
(9) we can not synthesize them must be obtained from diet
Hypertension
(>140/90 on three occasions)
7 major nursing roles health promotion
- Awareness of family roles and attitudes toward health promotion -Role model - Collaborate with family in Nursing Process - Identify health risk behaviors -Assist in decision-making process and problem solving strategies regarding lifestyle choices -Assist in learning behaviors to promote health/prevent disease, provide information -Resource, liaison, coordinator/advocate and refer if appropriate
Adaptive Model
-Ability to adapt positively to physical, mental, and physiological change -Illness occurs when a person fails to adapt or becomes maladaptive
Role performance model
-Ability to perform social roles -Includes work, family, social -school/work physicals and excuses are based on this model -Sick role
Identify (2-3) ways that culture affects diet/nutrition.
-food preparation and rituals -food is culturally defined -food choices are deeply rooted in who we are
Clinical Model
-health is based on absence of disease, signs and symptoms -Illness based on presence of conspicuous signs/symptoms -Often don't seek preventative services
Identify suggestions for patients to enjoy their cultural food preferences while making healthier changes:
-modify diet traditions, substitute less fattening ingredients and eat more fruits and vegtables
For what age group is "Injury" the leading cause of death??
1-44
Identify the FIRST LINE interventions for weight loss: a. b. c.
1. dietary therapy 2. physical activity 3. behavior therapy
Nurses teach patients/families almost every day - some times in a formal setting (new parent classes) sometimes in the course of patient care (at the bedside). In formal classes a strict teaching plan is typically developed and used. At the bedside this may not be the case. No matter the setting, the same process is used to determine the need for teaching and the appropriate content/delivery method for teaching. Identify the steps in the Teaching-Learning Process
1. Assessment: -Characteristics of the learner -Learning needs /how does this person learn best -Health beliefs -Motivation and readiness to learn -Health risks or problems -Current knowledge and skills -Cultural needs -Psychomotor needs (literacy, physical challenges) -Priorities -Barriers to learning 2.Diagnostic Statement: 3. Health-Seeking Behaviors 4. Knowledge deficit (lack of knowledge) _____ related to ______ AEB ________ •Readiness to learn:
What is Healthy People 2020 (2030)? What are the major goals of HP2020?
1. attain high quality, longer lives free of preventable disease 2. eliminate health disparities 3. create environments that promote health 4. promote quality of life and healthy behaviors
Health Promotion Model (Pender) 3 focus areas
1. individual characteristics and experiences 2. behavior- specific cognitions and affect 3. behavior outcomes
Identify 7 factors that impact the probability of making a change
1. individual perception/ readiness to change 2. value placed on health 3. perceived susceptibility to health problems 4. perceived seriousness of disease/ condition 5. risk factors attributed to heredity 6. perceived benefits 7. perceived barriers
How is socioeconomic status (SES) linked to health? What are some of the effects of low-SES on health? What are some the effects of chronic stress on health?
1. number of services aka volume not value 2. dont ask dont tell bc we dont necessarily know what to tell you 3. mobilize resources to create a solution chronic stress causes burn out holding on to fat etc linked to morbidity and mortality
In the US, what percentage of cancer is attributable to Smoking? _____ . What percentage of cancer is attributable to poor nutrition/inactivity/obesity? ______
30%, 33%
Waist circumference. How is used and what does it predict? Higher health risk is associated with waist circumference greater than ________ in females and ________ in males? What is an advantage of assessing waist circumference vs. BMI?
35 women 45 men allows us to know whether its abdominal vs gluteal femoral obseity and abdominal is more associated with issues
What is the recommended daily intake of potassium for most patients?
3500-4700 mg
Hemoglobin A1C is directly affected by blood glucose levels - it is the most reliable lab value for determining blood glucose control in a patient with diabetes (you have to know this). Desired level?
6.5%
genogram
A family diagram that depicts each member of the family and shows connections between the generations.
List vitamins, function, common food source:
A, B, C, D, E, K, B 1,2,3,6,12
What are the 10 ACES described/identified in the ACE study?
Abuse: 1) Physical, 2) emotional, and 3) sexual Neglect: 4) Physical and 5) emotional Household dysfunction: 6) Parental mental illness, 7) incarcerated relative, 8) mother treated violently, and 9) household substance abuse. The category that was previously called "divorce or parental separation" was recently updated to 10) "not being raised by both biological parents."
