WEEK 1: HEALTH PROMOTION

Secondary Versus Tertiary Prevention​ A client presents to the Emergency Department with difficulty breathing and a history of asthma. They are placed on oxygen and given a breathing treatment. This scenario represents ___________ prevention. ​ A client suffers a spinal cord injury during a motor vehicle accident. They are admitted to a rehabilitation facility to learn how to perform activities of daily living while using a wheelchair. This scenario represents _____________ prevention. ​

A client presents to the Emergency Department with difficulty breathing and a history of asthma. They are placed on oxygen and given a breathing treatment. This scenario represents secondary prevention. ​ A client suffers a spinal cord injury during a motor vehicle accident. They are admitted to a rehabilitation facility to learn how to perform activities of daily living while using a wheelchair. This scenario represents tertiary prevention. ​ Review Feedback Secondary prevention focuses on preventing the spread of disease, illness, or infection once it occurs. The goal is detection of a disease or injury and includes activities that are directed at diagnosis, prompt intervention, and prevention of worsening condition. A client seeking treatment for an asthma exacerbation is secondary prevention. ​ Tertiary prevention involves helping a client manage a chronic condition to lessen long-term complications and return to optimal functioning. In addition to restoration of quality of life, it prevents symptoms from becoming more terminal, leading to disability or death. This includes activities directed at rehabilitation rather than diagnosis and treatment. ​

Caring for Clients Using Maslow's Theory​ Read the scenario below, then select the highest priority need after successfully getting the client to eat. A healthcare professional is caring for an elderly client with dementia who is not eating, not communicating, and refuses to see family members. The client has a high fall risk and does not trust the staff. ​

A healthcare professional is caring for an elderly client with dementia who is not eating, not communicating, and refuses to see family members. The client has a high fall risk and does not trust the staff. ​ Review Feedback According to Maslow, in all cases, an emergent physiological need takes precedence over a higher-level need. Nutrition is a physiological need and should be addressed first. The next priority need is the fall risk as this represents a safety need. ​ Not communicating and refusing to see family members are love and belonging needs, which are lower-level needs than physiologic and safety needs. ​

Risk Reduction ​ Changes in risk behavior are the interventions used to achieve risk reduction. Within the broader framework of health promotion, risk behavior may be seen as a response or mechanism for coping with risk factors, such as adverse living conditions. Strategies to respond to this include the development of life skills and the creation of more supportive environments for health. During every encounter with an individual, family, group, or community, the nurse assesses not only the current state of health but the risks that threaten their health in the future. Once identified, the nurse works to offset the risks through health-promoting activities. In the interactive, read through each scenario and identify the desired outcome of risk modification. ​

A labor and delivery nurse observes interactions between a new mother and her partner that indicate the new mother may be experiencing intimate partner violence. The nurse documents the behavior and completes a more comprehensive risk assessment after the partner leaves, then people in the area continue to have access to fresh produce. no other children get sick.​ the nursing plan of care is updated.

Prioritizing Hypotheses Based on your understanding of the Illness-Wellness Continuum, Jonathan is facing towards ____________________.

Based on your understanding of the Illness-Wellness Continuum, Jonathan is facing towards high-level wellness. Review Feedback Based on Jonathan's situation, he is facing towards high-level wellness as evidenced by healthy eating, regular exercise, overall health, and absence of illness. Based on his childhood experiences and his chosen career path, he has the intellectual knowledge (awareness) to support health. Many consider wellness to be the absence of illness. However, there are degrees of wellness and degrees of illness. The Illness-Wellness Continuum depicts the relationship between the two concepts. Moving from the center to the left demonstrates worsening health. Moving from the center to the right displays increasing levels of health.

Taking Action At the health fair, Jamal stated that he could never quit smoking. Considering the transtheoretical model of change, which response by the healthcare professional is most appropriate? ​ "What do you think is the greatest challenge to stopping smoking?​" "You must immediately decrease the number of cigarettes you smoke each day to avoid lung cancer."​ "Please attend a smoking cessation program and use a nicotine replacement patch."​ "Do you understand your risk for lung cancer is significant?"​

"What do you think is the greatest challenge to stopping smoking?​" Review Feedback The client's statement indicates that he is in the precontemplation stage and does not intend to make a behavior change. In this stage, the client is not interested in information about his behavior and may be defensive when confronted with the information. Asking an open-ended question about smoking may encourage the client to identify a reason to begin a behavioral change. Discussing health risks, making demands, and requesting changes are unlikely to succeed until the client is motivated toward change.

What Level of Prevention?​ Complete the client statement. "Working back to health after an illness is always an important step to recovery. I had a heart attack last month and got out of the hospital about a week ago. I am on my way to my first cardiac rehabilitation visit at the hospital gym. I am practicing __________ prevention."

"Working back to health after an illness is always an important step to recovery. I had a heart attack last month and got out of the hospital about a week ago. I am on my way to my first cardiac rehabilitation visit at the hospital gym. I am practicing tertiary prevention." Review Feedback This action is a way of rehabilitating or coming back from an illness towards restorative health. This is part of the recovery period, which is where tertiary prevention takes place to reduce or reverse damage caused by a condition.

Evaluating Outcomes: Samara's Scenario​ Samara, a 22-year-old college student (preferred pronouns she, her), is finishing her senior year in nursing school. She works part-time as a waitress, but the diner's business has been slow and her paychecks have been small. Yesterday, Samara found out that she is pregnant and worries about telling her boyfriend. Samara just came home to find an eviction notice on her front door. She knew that her rent was behind several months, but thought she had time to get caught up. With all the stress in her life, she is struggling in school. Tonight, Samara receives a text from her boyfriend that he is not ready to be a father. She presents to the healthcare clinic crying uncontrollably and asking for assistance. She states, "Victor is the love of my life."​

*See question below*

Taking Action: Samara's Scenario​ Samara, a 22-year-old college student (preferred pronouns she, her), is finishing her senior year in nursing school. She works part-time as a waitress, but the diner's business has been slow and her paychecks have been small. Yesterday, Samara found out that she is pregnant and worries about telling her boyfriend. Samara just came home to find an eviction notice on her front door. She knew that her rent was behind several months, but thought she had time to get caught up. With all the stress in her life, she is struggling in school. Tonight, Samara receives a text from her boyfriend that he is not ready to be a father. She presents to the healthcare clinic crying uncontrollably and asking for assistance. She states, "Victor is the love of my life."​

*See question below*

Case Study: Levels of Prevention​ Michael presents to the healthcare provider for a physical examination. Review Michael's medical chart to answer the questions. ​

*See questions and PHI below*

Case Study: Health and Wellness Jonathan (preferred pronouns he, him) is a student in a healthcare profession program. To help pay for school, Jonathan works full-time in a family practice clinic caring for clients of all ages. Sometimes, Jonathan feels that there are not enough hours in the day to get schoolwork completed, study for exams, and work enough hours to pay the bills. Growing up, Jonathan's caregivers taught him how to choose and prepare healthy foods and he is active every day, either running or biking. Though he was taught healthy lifestyle behaviors during childhood, his caregiver was against vaccinations. Therefore, Jonathan currently remains unvaccinated. Despite learning the importance of vaccinations, Jonathan feels good about his state of health, admitting that he is never sick.

*See questions below*

Health Belief Model Drag and drop the missing pieces to the corresponding drop zone in the health belief model below.

1 = Individual perceptions 2 = Modifying factors 3 = Likelihood of action 4 = Perceived threat of disease X 5 = Likelihood of taking recommended preventive health action

Behaviors Leading to Self-Actualization ​ Self-actualization is the highest level of need and refers to a person's realized potential. Select the behaviors that lead to self-actualization. Select all that apply.​ Following traditional paths​ Being unconcerned about the welfare of humanity Boldly assuming unpopular views​ Trying new experiences​ Identifying weaknesses and working to overcome them​ Taking accountability and responsibility​

Boldly assuming unpopular views​ Trying new experiences​ Identifying weaknesses and working to overcome them​ Taking accountability and responsibility​ Review Feedback Self-actualization is the highest level of need and refers to a person's realized potential. This level represents a person's desire to accomplish all that is possible and become the best version of oneself.​ Behaviors that lead to self-actualization include trying new experiences, taking accountability and responsibility for actions, identifying weaknesses and working to overcome them, and boldly assuming unpopular views. ​ Following traditional paths and being unconcerned about the welfare of humanity do not lead to self-actualization. ​

Recognizing Cues Which variables are affecting Jonathan's health? Select all that apply. ​ Childhood experiences​ Degree of stress​ Cultural background ​ Gender Feelings about health​ Career choice​ Financial struggles​

Childhood experiences​ Degree of stress​ Feelings about health​ Career choice​ Financial struggles​ Review Feedback Variables affecting Jonathan's health include knowledge from his professional program and work experience, his childhood experiences, his degree of life stress, his financial struggles, and his personal feelings about his health. ​ Jonathan's gender is not a variable that impacts health. ​ The scenario does not state Jonathan's cultural background, so we cannot determine if this variable is impacting his health. ​

Health Promotion Models Select the correct model name that matches its application to nursing.

