NR 222 - Health and Wellness Exam 1

Ayurvedic medicine (Whole medical systems)

One of the oldest systems of medicine practiced in India since the first century AD. Treatments balance the doshas with a combination of dietary and lifestyle changes, herbal remedies and purgatives, massage, meditation, and exercise.

Social location

One's place in society is based on membership in a social group

Tertiary

Restoration and rehabilitation example: A woman who has breast cancer should go through chemotherapy to kill the cancerous cells.

Informatics

Use information and technology to communicate, manage knowledge, mitigate error, and support decision making. Examples: Navigate an electronic health record. Protect confidentiality of protected health information in electronic health records.

Breathwork (Mind-body Interventions)

Using a variety of breathing patterns to relax, invigorate, or open emotional channels

Music Therapy (Mind-body Interventions)

Using music to address physical, psychological, cognitive, and social needs of individuals with disabilities and illnesses; improves physical movement and/or communication, develops emotional expression, evokes memories, and distracts people who are in pain.

Acute illness

a trauma, myocardial infarction, or surgery; family members are often left in waiting rooms to receive information about their loved one

Disability Adjusted Life Year (DALY)

a year spent in less than healthy life

Empathy

ability to view other persons' situations from their perspective

Normative ethics

addresses the questions of the ought, the four fundamental terms of which are right and wrong, good and evil.

Health Belief Model

addresses the relationship between a person's beliefs and behaviors; helps you understand factors influencing patients' perceptions, beliefs, and behavior to plan care that will most effectively help patients maintain or restore health and prevent illness.

Arab Americans health concerns and care issues

adult-onset diabetes mellitus, coronary artery disease, role of acculturation, mental health, teenage smoking

Research of Health Promotion shows..

an increase in longevity, a decrease in mortality (death) and morbidity (disease), and an improvement in the quality of life for individuals who have been involved in health promotion activities such as physical activity and avoidance of smoking

Health disparities

an umbrella term that includes disparities in health and in health care; defined by Healthy People 2020 as a particular type of health difference that is closely linked with social, economic, and/or environmental disadvantage; adversely affect groups of people who have systematically experienced greater obstacles to health based on their racial or ethnic group

Patient

ancient roots in suffering, for millennia the term also connoted one who undergoes medical treatment

Social cognitive theory

another model that adds to the understanding of the determinants of health behavior; also describes the roles of reinforcement and observational learning in explaining health behavior change

Health behavior

any activities that an individual undertakes to enhance health, prevent disease, and detect and control the symptoms of a disease

Risk Factor

any situation, habit, or other variable such as social, environmental, physiological, psychological, developmental, intellectual, or spiritual that increases the vulnerability of an individual or group to an illness or accident example: falls, such as impaired gait, reduced vision, and lower extremity weakness

health care disparities

are differences among populations in the availability, accessibility, and quality of health care services (e.g., screening, diagnostic, treatment, management and rehabilitation) aimed at prevention, treatment, and management of diseases and their complications

Dilemmas

are ethical issues of a special sort

family forms

are patterns of people considered by family members to be included in a family

Ethical dilemmas

are those situations in which a choice must be made between two or more equally undesirable options

ANA Standards of Nursing Practice

assessment, diagnosis, outcome, planning, implementation, evaluation (ADOPIE)

culture

associated with norms, values, and traditions passed down through generations

Holistic Health Model

attempts to create conditions that promote a patient's optimal level of health; nurses recognize the natural healing abilities of the body and incorporate complementary and alternative interventions such as meditation, music therapy, reminiscence, relaxation therapy, therapeutic touch, and guided imagery because they are effective, economical, noninvasive, nonpharmacological complements to traditional medical care

Responsibilities of Professional Nursing

autonomy, accountability, and communicator

Contemplative

aware of, but not considering change soon

Educator

based on a perception of desirable individual behavior, to structurally planned teaching according to individual needs.

Family structure

based on the ongoing membership of the family and the pattern of relationships, which are often numerous and complex example: a family member may have a relationship with a spouse, child, employer, and work colleagues

Healing Touch (Energy Therapy)

biofield therapy; uses gentle touch directly on or close to body to influence and support the human energy system and bring balance to the whole body (physical, spiritual, emotional, and mental); a formal educational and certification system provides credentials for practitioners

The provisions

broad and non contextual statements of the obligation of nurses.

