Culture and Patient Education, EDAPT, week 4

Amelia Sanchez (preferred pronouns she, her) is a registered nurse working in a local health clinic. The surrounding community is largely immigrant, and many children are unvaccinated. Additionally, the community has seen a 10% increase in tuberculosis cases in the past year. Despite the availability of health services within very close proximity to the community, many residents are unaware of these services. ​

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Healthy People 2030 (HP2030) and SDOH, 5 Key areas.

uses a place-based framework that outlines five key areas of SDOH, 1-healthcare access and quality 2-education access and quality 3-Social and community context 4-economic stability 5-neighborhood environment

Blended family

A blended family is formed when parents bring children from previous relationships into a new joint-living situation.​

What family form is presented? (use story in previous slide)

An alternative family may include multi-adult households, grand families (grandparents caring for grandchildren), communal groups with children, adults living alone, and cohabitating partners. Marie's family is an alternative family.​

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

An alternative family may include multi-adult households, grand families (grandparents caring for grandchildren), communal groups with children, adults living alone, and cohabitating partners. Sally and Tommy represent an alternative family form. ​

What is anticipatory guidance?

Anticipatory guidance is given by healthcare professionals to clients or supporting family members for an anticipated developmental or situational crisis.

Social Determinants of Health (SDOH)

Are conditions in the places where people live, work, learn, and play that affect a wide range of health risks and outcomes. These determinants represtent biological, socioeconomic, psychosocial, behavior and social factors that contribute to current health status.

Which part of provision 9 addresses our need as nurses to have a unified voice in our shared values?

Articulation and assertion of values

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

Assess own biases and attitudes

Matching: analyzing learning and assessing needs

Assess patients' learning needs - The client is here to learn about their diagnoses Provide education on a variety of items and topics - Teaching to include medication actions and side effects Include interprofessional collaboration in the education process - Dietitian suggested certain foods and liquids to help with infection Consider the client's education and experience - The client is a college professor who has had this infection before Consider the client's own desire to participate actively - The client is asking questions about their treatment Include psychosocial, spiritual, and cultural values - The client is uncomfortable talking about this with a male provider Document the education and client response in the medical record - There is proof that this was discussed with the client

A father and his 2 children are experiencing homelessness. Which statement best describes the effects of homelessness on children? SATA -More cavities and dental problems​ -Stable educational opportunities -Decreased risk of malnutrition​ -Lack of recommended immunizations​ -higher incidence of asthma​

More cavities and dental problems, Lack of recommended immunizations, Higher incidence of asthma Experiencing homelessness can have a major impact on the health and well-being of the family. When housing is unstable, chronic health problems are more common. This results from exposure to the elements, poor nutrition, and lack of access to healthcare. ​ Children experiencing homelessness are especially vulnerable with higher rates of asthma, ear infections, and poor dental health. Lack of access to healthcare leads to a lack of immunizations. ​

Which observations indicate that the family is demonstrating hardiness and resiliency in this situation? Select all that apply. Marie is readmitted to the hospital after falling again due to lack of supervision​. Marie's son accepts physical and financial help from his local church community​. Marie's son experiences anxiety, needing medical treatment​. The children continue to attend school daily and are enrolled in an after-school program​. Marie's son contacts a local food bank to provide nutritious foods for the children​.

Observations that the family is demonstrating hardiness and resiliency include: ​ Marie's son accepts physical and financial help from his local church community.​ The children continue to attend school daily and are enrolled in an after-school program. ​ Marie's son contacts a local food bank to provide nutritious foods for the children. ​ Marie falling again due to lack of supervision and Marie's son suffering severe anxiety with the need for medical treatment are indications of a family crisis, not resiliency. ​

the Institute of Medicine (IOM) defines 6 domains for quality healthcare. The domains should be used to address improvements in healthcare services delivered to individuals families communities and populations. what are they?

