Human Exp FINAL

What are the CDC's Prevention roles?? (3)

1. Registers all communicable diseases 2. Investigates and sets guidelines from prevention/spread of communicable diseases 3. Implementing Standard Precautions: set of actions designed to reduce transmission

What are the two groups of classification for the Folk Medicine System?? What are some FOLK Health Care Characteristics??

Folk medicine system classifies into two groups natural and unatural and focuses is on personal data instead of scientific pursuasion. ----Folk---- Social and religious Combines mental and physical Community oriented Familiar surroundings Humanistic care Emphasizes caring Cultural care, prevention Moderate cost

When assessing Health what factors should you look at??

Individual Family Community

What are some costly health care cost

$100 million - OBESITY $150 billion - DIABETES $200 billion - CANCER $300 billion - HEART DISEASE

What are some ways to promote effective communication??

----------Awareness: •Acknowledge the presence of the client •Attending behaviors shows that you are paying attention and listening to what the client is saying •Examples: o Facing the client, leaning toward the client o Using appropriate eye contact o Keeping your eyes open with eyebrows raised o Maintaining an open body posture and body position in which the arms and legs are uncrossed --------Acceptance, Respect, and Unconditional Positive Regard: •Acceptance is openness to the unique qualities and attributes of individual clients. •Accept clients for who they are, even if their behavior is undesirable •Does not mean condoning inappropriate client behaviors ----------Respect: •An attitude of acceptance •Includes: Valuing, highly regarding, or esteeming clients or who they are. •Unconditional positive regard •Respect for the client does not depend on the client's behavior, you learn to value and care for clients simply because their humanity warrants your care ----------You avoid being critical: •Avoid being derogatory, or judgmental ----------Empathy: •Ability to "be in the other person's shoes" w/out taking on the client's feelings or thoughts •Accurate perception of the client's feelings •Not sympathy, wherein you feel pity or compassion for the client •Sense of understanding or "being with" the client. ----------Relatedness: •Recognition of similarities between you and the client and the forging of emotional connections based on those similarities ----------Caring: •Taking an emotional risk to feel a personal interest in the client's welfare ----------Objectivity: •An unbiased, reality-based stance that allows you to assess the facts of a client's situation w/out being emotionally pulled into the client's difficulties. -----------Protectiveness: •Leads you to shield the fragile and vulnerable client during the person's recovery from illness. •Protectiveness is a caring attitude that should be used judiciously while you continue to evaluate the client's capacity to defend the self ------------Genuineness: •Ability to be honest, open and sincere in self-presentation. •The phrase, "what you see is what you get" describes the demeanor of a genuine person ------------Openness: •Being open w/ a client reflects your ability and willingness to be real, genuine, and emotionally accessible ---------Professional Closeness or Distance: •Delicate balance between maintaining objectivity and professional distance, and the warmth, openness, and availability associated w/ professional closeness •Care about your clients and allow yourself to know their concerns, but it does not mean taking their thoughts, feelings, or attitudes as your own ------------Sense of Humor: •Appreciation of the humorous side of life can be desirable attitude in nurses

What are the 4 types of communication styles???

------Assertive: stands up for them but does not infringe on the rights of others—expresses feelings honestly and directly—can communicate both positive and negative feedback •Use "I" statements when sharing information. This respects the other person's viewpoint -------Aggressive—angry, dominating, puts others down, superior attitude, manipulative, demanding -------Passive—lets others push them but feels hurt and anxious about the communication—unable to share their feelings or needs and has difficulty asking for help -------Passive aggressive—sometimes they will say they will do something, but never actually do it. Usually cannot share direct feelings and unable to say "no" upfront, but then will undermine other's efforts to complete the project or tasks.

What are some Health Practices assessments?? What about Illness practices??

------Health Practices----- Physical fitness evaluation Health risk appraisal Social support systems Lifestyle assessment ------Illness Practices ---- Knowledge of disease Disease history History of assessing health care resources Treatment and preventative measures Adherence with treatment regimen

What are some interventions of Motivate Health Behaviors?? and Provide Supportive Care??

------Motivate Health Behaviors------- Increasing knowledge level Clarifying values Engaging participation Anticipating problems Providing reinforcing factors -----Provide Supportive Care----- Establish a therapeutic relationship Guide client through health system Planning for discharge Referring to health services Promoting social support

What are some important characteristics of the Health Promotion Model??

---People will not invest in a goal they find impossible to achieve. ----Self-efficacy and environmental influence determine likelihood of change. -----Value expectancy: the idea that a person has of whether a behavior is rational & economical.

Components of Food--Provider of calories for energy via proteins, fats & carbohydrates (CHO)

--CHO --protein --fat (lipids) --water --fiber --vitamins --minerals & trace elements CHO- stored as glycogen in the muscle tissue. And CHO are 4 calories per gram. Protein- contain amino acids essential and non essential also 4 . Fat- triglycerides- 9 calories per gram. Need to try to take in less fat. Water- human cells consist of 65-95 percent water. Fiber- good thing about it it gives us a delayed absorption of glucose lower serum cholesterol. prevent diverticulosis. Vitamins must be obtained from foods. Water and fat soluble vitamins. Min- regulate our electrolyte balance, acid based balance. Complex carbohydrate- need to be taken in more than simple carbs. They contain whole grains like whole wheat bread, brown rice. They are higher in fiber. If you can take in more of these then you can delay the absorption of glucose it won't attack our insulin levels and cause it to go into overtime.

What are some important characteristics of the Health Belief Model?? (4 Components, What people feel about change, etc)

--Explains why some people act to prevent / treat illness while others do not. --People will change if they feel that the benefits outweigh the risks. --4 Components: Perceived severity Perceived benefits Perceived barriers Self-efficacy

What are some things we can look at to get a nutritional status of the patient???

-Recommended Dietary Allowance (RDA) - BMI = weight(kg) ÷ height2 (meters) - Midarm circumference & triceps fat fold- -Hydrostatic weight & Displacement plethysmography RDA the level of nurtrient that is adequate to meet the levels of all healthy people. Our body mass index BMI is not accurate in people who have large muscle mass. MCTFF determines how much fat there is. Hydrostatic is the gold standard.

What is an optimal measurement for the waist-to-hip ratio??

.8 or less anything higher could indicate that you are at risk for diseases.

What are the categories of the 3 Major sleep disorders?? Give examples of each?

