H&W - week 4 (Exam 2)

Ask Me 3 Campaign

1. What is my main problem? 2. What do I need to do? 3. Why is it important for me to do this?

Examples of SDOH domains

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cognitive learning skills

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CASE STUDY: Marie fell last night and broke her hip. She is hospitalized and will need surgery and rehabilitation. Her son, the girls' uncle, will be the primary caregiver for the children until Marie is recovered. Additionally, Marie's sister will be staying with the family to help with household needs. Which family attribute does this represent?

Resiliency

What is Standard 9 of the ANA scope and standards of practice?

Respectful and equitable practice.

Justin and Jacob are a married couple with no biological children. They have two dogs. ​What family form is represented?​

nuclear family

psychomotor learning

occurs when the client develops manual or physical skills. Best teaching methods: demonstration, practice, return deomonstration Ex. the client newly diagnosed with diabetes learns to perform self monitoring blood glucose levels.

cognitive learning

occurs when the client gains information to further intellectual knowledge. Best teaching methods: discussion, lecture, role-play, answering questions Ex. a client with a new diagnosis of diabetes learns what causes this condition.

A healthcare professional is providing health education to an Asian client who is newly diagnosed with diabetes mellitus. The educator notes that the client is nodding yes to everything that is being said. Based on an understanding of cultural attributes in Asian Americans, how should the professional respond?

prompt further to elicit additional questions or concerns

What is standard 5B of the ANA scope and standards?

Health teaching and health promotion

what are the 6 domains for quality healthcare?

1. safe 2. effective 3. patient-centered 4. Timely 5. Efficient 6. Equitable

Family characteristic: Diversity

Each family unit is unique Ex. The family includes two parents, a family friend who needs shelter, and the friend's three children. ​

CASE STUDY: The nurse is teaching the client in the ____ domain and should use ___ discussion.

The nurse is teaching the client in the cognitive domain and should use discussion. ​

cultural desire

You must be motivated as a healthcare professional to engage in the process of becoming more culturally aware, culturally knowledgeable, and culturally skillful. EDAPT: Identifying and understanding one's own background, recognizing biases, prejudices, and assumptions about others. To develop a greater cultural awareness, time needs to be spent in thinking about and discussing various cultural experiences.

what are health concerns for native americans and alaska natives?

alcoholism, tuberculosis, accidents, diabetes mellitus, and heart disease

CASE STUDY: what family form is represented above?

alternative

What are health concerns for african americans?

ardiovascular disease, hypertension, sickle cell disease, diabetes mellitus, and lactose intolerance

which part of provision 9 shows that nurses must have a unified voice to assert shared values?

articulation and assertion of values

what are health concerns for european americans?

cardiovascular disease, cancer, and diabetes mellitus

what are the 3 domains of learning?

cognitive (understanding) affective (attitudes) psychomotor (motor skills)

Nuclear family

consists of 2 adults and sometimes one or more children. Ex. Mary and john live together with their daughter, susie.

extended family

consists of relatives in addition to the nuclear family. Ex. joan and jacob live wit their 2 children and joan's parents

CASE STUDY: Jared begins to recognize that he may have implicit bias against those from other cultures. What is the first step jared should take toward cultural competence?

cultural awareness

CASE STUDY:

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CASE STUDY: A few hours later, Mr. Liu's call bell rings and Jared enters the room with the medical interpreter. Mr. Liu's spouse is sitting on the couch. She states, "You do not need an interpreter. I speak English." Which response by Jared is most appropriate?​

"Mr. Lee is here to help with medical interpretation services in case I say anything that is confusing."​

when educating a client about diabetes, what factors should be considered regarding their health literacy?

1. socioeconomic status 2. age 3. primary language spoken 4. level of education completed

what are health concerns for latino americans?

heart disease, cancer, diabetes mellitus, accidents, and lactose intolerance

Using the nursing process with cultural differences

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You are in a health fair and are asked by a participant to explain an abnormal blood sugar. Put the following items in the proper sequence you would use to teach this client.

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psychomotor learning skills

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Sally and Tommy are an unmarried couple living together with Sally's child from a previous relationship. Sally is currently pregnant. Tommy's brother is living with the couple. ​ What family form is represented?