Safe effective patient centered Timely Efficient equitable

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

Social justice is the belief that everyone deserves an equal opportunity to achieve their full health potential, and no one is disadvantaged because of socially determined circumstances. Carmen is displaying the professional value of social justice. ​ Confidentiality is the nondisclosure of client secrets or information without authorization.​ Advocacy is the act or process of supporting a cause or proposal. ​ Responsibility is the opportunity or ability to act independently and make decisions without authorizations.​

SDOH: Structural Determinants

Socioeconomic and political : governance, policies, values (can contribute to an unequal distribution of material and monetary resources) Socioeconomic Position: gender, education, occupation, ethnicity, income, social class (can affect exposure, vulnerability and outcomes)

Which factors can influence a person's health? SATA -Political party membership -Peer pressure -Socioeconomic status -Vehicle registration -Geographic area of residence -Gun ownership

Socioeconomic status Geographic area of residence.

Adverse Childhood Experiences (ACEs)

Stressful or traumatic experiences, including abuse, neglect, and a range of household dysfunction, such as witnessing domestic violence or growing up with substance abuse, mental disorders, parental discord, or crime in the home.

Stacey begins to prepare the room for the teaching session. What should the nurse consider? Select all that apply. ​ Furniture placement​ Temperature​ Distractions​ Noise level​ Privacy​

The environment must be conducive to teaching and learning. Distractions or persistent noise may impede concentration. If the room is uncomfortable (e.g., poorly ventilated, too cold, too hot, poor lighting), adjustments may be necessary. Furniture should be placed in an arrangement that best supports the teaching method. Privacy should be provided. ​

Characterizing

The learner acts and responds based on internalized values. This includes self-examination of one's personal values. ​ Example: After learning about nursing's professional core values, the nursing student's behavior is consistent with displaying the values.

Valuing

The learner attaches value and worth to acquired knowledge as demonstrated by commitment. ​ Example: A group of nursing students committed to learning proper client care during a simulation. ​

Organizing

The learner internalizes values and beliefs. ​ Example: A nursing student embraces and internalizes the core values of the nursing profession. ​

Responding

The learner is actively participating in the learning process through verbal and nonverbal responses. ​ Example: A group of students working together to solve a problem. ​

Receiving

The learner is passively receiving information. ​ Example: Students in a classroom listening to a lecture while quietly sitting in a desk.

For each action taken by the nurse, click to specify which phase of the nursing process it represents. 1. Uses therapeutic communication ​2. Ensures that the client's assistive device for hearing is functioning properly​ 3. Uses teach-back method​ 4. Determines motivation and readiness to learn​ 5. Reviews data and decides that the client is not ready to learn​

The nurse determines motivation and readiness to learn during the assessment. After performing the assessment, the nurse can analyze the data and identify barriers to learning (motivation to learn). Before teaching, the nurse plans the session and prepares the environment, which includes ensuring that the client's assistive device for hearing is functioning properly. The nurse uses therapeutic communication during the teaching session (implementation). The nurse evaluates teaching using the teach-back method. ​

The nurse is teaching the client in the __________ domain and should use __________________.

The nurse is teaching the client in the cognitive domain and should use discussion. ​ The cognitive domain involves the acquisition of knowledge and the development of intellectual skills. Best to use discussion, lecture, Q&A session. ​ The psychomotor domain involves acquiring motor skills that require coordination. Best to use practice and return demonstration.​ The affective domain includes the manner in which we deal with things emotionally, such as attitudes, feelings, values, appreciation, enthusiasms, and motivations. Best to use role play. ​

matching

Upstream factors affect communities in a large and inequitable way. Example: A nurse works with a local community health department to implement a pediatric lead screening program. ​ Midstream factors represent social needs or individual factors that affect a person's health. Example: A nurse identifies that a client is struggling with food insecurity and recommends a local food bank for assistance. ​ Downstream factors represent immediate health needs of the population. Example: A nurse cares for a client diagnosed with asthma during an acute attack. ​

Matching: upstream, midstream and downstream

Upstream factors affect communities in a large and inequitable way. Example: The nurse meets with elected community officials to advocate for more affordable housing options.​ Midstream factors represent social needs or individual factors that affect a person's health. Example: The nurse works with clients to improve substandard housing. ​ Downstream factors represent immediate health needs of the population. Example: The nurse works with the local health department to increase the availability of allergy and asthma treatments for high-risk populations.