Blacks/African Americans selected cultural aspects

centered on family and religion, family needs to be involved in care, churches important in promoting health, use traditional healing approaches

Asian Americans/Pacific Islanders largest groups

chinese, korean, fillipinos

Arab Americans religious groups

christanity, judaism, islam

Weston

claims that true dilemmas are actually quite rare and that often options can be found by changing the way the situation is examined

immigrants

come for positive experience

Illness

composed of the subjective experience of the individual and the physical manifestation of disease; can be described as a response characterized by a mismatch between a person's needs and the resources available to meet those needs

nuclear family

consists of a married couple with or without children.

maintenance

continued commitment to behavior

Benefits of Physical Activity

contribute to the maintenance or improvement in mobility, which improves the quality of life and prevents disability and it enhances positive mental health through stress reduction and physical fitness, which contribute to the development of healthy behaviors

Dietary Supplements (Biologically Based Therapy)

defined by the Dietary Supplement Health and Education Act of 1994 and used to supplement dietary/nutritional intake by mouth; contain one or more dietary ingredients, including vitamins, minerals, herbs, or other botanical products

cultural competency

defined by the National Institutes of Health (2015) as the enabling of health care providers to deliver services that are respectful of and responsive to the health beliefs, practices, and cultural and linguistic needs of diverse patients

Health Promotion Model

defines health as a positive, dynamic state, not merely the absence of disease; designed to be a "complementary counterpart to models of health protection"

Deliverer of Services

delivery of direct services such as health education, flu shots, and counseling in health promotion.

ANA Standards of Practice (definition)

describe a competent level (ADOPIE) of nursing care.

ANA Standards of Professional Performance (definition)

describe a competent level of behavior in the professional role; provide a method to assure patients that they are receiving high-quality care, that the nurses must know exactly what is necessary to provide nursing care, and that measures are in place to determine whether nursing care meets the standards

Qualitative Studies

describe phenomena or define the historical nature, cultural relevance, or philosophical basis of aspects of nursing care

Quantitative Studies

describe situations, correlate different variables related to care, or test causal relationships between variables related to care

Vig and colleagues

described what helps and hampers surrogate decision-making

Genomics

describes the study of all the genes in a person and interactions of these genes with one another and with that person's environment

ANA Standards of Professional Performance

ethics, education, evidence-based practice and research, quality of practice, communication, leadership, collaboration, professional practice evaluation, resources, environmental health

Codes of Ethics

examples of normative ethics in that they prescribe how members of a profession ought to act, given the goals and purposes of the profession related to individuals and society

Latino/Hispanics selected cultural aspects

family supersedes individual needs, spiritual strength important, hot and cold concept of disease, disease attributed to supernatural or psychological causes, folk remedies used in combination with Western medicine

involuntary migration

fleeing or being forced out of homeland

Nursing interventions and outcome

focus provides a solid position from which nurses participate as decision makers in health care systems at organizational, community, national, and international levels

Arab Americans waves of immigration

from late 1800s to 1960s

Mycotherapies (Biologically Based Therapy)

fungi-based (mushroom) products

National Health Expenditures in the U.S.

greater than any other country with $2.593 trillion spent in 2010, a marked increase from the $1.9 trillion spent in 2004.

Caring is..

grounded in ethics beginning with respect for the autonomy of the care recipient; grounded as a science in nursing but is not limited to nursing; an attribute that may be taught, modeled learned and mastered; capable of being measured and analyzed scientifically, the subject of study withing caring science institutes/academics worldwide; central to relationships that lead to effective healing, cure, and/or actualization of human potential.

Goal for Scope and Standards of Practice

guide nurses to make significant and visible contributions that improve the health and well-being of all individuals, communities, and populations

Action

has begun to make behavioral change

Lifestyle Risk Factors

have positive or negative effects on health; those with potential negative effects are risk factors; some habits are risk factors for specific diseases example: excessive sunbathing increases the risk of skin cancer; smoking increases the risk of lung diseases, including cancer; and a poor diet and being overweight increase the risk of cardiovascular disease

one-test disease-specific screening

he administration of a single test that searches for a characteristic that indicates a high risk of developing a disorder example: blood pressure screening to evaluate hypertension

Primary

health promotion and specific protection example: If a person loves to swim and being out in the sun then they should wear sunblock to prevent skin cancer.

Healer

help individuals integrate and balance the various parts of their lives

Asian Americans/Pacific Islanders health concerns and care issues

hesitancy to seek early diagnosis/screening, higher rate of tuberculosis, mental health problems due to adjustment issues, lower rate of obesity, hypertension

Blacks/African Americans health concerns and care issues

higher cancer deaths, HIV, hypertension, obesity, mental health concerns

Latino/Hispanics health concerns and care issues

higher incidence of stomach cancer, diabetes mellitus, cardiovascular disease, HIV

Latino/Hispanics barriers to care

highest uninsured rate of any U.S. racial/ethnic group, use/receive less preventative health care, lack of interpreter services in health care, lack culturally appropriate health care services, reliance on folk systems of healing

lead agency

identified to oversee the development process of the community health program

American Nurses Association (ANA)

illustrates the consistent commitment of nurses to provide care that promotes the well-being of their patients and communities

Illness Prevention Activities

immunization programs protect patients from actual or potential threats to health; they motivate people to avoid a decline in health or functional levels

emerging population

include ethnic minorities and persons who are homeless; Asian Americans/Pacific Islanders, Blacks/African Americans, Latinos/Hispanic Americans, Native Americans, and Arab Americans

alternative family

include multi-adult households, "skip-generation" families (grandparents caring for grandchildren), communal groups with children, "nonfamilies" (adults living alone), and cohabitating partners.