Alternative

what is stereotyping?

An assumed belief regarding a particular group that we must avoid. For example, assuming that all people from a certain country are rude. ​

what are the consequences of low health literacy?

1. increased incidence of chronic conditions 2. poor self-care 3. increased emergency room visits 4. increased hospital admissions 5. increased medical costs

A father and his two children are experiencing homelessness. Which statement best describes the effects of homelessness on children?

1. more cavities and dental problems 2. lack of recommended immunizations 3. higher incidence of asthma

CASE STUDY: Select all the indications that show the two young girls have endured adverse childhood experiences (ACEs). ​

1. mother died in a car accident last year 2. father has been incarcerated for the past 3 years 3. abusive to their mother

Adverse childhood events (ACEs) can have a significant impact on future health. What are the adverse effects of ACEs?

1. poor self control 2. problem avoidance 3. decreased self-esteem 4. pessimistic thinking

Provision 9 of the ANA code of ethics

1. Articulation and assertion of values 2. Integrity of the Profession 3. Integrating social justice 4. Social justice in nursing and health policy "The profession of nursing, collectively through its professional organizations, must articulate nursing values, maintain the integrity of the profession, and integrate principles of social justice into nursing and health policy"

A healthcare professional is using an interpreter to communicate with a client. Which actions are appropriate when working with an interpreter? Select all that apply. ​

1. Avoid medical terminology and jargon 2. after the encounter, thank the client and interpretor 3. use short sentences and pause periodically for clarification.

CASE STUDY: what could Mary do to correct her errors with the interpreter.

1. seek clarification frequently 2. pause periodically to allow for interpretation 3. use short sentences 4. speak directly to the client

CASE STUDY: Stacey Simpson, a registered nurse in a medical clinic, is preparing to teach a client information about heart-healthy eating due to a recent diagnosis of cardiovascular disease. The 62-year-old client is unemployed with a hearing deficit. The client's preferred learning style is written materials. The client lives alone and has no support system. ​ Stacey begins to prepare the room for the teaching session. What should the nurse consider? Select all that apply. ​

1. Privacy 2. distractions 3. noise level 4. furniture placement 5. temperature

What are the 4 C's?

1. What do you CALL the problem you are having. 2. How do you COPE with the problem? 3. What are your CONCERNS about the problem? 4. What do you think CAUSED the problem?

CASE STUDY: Amelia Sanchez is a registered nurse working in a local health clinic. The surrounding community is largely immigrant, and many children are unvaccinated. Additionally, the community has seen a 10% increase in tuberculosis cases in the past year. Despite the availability of health services within very close proximity to the community, many residents are unaware of these services. ​ Question 1 / 2 Which actions may best serve this community?​

1. Working with community leaders to ensure public transportation stops near the clinic ​ 2. Raising awareness about community health and prevention resources 3. Teaching community classes about health promotion strategies

CASE STUDY: After the surgery, Marie is discharged to her home with a home health nurse to visit weekly. The home health nurse determines that Marie's son is struggling with caregiver role strain.​ What actions by the nurse may be beneficial?

1. describe the importance of accepting assistance to give the primary caregiver rest. 2. provide info about community resources, such as support groups and childrens day camps. 3. provide contact info for nursing and healthcare providers to call with questions or concerns.

What are the social determinants of health?

1. education access and quality 2. healthcare access and quality 3. economic stability 4. neighborhood and build environment 5. social and community context

CASE STUDY ABOVE: How does using a systematic process to plan client education assist the nurse?

1. identifies targeted information that is individualized for the client 2. determines what the client already knows about a health topic before teaching 3. allows the nurse an opportunity to assess the clients health literacy

What is explicit bias?