Health Promotion Model Nurses recognize individuals have unique personal characteristics and experiences that affect subsequent actions and understand behavior-specific variables influence motivation to adopt healthy behaviors. Transtheoretical Model Nurses recognize that people are at different stages of readiness to adopt healthful behaviors. Holistic Health Model Nurses using this model recognize the natural healing abilities of the body, acknowledge, and incorporate complementary and alternative interventions into the plan of care. Maslow's Hierarchy of Needs Nurses recognize that an individual's physiological needs are the highest order and priority need. Health Belief Model Nurses acknowledge that multiple factors influence a client's health perceptions, health beliefs, and likelihood of taking preventative health action.

What is Health?​ Health is a state of complete ____________, ____________, and ___________ well-being and not merely the absence of disease or infirmity.​

Health is a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.​ Review Feedback According to the World Health Organization (n.d.), health is a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.​ Reference World Health Organization. (n.d.). Constitution. https://www.who.int/about/governance/constitution ​

Meditation

Health promotion demands a coordinated action by governments, health and economic sectors, volunteer organizations, local communities, the health industry, and the media. Nurses have a responsibility to mediate between differing interests in society for the pursuit of health.

Equity

Health promotion should focus on achieving equity in health. This means reducing differences in current health status and ensuring equal opportunities and resources to help all people achieve full health potential.

Prioritizing Hypotheses If prevention strategies are not implemented, which is the most concerning consequence? ​ Heart attack Career burnout Diabetes mellitus Obesity

Heart attack Review Feedback The major concern with Michael's family history and ethnicity is the development of cardiovascular disease leading to a heart attack. ​ Although career burnout may occur due to stress and extended working hours, this is not the most concerning consequence of Michael's family history. ​Diabetes mellitus type 2 does have a genetic component based on Michael's strong family history of cardiovascular concerns. However, this is not the most concerning consequence. ​Michael is not currently overweight; therefore, obesity is not the most concerning consequence of the family history.

Generating Solutions The healthcare professional is planning a follow-up phone call with Jamal after the health fair. Based on Jamal's reported sleep habits, the professional will recommend relaxation and music therapy in the evening before bedtime. Which model of health is being used to assist Jamal? ​ Holistic health model​ Transtheoretical model of change​ Health promotion model ​ Health belief model​

Holistic health model​ Review Feedback The holistic health model acknowledges that all dimensions of an individual contribute to health and wellness. A holistic view also includes emotional and spiritual well-being. Healthcare providers recognize the body's natural healing abilities and may recommend or incorporate complementary and alternative interventions.​

Caring for Clients Using Levels of Prevention​ A client has several risk factors for cardiovascular disease, including:​ Father died of a heart attack at 53 years old​. Mother has high cholesterol​. The blood pressure reading today is elevated​. However, the client's cholesterol level is within the normal range. The healthcare provider decides to prescribe cholesterol-lowering medication and recommends a low-fat diet. This represents ___________ prevention. ​

However, the client's cholesterol level is within the normal range. The healthcare provider decides to prescribe cholesterol-lowering medication and recommends a low-fat diet. This represents primary prevention. ​ Review Feedback The client has several risk factors for developing cardiovascular disease, but the condition is not diagnosed. Prescribing cholesterol-lowering medication and recommending a low-fat diet are considered primary prevention. ​ If the client had an elevated cholesterol level or was overweight, these could be considered secondary prevention strategies. ​

Health, Wellness, and Illness While seeking to understand the relationship between the concepts of health, wellness, and illness, healthcare professionals are in a unique position to assist clients in achieving and maintaining optimal levels of health. What are some ways that healthcare professionals assist clients to achieve optimal health? Select all that apply. Identify actual and potential risk factors​ Provide preventative care​ Provide health education​ Encourage healthy behaviors​ Understand the dimensions of wellness​

Identify actual and potential risk factors​ Provide preventative care​ Provide health education​ Encourage healthy behaviors​ Understand the dimensions of wellness​ Review Feedback Healthcare professionals are in a unique position to assist patients in achieving and maintaining optimal levels of health and wellness. Healthcare professionals understand the challenges of today's healthcare system and embrace the opportunity to use wellness activities to promote health and to prevent illness. Healthcare professionals can encourage healthy behaviors, provide health education, identify actual and potential risks to health, understand the dimensions of wellness, and provide preventative care.

Immunizations Immunizations are an example of ________________ prevention.​

Immunizations are an example of illness prevention prevention.​ Review Feedback Illness prevention includes activities such as immunization programs and blood pressure screenings that protect clients from actual or potential threats to health and wellness. ​ Health promotion activities include helping clients maintain or enhance their present health by encouraging healthy activities, such as regular exercise and good nutrition.​

Evaluating Outcomes Jonathan decides to make additional lifestyle changes. For each change, indicate whether it would improve his health or decline his health. Jonathan received a seasonal flu vaccine. ​ Jonathan continues yoga classes.​ Jonathan reports reduced stress.​ Jonathan stayed up all night to cram for a final exam.​ Jonathan begins drinking alcohol on the weekends with his friends. ​

Improve Health Jonathan received a seasonal flu vaccine. ​ Jonathan continues yoga classes.​ Jonathan reports reduced stress.​ Decline Health Jonathan stayed up all night to cram for a final exam.​ Jonathan begins drinking alcohol on the weekends with his friends. ​

For each action, click to specify if Samara's situation is improving or declining. ​ Samara receives an extension on her eviction notice. Samara is fired from her job for calling out sick. Samara joins a support group for young mothers​. Samara passes her final exam​.

Improving Samara receives an extension on her eviction notice. Samara joins a support group for young mothers​. Samara passes her final exam​. Declining Samara is fired from her job for calling out sick. Review Feedback Actions that show Samara's situation is improving include:​ Receives an extension on her eviction notice (met physiological)​ Joins a support group for young mothers (met safety/security and love/belonging needs)​ Passes her final exam (met self-esteem needs)​ Actions that show Samara's situation is declining include:​ Fired from her job for calling out sick (unmet safety/security needs)​

Health and Climate Change After viewing the Climate Change Impacts on Health website answer the following question. Which of the following are threats due to climate change? Select all that apply. Increases in water quality Increases in air quality Increases in tick and insect diseases Increases in mental health disorders Increases in heat-related illnesses

Increases in tick and insect diseases Increases in mental health disorders Increases in heat-related illnesses Review Feedback Climate change has been linked to increases in insect and tick-related diseases, increases in heat-related illnesses, and increases in depression, anxiety, and post-traumatic stress disorders. Climate change has caused decreases (not increases) in water and air quality.

Analyzing Cues For each variable affecting Jonathan's health, identify if the variable is internal or external. Career choice​ Childhood experiences​ Degree of stress​ Feelings about health​ Financial struggles​

Internal Career choice​ Degree of stress​ Feelings about health​ External Childhood experiences​ Financial struggles​

Variables Influencing Health and Health Practices​ Many internal and external variables influence a person's health beliefs and health practices. Identify which variables are internal and which variables are external.