1. Dyssomnias: Altered amount, quality, timing of sleep. characterized by excessive sleepiness or insomnia. EX-Insomnia- Hypersomnia Narcolepsy Sleep apnea Restless leg syndrome Sleep deprivation 2. Parasomnias: abnormal behaviors or movements during sleep. patterns of waking behavior that occurs during sleep EX-Somnambulism-slow wave sleep parasomnia associated with stereotypical sleepwalking behaviors. Wake up with glassy eyes make body movements and walk around. Safety is a important ------Sleep terrors-also known as night terrors occur slow wave sleep characterized by arousal and aggitation and the sympathetic nervous system activity.pose little danger to the sleeper. Thrashing, kicking, gargled speech, sleeper often looks terrified and screams. They usually just return to sleep. Highly due to time of stress. ------- Bruxism-KNOW THIS ONE.. On the test. Violent repetative grinding of the teeth occurs during lighter stages of sleep and makes a loud unpleasant sound. It is pretty loud. Damaged teeth and jaw pain can occur usually lasts 5 seconds. Treat with a rubber mouth guard over mouth so you can grind. --------- Enuresis-bed wetting during sleep. Sleepers wake up to find themselves in wet bed clothes. About 1-3% of adults have this treatment includes tricyclic antidepressants TOFRANILE. Tell pt to be careful to not be in prolonged sunlight. Due to the medication. Also restrict fluids at night. Sensitive to sunlight. duemed ------- Sleep-related eating disorder- eating while asleep 3. Medical or Psychiatric illness EX.-Bipolar Disorder Anxiety Disorders Alzheimer's sundown syndrome Gastric Reflux Disease Chronic medical conditions (CHF, COPD)

What are the 3 types of Dyssomnias?? What is sleep apnea?? What can be done for this??

1. Intrinsic - primary disorders, insomnia, sleep deprevation, narcolepsy, sleep apnea, restless leg syndrome 2. Extrinsic - Secondary disorders due to environmental facts like drugs and alcohol 3. Circadian rhythm: Shift work and jet lag Insomnia- characterized by subjective sense that sleep is poor and inadequate. Sleep Dep- not getting enough sleep awakening usually has REM sleep deprivation. Narcolepsy- striking hypersomnia abnormal sleep tendencies and pathological REM sleep manifested by excessive daytime sleepiness, disturbed nighttime sleep. *Characterized by loud snoring , another primary dipsomania has serious consequences, then you quite breathing for a moment during sleep and will arouse the person in sleep. Increase incident in middle and older age. IT can be fatal. If you have obstructive sleep apnea. You can use a oral device Cpap or Bypap machine during sleep can be used also surgery can be done to help with this. CPAP- Continuous positive airway pressure. Use it every night is something that people need to do when using one of these machines. Weight gain and obesity can cause sleep apnea as well. Treatment for sleep apnea focus on maintaining an open airway during sleep.

What are the Phases of Therapeutic Relationship???

1. Pre-Orientation a. Nurse anticipates what the client needed to maximize the impending meeting (gathering supplies, prepping room, etc) 2. Orientation a. Trying to establish trust. Honest from the start. Establish goals and set limits. 3. Working a. Nurse analyzes results. Help the pt. express feelings. Working together towards goals. Looking at community resources. Doing the care, giving the meds 4. Termination a. Discharge planning begins at the very start. Acknowledging early what to expect

Explain some important information about the Theory of Reasoned Action??? What does this theory explain?? What are some Assumptions? and Behavioral Intention?

1. Theory of Reasoned ActionExplain a person's intention to perform a behavior. ASSUMPTIONS People are reasonable People will systematically process & use available information Behavior is totally under voluntary control Barriers to performance of intended behavior do not exist. BEHAVIORAL INTENTION Determined by person's attitude toward a specific behavior Influenced by subjective norms (what others think

What are 10 Leading Health indicators of Healthy People 2010-2020

10 Leading Health Indicators are: Physical Activity Nutrition and Overweight and Obesity Tobacco Use Substance Abuse Responsible Sexual Behavior Mental Health Injury and Violence Environmental Quality Immunization Access to Health Care ***For each leading health indicator there is a general objective with several specific target statements. Because the target statements include specific percentages they are measurable and can be used for comparing progress (or not) in the future.

What are some historical trends in the US throughout the years?? (1900's,1950's, 1980's Now)??

1900's - Healthy or ill concepts Conquer the most prevalent diseases 1950's - Less death from acute disease Antibiotics & immunizations 1980's - Prevent illness and prolong life Change behavior and health habits to reduce chronic disease Now - Comprehensive Program of Health Promotion and Disease Prevention

What are the 3 elements of a therapeutic relationship?? Explain/ define these terms Encoder Message Sensory Channel Decoder Content Feedback

3 Elements of a Therapeutic Relationship: 1. The Nurse 2. The Client 3. The Communication between the nurse and the client. •Encoder - the sender. This person initiates the transaction to exchange, to convey thoughts or feelings, or engage another person. •Message - content the sender wishes to relay. Must be encoded in language/cues that are both understood by sender and receiver •Sensory Channel - How we send it. Visual, Auditory, Kinesthetic •Decoder - Person must be able to decode the message sent. •Content - condition under which communication occurs.

How many of the 10 leading health indicators are lifestyle related?? What are they??

6 of the 10 leading health indicators are lifestyle related: Physical Activity Overweight and Obesity Tobacco Use Substance Abuse Responsible Sexual Behavior Immunizations

Healthy People 2010-2020 HealthIndicator Related to Health Promotion

Access to Health Care: Improve access to comprehensive, high-quality health care services This will include an increase in the number of health care professionals and a decrease in hospital stays due to chronic disease. This will include access to all for emergency care, trauma care, and long term care.

What is Secondary Prevention?? Give an example?

Actions that focus on early diagnosis and prompt treatment of health problems Examples: Screening programs Emergency response/care The illness or injury has occurred but there are no complications Newly diagnosed patient with high blood pressure that does not have any damage to his heart or cardiovascular system Pap smear, testicular, HIV screening, exam these are screenings. Family counseling is secondary because we are trying to screen something.

What is Primary Prevention for Health?? Give an example. What is Preventive Health care??? What is true prevention??

Actions that focus on the prevention of health problems There is no diagnosed dysfunction of disease at the time of the action Examples Exercise &/or eat well to stay healthy Identify high risk groups & intervene, such as immunization programs, drug education programs in grade school before drug use has begun, how to prevent pregnancy to those who are not pregnant. Immunizations are primary ex. Shingles immunization. Preventive health care---The recognition of the risk of disease and the actions taken to prevent that risk. True prevention- actions that focus on true prevention. true prevention so the disease does not happen.