Cultural Attributes

characteristic that define a culture.

Suggested questions to ask LGBTQ+

do you think of yourself as : heterosexual, gay, bisexual, pansexual or something else? do you think of yourself as : male, female, gender non-conforming, non-binary, gender diverse What sex was originally listed on your birth certificate? What is your name and how would you like it to appear on your health records? What are your preferred pronouns?

SDOH downstream

factors represent immediate health needs of the population Examples: disease treatment and management

SDOH midstream

factors that represent social needs or individual factors that affect a person's health. Examples: Homelessness, food insecurity, poor quality education options.

A healthcare professional is using an interpreter to communicate with a client. Which actions are appropriate when working with an interpreter? SATA

-After the encounter, Thank the interpreter and client -Use short sentences and pause periodically for clarification -Avoid medical terminology jargon.

Select all the underlined indications that show the two young girls have endured adverse childhood experiences (ACEs) Marie Jones, Giselle, and Sophia Marie Jones (preferred pronouns she, her) is the primary guardian for her two granddaughters, Giselle and Sophia. The girls' mother died in a car accident last year and their father has been incarcerated for the past 3years. He was abusive to their mother, which the girls witnessed numerous times. Marie's son lives with the family to provide financial and social support. ​

-Mother died in a car accident last year -Father has been incarcerated for the past 3 years -abusive to their mother

Which actions may best serve this community? SATA -Increase the amount of tuberculosis testing offered​ -Raising awareness about community health and prevention resources -Participating in professional development to maintain nursing competency -Working with community leaders to ensure public transportation stops near the clinic ​ -Teaching community classes about health promotion strategies

-Raising awareness about community health and prevention resources​ -Teaching community classes about health promotion strategies​ -Working with community leaders to ensure public transportation stops near the clinic ​ Though participating in professional development to maintain competency may indirectly impact the community, this is not the best action for this community. Increasing the amount of tuberculosis testing offered will only increase diagnosis rates; not prevent transmission. ​

Percentages of each ethnicity in US

13% African American persons​ 18.5% Hispanic or Latino persons​ 1.3% American Indian and Alaskan Native​ persons 6% Asian persons (U.S. Census Bureau, 2021)​. By 2050, these percentages are expected to increase to reach 15%, 22% and 8% respectively. And the percentage of non-Hispanic white Americans is expected to decline from 60% to 50% in 2050.

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

neighborhood and built environment

Justin and Jacob are a married couple with no biological children. They have 2 dogs. What family form is represented?

nuclear A nuclear family consists of two adults and sometimes one or more children. Justin and Jacob represent a nuclear family form. ​

Affective Learning

occurs when the client changes their attitude, feelings, values, or motivations about a topic. ​ Best teaching methods: role-play, discussion​ Example: The client newly diagnosed with diabetes mellitus learns coping skills to accept the lifestyle changes necessary to manage health. ​

According to the 2020 US Census, approximately _______ of the population belongs to a racial or ethnicity minority group (CDC, 2021)

40%

Healthy People 2030 is focused on reducing social determinants of health in five domains. One goal in the social and community context domain is to reduce the proportion of children with a parent or guardian who has served time in jail (SDOH-05). Review this objective (Healthy People, n.d.) to answer the following question. ​ The baseline data for this objective shows that ___________of children aged 17 years and under have experienced a parent or guardian serving time in jail. The target goal for this objective is to _______________ the percentage of children experiencing a parent or guardian serving time in jail to___________.​

7.7% Decrease 5.2%

Explicit Bias

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

Implicit Bias (Unconscious Bias):

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

What family form is represented?