Domains of Learning (Cognitive, Affective, Psychomotor). Describe each domain and identify the kind of information and/or tasks that correspond with each domain.
Affective - emotions - changes beliefs, attitudes or values - readiness to learn (role-playing, discussion, simulations) Cognitive - thinking - learning facts (lectures, reading material, discussion) Psychomotor - performing skills (demonstration, drills, peer teaching, games)
What are some low potassium alternatives?
Apples Beans (green or wax) Rice Grapes Cucumber Noodles Pears Onions Watermelon Lettuce Cereal Cranberries Carrots Bread & bread products Cherries
For the three (general) population groups identified in the lecture (Asian, Hispanic, African-American) list key traits/characteristics. Keep in mind that there are often wide variations within population groups. ALWAYS ask/assess individual preferences/needs - cultural and religious.
Asian- stir fry, barbeque, boiling, and steaming. Lactose intolerance is common -obtain protein from fish pork and poultry -rice is staple -may lack some essential AA Hispanic- rich in complex carbs- corn, beans, rice - often high in fat (lots of deep fried) African Americans- diet influenced by lifestyle of gparents or ggparents who live in southern US -collard greens, beans, rice, potatoes -high in Vit A, fiber, and iron (fried food, sauces) -many are lactose intolerant
Describe Binge-drinking? What are the trends surrounding binge-drinking?
Binge drinking is the most common, costly, and deadly pattern of excessive alcohol use in the United States.1,2,3 Binge drinking is defined as a pattern of drinking that brings a person's blood alcohol concentration (BAC) to 0.08 g/dl or above. This typically happens when men consume 5 or more drinks or women consume 4 or more drinks in about 2 hours.4 Most people who binge drink do not have a severe alcohol use disorder.
Identify 2-3 common nutritional preferences/needs of people from the religious groups identified in the lecture
Budhism- many abstain from eating meat and fish, rice is staple, they eat moderately, NOT until they are full Hinduism- meat and eggs are NOT consumed bc they represent life. nor chickens and pigs. most Hindus are vegetarian but some eat fish and others may consume dairy Judaism- Kosher foods, don't combine meat and milk in the same meal Islam- stop eating when still hungry. no pork or alcohol
Discuss three alcohol screening tools. (Cage, Audit, SBIRT)
Cage- CAGE should be included among standard history questions in primary care, emergency department, psychiatric and inpatient hospital settings. The recommendation of the National Institute of Alcohol Abuse and Alcoholism is that all patients who drink alcohol should be screened with the CAGE questions. (Fiellin DA 2000) CAGE is designed for adults and adolescents >16 years. Audit c- The 4-item CAGE questionnaire is the briefest effective screening test for lifetime alcohol abuse/dependence, but it is not sensitive for detecting heavy drinking and does not distinguish between active and past problem drinking. The AUDIT-C is more effective in identifying this population. AUDIT-C can be included among standard history questions or general health intake questionnaires in primary care, emergency department, psychiatric and inpatient hospital settings.
Describe dietary interventions for patients with COPD.
Eat 20 to 30 grams of fiber each day, from items such as bread, pasta, nuts, seeds, fruits and vegetables. Eat a good source of protein at least twice a day to help maintain strong respiratory muscles. Good choices include milk, eggs, cheese, meat, fish, poultry, nuts and dried beans or peas.
What is stress management? Benefits of managing stress?
Effective interventionsintended to improve quality of life by increasing healthy effective coping and reducing the unhealthy consequences of distress. strengthened Immune System • Better Cardiovascular Health • Decreased blood pressure • Better control of blood sugar • Improved sleep • Less Depression/better mood/happier • Improved productivity
Know which vitamins are FAT soluble and which are WATER soluble? Why is this important?
Fat: ADEK Water: B 1,2,6,12, C and folic acid
commonly used Health Risk Appraisal tool
Gordon's Functional Health Patterns
Gordon's Patterns - list each of the patterns and identify items/areas to assess and/or questions to ask for each pattern
Health Perception-Health Management Nutrition-Metabolic Elimination Activity-Exercise Sleep-Rest Cognitive-Perceptual Self-perception-self concept Roles-relationships
What is Health Literacy? Why is it important?
Health literacy is the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions.
What is health promotion? Why is it important for nurses to engage in health promotion activities?