What is Tertiary Prevention?? What are some examples??

Actions to minimize the effects of a permanent, irreversible disease and/or disability, prevent complications and deterioration Example: Rehabilitation for CVA IF grandma broke her hip but then goes to rehabilitation to help her walk again this is secondary not tertiary. Must be PERMANENT!!! If we go teach a bunch of pregnant teens about pregnancy then this is tertiary because they are ALREADY pregnant. Diabetes that is a chronic illness and other chronic illnesses that are not debilitating are secondary if the patient becomes permanent disabled such as loose a leg then they are now tertiary

What is the difference between aerobic and anaerobic exercise?? Behavior modification programs--appropriate nursing actions

Aerobic Exercise: (cardio) exercise that promotes cardiovascular fitness; it increases blood flow, heart rate, and the metabolic demand for oxygen over a period of time o Jogging, swimming, cycling, etc. Anaerobic Exercise: exercise in which the supply of oxygen is less than the demand created by contracting muscles; oxygen debt results o Power lifting, sprinting, etc. -----Assumption behind behavior modification • Overeating is a learned disorder • Critical difference between an obese person and a non-obese person are cues that regulate eating behavior • Goal is to deemphasize diet and focus on how and when a person eats • Has been successful helping people maintain weight loss • Useful basic techniques o Self-monitoring: Show what and when foods are eaten o Stimulus control: Separate events • That trigger eating from the act of eating o Rewards: Incentives for weight loss

What are the lab tests for nutritional status??

Albumin Prealbumin Lymphocyte count Transferrin Hematocrit (HCT) Urine Specific Gravity Blood Urea Nitrogen (BUN) Creatinine Hemoglobin (Hgb) Total Cholesterol LDL (Low Density Lipoprotein) HDL (High Density Lipoprotein) Triglycerides (fasting state) *Al-viceral protein status used for long term monitoring. Pre-indicative of our viceral status and it is used for short term monitoring. Lym-tells about our immune function. Tells us the risk of dev a disease. Tran- iron status, protein for iron absorb and transport. Hema-keep in memory bank!!!! Percentage of blood that is composed of the red blood cells. If it is low then it could be deficiencies in iron, B12 or acid. Might means there is bleeding inside or destruction of red blood cells. Anemia can be caused by cancer etc. urine- this tells us if we have a fluid def or excess. Indicates high ratio status the higher it is you will have concentrated urine. This can tell you that there is dehydration. If it is less concentrated then the patient is overhydrated. Normal is 1.010-1.020 or 1.030(depending on which book you are looking at) BUN- measure amount of nitrogen in the blood that comes from urea waste product. Urea make in liver and passed out of urine. The BUN will increase with excessive exercise or prolonged bed rest meaning the body is breaking down protein. If patient has accute kidney failure increased levels would show. Creatini- food is changed into energy and broken down into creat and passed through the urine. Hemog-measures ability of blood to carry oxygen throughout the body. Low levels will show def in iron folate and vit B12. Total-desirable less than 200. tells us the risk for heart disease. If you are over 200 the dr is going to put you on medication to lower your cholesterol. Your LDL-want it to be low because it is the bad cholesterol- less than 100. we want the HDL to be high it is the good cholesterol. Males- 40-50 females -50-60. want it to be in the high range. Cholesterol is often times genetic. Genetics play a large percentage of passing this onto offspring. Tri- when these are drawn it needs to be in a fasting state for accuracy. Less than 150 mg /deciliter - diabetics have high tri-levels.

What are some ways to keep communication clear???

Asking for clarification Restating Seeking validation Events in sequence Silence Offering of self **Keeping communication clear is important. The nurse can ask for clarification. Suggests ways to make the message clear restate what the client says . Seeking validation- to make sure a certain terms mean the same thing. Ex. Lethargic- means almost comatose but the client might mean she is sleepy. Events in sequence Add Providing Silence. The nurse allows the conversation to stop to allow quiet meditation. And OFFERING OF SELF- nurse offers to stay with the client and offers to talk or to just sit quietly. Events of sequence- ex we are going to take a shower after physical therapy etc

What are ineffective therapeutic regimen -contributing factors??

Assessments: pt. reporting difficulty in carrying out proposed activities on in making choices to incorporate these activities of the regimen into daily living, or the pt. may report making no attempt to incorporate these activities into patterns of daily living. Interventions: • Increasing knowledge level, clarifying values, engaging participation, anticipating problems, providing reinforcing factors Evaluations: pt. agrees to participate in therapeutic regimen. R/T mistrust of traditional healthcare personnel Acceleration of illness symptoms; inappropriate activities for meeting health goals; failure to take actions to reduce risk factors; lack of attention to illness; verbalizes desire to manage the illness; verbalizes difficulty with therapeutic regimen

What is important when communicating with adolescents?? What about parents or significant others?? Elderly??

Be calm open minded. Avoid criticizing, and prying. Don't give advice educate Be informed and prepare to repeat the information. Include the family in goals. Provide emotional support for families. Consider their sensory deficits. Provide ample time for informing. Remain calm. Allow them to reminisce.

What does CAM and CAT stand for??

CAM -Complimentary and Alternative Medicine CAT - complimentary and alternative therapies ( unconventional practices used in addition to medicines. According to the National Institutes of Health, CAM use in the United States continues to increase

What are some factors that affect change???

Change is a Complex Process and many patients do not want to change. Think about something you have changed in your life and how hard it was to keep that change permanent. Factors that affect change are: Communication Cognition and Perception Age and Developmental Level Lifestyle and Habits - Economic Resources Cultural Values and Beliefs - Environment Roles and Relationships Coping and Stress Tolerance

Evaluation for Lifestyle and health behavior???

Client must be reassessed for progress toward desired outcomes Establish new goals Identify barriers if no change occurs or outcomes are not achieved

What are Factors Affecting Behavioral Change???

Communication Cognition and Perception Age & Development Level Lifestyle and Habits Economic Resources Cultural Values and Beliefs Roles & Relationships Coping and Stress Tolerance Workplace and Environmental Conditions

What are some factors that affect sleep?? Tell whether the following statement is true or false. Barbiturates, amphetamines, and antidepressants increase REM sleep. A. True B. False

Developmental considerations-ex. If a babies diaper is wet. Motivation Culture Lifestyle and habits- caffine Physical activity and exercise Dietary habits Environmental factors- too hot or too cold, ex being in a hospital Psychological Stress- emotional stress Illness-stuffy nose, pain Medications-some can hype you up. *Rationale: Barbiturates, amphetamines, and antidepressants decrease REM sleep. ANSWER IS FALSE

What are some things that could modify communication?? What could you do in these situations??