Internal Growth and development Intellectual background Emotional factors​ External Family health practices​ Cultural background​

Cue to action

It is the stimulus needed to trigger the decision-making process to accept a recommended health action. These cues can be internal (e.g., chest pains, wheezing, etc.) or external (e.g., advice from others, illness of family member, newspaper article, etc.).​

Case Study: Models of Health​ (Questions 1-6)

Jamal, a 55-year-old client (preferred pronouns he, him), attends a community health fair. While at the health fair, he is provided information about a smoking cessation program. When asked if he would like to join the program, Jamal states, "I could never quit smoking! I've been smoking since I was 14 years old."​ A few minutes later, Jamal completes a questionnaire asking about his sleeping habits. He indicates that he doesn't sleep well and eats snacks very late. He thinks this issue is related to work stress. He is unhappy with his job and is searching for another. Jamal moves to the next station at the health fair, which focuses on teaching about alternative and complementary therapies to help with stress reduction. When asked, Jamal states that he takes a daily multivitamin and melatonin to help him sleep most nights.​ The last station at the health fair is for immunizations. Jamal consents to receive both the influenza vaccine and the shingles vaccine.​

Evaluating Outcomes The following year, Michael returns to the clinic for a physical exam. Which findings indicate preventive measures were effective? Select all that apply.​ Blood sugar elevated​ Normal BMI​ Daily walking or cycling ​ Blood pressure is slightly elevated​ Reports a low-fat, low-cholesterol diet​

Normal BMI​ Daily walking or cycling ​ Reports a low-fat, low-cholesterol diet​ Review Feedback Exam findings that indicate that preventive measures have been effective include maintaining a normal BMI, reporting a heart-healthy diet (low-fat, low-cholesterol), and daily physical activity. ​ However, blood pressure and blood sugar elevations are abnormal and represent a decline in Michael's health. ​

Recognizing Cues Which findings from Michael's physical examination require preventive strategies? Select all that apply​. Vital signs Occupation Grandfather's history Parents' history BMI

Occupation Grandfather's history Parents' history Review Feedback Health promotion is the process of helping people gain control of and improve their health. An individual takes responsibility for health and wellness by making positive lifestyle choices and avoiding negative ones. Michael has already been exposed to several risk factors for the development of cardiovascular disease, including family history and long working hours, which may contribute to sedentarism and work-related stress. Additionally, high blood pressure is more common in African American males than Caucasian, Asian, or Hispanic adults (CDC, 2020). Therefore, a heightened response is required. ​ Michael's vital signs and BMI are within normal limits and do not require preventive measures at this time. ​ Reference Centers for Disease Control and Prevention. (2020, November 2). A closer look at African American men and high blood pressure control. https://www.cdc.gov/bloodpressure/aa_sourcebook.htm ​

Applying Maslow's Hierarchy​ A healthcare professional is conducting a home care visit with an older adult couple. While in the home, the professional weighs each individual and reviews the food diary. The professional checks vital signs and encourages the couple to increase daily fluids and activity levels to help with their voiced concern about constipation. The professional is addressing which level of need according to Maslow's hierarchy of needs?​ Love and belonging Physiological Safety and security Self-actualization

Physiological Review Feedback The healthcare professional's actions address the basic physiological needs of nutrition, fluids, elimination, and oxygen. According to Maslow's hierarchy of needs, basic physiological needs must be met before meeting higher-level needs, such as safety and security, love and belonging, and self-actualization. ​

Generating Solutions: Samara's Scenario​ Samara, a 22-year-old college student (preferred pronouns she, her), is finishing her senior year in nursing school. She works part-time as a waitress, but the diner's business has been slow and her paychecks have been small. Yesterday, Samara found out that she is pregnant and worries about telling her boyfriend. Samara just came home to find an eviction notice on her front door. She knew that her rent was behind several months, but thought she had time to get caught up. With all the stress in her life, she is struggling in school. Place Samara's unmet needs in the correct order of concern, according to Maslow's theory, with the highest level first (at the top). Love and belonging Physiological Safety and security Self-esteem

Physiological Safety and security Love and belonging Self-esteem

Maslow's Five-Tier Model​ According to Maslow's five-tier model, place the needs in the correct order, from the most basic needs at the top of the list to the highest-order needs at the bottom of the list. Love and belonging Physiological Safety and security Self-actualization Self-esteem

Physiological Safety and security Love and belonging Self-esteem Self-actualization

Examples of Needs by Level Match each level of need to the correct example. ​

Physiological Shelter Safety and Security Health and well-being Love and belonging Intimacy Self-esteem Independence Self-actualization Personal growth

Prioritizing Hypotheses: Samara's Scenario Samara, a 22-year-old college student (preferred pronouns she, her), is finishing her senior year in nursing school. She works part-time as a waitress, but the diner's business has been slow and her paychecks have been small. Yesterday, Samara found out that she is pregnant and worries about telling her boyfriend. Samara just came home to find an eviction notice on her front door. She knew that her rent was behind several months, but thought she had time to get caught up. With all the stress in her life, she is struggling in school. Which of Samara's unmet needs has the highest priority according to Maslow's theory? Safety and security​ Physiological​ Self-esteem​ Love and belonging ​

Physiological​ Review Feedback Samara's physiological need for shelter is the highest priority. ​ Self-esteem, safety and security, and love and belonging needs are not the highest priorities.

Advocacy

Political, economic, social, cultural, environmental, behavioral, and biological factors can all promote health or harm it. Health promotion aims at making these conditions favorable through advocacy for health.

Positive and Negative Health Behaviors For each health behavior below, click to specify if it is a positive or negative behavior. Annual medical screening exams Lack of medical insurance Exposure to air pollution Adequate exercise Injury or violence Immunizations Access to education Stress management Obesity Barriers to healthcare access

Positive Behavior Annual medical screening exams Adequate exercise Immunizations Access to education Stress management Negative Behavior Lack of medical insurance Exposure to air pollution Injury or violence Obesity Barriers to healthcare access

Prioritizing Hypotheses Over the next two months, Jamal attends several meetings of the smoking cessation program. ​Match Jamal's statements with the appropriate stage within the transtheoretical model of change. ​

Precontemplation "I could never quit smoking." Contemplation "Maybe I could consider cutting back to one pack per day." Preparation "I will ask my healthcare provider for prescription medication to help me quit." Action "I only buy one pack of cigarettes every two weeks and smoke half of them each week." Maintenance "For the past month, I have cut back to one-half pack per week."

Transtheoretical Model of Change The Transtheoretical Model of Change assesses one's readiness for new behaviors and it consists of five stages. Place the five stages below in the correct order. Preparation Contemplation Maintenance Action Precontemplation

Precontemplation Contemplation Preparation Action Maintenance Review Feedback As much as people want to live healthy lifestyles, change can be difficult to start and maintain. Breaking change into steps that can be identified and managed is one way healthcare professionals can help patients make healthier, long-lasting choices.

Analyzing Cues Based on Michael's physical examination, which type of prevention should the healthcare professional implement now?​ Primary Primordial​ Secondary Tertiary

Primary Review Feedback Since Michael already has risk factors but those risks have not yet affected their health, primary prevention is the best strategy to implement. ​Primary prevention involves intervening before health effects occur. Primordial prevention involves the prevention of risk factors. Michael already has risk factors for cardiovascular disease. ​ Secondary prevention includes screening to identify diseases in the earliest stages. Michael does not currently have any signs of cardiovascular disease. ​ Tertiary prevention involves managing disease post-diagnosis to slow or stop progression. Michael does not currently have any signs of cardiovascular disease. ​

Health Promotion Model: Case Scenario​ An overweight client with diabetes and coronary artery disease visits their primary care provider (PCP) for an annual examination. The PCP educates the client that diabetes and coronary artery disease are comorbidities and discusses losing weight to avoid serious complications. Based on the health promotion model, click to specify one factor to match each action or statement by the client.

Prior Related Behavior Prior attempts at weight loss Biological Factor Family history of obesity Perceived Benefit "Regular exercise and healthy eating will decrease cholesterol levels." Perceived Barrier "My arthritis may lmit my ability to exercise." Interpersonal Influence "My wife will go with me to the gym."

Taking Action What are the benefits of health education?​ Select all that apply. Solve health-related problems​ Promote lifestyle changes​ Inform understanding of healthy behaviors​ Develop health-oriented habits​ Improve wellness management​

Promote lifestyle changes​ Inform understanding of healthy behaviors​ Develop health-oriented habits​ Improve wellness management​ Review Feedback Health education assists clients in understanding their health and how to better manage wellness. Education promotes lifestyle changes and assists clients in developing health-oriented habits. ​ Health education does not solve health-related problems. It is up to the client to implement the knowledge gained from health education to promote health and wellness.