Health promotion- the process of enabling people to increase control over, and to improve, their health. It moves beyond a focus on individual behavior towards a wide range of social and environmental interventions. - to educate patients and prevent illness
Describe the role of proteins in: a. The immune system- b. Circulation- c.Energy (source)
IS- to build and repair body tissue and fight viral and bacterial infections
A diet that helps prevent cancer is characterized by:
Limit red meat and processed meats Limit alcohol Limit salt Maintain healthy weight Increase fruits and vegetables - wide variety (at least 5/day) Lycopene (tomatoes) Cruciferous ve
Review the types of diabetes - pre-diabetes, Type 1, Type 2, gestational.
In type 2 diabetes, the body does not use insulin properly. Inulin resistance. At first, the pancreas makes extra insulin to make up for it. But, over time the pancreas isn't able to keep up and can't make enough insulin to keep blood glucose levels normal. Type 2 is treated it with lifestyle changes, oral medications (pills), and insulin. May be able to control blood glucose with healthy eating and activity. Oral medication (hypo-glycemic) or insulin may be used to help meet target blood glucose levels. Type 2 usually gets worse over time - even if you don't need medications at first, you may need to later on. In type 1, the body treats the cells that make insulin as invaders and destroys them. This can happen over a few weeks, months, or years. When enough of the cells are gone, your pancreas stops making insulin, or makes too little insulin. Without insulin, your blood glucose rises higher than normal, so the insulin needs to be replaced.
What are some of the major health related effects of alcohol (and other substance misuse)? Think long - term chronic diseases and short term - such as injury, violence, overdose/toxicity)
Injuries, such as motor vehicle crashes, falls, drownings, and burns.6,7 Violence, including homicide, suicide, sexual assault, and intimate partner violence.6-10 Alcohol poisoning, a medical emergency that results from high blood alcohol levels.11 Risky sexual behaviors, including unprotected sex or sex with multiple partners. These behaviors can result in unintended pregnancy or sexually transmitted diseases, including HIV.12,13 Miscarriage and stillbirth or fetal alcohol spectrum disorders (FASDs) among pregnant women long term: High blood pressure, heart disease, stroke, liver disease, and digestive problems.6,16 Cancer of the breast, mouth, throat, esophagus, liver, and colon.6,17 Weakening of the immune system, increasing the chances of getting sick.6,16 Learning and memory problems, including dementia and poor school performance.6,18 Mental health problems, including depression and anxiety.6,19 Social problems, including lost productivity, family problems, and unemployment.6,20,21 Alcohol use disorders, or alcohol dependence.
Why are fluids restricted in the diets of renal patients? What is the range for fluid restriction in dialysis patients?
Kidneys help control the amount of fluid that leaves your body. As renal disease progresses, kidneys may be unable to regulate the removal of fluid from your body resulting in fluid intake limitations. Too much fluid may cause swelling (edema), shortness of breath, or high blood pressure.
Dietary Habits linked to Cancer. What are the four recommendations to decrease overall cancer risk?
Maintain healthy weight (overweight/obese) Be physically active Healthy diet - emphasizing plant sources Limit alcohol consumption
What are the goals of nutrition therapy for renal disease?
Maintain optimal nutritional status Decrease protein catabolism Minimize uremic toxicity Adequate hydration Normal serum K levels Slow progression of renal osteo-dystrophy Meet other nutritional concerns (comorbidities)
Identify common foods that are high in potassium and should be limited in a renal diet?
Melons such as cantaloupe and honeydew (watermelon is okay) Bananas Oranges and orange juice Grapefruit juice Prune juice Tomatoes, tomato sauce, tomato juice Dried beans - all kinds Pumpkin Winter squash Cooked greens, spinach, kale, collards, Swiss Chard
According to HP2030, how many people in the US have had a substance misuse disorder in the past year? Are there effective treatments? Are people likely to seek treatment?
More than 20 million adults and adolescents in the United States have had a substance use disorder in the past year Effective treatments for substance use disorders are available, but very few people get the treatment they need. Strategies to prevent substance use — especially in adolescents — and help people get treatment can reduce drug and alcohol misuse, related health problems, and deaths.
binge eating disorder
People with binge-eating disorder lose control over his or her eating. Unlike bulimia nervosa, periods of binge-eating are not followed by purging, excessive exercise, or fasting. As a result, people with binge-eating disorder often are overweight or obese. Binge-eating disorder is the most common eating disorder in the U.S.