Dysphasia or aphasia respiratory distress You could alter the questions to where they can squeeze your hand for level of pain (example)

What are some Psychosocial factors to overeating?? What is the difference between primary obesity and secondary obesity??

Emotional component to overeat is powerful People use food for many reasons Social component of eating is developed early in life *Primary obesity is Simply taking in to many calories than using. Secondary is a chromosome problem, central nervous problem, growth hormone issues, oral contraceptive, hypothyroidism, these are secondary most are usually primary obesity.

What are some Non-Western World Views??

Emphasizes group cooperation Achievement as it reflects on the group Harmony with nature Accepts affective expression, embraces extended family, thinks holistically. Religion permeates culture Emphasizes social orientation

Therapeutic Communication-- Ways to enhance therapeutic communication?? What are some therapeutic techniques??

Encourages clients to open up and speak more freely Enhancing Therapeutic Communication: • Beginning the interaction - provide broad openings • Continuing the interaction - providing silence, generally leads to convo going forward • Concluding the interaction - summarizing the convo. Encouraging the formulation of a plan of action. Therapeutic Techniques •Beginning the interaction a. Offering self b. Providing broad openings c. Making observations d. Suggesting collaboration •Continuing the Interaction e. Providing silence f. Accepting messages g. Providing general leads h. Exploring i. Focusing j. Active listening k. Passive listening •Concluding the interaction l. Encouraging formulation of a plan of action m. Summarizing

What is Rapport?? Who is it easy to have this with? Who should you have this with??

Essentially the same as "mutuality" with understanding, confidence, respect and harmony. Essential bond between nurse and client. It is easy to have Rapport with people of the same qualities-christian, jewish, etc. Don't be Bias Have rapport for everyone.

What are the worldviews of health??

FOLK and SCIENTIFIC! ----------FOLK---------- Illnesses are classified as Natural or Unnatural Often used to treat chronic illnesses or those thought to be supernatural Based on the individual and experiences Help sought from multiple sources, including family ----------SCIENTIFIC---------- Emphasis on cure Uses a scientific base Takes into consideration biology, psychology, spirituality, culture and social factors to explain illness

What are some general nutrition recommendations??? To reduce risk of disease (stroke, heart disease, cancer, etc)

Fat Sodium Calcium Avoid alcohol Fluoride intake: Fats should be 30 % or less of our intake. Saturated fat should be less than 10% our sodium needs to be limited to prevent hypertension. Less than 6 g per day. avoid alcohol- Calcium- promote bone growth- fluoride-prevent tooth decay Periodontal can be associated with disease. Grains - 6 ounces/day Vegetables - 2.5 cups/day Fruits - 2 cups/day Milk - 3 cups/day (2 cups for ages 2-8 years) Meat/Bean - 5.5 ounces/day

What are health disparities related to Healthy People 2010-2020 goals??

Health disparity- refer to gaps in the quality of health and health care across racial, ethnic, sexual orientation and socioeconomic groups: • Race or ethnicity, sex, sexual identity, age, disability, socioeconomic status, and geographic location • A particular type of health difference that is closely linked w/ social, economic, and/or environmental disadvantage

Define These Terms- Health Perception Health Promotion Health disparity Wellness Disease Illness (Acute and Chronic) Morbidity Mortality Lifestyle health Primary Health Care

Health perception- the knowledge and experience of one's state of wellness and well being Health promotion- the advancement of health through the encouragement of activities that enhance the wellness of individuals, families, and communities Health disparity- refer to gaps in the quality of health and health care across racial, ethnic, sexual orientation and socioeconomic groups Wellness- state of optimal health or optimal physical and social functioning Disease- specific disorder characterized by a recognizable set of signs and symptoms and attribute to heredity, infection, diet, or environment. Illness (acute and chronic)- Acute illness - sudden onset and short duration Chronic illness - extended time, often the person's lifetime Morbidity- A state of wellness, disease, or abnormal condition, which examines the number of people who develop a certain condition per yea Mortality - The state of being mortal. This identifies the number of people who die from various causes each year. Lifestyle- a behavior/ group of behaviors chosen by a person that may have influence on health Health: state of complete physical, mental, and social welling being, and not merely as the absence of illness. (WHO definition) Primary Health Care - ALL care necessary to people's lives and health. (Health Care for ALL)

What are some Diagnosis when it comes to behavioral change and lifestyle management??

Health-seeking behaviors Ineffective health maintenance Noncompliance Deficient knowledge Decisional conflict Ineffective therapeutic regimen management

What is transference?? What is counter transference??

IF you have any terms in slides KNOW THEM Transference-unconscience thing where the nurse reminds the client of someone else. Feelings associated with the prior person comes off onto the nurse. It can be positive or negative. Feelings from these prior experiences become present in situation. Clues can be found in comments Same as transference but in reverse. It is the client that reminds the nurse of someone else. Ex. You had a terrible experience with your alcoholic father and this person reminds you of him. It can be a positive or negative. We don't want to impair our nurse patient relationship just be aware of this. One thing we can do is to identify our own value systems what we believe what we feel etc.

Define Illness?? Define Disease?? What are the Healthy People 2010-2020 Goals??

Illness is a personal experience of feeling unhealthy and it changes a persons state of well being and social function. Disease- a specific disorder characterized by recognizable signs and symptoms that may be contributed by the environment diet etc. Healthy people 2010-2020 goal is number 1 to increase the quality and years of healthy life in the USA. Number 2 to eliminate health disparities.

In which one of the following stages of NREM sleep does the person fall into a stage of sleep but can be aroused with relative ease? A. Stage 1 B. Stage 2 C. Stage 3 D. Stage 4

In Stage 2 of NREM sleep, the person falls into a stage of sleep but can be aroused with ease. In Stage 1, the person is in a transitional stage between wakefulness and sleep. In Stages 3 and 4, the depth of sleep increases, and arousal becomes increasing difficult.