A bias that we are aware is present and are responsible for; we must recognize and acknowledge our actions as they impact behavior, decisions, and patient-centered care provided. This type of thinking is slow, logical, effortful, conscious thought, where reason dominates. For example, feeling threatened by another group and delivering hate speech as a result.​

Case study using the clinical judgement model

A client is a smoker from a country where it is socially acceptable see photo

Adverse childhood events (ACEs)

Adverse childhood events are potentially traumatic events occurring during childhood that can affect brain development and how the body responds to stress. ​

A healthcare professional is practicing cultural competence to improve care. Which step should the professional take first?​

Assess own biases and attitudes

CASE STUDY: At the end of the shift, Jared reflects on what he has learned today through his interactions with Mr. Liu. Which reflection best describes Jared's experiences?​

Developing cultural competence is a process that occurs over time.

what is ethnocentrism?

Evaluation of other cultures according to preconceptions originating within one's own culture. For example, a nurse states that she treats all clients just as she would want to be treated.

Family characteristic: Dynamic

Family interactions are affected by family configuration, structure, function, problem solving and coping capacity. Ex. Last month, the family was well fed and both parents were working. Today, one parent lost their job and is unable to afford the rent. ​

What is cultural identity?

How individuals identify consciously or unconsciously with those whom they feel a common bond because of similar traditions, behaviors, values, and beliefs.​

CASE STUDY ABOVE: Which part of Provision 9 of the American Nurses Association (ANA) Code of Ethics is Amelia displaying through her actions?​

Integrating social justice

What factor may result in an increased likelihood of developing an acute or chronic health problem?​

Limited access to healthcare clinics providing prevention services​

CASE STUDY: Which outcome would indicate that Carmen's efforts to reduce health disparities have been effective?

No clients are treated for frostbite in the E.D. for the past 3 months

What is acculturation?

Occurs when an individual or group transitions from one culture and develops traits of another culture, but still retains unique cultural markers of the original culture. For example, an Asian couple recently moved to the U.S. and have adapted to a new cultural norm in preparation for the birth of their first baby. ​

A healthcare professional is providing care for a culturally diverse population. Which action indicates the professional is successful in the role of providing culturally competent care?​

Provides care that fits the client's valued life patterns and set of meanings

social determinants of health are ____ that have considerable impacts on health. Health disparities are ____ in a population's ability to achieve optimal health.

Social determinants of health (SDOH) are external factors that have considerable impacts on health.​ Health disparities are preventable differences in a population's ability to achieve optimal health.

Family characteristic: Resiliency

The ability to cope with expected and unexpected stressors Ex. A single parent becomes ill with colon cancer. The adolescent son steps in as primary caregiver to the younger siblings. ​

Family characteristic: Durability

The ability to withstand pressure and form a system of support. Ex. One parent dies when the children are very young. The remaining partner remarries and the children form a bond with the stepparent. ​

Upstream factors

The affect communities in a large and inequitable way. Example: A nurse advocates for community funding to reopen the nighttime shelter Example: The nurse meets with elected community officials to advocate for more affordable housing options.

what is enculturation?

The process by which an individual learns the traditional context of a culture and assimilates its practices and values. For example, a Hispanic grandmother teaches her granddaughter about their culture and customs.

What is assimilation?

The process in which an individual adapts to the host's cultural values and no longer prefers the components of the origin culture; after this process, there is no identifiable minority culture. For example, after immigrating to the U.S., a young adult changes the way they dress and behavior to fit into the new culture. ​

CASE STUDY: After the teaching session, Stacey uses the teach-back method to evaluate the client's learning. What are the benefits of this method of evaluation?

The teach-back method of evaluation can be used for all clients in any setting and helps:​ 1. Improve client understanding (not decreases) and adherence to instructions​ 2. Identifies misconceptions and confusion​ 3. Decreases call-backs and hospital readmissions​ 4. Improves client satisfaction and outcomes​

Downstream factors

They represent immediate health needs of the population. Example: A nurse hosts a winter coat drive and provides donations to the local hospital to distribute to clients treated for frostbite. Example: The nurse works with the local health department to increase the availability of allergy and asthma treatments for high-risk populations.​

cultural awareness

You must be aware of your own view of the world and biases toward other cultures. This is the first step toward becoming more culturally competent.​ EDAPT: Ability to assess factors that influence client treatment and care. Acquired through the practice of communication. One example is learning a different language.