What is the impact of exercise on health?
Obesity - maintain healthy weight • Blood pressure ‐ decrease • Cholesterol - increase HDL, decrease in triglycerides • Improved glucose tolerance (diet and exercise are FIRST LINE interventions for diabetes) • Decreases risk of ventricular arrythmia) • Exercise protects against/intervention for mild to major depression (Graven, 2011). • Exercise the spirit • Relaxation Response • Release of tension • Increases self‐awareness • Rhythmic aerobic exercises - deep‐breathing - yoga, dance, swimming • Shifts awareness from internal to external environment.
And secondary interventions: a. Pharmacological (don't need to know meds for this class) b. Surgical (specific surgical procedures not tested) c.Combination
Pharmacotherapy: FDA approved -Sibutramine(Meridia), Orlistat - text, more recently others, including Contrave (generic: bupropion and naltraxone), Saxenda (phentermine and topiramate), Belviq (lorcaserin) serotonin 2C receptor agonist indicated for chronic weight management in adults who are obese, or overweight and who have at least one weightrelated condition such as high blood pressure, type 2 diabetes, or high cholesterol. (don't need to know drugs for this class) Surgery - gastric banding or bypass Combination
Why is important to balance of calcium, phosphorus, and vitamin D in the body. What are some common foods high in phosphorus?
Phosphorus is a mineral that works with calcium to maintain strong bones. Necessary for building and maintaining bones and teeth and for normal nerve and muscle function. When kidney function declines, the body has a difficult time keeping phosphorus and calcium in balance. Body cannot eliminate excess phosphorus (phosphorus levels increase) The body cannot take in enough calcium (calcium levels decrease). The body will "steal" calcium from the bones making the bones weak. High phosphorus levels include itchy skin, bone and joint pain, and brittle bones. Cola Drinks • Peanut Butter • Cheese • Sardines • Chicken/beef liver • Nuts • Caramels • Beer • Ice Cream
Describe the Healthy People 2030 Objectives for Physical Activity:
Physical activity - body movement that increases energy expenditure. Includes: transportation, leisure activities, sports, exercise. Exercise ‐ planned, structured, repetitive body movement performed to improve or maintain one or more component of physical fitness. Health Benefits of activity/exercise
Preventive action
Primary- precedes disease or dysfunction. Proactive, increases awareness. Decreases vulnerability. (education and immunizations) Secondary- early diagnoses (screenings) and interventions. Limits disease process and prevents complications. Tertiary- minimizes effects of disease or disability. Rehabilitation. Retain or return to optimal level of functioning consistent with condition or disability. --The disease is permanent and irreversible.
What is the nurse's role in stress management (self and patients)?
Provider of Care ‐ nurses interact with depressed, anxious and stressed patients - develop skills to listen and alleviate fears/stress. Active role in reducing stress and anxiety through breathing exercises, guided imagery or massage. • How a nurse reacts to patients' stress can have an enormous effect on their general well‐being. Nursing presence. • Educator - providing information to patients...helping them understand what they can expect, knowledge about their condition and procedure can help to reduce their anxiety levels. • Listener ‐ ask questions and prompt patients to talk about their fears plays a role in recovery and chronic disease control. • Role Model
How do Resting Energy Expenditure (REE), Thermic Effect of Food, and Physical Activity impact an individual's energy needs?
REE- amount of calories needed for 24 hrs during a non active period TEF- increase in metabolic rate after ingesting a meal PA- increases need of calories
What is the recommendation for HALTING the PROGRESSION of CKD? This is accomplished by: 1) 2) 3)
Renal diet limits/controls intake of potassium, fluid, protein, phosphorus (vit. D and calcium) and sodium.
Describe the STOP method
STOP Slowing down • Taking three deep breaths • Observing your mind and body (e.g., "Am I hungry?") • Proceed with your day
Define SBIRT and identify why/how it is used in practice. How does it apply to nursing practice/assessment.
Screening, Brief Intervention and Referral to Treatment (SBIRT) is a comprehensive, integrated, public health approach for early identification and intervention with patients whose patterns of alcohol and/or drug use put their health at risk.
Health Belief Model
Self efficacy- belief in ability to complete a task -Helps the health care provider determine the patient's readiness to learn/change behavior -Action occurs based on belief regarding: perceived susceptibility, consequences, benefits, barriers, willingness to change, self-efficacy
What is the difference between managing internal and external stressors? Why/how can each be beneficial?