A blended family is formed when parents bring children from previous relationships into a new joint-living situation. Ted and Rhonda are a blended family. ​

Malcolm Knowles's theory of adult learning- 5 assumptions

Adults are independent and self-directed learners who need to actively participate in the learning process.​ Past experience is used as a personal reference for continued learning.​ Readiness to learn is necessary for learning to be effective.​ Adult learners desire problem-centered versus content-focused activities and relevant learning environments and need to take newly acquired information and apply it immediately.​ Adults have an internal motivation and willingness to continue learning.

When educating a patient on diabetes type 2, what are important factors to consider related to their health literacy? Select all that apply. Primary language spoken​ Level of education completed​ Age​ Last visit date​ Health insurance carrier​ Socioeconomic status​

Age, socioeconomic status, level of education completed, and primary language spoken can all indicate lower levels of health literacy and may identify patients who need more information on their disease, or adjustments to the educational materials you may give them (e.g., reading level, language).​ Health insurance and last visit date should not matter in identifying someone's health literacy level.​

Stereotyping

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

Read the case scenario below, then click to select all the underlined potential barriers to the client's learning. Stacey Simpson, a registered nurse in a medical clinic, is preparing to teach a client information about heart-healthy eating due to a recent diagnosis of cardiovascular disease. The 62-year-old client is unemployed with a hearing deficit. The client's preferred learning style is written materials. The client lives alone and has no support system. ​

Barriers to learning include any physical, psychological, or socioeconomic factors that may impede a client's ability to learn. ​ Barriers for this client include:​ Unemployed (low socioeconomic status)​ Hearing deficit (sensory perception deficit)​ No support system (no one in the home to reinforce teaching)​ The client's diagnosis and preferred learning style are not barriers to learning. ​

Carmen works to organize a community health fair. Specify if each health fair station would be beneficial or not beneficial to persons experiencing homelessness. Immunizations (influenza and pneumonia)​ Free winter clothing, coats, gloves, and hats ​ Job interviewing skills​ Food donation boxes for pickup

Beneficial: Immunizations, Free winter clothing, coats, gloves, and hats, food donation boxes for pickup

Psychomotor Learning

occurs when the client develops manual or physical skills. ​ Best teaching methods: demonstration, practice, return demonstration ​ Example: The client newly diagnosed with diabetes mellitus learns to perform self-monitoring of blood glucose levels.

After the surgery, Marie is discharged to her home with a home health nurse to visit weekly. The home health nurse determines that Marie's son is struggling with caregiver role strain.​ What actions by the nurse may be beneficial? Select all that apply. ​ Provide information about community resources, such as support groups and children's day camps​. Describe the importance of accepting assistance to give the primary caregiver rest. Contact child and family services to temporarily place the children in foster care​. Explain that the situation is temporary and the caregiver should persevere​. Provide contact information for nursing and healthcare providers to call with questions or concerns​.

Caregiver role strain occurs when a caregiver finds it difficult to perform their role due to stress, financial burdens, or taxing responsibility. The nurse can assist by taking the following actions: ​ Describe the importance of accepting assistance to give the primary caregiver rest. ​ Provide information about community resources, such as support groups and children's day camps.​ Provide contact information for nursing and healthcare providers to call with questions or concerns. ​

Cognitive Learning

occurs when the client gains information to further intellectual knowledge. ​ Best teaching methods: discussion, lecture, role-play, answering questions​ Example: A client with a new diagnosis of diabetes mellitus learns what causes this condition. ​ Cognitive learning occurs throughout six cognitive behaviors, which are known as Bloom's taxonomy. Each simpler category is a prerequisite to mastery of the next more complex one. Let's learn more about each category of cognitive learning. Review the pyramid shown here and note the related definitions of each level of Bloom's taxonomy.​

Healthcare disparities

the population-specific differences in the presence of disease, health outcomes, and qualities of healthcare in different social groups

Adverse childhood events are potentially ______ events occurring during __________ that can affect ___________ development and how the body responds to _______

traumatic childhood brain stress

Family caregivers are more likely to suffer from declining health, which disorder is most common?