In which of the following sleep disorders does the patient have an uncontrollable desire to sleep? A. Insomnia B. Sleep apnea C. Narcolepsy D. Restless leg syndrome What is some treatment that can be done for Dyssomnias?? Which of the following snacks is an appropriate bedtime snack to promote sleep in a patient? A. Candy B. Toast C. Lunchmeat D. Cheese

In narcolepsy, a person can literally fall asleep while performing ADLs. Insomnia is characterized by difficulty falling asleep. Sleep apnea is a condition in which a person experiences the absence of breathing during sleep between snores. Restless leg syndrome is a crawling or tingling sensation in the legs. ANSWER is C. *Pharmacologic therapy-sedatives and hypnotics(drug that acts on CNS to shorten sleep onset) to decrease nighttime wakefulness or to decrease anxiety when insomnia is associated with increased anxiety. Nonpharmacologic therapy-relaxation therapy. Message decrease stimuli, comfort control. *Rationale: Because carbohydrates seem to promote sleep, there appears to be justification for offering a snack or beverage high in carbohydrates (such as toast or crackers) before bedtime. Candy, lunchmeat, and cheese do not contain carbohydrates.

What is the most common nutritional problem in the US?? What are some genetic/biologic basis of this problem??

In the United States Most common nutritional problem Affects one third of the population Second leading cause of preventable death Third leading reason for liver transplantation Most common form of obesity is considered to be polygenic, arising from the interaction of multiple genetic and environmental factors. Appetite is influenced by many factors that are integrated by the brain, most importantly, the hypothalamus. Associated with ↑ circulating plasma levels of leptin, insulin, and ghrelin, and ↓ levels of peptide YY Adipocytes secrete a number of hormones and cytokines known as adipokines The more fat you have the more circulating plasma levels.

What are barriers to effective communication??

Include: belittling, offering false reassurance, parroting, disapproving, disagreeing, rationalizing, interpreting, advising, blaming, patronizing. Making stereotypical comments, introducing unrelated topic, using jargon, giving literal responses, requesting explanation and proving

Nutrition across the life span information slide.

Increase in calories increase in proteins vit and min extra iron extra folic acid calcium and zinc. This is for pregnancy. Infant- breast milk and or iron, and caloric fortified formula if not breast milk. If it is hot weather or diarrhea or vomiting needs to supplement with water. Neonate- have trouble sucking and swallowing and breathing at the same time. To get the calories they need we don't give water we try to let them suck for about 10 min and then put an OG tube down and give them the rest. Children- need calories, proteins water vitamins and minerals. Milk is esspecially important for bone growth We go by growth charts. Adolescents-girls need iron both boys and girls need milk go by growth charts. Older adults- need to eat less because our metabolism goes down we need mostly fruits and vegetables. Vitamins and minerals supp. Adequate calcium, iron and vit D. with increase exercise you can keep eating the same way. Pregnancy/Lactation Infant Children Adolescents Older Adults

What are 8 WESTERN world views???

Individual Competition Individual Achievement Mastery and control of nature Rigid time schedule Limited affective expression Religion is separate from other parts of culture Perceives own view to be superior Emphasizes task orientation

What are these types of exercise?? Isometric Isotonic isokinetic What are the benefits of physical activities??

Isometric-- contractions without shortening muscle Isotonic- muscle shortening like swimming, walking, jogging isokinetic- muscle contractions with resistance, lifting weights Decreased risk of chronic disease (ex. Diabetes, heart disease) Maintenance of healthy body weight Improvement of body image Improves and encourages social relationships Increases functional capacity(ADLs and fall prevention) Prevention of premature death Increases cognitive functioning and decreases depression

How much of the sleep is spend in NREM sleep how much is spend in REM sleep?? What type of physiological changes occur during NREM sleep??

KNOW THE 25% and the 75% of NREM and REM sleep. The slides have discrepancies on the percentages. Our blood pressure, temperature, pulse and respirations decrease. 75% total sleep time. Our body movement remains active. Metabolic rate slows, cerebral blood pressure decreases.

What is Assertiveness?? What is a way to convey true feelings, needs and expectations with essential assertive communication that is less threatening and keeps communication open compared to "you-messages"

Key to effective personal and professional communication - use "I" statements when sharing information. This respects the other person's viewpoint. "I" Statements the formula is I feel (describle how you feel)_______ When you(objectively describe the other's behavior) _________ because______ I wish you would ___________

What is lifestyle related to in terms of health?? What is important about behavior??

Lifestyle is connected to the incidence of chronic illness Behavior or group of behaviors, chosen by the person, that may have a positive or negative influence on health

What are some lifestyle factors that play a role in sleep?? What about environmental factors??

Lifestyle---Nutrition Exercise Smoking, Alcohol & Caffeine intake Lifestyle disruptions Environmental--- Hospitalization Temperature Client perception

Patient families want nurses to???

Listen Respect their expert knowledge about the client Ask: How are you doing with this situation? How can I help you? What would be most helpful to you? Offer helpful, practical tips Pace the amount of information they are given In addition to the client the nurse has to report to the family as well. Ask the family "how can I help you" are you ok? They will say things like Im hungry etc. tell them that they can go home and you can take their number and will get back to them if there is a problem.

What are the stages of sleep?? What are the characteristics of NREM Stages of sleep??

Non-rapid eye movement (NREM)Consists of 4 stages.Stage 1 to 2 5%-50% and is light sleep Overall we are 75% in NonREM sleep Stage 2 and 3 are Deep sleep Rapid eye movement (REM)accounts for 25% total time of sleep. During REM sleep the brain is very very active. Our vital signs fluctuate. Loss of muscle tone, dreaming, variable arousibility and potential physiological instability. Also in Rem sleep the increase of brain activity is accompanied by decreased in motor activity where by deep tendon reflexes are absent and muscles are relaxed. In adults REM sleep will progressively lengthen as the night goes on. NON REM sleep predominates during the first 3rd of the night. It is a state in which a quiet brain functions in an active body. Stage 1 -light sleep, going from being awake to being asleep arousal threshold is usually low. The sleeper is easily awaken. Stage 2 -Arousal threshold is increased. Brain waves are more sincrinized. Stage 3 -begins slow wave sleep/deep sleep,High arousal threshold. Difficult to arouse the sleeper Stage 4- EEG thresholds is how these are differentiated. represents the deepest sleep. Arousal is at its peak . It is difficult to wake the sleeper. May sleep walk Much of sleep is spend in this stage.

What is nutrition?? Nutrients? Gastrointestinal System??? Major components of food?? (MCF) What are daily energy requirments determined by??

Nutrition is the science of food. The study of the nutrients. Nutrients are our building blocks our biochemical structures. G.S system the nutrients goes into . MCF-carbs, proteins and lipids. Are the major substrates of food and then the vitamins minerals and fibers. --Resting energy expenditure (REE) and Basal metabolic rate (BMR) --The degree of physical activity --Specific dynamic action of food * These two terms are the same thing BMR and REE. These are the three things that our daily energy requirements. Patients who are septic highly infection in the blood would have a higher BMR.