Stressors in the Inner (internal) Environment • Maybe you cannot change the situation causing you stress right now, but you can change your inner environment by practicing positive thinking, such as being grateful for whatever is good in your situation. • Examples ‐meditating/praying, deep‐breathing, looking for the humor in everyday life. Put things in perspective. Stressors in the external (extrinsic) Environment • Sometimes you can change aspects of your environment that are causing you stress. First, identify what is causing the stress and determine what changes you can make. For example, if you are stressed by your job consider finding a new one, or change the atmosphere at work by rearranging your space, taking a break to walk at lunchtime, or seeking out more positive co‐workers with whom to associate.
What is the Glycemic Index (GI)? Glycemic Load (GL)? What are the benefits of following a diet with lower GI/GL?
The glycemic index rates foods by how much they raise blood glucose. Candy, sugar, cake and cookies have a high glycemic index, while whole-grains have a lower glycemic index.
health education
combination of planned learning activities based on sound theories that provide people the opportunity to acquire the info and skills to make quality health decisions
optimal health
a holistic focus with the aim of attaining the best possible health outcomes by promoting healthier behaviors and not the absence of disease
Describe the nursing assessment focus appropriate for each stage (i.e., , adolescence - eating disorders.)
adolescents: acnea, lots of eating disorders older adult - weight loss, ability to obtain & prepare food, malnourished chewing/swallowing, social isolation
What is an ACE - identify two key findings of the ACE study
adverse childhood experiences 1. ACEs are incredibly common — two-thirds of study participants had experienced at least one ACE category and one in eight individuals had experienced four or more ACEs. 2. The higher your ACE score, the higher the likelihood of developing long-term health problems like heart disease, stroke, cancer, and diabetes.
What is the difference between aerobic exercise and anaerobic exercise? Examples of each?
aerobic- requires oxygen anaerobic- no oxygen
Elder Maltreatment?
an intentional act, or failure to act, by a caregiver or another person in a relationship involving an expectation of trust that causes or creates a risk of harm to an older adult.
Most complete proteins come from which (animal or plant) sources
animal
stressor
any physical psychological, social, or spiritual stimulus that threatens homeostasis
stress
anything that changes homeostasis
Food Desert
areas where people are unable to gain access to healthful foods
Nurse's role in Nutritional Assessment : What assessment data provides nutritional information that the nurse can use to assess nutritional status?
assess nutritional stats including intake of food, tolerance, response identify nutritional risk and make referrals as appropriate teach/provide nutritional info to patients and families
bulemia
ave recurrent and frequent episodes of eating unusually large amounts of food and feeling a lack of control over these episodes. This binge-eating is followed by behavior that compensates for the overeating such as forced vomiting, excessive use of laxatives or diuretics, fasting, excessive exercise, or a combination of these behaviors. People with bulimia nervosa may be slightly underweight, normal weight, or over overweight.
What is Energy Balance? (Intake, expenditure).
balance of calories consumed through eating and drinking compared to calories burned through physical activity
Behavior & lifestyle (SES)
behavioral factors account for about half of premature mortality ex: tobacco use
Education Income and Occupation (SES)
better nutrition housing school and recreation all powerful determinants of health
According to the CDC, what is considered excessive alcohol use? According to the CDC, what is considered "a drink."
binge drinking the most common form of excessive drinking, is defined as consumingFor women, 4 or more drinks during a single occasion.For men, 5 or more drinks during a single occasion. Heavy drinking is defined as consumingFor women, 8 or more drinks per week.For men, 15 or more drinks per week. 12-ounces of beer (5% alcohol content). 8-ounces of malt liquor (7% alcohol content). 5-ounces of wine (12% alcohol content). 1.5-ounces of 80-proof (40% alcohol content) distilled spirits or liquor (e.g., gin, rum, vodka, whiskey).4
physical activity
body movement that increases energy expenditures
impact sodium and caffeine on calcium absorption.
both have a negative impact sodium takes calcium with it in the urines caffeine limits calcium metabolism also increasing loss in urine
To meet daily energy requirements while minimizing the risk for chronic Disease adults (and children) should receive between _______ and ______ % of their Daily calories from a. Carbohydrates: b. Proteins: c.Fats:
calories: 45-65% proteins: 10-30% fats: 25-35%
What are some underlying causes(that you may see in the patients you care for) of negative nitrogen balance
cancer, muscular dystrophy, low protein diet
What are the three (major) energy nutrients? How many kilocalories/gram for each (energy nutrient values).