When providing care to Samara, which must the healthcare professional consider?​ Dropping out of school is recommended to reduce anxiety. Samara's need for love and belonging may supersede her other needs​. Basic physiological needs must always be met first​. Financial security is the priority with the pending birth of a baby​.

Samara's need for love and belonging may supersede her other needs​. Review Feedback Despite Maslow's needs being presented in a certain order on the pyramid, flexibility is needed based on external circumstances and individual differences (McLeod, 2020). The order of the needs is not rigid, but instead, it must be flexible. Samara's need for love and belonging may supersede her other needs, including basic physiological needs. ​ Financial security is a concern but is not the reason Samara is seeking assistance, indicating it is not her priority need at this time. ​Dropping out of school will likely produce more unmet needs. Reference​ McLeod, S. (2020, December 29). Maslow's hierarchy of needs. https://www.simplypsychology.org/maslow.html ​

Recognizing Cues: Samara's Scenario​ Select the potential unmet needs from the following situation.​ Samara, a 22-year-old college student (preferred pronouns she, her), is finishing her senior year in nursing school. She works part-time as a waitress, but the diner's business has been slow and her paychecks have been small. Yesterday, Samara found out that she is pregnant and worries about telling her boyfriend.

Samara, a 22-year-old college student (preferred pronouns she, her), is finishing her senior year in nursing school. She works part-time as a waitress, but the diner's business has been slow and her paychecks have been small. Yesterday, Samara found out that she is pregnant and worries about telling her boyfriend. Review Feedback Samara's potential unmet needs include small paychecks and anxiety about telling her boyfriend that she is pregnant. ​ Age, status in school, employment, and pregnancy are not potential unmet needs.

Prioritizing Hypotheses: School-Aged Child With Asthma​ Jordan, a 6-year-old school-aged child, was diagnosed with asthma last year. His symptoms have been well controlled with daily use of an inhaler. Last week, his older sister got a guinea pig for her birthday. This morning, Jordan presents to the clinic coughing with wheezing breath sounds heard while taking a breath. The inhaler was used this morning with no improvement in symptoms. ​ Read "Animals, Pets and Asthma" (Asthma UK, 2020) and use the information to answer the question. The nurse should first address the client's __________ followed by the client's _____________.

The nurse should first address the client's symptoms followed by the client's environment. Review Feedback Jordan's symptoms represent an acute asthma exacerbation (attack) and an alteration in oxygenation. Resolving Jordan's acute symptoms is the priority, then the nurse should address the client's environment that triggered the problem. ​ Reference Asthma UK. (2020, March). Animals, pets and asthma. https://www.asthma.org.uk/advice/triggers/animals-and-pets/

Holistic Health Model

This model acknowledges multi-dimensional components of an individual, inclusive of emotional and spiritual well-being that contribute to physical health and wellness.

Maslow's Hierarchy of Needs

This model explains the interrelationships of basic human needs. The higher order needs can only be met when the ones beneath have been met satisfactorily: self-actualization, self-esteem needs, love and belonging needs, safety and security needs (physical and psychological), and physiological needs.

Health Belief Model

This model explores the relationship between what individuals believe (self-perception), modifying factors, and how they behave - likelihood to take action to avoid illness and those who do fail to take preventative action.

Health Promotion Model

This model is directed at increasing a person's level of well-being; focusing on individual characteristics and experiences, behavior-specific cognition and affect, and behavioral outcomes.

Transtheoretical Model

This model proposes that health-related behavior moves through five stages; precontemplation, contemplation, preparation, action and maintenance. This model identifies "stages of change."

Analyzing Cues Which model of health is best used to assist a client who needs to stop smoking but may be resistant? ​ Holistic health model​ Health promotion model ​ Transtheoretical model of change​ Health belief model​

Transtheoretical model of change​ Review Feedback The transtheoretical model of change is widely used in health promotion activities that conceptualize the process of intentional behavior change in alcohol and drug abuse and smoking cessation programs. A person must move from one stage to another before a lasting change occurs.​ The holistic health model acknowledges that all dimensions of an individual contribute to health and wellness. A holistic view also includes emotional and spiritual well-being. Healthcare providers recognize the body's natural healing abilities and may recommend or incorporate complementary and alternative interventions.​ The health promotion model is directed at increasing a person's level of well-being, focusing on three areas: individual characteristics and experiences, behavior-specific knowledge and effects, and behavioral outcomes. These personal characteristics interact with the environment to determine a person's motivation, attitudes, and actions to engage in health-promoting behaviors.​ The health belief model is used to understand factors influencing the client's perceptions, beliefs, and behaviors. This knowledge is used to plan care that will most effectively assist individuals in recognizing their risk for disease, the significance of the disease, and taking action to prevent the disease.​

Basic Physiological Needs​ Identify the basic physiological needs according to Maslow's hierarchy of needs. Select all that apply. Self-respect Water Love Sleep Food Elimination Oxygenation Personal growth

Water Sleep Food Elimination Oxygenation Review Feedback Physiological needs are oxygenation, food, water, sleep, and elimination. These must be addressed first. Remember, physiological needs are a "matter of survival."​ Love, self-respect, and personal growth are higher-level needs. ​

Health Promotion Model After a class on the health promotion model, students make the following statements. Which statement does the faculty member need to clarify? "Perceived self-efficacy is not related to the model." "The individual has unique characteristics and experiences that affect their actions." "Clients need to commit to a plan of action before they adopt a health-promoting behavior." "The desired outcome for the model is health-promoting behavior."

"Perceived self-efficacy is not related to the model." Review Feedback Within the model, perceived self-efficacy is one of the behavior-specific cognitions and effects. The behavior-specific cognitions have motivational significance within the model. All other statements are correct and do not require clarification. ​

Applying the Health Belief Model​ A healthcare professional is planning a health promotion program on testicular self-examination. Using the health belief model, which statement made by a participant indicates perceived susceptibility to illness?​ "I have a reminder on my phone to perform a testicular self-examination monthly."​ "Next month is testicular awareness month, so I will participate in a local community fundraiser."​ "Since I am so young, my risk for developing cancer is very low."​ "My brother had testicular cancer when he was a teenager, so I know my risk is elevated."​

"My brother had testicular cancer when he was a teenager, so I know my risk is elevated."​ Review Feedback Using the health belief model, the statement, "My brother had testicular cancer when he was a teenager, so I know my risk is elevated," indicates that the client is concerned about developing testicular cancer and feels that there is an increased risk based on a familial link for the disease. Therefore, the client perceives a personal risk. ​ Using a reminder to perform self-exams and participating in awareness campaigns are modifying factors (cues to action), not perceived susceptibility. ​ Assuming that young adults do not develop cancer is an inaccurate perception and a perceived barrier to preventive action. ​

Wellness and Illness​ An individual can have ____________ in the presence of illness.

An individual can have wellness in the presence of illness. Review Feedback Wellness is in a continual state of change and adaptation across the lifespan, even in the presence of illness. Healthcare professionals learn how wellness is individualized to support optimal health across the continuum in the presence or absence of illness. Optimal function is not found when illness is present.

Contributions to Health Review the factors below and select whether they apply or do not apply to health. Lifestyle choices Genetic make-up Environment in which you live Disease or disability Psychological or mental health issues

Applies to Health Lifestyle choices Genetic make-up Environment in which you live Disease or disability Psychological or mental health issues Review Feedback All of the factors listed in this question contribute towards health.

Perceived Benefits Which examples are perceived healthcare benefits of action? Select all that apply. A mother making an informed decision regarding her child receiving an immunization. An older adult canceling a colonoscopy procedure fearing pain. An adult female undergoing a mammogram screening test. A sexually active teenager scheduling an appointment with a healthcare provider to discuss oral contraceptive use.