Give the definition and the examples of each Offering self Offering information Seeking clarification Clarifying

Offering self: -----techniques in which you offer to stay with the client and either talk or just sit quietly • I have 30 minutes available to talk with you at 10 o'clock today • I will stay with you while you wait for your family ---Offering Information: offering information to the client ---Seeking Clarification: clients say things that are unclear, or may have more than one specific meaning, or that are simply vague • Ask client for clarification • Let the client know that you are not certain about what was said and, if necessary, request that the client clarify anything that is obscure • "I'm not sure I follow what you mean" • May have to clarify by stating what the client said and what you take it to mean ----Restating/Clarifying: another way to clarify is to use the therapeutic technique of restating, or paraphrasing, what the client has said • You alter the client's words to express your understanding of the client's meaning • You send this back to the client in the form of a statement or question, and you provide the client the opportunity to agree or disagree that this was the intended message and, if necessary, to clarify further.

What is PQRST model assessing???

P- provoking incident that created the pain Q- what is the quality of pain R region of pain radiation and what relieves it. S severity chart 1-10 T is the timing of the pain when does it happen. Only when I get out of bed or all the time it is painful.

Explain the stages in the Transtheoretical Model of Behavior Change??

PRECONTEMPLATION CONTEMPLATION PREPARATION ACTION MAINTENANCE TERMINATION

What are the Theories of Nurse-Client relationships and Who introduced these??

Peplau's theory - identifies 6 roles assumed by the nurse Travelbee's theory - human deduction King's theory - communication is how human relationships are developed and maintained Watzlawick's theory - inevitable BE SURE TO KNOW THESE THEORIES!! IMPORTANT. PT- You're a stranger 1. 2. we are a resource- we provide care and assist and provide answers 3. we are the teacher, we help them understand their experiences and to attain their goals. 4. we are leader- we help client follower participate in the nursing process. 5. we are a Surrogate- we help resolve interpersonal problems in the presence of understanding each other. 6. we are a counselor help integrate reality and the client emotional responses illness into the total life experience. FYI peplau was a psychiatric nurse. Travelbee- nurse is a human being that is vulnerable to stereotypes ex heart attack in a room, alcoholic in another room. Nurses in nursing to understand the individual uniqueness and not label the room/people. Human deduction. Kings theory- based on interacting personal and interpersonal and social systems. This lady is imajean king. Mutually identify goals and the means of which to meet the goals. Individuals are involved in identify goals and the means to which to meet the goals. It is verbal, nonverbal, situational, perceptual, trans actual and irreversible. Watzlawick; communication theorist believed communication to be inevitable. All behavior has a message value or meaning. Your always behaving you can't fail to behave. You can't stop communicating because we can't stop bahaving it is inevitable. Peplau- believed that nurses that communicated with clients in a healthy way they will provide corrective interpersonal experiences for them. So he said relating in a authentic manner meant that the nurse shared feelings appropriately.

What are some examples of body language??? What is important for nurse and patient???

Personal appearance Facial expressions Body posture Gestures Personal distance Touching To always ask before you touch your patient.

What are phytochemicals?? Examples of where these chemicals can be found??

Phytochemicals : Antioxidants Carotenoids Flavonoids Phytoestrogens Polyphenols Phytochemicals- are compounds in foods that prevent some diseases. Antioxidants-vitamin A,C,E find in veg fruits nuts sea food, unrefined grains. Prevent cancer. Caro- green leafy veg. red and yellow fruits kelp. Eye protection from light and prevent prostate cancer. Flav-plant chemical and veg and fruits believe to help with antiallernergic and anti-inflammatory and to decrease cancer risk. Phyt-hormone like substance found in grains, legumes and soy. It is often recommended for pre and menstrual inhibits blood clotting mimics estrogen effects and decreases cancer. Poly-red wine , tea , apples, grapes, etc. help decrease cancer and heart disease. Fish oil and antioxidants.

What are the phases of therapeutic relationship

Preorientation Orientation Working Termination KNOW THESE WELL. Preorientation- also preinteraction nurse prepares the room and self(what does she need) thinks ahead. Planning stage in which the nurse anticipates what is needed to maximize effectiveness. They are establishing trust. Be honest, form that contract ill be your nurse for the next 12 hours estABLISH goals set limits. Work together to solve one of more of patients problems. Forms basis for the work to do together. Trust is key in this phase and establish ground rules ex meeting times and places. Building trust - working phase- express feelings might be doing referrals to community resources. This is where the care is done giving the shots and Ivs medication etc. working phase to complete nursing interventions. Termination phase is acknowledged early and set limits. If you know a mom with a baby is going to be there for 72 hours. You can tell them general you will be here in 72 hours if everything goes well. You set this up early, setting limits, I will be your nurse today til 7pm. Etc. you need to talk about when the work will come to a close. They should know when you come on the shift what time you will be off the shift. ALWAYS kNOW the terms in the modules. +

Define Professional Boundaries?? What are some characteristics of professional boundaries??

Professional boundaries—what the client-nurse relationship is characterized by. The nurse should be accessible to the client, while maintaining awareness that the therapeutic relationship is not a friendship or other social relationship. • Relationship does not occur spontaneously • Helping relationship characterized by an unequal sharing of information • Patient shares info related to personal health problems, Nurse shares info in terms of a professional role • Built on patients needs, not on those of the helping person • Rudeness, sloppiness, inattention to professionalism undermines image of nursing professionalism and the effectiveness of individual nurses

What are side effects of sibutramine (Meridia)??

Promote weight loss Most common are: Dry mouth, increased appetite, nausea, strange taste in the mouth, upset stomach, constipation, trouble sleeping, dizziness, drowsiness, menstrual cramps/pain, headache, flushing, or joint/muscle pain may occur

What do hospitalized clients want nurses to do??

Provide necessary information; Take care of their pain; Do these with a good attitude.

What is the Healthy Oklahomans Initiative???

Purpose: Examine, prioritize & create action plans to address health problems in OK. Citizen based organization Current status: Oklahoma ranks #46 in nation in overall health—has dropped from #33 in 1990 Major emphasis is on teen pregnancy, tobacco use, obesity, communicable disease, and poverty

Tell whether the following statement is true or false. Somnambulism is a parasomnia in which the person walks in his or her sleep. A. True B. False What is SIDS??? What are some important developmental factors for sleep??