carbs 17 kj/g ( 1g= 5 kc) protein 17kj/g (1g= 4 kc) fats 37kj/g (1g=9 kc)
water
carries nutrients lubricates, flushes out waste
Role of iron in the body? Identify three factors that may interfere with iron absorption
carries oxygen low iron intake blood loss excess calcium
Gluten free - identify who should be on this diet/why? Common sources of gluten, nutritional risks associated with this diet.
celiac disease, gluten sensitivity, wheat allergy, gluten ataxia. Wheat Barley Rye Triticale — a cross between wheat and rye Oats lack: Iron Calcium Fiber Thiamin Riboflavin Niacin Folate Therefore, following a gluten-free diet will likely change your nutrient intake. Some gluten-free breads and cereals have significantly varied nutrient levels compared with the products they are replacing. Some gluten-free foods also have higher fat and sugar contents than the gluten- containing food being replaced. It's important to read labels, not only for gluten content but also for overall nutrient levels, salt, calories from fats and calories from sugars
Macronutrients
chemical agents that humans consume in the largest quantities, provide the bulk of energy requirements - fats, proteins, carbs (CHO-sugars), water
Health Protection
concerned with preventing the spread of communicable disease by establishing minimum standards
complete proteins
contain an essential amino acid
incomplete proteins
contain some of the essential amino acids
What is the single most important indicator of fluid status in the human body?
daily weights
Hydrogenated oils should be increased or decreased
decreased- they increase LDL
Atherosclerosis
deposits of cholesterol, fat accumulate in the arteries, accompanied by inflammation. Initially soft, hardens over time. Interferes with blood circulation. Leads to CAD/CHD.
Trans-theoretical Model (Stages of Change). What are the stages? How is it used by the nurse? (helps the nurse identify if/when an individual is likely to make a change)
determines where the patient is in relation to readiness to learn/change behavior 1. pre-contemplation 2. contmeplation 3.preparation 4. action 5. maintanance 6. relapse
What is a nutritional intervention for reducing urinary tract infections?
drinking lots of water
What is a common cause of sodium deficiency (hyponatremia)
drinking too much water -HF, KF, cirrhosis
Sources and function of cholesterol
egg yolks, meat, cheese, beef, pork -to make hormones, vit b, and substances that help you digest foods
Who is most at risk for experiencing low rates of health literacy?
elderly, minorities, or uninsured
fats and carbs
energy
What are the major functions of fats in the body?
energy reserve, protects vital organs, isolation, transport fat soluble vitamins
Why do renal patients often suffer from anemia? Why is iron supplementation needed?
failure to make EPO therefore limited RBC
What are the benefits dietary fiber and complex carbohydrates?
fiber- normalizes bowel movements, lower cholesterol, helps control blood sugar complex carbs- more nutrients than simple carbs. higher in fiber and digest more slowly. good for weight control
Using Gordon's Assessment framework How are problems and potential problems defined/distinguished?
focuses on patterns or lack of patterns
What is a protein of high biologic value (HBV)? Source? Provide three examples.
food containing essential amino acids meat fish eggs dairy
What is the Five-hundred Rule? How is it applied?
general guideline for weight loss. 500 calories a day deficit so body requires 2000 and you only consume 1500 or you eat 1750 and exercise for 250 worth
What is the difference (advantages and/or disadvantages of) between abdominal obesity and gluteal-femoral obesity?
gf- more common in women and happens with weight gain ao- men and women and is more related to diseases than gf and contributes to BMI
eustress
good/positive stress
distress
harmful, especially if un-adapted
What is the goal of health Education?
help individuals, families, communities achieve optimal health through their own initiative and action
What are the health benefits of Exercise?
improved quality of life improved mood and sense of well being, improved flexibility, strength and endurance increase bone density help maintain a healthy weight decrease risk of HD, stroke diabetes
Identify the skills nurses use to assist in providing culturally competent care
increase awareness, respect, cultural preferences
Identify recommendations or strategies for improving nutrition at each stage
infant- breast feeding toddler- autonomy, finger foods, single item foods, increase calcium preschool- 4-6 yrs serving size same as adults school age: increase fruit and veggies, decrease fried and fast foods, involve kids in meal prep
Iron deficiency - what populations are at risk for inadequate iron intake?