cultural encounter

You must engage in face-to-face cultural interactions with clients from culturally diverse backgrounds to modify existing beliefs and prevent possible stereotyping. EDAPT: Motivation and willingness to learn from others. Be open-minded to learn about cultural differences. Accept learning about others as part of your professional nursing role.

cultural skill

You must learn how to conduct a cultural assessment and collect relevant cultural data about the client's presenting problem as well as conduct a culturally sensitive physical assessment. EDAPT: Develops through exposure to other cultures. This exposure can be through reading, travel, movies, visits to ethnic neighborhoods and restaurants, attending ethnic celebrations, speaking with persons from other cultures, and attending religious events outside your own religious affiliation.

cultural knowledge

You must seek and obtain knowledge about culturally diverse groups, particularly health-related beliefs and cultural values, care practices, and disease incidence and prevalence. EDAPT: Interactions to learn about other cultures. Acquired through caring for culturally diverse populations across the lifespan.

what is implicit bias (unconscious bias)?

a bias we are unaware of and that happens outside of our control, which is influenced by our personal background, cultural environment, and personal experiences. Implicit biases are prejudices and stereotypes that we act upon without intending to do so. This type of thinking requires little effort but is often prone to error. For example, activities like driving, talking, and cleaning use implicit bias.

CASE STUDY: Ted and Rhonda are a married couple. Ted has three children from a previous relationship that are grown and living independently, while Rhonda's son still lives at home. Ted recently suffered a stroke and has been hospitalized. Last week, he came home but still requires a lot of home care. ​What type of family is represented?

blended family

single parent family

formed when one parent leaves the nuclear family because of death, divorce, desertion, or when a single person decides to have or adopt a child.

blended family

formed when parents bring children from a previous relationship into a new joint-living situation

Family caregivers are more likely to suffer from declining health. Which disorder is most common?​

depression

health concerns for asian and pacific islander americans

hypertension, cancer, diabetes mellitus, accidents, and lactose intolerance

what is culture?

learned and shared beliefs, values, norms, and traditions of a particular group, which guide thinking, decision making, and actions.

alternative family

may include multi-adult households, grand families, communal groups with children, adults living alone, and cohabitating partners. Ex. Sandy and Jennifer live together with their adopted son dakota.

A client recently purchased a home in an older neighborhood where lead paint was used. The client has two young children. The client decides to take the children to a local community clinic's lead screening program. Which Healthy People 2030 domain to mitigate social determinants of health is this clinic addressing?​

neighborhood and built environment

CASE STUDY: Which social determinant of health domain should be Carmen's primary focus?

neighborhood and built environment

Affective learning

occurs when the client changes their attitude, feelings, values, or motivations about a topic. best teaching methods: role-play, discussion Ex. The client newly diagnosed with diabetes mellitus learns coping skills to accept the lifestyle changes necessary to manage health. Receiving, Responding, Valuing, Organizing, Characterizing

CASE STUDY: For each observation, click to specify if Ted and Rhonda are demonstrating resilience or crisis. ​

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CASE STUDY: select the mistakes that the nurse used with the interpretor

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Drag and drop the nursing action to match with the correct social determinant of health classification. ​ ​

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Education standards: A client was just diagnosed with a urinary tract infection. Match each standard below with the statement that meets that standard.

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Recognizing cues case Study. Select the cues that indicate health disparities in the community

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Barriers to learning match up

see photo Barriers for this client include:​ * Unemployed (low socioeconomic status)​ * Hearing deficit (sensory perception deficit)​ * No support system (no one in the home to reinforce teaching)​ Barriers to learning include any physical, psychological, or socioeconomic factors that may impede a client's ability to learn. ​

what are health concerns for arab americans?

sickle cell disease, thalassemia, cardiovascular disease, and cancer

CASE STUDY: Carmen believes her clients deserve equal rights and opportunities, including the opportunity to reach their full health potential. What professional value is Carmen displaying?​

social justice

What best defines this statement "I find that most hispanic immigrants live in unsanitary conditions but are hard workers."

stereotyping

Midstream factors

they represent social needs or individual factors that affect a persons health. Example: A nurse organizes a free health fair in the community, offering immunizations and health screenings. Example: The nurse works with clients to improve substandard housing. ​