Rationale: Somnambulism is a parasomnia in which the person walks in his or her sleep. *Sudden death of infant that remains unexplained after complete investigation. Most occur while infant sleeps. A leading cause of death in infant: most cases occur between 1-4 months. Cannot predict who will develop it. Risk factors include sleeping on stomach, mother's who smoked while pregnant, exposure to second-hand smoke, prematurity, low birth weight, and recent infection. in general sleep pattern newborns sleep an average of 16-17 hours a day sleep cycle is fully developed by age 2. age school children should have 8-10 hours of sleep.

What are some other verbal techniques??? What should you use caution with in communication??

Reflection- ex. it sounds like you are feeling ...... Open ended questions are better than closed ended questions. Use Caution for requests to keep secrets "Secrets" vs. "Confidentiality" Do not agree to keep secrets in advance. You MUST inform others if the secret involves harm to self or others such as suicide thoughts or thoughts of harming someone else. Also past abuse if it is to a minor. **Non verbal communication is very important.

Define Rest Sleep Coma What are the two biorhythms???

Rest-A state of mental and physical relaxation while being alert, responsive, and awake. Sleep-A regular occurring reversible behavior state in which consciousness skeletal muscle activity metabolism and response to external stimuli are decrease Coma -A state of unconscious in which a person cannot be aroused. IN order to maintain optimal level of health is why we rest and sleep. Lack of responsiveness to external stimuli differentiates sleep from rest. If your resting you are aware of what is happening around you. Rest- feeling of serenity and freedom of worries. * Circadian Rhythm and Ultradian Rhythm 2 cerebral mechanisms that are antagonist to each other - One causes sleep: Bulbar synchronizing system (BSS) - One causes wakefulness: Reticular activating system (RAS)

What is the Reticular Activating System?? Ultradian Rhythm?? Bulbar Sychronizing system??

Reticular Activating System: Network of nerve fibers in the Thalamus that wake us up. The hypothalamus, brain stem and cerebral cortex. It is essential for wakefulness, attention , and concentration. Releases Catachoalines which is norepinephrine. Ultradian Rhythm:associated with the length of time a person spends in REM and nonREM sleep Bulbar Synchronizing System: This is the BSS. Causes sleep. The bulbar is associated with the medulla in the brain, melatonin (strong sleep inducer-harmone of darkness) tryptophan,(amino acid that is a precursor or serotonin found in turkey, milk, bananas etc) Sleep depends on the balance of the RAS and BSS. RAS- decreases when stimuli declines, BSS-take over and sleep occurs. Increase carbohydrates to help people sleep is good as well.

What is a Scientific Health approach?? What are some characteristics for Scientific Health??

Scientific- on bio psycho social cultural spiritual approach to explain illnesses that places emphasis on a cure. Cares provided in diets, nurse care or physician care -----Scientific----- Disease focus Mental and physical are separate Individual orientation Unfamiliar settings Impersonal care Fragmented care, cure Low on cultural support Expensive

Think about social relationships What characteristics do they have?? How will they compare/contrast to the therapeutic nurse-client relationships?? Description goals of a Therapeutic relationship??

Social are very different from therapeutic relationships. Althought the nurse needs in depth information she would not share personal information. Dating and giving personal phone numbers are inappropriate. We can talk about a simple statement like "yes I had breast cancer and I did this and that" Only information that will help the client not hurt the client. There is an unequal sharing of information. More on the patients side . ---Description/Goals of a therpeutic relationship-------- Helping Relationship Client focused relationship in which nurse helps client reach mutually determined goals. Client Growth is a major goal -----Goal of the therapeutic relationship is usually called the helping relationship. Nurse helps client reach those goals. The goals that have been created with with client. Hopefully they have created new coping skills. We need to promote independent than independent goals.

What are some characteristics to implement a weight loss plan??

Supervise a plan Successful weight loss, requiring a short-term energy deficit Successful weight control, requiring long-term behavior changes Pay attention to multiple factors All opportunities for patient education should primarily focus on healthy eating & exercise Motivation is essential for weight loss Set realistic and healthy goals for weight loss Weight loss of 1 to 2 pounds per week Slower weight loss offers better cosmetic results Plateaus in weight can last from several days to several weeks Daily weighing is not recommended Weigh once a week with similar clothing, at the same time of day Nutrition for weight loss--- Restricted food intake is a cornerstone. Correct food portion sizes, recommened servings of food.

What is metabolic syndrome??

Syndrome X, insulin resistance syndrome, dysmetabolic syndrome factors that ↑ an person's risk of developing CV disease & DM Diagnosed if an individual has three or more of the conditions listed 1.) Waist circumference ≥40 inches (men) or ≥35 inches (women) 2.) Triglycerides >150 mg/dl or being treated with drug(s) 3.) High-density lipoprotein (HDL) cholesterol <40 men, <50 women or being treated with drug(s) 4.) Blood pressure ≥130 mm Hg systolic or ≥85 mm Hg diastolic or being treated with drug(s) 5.) Fasting glucose is ≥100 mg/dl or being treated with drug(s) This goes up with age. If you have 3 of these 5 then you probably have metabolic syndrome. No symptoms Health problems develop if syndrome is not addressed (vascular disease: heart, kidney, brain; DM) Nursing and Collaborative Management Lifestyle therapy is first line of intervention

What are some plannings that can successful move the patient toward treatment goals??

The client: Makes effective choices. Actively participates in prescribed regimen Seeks help as needed. Expresses positive ways of dealing with stress.

Define Confidentiality?? Who increased the emphasize of this??

The legal and ethical responsibility to keep information about a client private. HIPPA increased the emphasize of this

How is the sleep cycle between stages occur?? What does sleep provide??

The person passes consecutively through four stages of NREM sleep. The pattern is then reversed. Return from stage IV to III to II Enter REM sleep instead of reentering stage I The person reenters NREM sleep at stage II and moves on to III and IV. Each cycle lasts about 90 minutes. Sleep provides energy conservation and restoration

What is Milieu??

This includes the physical, social, and emotional aspects of the patient's environment. To be therapeutic, the client should feel safe and comfortable in every aspect. Milieu It might be internal environment (feelings and thoughts) external - hospital room or home. It could be psychosocial- whether the patient feels accepted physical- whether the room is comfortable.