infants, young children, teen girls, pregnant women, premenopausal women, people with chronic health conditions
Identify the leading causes of injury/death by age group (see CDC link)
injury is the leading cause of death from age 1-44
understand ways that WATER BALANCE is assessed. What is the most common/accurate way to assess water balance? Read about- Intake and Output.
intake and output
disease prevention
intervention to prevent disease state
Social environment (SES)
isolation and the lack of engagement in social networks are strong predictors of health
fiber
keeps hunger and blood sugar in check- regulates body's use of sugar
Access to healthcare (SES)
lack of insurance= less medical care
Food Insecurity: What is the principle of NUTRIENT DENSITY
limited or uncertain of availability of safe, nutritionally adequate food. Nutrient dense foods- provide substantial amounts of vitamins and minerals and relatively few calories
Unsaturated Fats
liquid at room temperature (generally) - source - plant.
Identify the types of skills that Health Literacy includes
literacy skills knowledge of health topics
Give an example of a nurse "modifying the environment" to help prevent injury.
locks on the cabinets to prevent young children from getting into meds
Physical (built) environment (SES)
lower in SES are more likely to live and work in worse physical environments
Benefits of cardiovascular and strength training exercises?
maintain a healthy weight, decrease BP, increase HDL, dec tirglycerides, improved glucose tolerance anddecrease risk of ventricular arrhythmias
Review Dietary Guidelines - goals, do's and don'ts
maintain calorie balance over time achieve and sustain healthy weight- balance energy requirements (intake/ expenditure) focus on consuming nutrient dense foods and beverages 1. prevent of reduce overweight by improving calorie consumption 2. reduce sodium 3. consume less than 10% of daily calories from saturated fat 4.avoid trans fat 5. limit refined grains 6.consume alcohol in moderation 7. increase fruits and veggies 8. consuem 1/2 grains as whole grains 9.increse seafood 10. increase low fat dairy 11. choose foods with more calcium, vit k, potassium, and fiber
Health Literacy affects people's ability to:
make sound healthcare decisions
anorexia nervosea
may see themselves as overweight, even when they are dangerously underweight. People with anorexia nervosa typically weigh themselves repeatedly, severely restrict the amount of food they eat, often exercise excessively, and/or may force themselves to vomit or use laxatives to lose weight. Anorexia nervosa has the highest mortality rate of any mental disorder. While many people with this disorder die from complications associated with starvation, others die of suicide.
Define Calorie Density of foods? (i.e., 1 cup of raisins vs. one cup of grapes). Don't confuse this term with nutrient density.
measure of the calorie content of food relative to its weight or volume.
Vegan - characteristics, benefits, potential risks:
no meat, eggs, dairy, honey- plants only benefits: lowers risk for certain diseases like HD, diabetes,, cancer risks: lose nutrietns such as: protein, calcium, fatty acids, B12, omega 3
Micronutrients
nutrients for humans required in small quantities through out life -trace minerals and vitamins
Cerebrovascular Accident (CVA) commonly referred to as a "stroke" - there are TWO types - know the difference - which is most common?
obstructed blood flow to brain tissue. Ischemic and hemorrhagic ischemic is more common
malnutrition
occurs when the body ingests absorbs and is able to use too few or too many nutrients. loss of balance btw nutritional needs and nutritional intake -a variety of food should be consumed in moderation
List 5 good sources of Potassium
oranges, bananas, cereal, potatoes, dried beans
Exercise
planned, structured, repetitive movement intended to improve or maintain physical fitness
Disease
presence of a recognizable condition (physiological)
Hydrogenation
process of adding hydrogen to the carbon double bonds, thus making the fatty acid saturated
(TED talk) What does the speaker identify as the as the "prescription" for malnutrition?
proper food
What is the relationship between exercise and mental health?
protects against depression, shifts awareness from internal to external environment
Describe Health Belief Model
provides guidelines for nurses to analyze factors that contribute to perceived state of health and probability of change
What is "ChoseMyPlate" and how can it be used?
reminder to find your healthy eating style and build it throughout your lifetime
How is the RDA for protein determined? OR What is the protein requirement for a healthy adult who weighs 150 lbs?
serving size is - 3/4 oz
ecomap
shows the family unit and all the things in the environment that the family members interact with
amino acids
simple subunits made of carbon, oxygen, hydrogen, and nitrogen
What are common risk factors for Sudden Infant Death Syndrome (SIDS)?
smoking, drinking, or drug use during pregnancy, poor prenatal care, stomach sleeping
CHO - major source of energy Identify major sources of "added sugars"
soft drinks, candy, cookies
Saturated Fats
solid at room temperature - source: animal products: less healthy
function of nutrients
source of energy tissue growth and repair regulation of basic processes of the body
Illness
state of being (holistic)- subjective experience of the individual along with the physical attributes of the disease. response.