A mother making an informed decision regarding her child receiving an immunization. An adult female undergoing a mammogram screening test. A sexually active teenager scheduling an appointment with a healthcare provider to discuss oral contraceptive use. Review Feedback A mother making an informed decision regarding a child receiving an immunization is a perceived benefit to action, although having an immunization may be painful for the child. An adult female undergoing a mammogram screening test is a perceived benefit to action in early detection of breast cancer, although the procedure may feel invasive and uncomfortable to the client. A sexually active teenager wanting to discuss oral contraceptive use with their healthcare provider is a perceived benefit to action as the teenager does not want to get pregnant. An older adult canceling a colonoscopy procedure fearing pain is a perceived barrier to action, not a perceived benefit. The perceived benefit would be to have the procedure although there may be some discomfort.

Active Versus Passive Health Promotion Strategies​ A nurse recommends iron-fortified infant formula to a new mother. This is an example of ___________ promotion. ​ A client attends yoga daily that ends with a meditation session. This is an example of ____________ health promotion. ​

A nurse recommends iron-fortified infant formula to a new mother. This is an example of passive promotion. ​ A client attends yoga daily that ends with a meditation session. This is an example of active health promotion. ​ Review Feedback With passive health promotion strategies, individuals gain from the activities of others without acting themselves. Iron-fortified infant formula is passive health promotion. With active health promotion strategies, individuals become personally involved in health promotion. Attending yoga and meditation sessions daily is active health promotion. ​

Health Promotion Strategies ​​ Select the correct strategy for health promotion for each example of a nurse promoting health. ​

Advocacy The public health nurse recognizes an increase in the incidence of diabetes mellitus type 2 among school-aged children and works with local school nurses to improve lunch menus in the schools. Equity The public health nurse recommends telehealth medical appointments be available for clients with limited transportation. Meditation A local elementary school wants to implement a mask mandate to protect children from exposure to COVID-19 during an outbreak, but the school board is resistant. The public health nurse presents information during a school board meeting.

Taking Action: School-Aged Child With Asthma​ Jordan, a 6-year-old school-aged child, was diagnosed with asthma last year. His symptoms have been well controlled with daily use of an inhaler. Last week, his older sister got a guinea pig for her birthday. This morning, Jordan presents to the clinic coughing with wheezing breath sounds heard while taking a breath. The inhaler was used this morning with no improvement in symptoms. ​ Read "Animals, Pets and Asthma" (Asthma UK, 2020) and use the information to answer the question.

Allergy testing reveals that Jordan is allergic to both hay and pet dander. It is determined that the pet must be re-homed to protect Jordan from future problems. Both Jordan and his sister are very sad to lose their pet.​ What advice should the nurse offer to Jordan's caregivers? Select all that apply.​ Consider a hypoallergenic pet (e.g., fish, reptile) Continue to take medications as prescribed Suggest a virtual pet Keep the pet but move the cage outside Sponsor an animal at the local zoo ​ Review Feedback The nurse could offer the following advice to Jordan's caregivers: Hypoallergenic pets do not shed dander and are less likely to trigger an allergic reaction.​ Allow the children to sponsor an animal at the local zoo and visit often.​ Jordan must continue to take all medications as prescribed, even if the pet is removed from the home. ​ Virtual pets allow children to feel as though they are caring for an animal without the risk of triggering asthma symptoms. ​ Moving the pet outside may not prevent asthma symptoms because allergens can remain in the clothes and be transferred to the carpet and furniture. ​ Reference Asthma UK. (2020, March). Animals, pets and asthma. https://www.asthma.org.uk/advice/triggers/animals-and-pets/

Maslow's Hierarchy of Needs: Case Scenario​ An adolescent is sent to the principal's office for not paying attention in class. The student states they didn't eat breakfast. These concerns represent ___________ needs. Additionally, the student discloses that the family slept in their car last night and they were fearful of being robbed. These concerns represent __________ needs. The school staff notices that the adolescent's clothes have an unpleasant odor and the student admits to being bullied in homeroom. These concerns represent ___________ needs. Due to these unmet needs, the student is unable to concentrate and fails to complete assignments. These concerns represent _________ needs. ​

An adolescent is sent to the principal's office for not paying attention in class. The student states they didn't eat breakfast. These concerns represent physiological needs. Additionally, the student discloses that the family slept in their car last night and they were fearful of being robbed. These concerns represent safety needs. The school staff notices that the adolescent's clothes have an unpleasant odor and the student admits to being bullied in homeroom. These concerns represent belonging needs. Due to these unmet needs, the student is unable to concentrate and fails to complete assignments. These concerns represent cognitive needs. ​

Transtheoretical Model of Change Complete the following activity on how the health professional assumes different roles within the model to promote healthy change in an individual who is trying to quit smoking. Select the correct stage that applies to the description.

Contemplation Stage Counselor: Guides in problem solving, supports self-determination, and shows that change is possible and necessary. Educator: Reinforces education about the evidence of smoking effects, success with abstinence, and available options to support smoking cessation. Critical Thinker: Uses a specific process to support change with the client​. Maintenance Stage Mentor: Provides follow-up support, consultation, and referrals as needed. Researcher: Measures outcomes over time to build effective interventions. Innovator: Creates new solutions for unseen problems particular to each client's smoking recovery. ​ Precontemplation Stage Guide: Helps the smoker through unfamiliar circumstances and guides plan development with evidence-based science. Motivator/Change Agent: Creates motivation through honest involvement, active listening, and encouragement. Coordinator: Links available resources and creates a supportive network for success. Preparation Stage Communicator: Establishes therapeutic relationships upon which to build trust and honest, factual communication. Educator: Available to provide accurate information so that an individual can weigh the pros and cons of behavior. Supportive Advocate: Reaches out to encourage and offer help while protecting the individual's right to self-determination. Action Stage Coach: Provides training, prompting, leadership, and instruction. Caregiver: Implements a specific process to assist with antismoking medications, patches, and other support materials and aids as appropriate. Teacher: Provides practical strategies to deal with urges, withdrawal, and emotions​.

Assessing Health Risks At which point in care does a nurse assess health risks? When the person makes an appointment Never After an individual asks for help During each client encounter

During each client encounter Review Feedback The nurse assesses health risks during each encounter with an individual, group, or community.

Generating Solutions The healthcare professional considers which prevention strategies may be most effective for Michael. From the list provided, identify which strategies may be effective or unnecessary. ​ Weight loss Diet alterations Stress reduction Medication Physical activity

Effective Diet alterations Stress reduction Physical activity Unnecessary Weight loss Medication Review Feedback Based on Michael's physical examination, the most effective prevention strategies at this time may be diet alterations, stress reduction, and physical activity. ​Implementing a heart-healthy diet now may prevent cardiovascular decline in the future. Stress contributes to cardiovascular risk, so reduction may be beneficial. Physical activity improves cardiovascular function.​ Michael is not overweight; therefore, weight loss is not indicated. There is no indication at this time that Michael needs prescription medication.

Dimensions of Wellness​​ Which are the dimensions of wellness? Select all that apply. Environmental Occupational Intellectual Social Physical Financial Spiritual Familial Emotional

Environmental Occupational Intellectual Social Physical Financial Spiritual Emotional Review Feedback ​Familial is not a dimension of wellness. ​

What is Wellness? There are many factors that determine wellness. Identify the factors below which contribute to wellness. Select all that apply. Environmental state Social state Mental state Physical state Financial state

Environmental state Social state Mental state Physical state Financial state

Generating Solutions What recommendations could be made to assist Jonathan in improving his health? Select which recommendations are essential versus nonessential. Quit job at family practice clinic to reduce stress​. Consider vaccination based on age recommendations​. Explore stress reduction strategies, such as meditation or yoga​. Eat more fast food to save money​. Reduce exercise time to have more time to study​.

Essential Consider vaccination based on age recommendations​. Explore stress reduction strategies, such as meditation or yoga​. Nonessential Quit job at family practice clinic to reduce stress​. Eat more fast food to save money​. Reduce exercise time to have more time to study​. Review Feedback Essential recommendations for Jonathan to consider are vaccination based on age recommendations (vaccination will help protect Jonathan against several acute illnesses) and exploring stress reduction strategies (emotional factors, such as stress, can impact health and lead to illness). ​ Though Jonathan may need to reprioritize activities and work on time management skills, it would not be beneficial to quit his job, eat more fast food, or reduce exercise time. These are healthy behaviors that are contributing positively to Jonathan's state of wellness.