The Communication Process----Encoder--Message---Sensory Channel---Decoder---Content---Feedback. (Some Info )

Two or more individuals called the sender and receiver. Both verbal and nonverbal messages. And each message has many components encoder- is basically the sender initiates a transaction to exchange a message, to engage or communicate with another person. To convey thoughts and feelings. Message- content that a sender wishes to transmit to another person. The other person is the receiver. Message must be encoded in language or cues that both can understand. Sensory channel-means by which a message is sent. Three primary channels are visual auditory and canisthetic. It could be a wink , a tone of a voice or a hand gesture these can all convey a message without words. Decoder- the receiver this is the person to whom a message is aimed at must be able to decode the message sent to understand it clearly. If the message that the sender sent and the receiver understands then there is clear communication - content- condition under which communication occurs. Feedback- is just the process by which effectiveness is determined. "did we communicate effectively"

When communicating with children what are some good techniques to use?? You work in a pediatrician's office. The parents of a child who stutters want to know what they can do to "cure the stuttering." What suggestions do you provide?

Use familiar words for them. Use favorite toys and look at nonverbal cues. Offer them choices and foster independence. This is common in children as they develop language skills. - Identify times when stuttering is worse and try to decrease the stress. - Avoid ridicule, give positive feedback. - If over age 5 may need a referral to speech therapist.

What are the 6 models of behavior change??

Used to explain and predict health behaviors 1.) Theory of Reasoned Action - Poss 2.) Transtheoretical Model for Behavior Change - Prochaska 3.) Health Believe Model - Rosenstock 4.) Health Promotion Model - Pender, Murdaugh, & Parsons 5.) Health Illness Continuum 6.) Agent - Host - Environment Model - Leavell & Clark

What is the Agent-Host-Environment model continuum useful for???

Useful for examining the causes of disease in an individual Agent Host Environment

What are the the three types of communication???

Verbal communication: the use of words to convey messages Nonverbal communication: a set of behaviors that conveys message either without words or by supplementing verbal communication Misperceptions-The client is laughing when explaining how angry they are. These are misperceptions I communications. Misperceptions- you can ask the patient what they think you said.

What are ways to help increase self-awareness??

Verbalizing the implied Encouraging assessment of emotions Translation into feelings Reflecting Encouraging comparison

The Health Illness Continuum views health as what???

Views health as a constantly changing state, with high-level wellness and death being on the opposite ends of a graduated scale, or continuum

What type of assessment would be done to determine general nutritional needs?

We might wan to do a 24 hour recall. What have you eaten in 24 hours. Might do a food frequency recall. Do a written food diary. Have them do this. Also look at the home food consumption We can get a health history client report, evaluate food intake, physical examination (signs and symptoms, anthropometric measurements) Evaluation of laboratory tests

Working Phase of the therapeutic relationship-Definition and example?? Maintaining Client Confidentiality?? Breach of Confidentiality??

Working Phase: usually the longest phase of the helping relationship. You will work together with the patient to meet physical and psychological needs. • Interaction is the essence of the working phase • Patient will actively participate in the relationship • Doing the care, giving the meds ----------Confidentiality: the legal and ethical responsibility to keep information about a client private. • Indicate with whom the information that the patient gives will be shared • Patient should know about right to specify who might have access to the information Breach of Confidentiality: • Discussing patient information in any public area where those who have no need to know the information can overhear. • Leaving patient medical information in a public area. • Leaving a computer unattended in an accessible area with medical record information unsecured. • Failing to log off a computer terminal. • Sharing or exposing passwords. •Copying or providing data, either in hard copy or machine-readable form, for one's self, coworkers, or any other party, except as required to fulfill job responsibilities.

What do the WHO do to prevent the spread of disease??

World Health Organization (WHO) Look Beyond individual, local or community perspectives Looking at the entire world Look into The threat of pathogen transmission across international boundaries. -People to People -Other Vertebrates to People This potential threat is much greater than most realize - a recent example is the concern over bird flu.

What does WHO stand for and What do they do? What have they declared and what is their international goal??

World Health Organization---Monitors Disease outbreak Assesses the performance of health systems around the globe WHO also declared that health is a fundamental human right and established a social goal to obtain the highest possible level of health for all people. --International Goal: to eliminate the threat of pathogen transmission across international boundaries & attain the highest level of health for ALL people.

What do you have to understand to be a good health advocate?? What are the dimensions of health???

You must understand the client's view of health to be an effective advocate!! ETIC DIMENSION The objective view ofhealth from a trained,healthcare  professional EMIC DIMENSION The individual or group, subjective, view and experiences of health

What is High level wellness?? What are the 5 factors that affect Health?? Give an example/subject of each??

Your definition for yourself What you think you should be able to accomplish What others expect from you Your willingness to reach optimal wellness 5 FACTORS--1.) Biology (heredity), 2.) Social Environment (Social Environment, Social networks, Socioeconomic status, Knowledge), 3.) Public Policy and Intervention (Seat belt laws), 4.) Behaviors (Personal habits, Cultural Factors), 5.) Physical Environment (Work, Ecosystem, Safety)

Define Morbidity?? Define Mortality?? Define Homeostasis?? Define Health??

a state of illness, disease, or an abnormal condition. This examines the number of people who develop a certain condition each year. Mortality - the state of being mortal. This identifies the number of people who die from various causes each year. Homeostasis -a relative constant state Health: - Complete physical, mental, and social wellbeing; - The absence of disease; - A continuum; - Wellness and well-being

termination of the nurse-client relationship occur??

• Occurs when the conclusion of the initial agreement is acknowledged. • Patient will participate in identifying the goals accomplished or the progress made towards goals • Patient will verbalize feelings about the termination of the relationship

What is the appropriate use of daily vitamins??? What is the purpose of phytochemicals???

• Vitamins are organic compounds needed by the body in small amounts. • Most are active in the form of coenzymes, which, together with enzymes, facilitate thousands of chemical reactions in the body • Do not provide energy (calories), they are needed for metabolism of carbs, protein, and fat • Essential in the diet b/c most are not synthesized in the body or are made in insufficient quantitates o Recommended that people take a daily multivitamin, along with eating a well-balanced diet. Not a replacement supplement, but rather an addition to an already healthy diet • Increases necessary nutrients that are diminished during the everyday wear and tear of the body. Phytochemicals—compounds in food that seem to prevent disease (increase consumption of fruits and vegetables in the diet) • Flavonoids—fruits and vegetables • Carotenoids—vegetables • Antioxidants—selenium, Vitamin E, Vitamin C People who consume plants w/ a high presence of these chemicals may be able to benefit from these protective chemicals too, though they may serve a different purpose for people than they doe for plants.