Depression

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

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Asian and Pacific Islander Americans

Countries of Origin: Japan, China, Korea, Vietnam, Philippines, Thailand, Cambodia, Laos, Pacific Islands, and others Communication: more than 30 different languages spoken; comfortable with silence; subtle nonverbal cues may be misunderstood Space: large personal space; uncomfortable with touch Social Organization: families include nuclear and extended; children are taught the importance of family loyalty and tradition; religions include Taoism, Buddhism, Islam, Hinduism, and Christianity; community-based social organizations Time: present-time-oriented with importance and value placed on the past Environmental Control: traditional healthcare delivery system; some members prefer to use folk practices (yin & yang, herbal medicine, and moxibustion) Biological Variations: health concerns include hypertension, cancer, diabetes mellitus, accidents, and lactose intolerance

Latino Americans

Countries of Origin: Mexico, Spain, Cuba, Puerto Rico, and other islands of Central and South America Communication: Spanish with many dialects Space: close personal space; lots of touching and embracing; strongly group-oriented Social Organization: nuclear and large extended families; strong ties to Roman Catholicism; community-based social organizations Time: present-time-oriented Environmental Control: traditional healthcare delivery system; some prefer to use folk practitioners, called curandero or curandera; folk practices include hot and cold herbal remedies Biological Variations: health concerns include heart disease, cancer, diabetes mellitus, accidents, and lactose intolerance

Which part of Provision 9 of the American Nurses Association (ANA) code of ethics is Amelia displaying through her actions?

Integrating social justice Nurses vigilantly pursue improvements in healthcare, address unjust systems, and address determinants of health. Amelia's actions to benefit her community demonstrate a commitment to social justice. ​

African Americans

Countries of origin: Largely descendants of Africans brought forcibly to America as slaves. Communication: National Languages: The primary language is English for those born in America, Highly verbal and non verbal. Space: Close personal space, comfortable with touch Social organization: large extended families. Many female-headed households. traditionally strong religious orientation, mostly protestant. Community social organizations. there are cultural differences between African American natives and recent immigrants. Time: present time oriented Environmental control: traditional healthcare delivery system. some individuals prefer to use folk practitioners or home remedies. Biological Variations: health concerns include cardiovascular disease, hypertension, sickle cell disease, diabetes mellitus, and lactose intolerance.

Blooms Taxonomy

Creating: Using knowledge and skills to create something new ​​ Evaluating: Making judgment based on criteria or standards ​​ Analyzing: Breaking material into parts, then determining how the parts relate to each other ​​ Applying: Applying learned ideas in an actual situation ​​ Understanding: Constructing meaning from different types of activities ​​ Remembering: Recognizing or recalling information from memory ​​

Arab Americans

Countries of Origin: Algeria, Bahrain, Comoros, Djibouti, Egypt, Iraq, Jordan, Kuwait, Lebanon, Libya, Mauritania, Morocco, Oman, Palestine, Qatar, Saudi Arabia, Somalia, Sudan, Syria, Tunisia, United Arab Emirates, and Yemen Communication: Arabic and English Space: much personal space between members of the opposite gender outside of the family; touching common between members of the same gender Social Organization: families include nuclear and extended; religions include Muslim and Christianity Time: past- and present-time-oriented Environmental Control: traditional healthcare delivery system; the authority of physicians is seldom challenged or questioned; adverse outcomes are attributed to God's will; mental illness may be viewed as a social stigma Biological Variations: health concerns include sickle cell disease, thalassemia, cardiovascular disease, and cancer