Define the term health
state of physical, mental, spiritual and social functioning that realizes a person's potential. -individuals responsibility -Collective action to ensure a society and an environment in which people can act responsibly
What is meant by a "Systems" perspective? Developmental Perspective?
systems- family developmental perspective- family life cycle and developmental stage and associated risk factors
(TED talk) Upstream Thinking: What is it and how may it be helpful in addressing health outcomes? How might it guide nursing actions (think finding root causes and being pro-active vs. reactive to health problems).
taking wise collective action to ensure better outcomes rather than simply responding to, and being overwhelmed by, crises we could have foreseen -allows us to prevent further problems and allows it to get to the root of problems rather than treat symptoms
Nutrigenomics
the scientific study of the interaction of nutrition and genes, especially with regard to the prevention or treatment of disease
Nutrigenetics
the study of the relationship among genes, diet and health outcomes
What does the speaker identify as the measure of success for healthcare (prevention vs. cure)?
to go to the root of the problem to cure the person as a whole and not just the symptoms
What is the purpose of evaluating patient teaching?
too see if patient understands and if the plan needs to change, if the goal was met or not
Identify/recognize common cultural differences that may be found among patients you care for. Identify common strategies for communicating when there is a culture/language barrier.
translator listening and understanding removing biases
What is the bodies potential for fat storage? In other words, how much fat (weight) can a human being gain?
unlimited potential
What are some underlying causes of kidney stones? What are nutritional interventions to reduce occurrence of kidney stones?
urine contains more crystal-forming substances — such as calcium, oxalate and uric acid — than the fluid in your urine can dilute.
What is a Dietary Reference Intake ? How many components?
values that are quantitative estimates of nutrient intakes to be used for planning and assessing diets for healthy people 1. Estimated Average Requirements (EAR) 2. Recommended Dietary Allowance (RDA) 3. Adequate Intakes (AI) 4. Tolerable Upper Intake Level (TUIL)
What is Energy Balance?
we should be consuming the number of calories out body requires and uses during the day and if you need to gain or lose weight you should add/limit calories as needed
Calculate BMI
weight (kg) / height (m^2) 18.5 underweight 18.5-24.9 normal 25-29.9 overweight 30+ obese
Who (what populations) is at risk for low levels of exercise?
women, ppl w lower income and educational levels, african americans, ppl with disabilities, and over 75
Identify interventions for Stress management. Describe importance of using stress reduction techniques, role of sleep (sleep hygiene), nutrition, and physical activity in managing stress.
• Identify stress reduction techniques (deep‐breathing, prayer or meditation, journal writing, planning, diversionary activity, self‐ awareness, social support, cognitive‐behavioral restructuring, affirmations) . • Importance of sleep (sleep hygiene), physical activity, and nutrition (caring for physical health) importance of mind‐body connection. • Self‐awareness: includes learning to monitor stress warning signs*, stress inventory. • Identifying Resources
What is the impact of stress on health? (physiological, psychological, socio-behavioral, spiritual)
• ‐physiological - (stress response - increased metabolism, pulse, blood pressure, respirations, muscle tension, sense of awareness, blood sugar levels • ‐psychological - negative mood states, anxiety, depression, anger, hostility. • ‐socio‐behavioral - revert or increase reliance on unhealthy behaviors (over‐eating, alcohol or drug use, smoking) • ‐spiritual - feelings of being disconnected from life's meaning or purpose.
Identify/describe the LEVELS OF LEARNING
•Taxonomies (Blooms taxonomies) for learning help arrange levels of learning according to type and complexity -Knowledge - recall facts -Comprehension - understands the meaning of the concept -Application - uses the concept -Analysis - examine or explain the concept -Synthesis - integrates the concept with other learning -Evaluation - judges or compares the concept