Maslow's Needs and Healthcare​ Healthcare professionals often use Maslow's hierarchy of needs when planning and implementing client care. How does Maslow's theory provide structure for client care? Decides on appropriate laboratory testing​ Helps to accurately diagnose disease Establishes priorities of care​ Communicates client needs concisely​

Establishes priorities of care​ Review Feedback Maslow's hierarchy of needs is used by healthcare professionals to establish priorities of care. It provides a basis for healthcare professionals to care for clients of all ages in all settings.​ Maslow's theory does not help with an accurate diagnosis, selecting appropriate laboratory testing, or communicating client needs.

Terms and Definitions​​ Match the following terms to their proper definitions. State of complete physical, mental, and social well-being, not merely the absence of disease or illness Positive state of health that is continually changing Subjective experience and may include physical indicators Functional or structural disturbance

Health State of complete physical, mental, and social well-being, not merely the absence of disease or illness Wellness Positive state of health that is continually changing Illness Subjective experience and may include physical indicators Disease Functional or structural disturbance

Defining Health Promotion Match the definitions to the proper terms.

Health Promotion Activities that help individuals maintain or enhance their present level of health. Wellness Education Interventions that teach people how to care for themselves in a healthy way. Illness Prevention Activities that protect people from actual or potential threats to health.

Evaluating Outcomes: School-Aged Child With Asthma​ Jordan, a 6-year-old school-aged child, was diagnosed with asthma last year. His symptoms have been well controlled with daily use of an inhaler. Last week, his older sister got a guinea pig for her birthday. This morning, Jordan presents to the clinic coughing with wheezing breath sounds heard while taking a breath. The inhaler was used this morning with no improvement in symptoms. ​ Allergy testing reveals that Jordan is allergic to both hay and pet dander. It is determined that the pet must be re-homed to protect Jordan from future problems. Both Jordan and his sister are very sad to lose their pet.​ Read "Animals, Pets and Asthma" (Asthma UK, 2020) and use the information to answer the question.

Jordan presents to the clinic two weeks later for a follow-up visit. For each statement made by the caregivers, click to specify if Jordan's situation is improving or declining. "Jordan is no longer coughing and wheezing."​ "Jordan is doing so well and doesn't need the inhaler anymore." "Jordan and his sister got a fish tank last week."​ "The children were so sad, so we decided to keep the pet."​ Improving "Jordan is no longer coughing and wheezing."​ "Jordan and his sister got a fish tank last week."​ Declining "Jordan is doing so well and doesn't need the inhaler anymore." "The children were so sad, so we decided to keep the pet."​ Review Feedback Statements that indicate Jordan's situation is improving include:​ No longer coughing and wheezing shows improvement in the acute condition.​ Getting a fish tank helps the children cope with the loss of the pet and will not produce allergens.​ Statements that indicate Jordan's situation is declining include:​ No longer taking inhaler medications which are needed regularly to prevent asthma attacks. ​ Keeping the pet represents a serious risk to Jordan's health. ​ Reference Asthma UK. (2020, March). Animals, pets and asthma. https://www.asthma.org.uk/advice/triggers/animals-and-pets/

Recognizing Cues: School-Aged Child With Asthma​ Read "Animals, Pets and Asthma" (Asthma UK, 2020) and use the information to answer the question. Click to select all the findings that require immediate follow-up by the nurse. Jordan, a 6-year-old school-aged child, was diagnosed with asthma last year. His symptoms have been well controlled with daily use of an inhaler. Last week, his older sister got a guinea pig for her birthday. This morning, Jordan presents to the clinic coughing with wheezing breath sounds heard while taking a breath. The inhaler was used this morning with no improvement in symptoms. Reference Asthma UK. (2020, March). Animals, pets and asthma. https://www.asthma.org.uk/advice/triggers/animals-and-pets/

Jordan, a 6-year-old school-aged child, was diagnosed with asthma last year. His symptoms have been well controlled with daily use of an inhaler. Last week, his older sister got a guinea pig for her birthday. This morning, Jordan presents to the clinic coughing with wheezing breath sounds heard while taking a breath. The inhaler was used this morning with no improvement in symptoms. Review Feedback The nurse's immediate concerns include Jordan's coughing with wheezing and that no improvement was seen after use of the inhaler. ​ Jordan was diagnosed with asthma last year, but symptoms have been well controlled with daily use of an inhaler. These are not the primary nursing concerns. ​

Analyzing Cues: Samara's Scenario​ Samara, a 22-year-old college student (preferred pronouns she, her), is finishing her senior year in nursing school. She works part-time as a waitress, but the diner's business has been slow and her paychecks have been small. Yesterday, Samara found out that she is pregnant and worries about telling her boyfriend. Samara just came home to find an eviction notice on her front door. She knew that her rent was behind several months, but thought she had time to get caught up. With all the stress in her life, she is struggling in school. Match each unmet need to the appropriate level according to Maslow's hierarchy of needs.​

Level/ Unmet Need Safety and Security Samll paychecks Self-esteem Struggling in school Physiological Eviction notice Love and belonging Rejection by boyfriend

Location of Prevention Strategies​​ Match each prevention strategy to the location where it would most likely occur.

Local Trash pickup days increase during the holidays State Vaccination clinics sponsored by the state health department National Centers for Disease Control and Prevention's Childhood Lead Poisoning Prevention Program

Models of Health Models of health provide various ways of understanding ___________ and ___________ concepts.​

Models of health provide various ways of understanding health and wellness concepts.​ Review Feedback Models of health provide various ways of understanding health and wellness (not diet, illness, exercise, or activity) concepts by guiding you to think about:​ different ways of understanding health and wellness relationships between health and wellness individual beliefs and subjective experiences of health and wellness ​

Risk Factors for Diabetes Mellitus​​ Click to specify whether each risk factor for developing diabetes mellitus type 2 is modifiable or nonmodifiable. ​ Obesity 45 years old​ Parent with diabetes mellitus type 2​ Sedentary lifestyle​ African American ​ History of gestational diabetes during pregnancy​

Modifiable Obesity Sedentary lifestyle​ Nonmodifiable 45 years old​ Parent with diabetes mellitus type 2​ African American ​ History of gestational diabetes during pregnancy​ Review Feedback A client can prevent or delay the onset of diabetes mellitus type 2 by losing weight, eating healthy, and getting regular physical exercise. ​

Focus on the Future By leading health promotion activities, in which areas do nurses improve healthcare outcomes? Select all that apply. Natural disasters Increasing healthcare costs Emerging infections Aging population Bioterrorism

Natural disasters Emerging infections Aging population Bioterrorism Review Feedback As a collective workforce, nurses are engaged in health promotion at multiple levels: providing care in a variety of situations (emerging infections, bioterrorism events, natural disasters); addressing the changing health needs of an aging population; and working on institutional and legislative policies that promote all aspects of health, including the decreasing (not increasing) costs of healthcare.

Recognizing Cues Based on Jamal's visit to the community health fair, click to specify if each of Jamal's behaviors is positive or negative. ​

Negative Behavior Smoking for 41 years​ Snacking late at night​ Work-related stress​ Positive Behavior Receives vaccines​ Takes daily multivitamin​

Types of Risk Factors​ Drag the risk factors into the appropriate category to identify each as either nonmodifiable or modifiable.

Nonmodifiable Gender at birth Family health history Age Genetics Ethnicity Personal health history Modifiable Stress Diet Lifestyle Exercise Substance misuse Wearing a seatbelt Sleep pattern Tobacco use Review Feedback Modifiable risk factors are lifestyle behaviors and practices that can be changed. Nonmodifiable risk factors cannot be changed.