Northern European Americans

Countries of Origin: England, Ireland, and others Communication: the language of the country of origin; regional dialects; English, often learned quickly if a second language; more verbal than nonverbal Space: territory valued; personal space 18 to 36 inches (1.5 to 3 feet); uncomfortable with personal contact and touch Social Organization: families include nuclear and extended; religions include Jewish and Christian; community-based social organizations Time: future-oriented Environmental Control: most value preventative medicine and primary healthcare through traditional healthcare delivery systems; alternative health practices on the increase Biological Variations: health concerns include cardiovascular disease, cancer, and diabetes mellitus

matching for durability resiliency diversity and dynamic

Durability- ​One parent dies when the children are very young. The remaining partner remarries and the children form a bond with the stepparent. ​The ability to withstand pressure and form a system of support​. -Resiliency- ​A single parent becomes ill with colon cancer. The adolescent son steps in as primary caregiver to the younger siblings. ​The ability to cope with expected and unexpected stressors​. -Diversity- ​The family includes two parents, a family friend who needs shelter, and the friend's three children. ​Each family unit is unique.​-Dynamic- ​Last month, the family was well fed and both parents were working. Today, one parent lost their job and is unable to afford the rent. ​Family interactions are affected by family configuration, structure, function, problem solving, and coping capacity​.

matching

Economic stability - Food insecurity Education access- language and literacy social and community context- discrimination Healthcare access and quality - Health literacy Neighborhood and built environment

Social Determinants of Health represent ___________ that impact health. Health disparities are_________ that impact a person's ability to achieve health.

External factors preventable differences

SDOH upstream

Factors affect communities in a large and inequitable way. Examples: low education level, income disparity, discrimination, social marginalization.

Matching: Barriers to learning

Fatigue: Too mentally or physically tired to learn​ Illness: Less than optimal health​ Motivation: Desire to learn​ Myopia: A common eye disorder that may impact learning​ Sensorineural: A common type of hearing loss that affects learning​ Apprehension: Nervousness or fear ​ Culture: Common characteristics of a group of people

Psychomotor learning seven stages

Fundamental- Basic skills such as walking, running, jumping, pushing, pulling Perception- skills are related to kinesthetic, auditory, tactile, or coordination activities Guided Response- Early stages of learning a skill which involves imitation and practice. Mechanism- The learner gains confidence and proficiency with skill performance. Complex overt response- The learner accurately performs a motor skill that requires complex movement patterns. Adaptation- Skills are well developed and can be modified when a problem occurs Origination- the learner uses existing psychomotor skills to create new patterns and performs new skills as needed.

Carmen Nelson select all the underlined cues that indicate health disparities in the community. Carmen Nelson (preferred pronouns she, her) is a nurse working in a community clinic. The climate in her state is very cold most of the year, and her community has a large population of people experiencing homelessness. There is a day shelter that serves two meals per day available for now, but the night shelter recently closed due to lack of funding. Last week, two community members were treated in the Emergency Department for frostbite.

Health disparities are preventable differences in a population's ability to achieve optimal health. Poor health status, disease risk factors, poor health outcomes, and limited access to healthcare are the types of disparities that are often interrelated and influenced by the social context in which people live. ​ Health disparities in this scenario are the large population of people experiencing homelessness, the cold climate, and the night shelter closing. These differences are contributing to a person's ability to achieve health and wellness. ​ The day shelter serving meals is assisting the clients with nutrition. Clients being treated in the emergency department for frostbite is a consequence of the health disparities. ​

Cultural Identity

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

Click to specify if each factor below increases or decreases learning. No concentration Actively involved Unmotivated Topic important to you Mobile devices and alerts Desire to learn Forced learning Attentive Need to learn Interest in the topic

Increases Learning: Actively involved, topic important to you, Desire to learn, Attentive, Need to learn, Interested in the topic. Decreases Learning: No concentration, Unmotivated, Mobil devices and alerts, forced learning

Culture

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

Which of the following are domains of learning? Select all that apply. ​ Psychomotor​ Remember​ Analyze​ Affective​ Create​ Cognitive​

Learning occurs in three domains: cognitive (understanding), affective (attitudes), and psychomotor (motor skills). ​ Remember, analyze, and create are three of six cognitive behaviors, through which knowledge is gained. ​

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

Limited access to healthcare clinics providing preventions services.

Intermediary determinants

Material circumstances, psychosocial factors, behaviors, biological factors, and Health systems. (all impact Health)

Nuclear Family

Mother, father and children living as a unit

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

Neighborhoods and built environment The neighborhoods people live in have a major impact on their health and well-being The neighborhood and built environment domain focuses on improving health and safety in the places where people live, work, learn, and play. ​ The healthcare access and quality domain focuses on improving health by helping people get timely, high-quality health care services.​ The social and community context domain focuses on helping people get the social support they need in the places where they live, work, learn, and play.​ The economic stability domain focuses on helping more people achieve economic stability. ​

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

No clients are treated for frostbite in the Emergency department in the past 3 months Remember in order for outcomes to be evaluated they need to be specific, measurable, achievable, realistic, and timed. The outcome that best meets client needs is: No clients are treated for frostbite in the Emergency Department in the past three months.​ Community members vaccinated and employed does not target the specific population experiencing homelessness. The word "more" is not measurable. Also, unemployment was not one of Carmen's targeted actions for reduce health disparities. ​

American Indians and Alaskan Natives

North America, Alaska, Aleutian Islands. Communication: 200 tribal languages recognized. comfortable with silence. Space: large, extended space important, uncomfortable with touch. Social Organization: families: nuclear and extended. children taught the importance of tradition, social organizations: tribe and family most important. Time: present time oriented Environmental control: religion and health practices intertwined; a non-traditional healer (shaman) uses folk practices to heal; a shaman may work with a modern healthcare practitioner Biological Variations: health concerns include alcoholism, tuberculosis, accidents, diabetes mellitus, and heart disease

How does using a systematic process to plan client education assist the nurse? Select all that apply.​ -Allows the nurse an opportunity to assess the client's health literacy​ -Makes it harder to document the teaching session once completed -Provides a guarantee that the client understands the material after teaching​ -Identifies targeted information that is individualized for the client​ -Determines what the client already knows about a health topic before teaching​

Nurses use the teaching process to assess the learning needs of clients and identify barriers to learning. This systematic process identifies targeted information that is individualized for the client, determines what the client already knows about a health topic before teaching, and allows the nurse an opportunity to assess the client's health literacy. ​ Using the nursing process to guide client teaching does not guarantee client understanding nor make it harder to document the teaching session. ​

Acculturation

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

mix and match the 7 stages of psychomotor learning

Perception: Being aware of objects or qualities through the use of sensory stimulation ​ Set: Readiness to take a particular action; there are three sets: mental, physical, and emotional ​ Guided response: Early stages of learning a particular skill under the guidance of an instructor that involves imitation and practice of a demonstrated act Mechanism: Higher level of behavior in which a person gains confidence and proficiency in performing a skill that is more complex or involves several more steps than a guided response Complex overt response: Smoothly and accurately performing a motor skill that requires complex movement patterns ​ Adaptation: Motor skills are well developed and movements can be modified when unexpected problems occur ​ Origination: Using existing psychomotor skills to create new movement patterns and perform them as needed in response to a particular situation or problem​

ACEs can have a significant impact on future health. What are the adverse effects of ACEs? SATA Poor self-control Pessimistic thinking​ Problem avoidance​ Decreased self-esteem​ Improved problem solving​ Empathy for others​

Poor self-control pessimistic thinking problem avoidance decreased self-esteem

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

Prompt further to elicit additional questions or concerns

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

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

For each observation, click to specify if Ted and Rhonda are demonstrating resilience or crisis. ​ Ted and Rhonda maintain a close relationship through illness.​ Rhonda adapts to the challenges of Ted's situation.​ Rhonda refuses to accept supportive help in the home.​ Ted's oldest son moves home temporarily to help the family.​

Resilience: Ted and Rhonda maintain a close relationship through illness, Rhonda adapts to the challenges of Ted's situation, and Ted's oldest son moves home temporarily to help the family. Crisis: Rhonda refuses to accept supportive help in the home

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

Resiliency means the family can cope with expected and unexpected stressors. Marie's family is demonstrating resiliency by adapting to an unexpected stressor. ​