Identifying Primary Versus Secondary Prevention​ For each action, click to specify if the action is a primary or secondary prevention strategy. ​ Blood transfusion for anemia​ Teaching a community class on heart-healthy eating Wearing a car seat belt​ A parent bringing children to a vaccine clinic​ Visiting the urgent care clinic for a sore throat​ Using crutches due to a broken leg​ Making an appointment for a school sports physical​ Attending a class on mindfulness​ Screening by mammogram for women over age 45 years​

Primary Teaching a community class on heart-healthy eating Wearing a car seat belt​ A parent bringing children to a vaccine clinic​ Making an appointment for a school sports physical​ Attending a class on mindfulness​ Secondary Blood transfusion for anemia​ Visiting the urgent care clinic for a sore throat​ Using crutches due to a broken leg​ Screening by mammogram for women over age 45 years​ Review Feedback Primary prevention promotes health by focusing on activities the client can do to avoid disease or injury before it happens. This includes eliminating risk factors from the surrounding environment and making lifestyle changes before problems arise. ​ Examples include: learning about heart-healthy eating wearing a seat belt receiving vaccinations getting an annual school sports physical learning about mindfulness techniques​ Secondary prevention focuses on preventing the spread of disease, illness, or infection once it occurs. The goal is the detection of a disease or injury in the earliest stages, often before signs and symptoms are present. This includes activities that are directed at diagnosis, prompt intervention, and prevention of worsening conditions.​ Examples include: blood transfusion to treat anemia visiting an urgent care clinic to treat a sore throat using crutches due to a broken leg screening by mammogram for women over the age of 45 years to detect the presence of breast cancer

Generating Solutions: School-Aged Child With Asthma​ Jordan, a 6-year-old school-aged child, was diagnosed with asthma last year. His symptoms have been well controlled with daily use of an inhaler. Last week, his older sister got a guinea pig for her birthday. This morning, Jordan presents to the clinic coughing with wheezing breath sounds heard while taking a breath. The inhaler was used this morning with no improvement in symptoms. ​ Read "Animals, Pets and Asthma" (Asthma UK, 2020) and use the information to answer the question. For each possible action, click to specify if the action represents primary or secondary prevention. ​ Prescription for a rescue inhaler ​ Keep the window open and use a fan in the pet room​ Allergy testing​ ​ Move the pet to an area of the home that Jordan does not frequent ​ Clean the pet cage daily Use an air filter in the home​

Primary Prevention Keep the window open and use a fan in the pet room​ Move the pet to an area of the home that Jordan does not frequent ​ Clean the pet cage daily Use an air filter in the home​ Secondary Prevention Prescription for a rescue inhaler ​ Allergy testing​ ​ Review Feedback Primary prevention is aimed at reducing the incidence of disease or injury. Therefore, primary prevention promotes the general health of the individual, family, or community by focusing on activities the client can do to avoid disease or injury before it happens. Strategies for Jordan include moving the pet to a less frequented area of the home, cleaning the pet's cage daily, keeping the window open and using a fan in the pet room, and using an air filter.​ Secondary prevention focuses on preventing the spread of disease, illness, or infection once it occurs. The goal is detection of a disease or injury in the earliest stages. This includes activities that are directed at diagnosis, prompt intervention, and prevention of worsening conditions. Strategies for Jordan include a prescription for a rescue inhaler to use during an acute attack and allergy testing. ​ Reference Asthma UK. (2020, March). Animals, pets and asthma. https://www.asthma.org.uk/advice/triggers/animals-and-pets/

Taking Action In planning future care for Michael, click to specify if each strategy is primary, secondary, or tertiary prevention. ​ Reducing work hours ​ Taking medication to treat high blood pressure​ Screening annually for high blood sugar​ Practicing meditation Joining a cycling club​ Attending cardiac rehabilitation after a heart attack

Primary Prevention Reducing work hours ​ Practicing meditation Joining a cycling club​ Secondary Prevention Taking medication to treat high blood pressure​ Screening annually for high blood sugar​ Tertiary Prevention Attending cardiac rehabilitation after a heart attack Review Feedback Primary prevention, often called "true" prevention, is aimed at reducing the incidence of disease or injury. Therefore, primary prevention promotes the general health of the individual, family, or community by focusing on activities the client can do to avoid disease or injury before it happens. Strategies for Michael include reducing work hours, practicing meditation, and joining a cycling club. ​ Secondary prevention focuses on preventing the spread of disease, illness, or infection once it occurs. The goal is detection of a disease or injury in the earliest stages, often before signs and symptoms are present. This includes activities that are directed at diagnosis, prompt intervention, and prevention of worsening conditions. Strategies for Michael may include taking medication in the future to treat high blood pressure and screening annually for high blood sugar. ​ Tertiary prevention involves helping a client manage a chronic condition to lessen long-term complications and return to optimal functioning. In addition to restoration of quality of life, it prevents symptoms from becoming more terminal, leading to disability or death. Strategies for Michael may include attending cardiac rehabilitation after a heart attack in the future. ​

Defining Levels of Prevention​ Drag and drop the level of prevention to the correct description.

Primordial Prevention Preventing exposure to risk factors that promote disease onset Primary Prevention Reducing the incidence of disease or injury Secondary Prevention Preventing the spread of disease, illness, or infection once it occurs Tertiary Prevention Managing a chronic condition to lessen long-term complications

Identifying Levels of Prevention ​​ The healthcare professional can promote health and assist clients in preventing disease through prevention strategies. Match the level of prevention to the prevention strategy. Avoiding second-hand smoke Rehabilitation after stroke Monthly testicular exams Teaching about the use of a spacer to a client with asthma​ Mammograms for women over 45​ ​Health education about the dangers of underage marijuana use​ Increased physical activity Low-dose aspirin to prevent heart attack​ Preventing the legalization of marijuana ​

Primordial Prevention Preventing the legalization of marijuana ​ Primary Prevention Avoiding second-hand smoke Health education about the dangers of underage marijuana use​ Increased physical activity Secondary Prevention Monthly testicular exams Mammograms for women over 45​ Low-dose aspirin to prevent heart attack​ Tertiary Prevention Rehabilitation after stroke Teaching about the use of a spacer to a client with asthma​ Review Feedback Primordial prevention involves risk factor prevention. Strategies are often aimed at children to decrease as much risk exposure as possible. Activities focus on social and environmental conditions that promote disease onset. Preventing the legalization of marijuana is primordial prevention. ​ Primary prevention promotes health by focusing on activities the client can do to avoid disease or injury before it happens. Increased physical activity, avoiding second-hand smoke, and health education about the dangers of marijuana use are considered primary prevention. ​ Secondary prevention involves the detection of a disease or injury in the earliest stages. Annual mammograms for women over age 45, low-dose aspirin to prevent a heart attack, and monthly testicular exams are examples of secondary prevention. ​ Tertiary prevention involves helping a client manage a chronic condition to lessen long-term complications and return to optimal functioning. Rehabilitation after a stroke and teaching about the use of a spacer with a metered-dose inhaler for a client to manage asthma are examples of tertiary prevention. ​

Case Scenario: Levels of Prevention Sara, a 28-year-old female, is currently pregnant. Before becoming pregnant, she lost 20 pounds by eating a healthy diet and exercising daily. Sara attends prenatal yoga and performs monthly breast self-exams. As a diabetic, she checks her blood sugar levels four times daily. ​ Question 1/2 Click to specify if each prevention strategy is primary or secondary prevention. ​ Eating healthy and exercising daily​ Attending prenatal yoga​ Performing monthly breast self-exams​ Monitoring blood sugar levels​ Question 2/2 Last night, Sara became very dizzy and almost passed out. Her partner took her to the Emergency Department where it was determined that Sara's blood sugar was dangerously low. She was admitted to the hospital for treatment of hypoglycemia and monitoring of her fetus. ​ What type of prevention is Sara receiving?​ Tertiary Primary Primordial Secondary

Question 1/2 Primary Eating healthy and exercising daily​ Attending prenatal yoga​ Secondary Performing monthly breast self-exams​ Monitoring blood sugar levels​ Question 2/2 Secondary Review Feedback Secondary prevention focuses on preventing the spread of disease, illness, or infection once it occurs. The goal is detection of a disease or injury and includes activities that are directed at diagnosis, prompt intervention, and prevention of a worsening condition. Seeking treatment for low blood sugar and fetal monitoring is a type of secondary prevention. ​ Primordial prevention involves risk factor prevention. Strategies are often aimed at children to decrease as much risk exposure as possible. Activities focus on social and environmental conditions that promote disease onset. Primary prevention promotes health by focusing on activities the client can do to avoid disease or injury before it happens. Tertiary prevention involves helping a client manage a chronic condition to lessen long-term complications and return to optimal functioning.