Ask me 3

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

Emotions play a large part in learning. When understanding concepts that are not tangible, it is often the affective domain that we teach within. Affective learning encompasses the development of values and expression of feelings. Select the proper step of the levels of affective learning below. ​ Requires active participation through listening and reacting verbally and nonverbally Developing a value system by identifying and organizing values according to their worth Learner is passive and needs only to pay attention and receive information Acting and responding with a consistent value system; requires introspection and self-examination of one's own values in relation to an ethical issue or particular experience Attaching worth and value to the acquired knowledge as demonstrated by the learner's behavior

Responding- Requires active participation through listening and reacting verbally and nonverbally Organizing- Developing a value system by identifying and organizing values according to their worth Receiving- Learner is passive and needs only to pay attention and receive information Valuing- Acting and responding with a consistent value system; requires introspection and self-examination of one's own values in relation to an ethical issue or particular experience Characterizing- Attaching worth and value to the acquired knowledge as demonstrated by the learner's behavior

What brings the structural and intermediate determinants together?

Social cohesion, social capital

According to the video on health literacy (Blue Cross Blue Shield of Michigan, 2021), what are the consequences of low health literacy? Select all that apply. Increased emergency room visits​ Increased incidence of chronic conditions​ Poor self-care Decreased medical costs​ Decreased hospital admissions​

The consequences of low health literacy are:​ Increased incidence of chronic conditions​ Poor self-care​ Increased emergency room visits​ Increased hospital admissions​ Increased medical costs​

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

The correct order is: Ask the client what they know about diabetes​ Identify and compare what the client knows with what they need to know​ Decide what you will teach the client about high blood sugar and diabetes​ Use pictures, charts, and models to teach diabetes ​ Ask the client questions about what they've learned about diabetes and high blood sugar

What family values or behaviors may negatively impact health and wellness of one of its members?

The father consistently smokes marijuana at home

Assimilation

The process in which an individual adapts to the hosts culture values and no longer prefers the components of the origin culture. after this process, there is no identifiable minority culture. For example: after immigrating to the US, a young adult changes the way they dress and behavior to fit into the new culture.

provision 9 of the ANA Code of Ethics

The profession of nursing, collectively through its professional organizations, must articulate nursing values, maintain the integrity of the profession, and integrate principles of social justice into nursing and health policy.

ANA Standard 5b. Health Teaching and Health Promotion

The registered nurse employs strategies to teach and promote health and wellness. This includes:​ Providing opportunities for the client to identify learning needs.​ Using teaching methods in collaboration with the client's values and beliefs, developmental level, learning needs, readiness and ability to learn, and language and learning preferences.​ Using feedback from the client to determine the effectiveness of teaching. ​ Using technology to communicate information to the client.​ Providing clients with information and education about intended effects of treatment and potential adverse effects. ​ Engaging the community in health teaching and promotion activities.​ Providing anticipatory guidance to clients to promote health and prevent or reduce risk. ​

After the teaching session, Stacey uses the teach-back method to evaluate the client's learning. What are the benefits of this method of evaluation? Select all that apply. ​ Decreases client understanding​ Improves client satisfaction​ Improves client adherence to education​ Decreases hospital readmissions​ Identifies misconceptions or confusion​

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

Carmen begins to think about how her role as a nurse could influence this situation positively. Drag and drop the nursing action to match the correct social determinant of health classification. ​ -Host a winter coat drive and provide donations to the local hospital to distribute to clients treated for frostbite. -Advocate for community funding to reopen the nighttime shelter. -Organize a free health fair in the community, offering immunizations and health screenings.

Upstream factors affect communities in a large and inequitable way. Example: A nurse advocates for community funding to reopen the nighttime shelter. ​ Midstream factors represent social needs or individual factors that affect a person's health. Example: A nurse organizes a free health fair in the community, offering immunizations and health screenings. ​ Downstream factors represent immediate health needs of the population. Example: A nurse hosts a winter coat drive and provides donations to the local hospital to distribute to clients treated for frostbite.