MASTERED - DEFINING HEALTH AND WELLNESS

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MASTERED - LEVELS OF PREVENTION

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MASTERED - MASLOW'S HIERARCHY OF NEEDS

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MASTERED - MODELS OF HEALTH

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MASTERED - NURSES AS PROMOTERS OF HEALTH

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Evaluating Outcomes Based on client actions as a result of participating in the community health fair, which findings indicate the health promotion activities were effective? Select all that apply.​ Gained 10 pounds since reducing smoking​ Reduced number of cigarettes smoked per day Reports sleeping 6-7 hours nightly​ Recently quit his job and is still searching for a replacement​ Did not develop influenza this season​ Brought spouse to pharmacy to receive shingles vaccine

Reduced number of cigarettes smoked per day Reports sleeping 6-7 hours nightly​ Did not develop influenza this season​ Brought spouse to pharmacy to receive shingles vaccine Review Feedback Indications for effective health promotion activities include a reduction in smoking, reporting improved sleeping, not contracting influenza due to vaccination, and encouraging the spouse to be vaccinated.​ Indications that the client's situation is declining include quitting a job without a replacement (this will increase his stress level) and gaining 10 pounds since smoking reduction indicates unhealthy eating habits.

Perceived barriers

Refers to a person's feelings on the obstacles to performing a recommended health action. There is wide variation in a person's feelings of barriers, or impediments, which leads to a cost/benefit analysis. The person weighs the effectiveness of the actions against the perceptions that it may be expensive, dangerous (e.g., side effects), unpleasant (e.g., painful), time-consuming, or inconvenient.​

Perceived severity

Refers to a person's feelings on the seriousness of contracting an illness or disease (or leaving the illness or disease untreated). There is wide variation in a person's feelings of severity and often a person considers the medical consequences (e.g., death, disability) and social consequences (e.g., family life, social relationships) when evaluating the severity.​

Perceived benefits

Refers to a person's perception of the effectiveness of various actions available to reduce the threat of illness or disease (or to cure illness or disease). The course of action a person takes in preventing (or curing) illness or disease relies on consideration and evaluation of both perceived susceptibility and perceived benefit, such that the person would accept the recommended health action if it was perceived as beneficial.​

Perceived susceptibility

Refers to a person's subjective perception of the risk of acquiring an illness or disease. There is wide variation in a person's feelings of personal vulnerability to an illness or disease.​

Self-efficacy

Refers to the level of a person's confidence in their ability to successfully perform a behavior. This construct was added to the model most recently in mid-1980. Self-efficacy is a construct in many behavioral theories as it directly relates to whether a person performs the desired behavior.​

Maslow's Hierarchy of Needs Drag and drop the proper characteristic to match each level of Maslow's hierarchy below.

Review Feedback The correct characteristics of each level are: Self-actualization - problem solving Esteem - confidence Love/Belonging - friendship Safety - security of resources Physiological - breathing

Immunizations and Maslow's Needs​ A client presents to an immunization clinic to receive influenza and tetanus (Td) vaccines. Which need, according to Maslow's hierarchy, is being met?​ Physiological Cognitive Aesthetic Safety and security

Safety and security Review Feedback Receiving an immunization meets physical safety needs by preventing injury. ​ Toileting, nutrition, and exercise meet physiological needs.​ Appreciation for the beauty and balance in the world meets aesthetic needs.​ Knowledge and understanding meet cognitive needs. ​

External Factors Impacting Health​ A 34-year-old male client has been laid off from his job and has many unpaid bills. The client has been having thoughts of suicide but denies needing medical help and has reached out to his pastor for emotional support. The client does not have a primary healthcare provider because he has never been very sick. As a child, his caregivers did not have money to pay for healthcare provider visits, so this has never been a priority. The client is married and has a close network of friends through his church. ​ Which external variables influence this client's current health practices? Select all that apply. Support from social networks Age of client Difficulty paying bills Denies needing help for suicidal thoughts Family practice of not routinely seeing a healthcare provider

Support from social networks Difficulty paying bills Family practice of not routinely seeing a healthcare provider Review Feedback External factors impacting health practices include family beliefs, family practices, and socioeconomic variables. The way that clients' families use healthcare services generally affects their current health practices. History of preventive care behaviors (or lack of them) can also influence how clients think about their current health practices. A person may seek support from social networks (friends, family, and spiritual advisors). Economic variables may affect a client's level of health by increasing the risk for disease and influencing how or at what point the client enters the healthcare system. A client's age, degree of psychological stress, and denying the need for help are internal factors.

Risk Factors A nurse is caring for a client with several risk factors for developing cardiovascular disease, including obesity and family history. How should the nurse interpret these findings?​ Risk prevention strategies will have no effect. ​ If risks are controlled, the client will not get the disease. ​ The chances of having a myocardial infarction are increased.​ The disease is guaranteed to develop. ​

The chances of having a myocardial infarction are increased.​ Review Feedback The presence of risk factors does not mean that a disease will develop, but risk factors increase the chances that the individual will experience a particular disease or dysfunction. ​ Control of risk factors does not guarantee that a disease will not develop. However, risk factor modification can assist clients in adopting activities to promote health and decrease risks of illness.​

Applying the Transtheoretical Model of Change​ Using the transtheoretical model of change, place the steps needed to make a lifestyle change in the correct order. Six months after beginning the workout regimen, the client has lost 20 pounds. The client becomes angry when the healthcare provider suggests losing 40 pounds. The client joins a gym and hires a personal trainer. The client recognizes the need to lose weight when struggling to play catch with the son. The client works out 4 days per week with their spouse.

The client becomes angry when the healthcare provider suggests losing 40 pounds. The client recognizes the need to lose weight when struggling to play catch with the son. The client joins a gym and hires a personal trainer. The client works out 4 days per week with their spouse. Six months after beginning the workout regimen, the client has lost 20 pounds. Review Feedback This sequence follows the order of the steps of the transtheoretical model of change: Precontemplation: The client becomes angry when the healthcare provider suggests losing 40 pounds. Contemplation: The client recognizes the need to lose weight when struggling to play catch with the son. Preparation: The client joins a gym and hires a personal trainer. ​ Action: The client works out 4 days per week with their spouse. Maintenance: Six months after beginning the workout regimen, the client has lost 20 pounds. ​

Primordial Versus Primary Prevention​ The nurse is working in a vaccination clinic providing influenza immunizations and health education about preventing the spread of respiratory diseases. This scenario represents _________ prevention. ​ A pregnant client participates in a prenatal nutrition program to ensure delivery of a healthy newborn. This scenario represents __________ prevention. ​

The nurse is working in a vaccination clinic providing influenza immunizations and health education about preventing the spread of respiratory diseases. This scenario represents primary prevention. ​ A pregnant client participates in a prenatal nutrition program to ensure delivery of a healthy newborn. This scenario represents primordial prevention. Review Feedback Primary prevention promotes the general health of the individual, family, or community by focusing on activities the client can do to avoid disease or injury before it happens. This includes eliminating risk factors from the surrounding environment and making lifestyle changes before problems arise. Health education programs and immunizations are examples of primary prevention. Primordial prevention involves risk factor prevention. Strategies are often aimed at children to decrease as much risk exposure as possible. Activities focus on social and environmental conditions that promote disease onset. The pregnant client eating healthily to prevent risk factors from developing prenatally in her newborn is an example of primordial prevention.

Analyzing Cues: School-Aged Child With Asthma​ Jordan, a 6-year-old school-aged child, was diagnosed with asthma last year. His symptoms have been well controlled with daily use of an inhaler. Last week, his older sister got a guinea pig for her birthday. This morning, Jordan presents to the clinic coughing with wheezing breath sounds heard while taking a breath. The inhaler was used this morning with no improvement in symptoms. ​ Read "Animals, Pets and Asthma" (Asthma UK, 2020) and use the information to answer the question. The nurse recognizes that Jordan's issues stem from a/n ______________ risk factor. ​

The nurse recognizes that Jordan's issues stem from a/n environmental risk factor. ​ Review Feedback An environmental risk factor is a substance that has the ability to cause an adverse health event. The likely trigger of Jordan's symptoms is the introduction of a pet into the household.​ Modifiable risk factors are lifestyle behaviors and practices that can be changed. ​ Nonmodifiable risk factors are things that cannot be changed. ​ Reference Asthma UK. (2020, March). Animals, pets and asthma. https://www.asthma.org.uk/advice/triggers/animals-and-pets/