Internal Variables

includes a person's developmental stage, intellectual background, perception of functioning, and emotional and spiritual factors.

extended family

includes relatives (aunts, uncles, grandparents, and cousins) in addition to the nuclear family.

Transtheoretical Model (TTM)

incorporates Stages of Change (readiness to take action), Decisional Balance (benefits to and detractors from changing a behavior), Self-Efficacy (personal confidence in making a change), and Processes of Change (cognitive, affective, and behavioral activities facilitating change)

holism

incorporates family and support system in care; considers patient view point

false-negative test results

individuals actually have the condition but were told they are disease-free or negative

false-positive test results

individuals are told that they have a disease or condition when in actuality they do not

Stakeholders

individuals or groups who have a legitimate interest in the topic examples: key community individuals, hospitals, health and social service agencies such as primary health care centers, and community organizations including houses of worship, community centers, schools, transportation agencies, and volunteer organizations

External Variables

influences a person's health beliefs and practices include family practices, psychosocial and socioeconomic factors, and cultural background

Cultural Background

influences beliefs, values, and customs; influences the approach to the health care systems, personal health practices, and the nurse-patient relationship

Blacks/African Americans background

involuntary migration history, american slave system facilitated racism/alienation, recent substantial progress; inequities remain

Physiological Risk Factors

involve the physical functioning of the body example: being overweight

Cost-benefit ratio analysis

it allows the comparison of various outcomes in monetary terms

The Future of Nursing: Leading Change, Advancing Health emphasized..

need for advocacy in nurses through practicing to the fullest extent of their education and training and as full partners with physicians and other health care professionals in redesigning health in the United States

Precontemplative

not considering change

Beauchamp and Childress

note that informed consent occurs when a person with substantial understanding, and without substantial control by others, intentionally authorizes a professional to intervene on his or her behalf key phrase: "with substantial understanding."

Benner's Five Levels of Proficiency

novice, advanced beginner, competent, proficient, expert

Standard 5b in Nursing Scope and Standards of Practice requires..

nurses "to promote health and a safe environment" through health teaching and evaluation of teaching effectiveness in clinical practice

Advocate

nurses help individuals obtain what they are entitled to receive through the health care system, try to make the system more responsive to individual and community needs, and help persons develop the skills to advocate for themselves; strives to ensure that all persons receive high-quality, appropriate, safe, and cost-effective care

Health Education

nurtures health promoting habits, values, and attitudes that must be learned through practice; these must be reinforced through systematic instruction in hygiene, bodily function, physical fitness, and use of leisure time

Moral distress

occurs when a nurse knows the ethically correct action to take but feels powerless to take that action; can occur when the nurse's values and perceived obligations conflict with the needs and prevailing views of the work environment

Group/mass screening

occurs when a target population is selected on the basis of an increased incidence of a condition or a recognized element of high risk within an identified group example: the target population may be invited to a central location on a designated day to be tested for the selected disorders

Paternalism

often justified by the assertion that the persons affected will be better off or protected from harm

Moral agency

on the part of the nurse requires action and motivation directed to some moral end that is enacted through relationships

single parent family

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

Individual screening

one person is tested by a health professional who has designated the individual as high risk

Client

one who listens, leans upon, or follows another; connotes a more advisory relationship often associated with consultation or business

Health belief model

paradigm used to predict and explain health behavior; developed to describe why people failed to participate in programs to detect or prevent disease

blended family

parents bring unrelated children from prior adoptive or foster parenting relationships into a new, joint living situation.

Key community individuals

people who are considered leaders within the community

Preparation

planning to act soon

Herbal Medicines (Biologically Based Therapy)

plant-based therapies used in whole systems of medicine or as individual preparations by allopathic providers and consumers for specific symptoms or issues

Blacks/African Americans barriers to care

poverty, lack of health insurance, inadequate or unsafe environments

Asian Americans/Pacific Islanders barriers to care

poverty, stress intergenerational relationships, cultural norms that prevent health care seeking, loss of social networks, poor access to services

Native Americans/ Alaskan Natives selected health related cultural aspects

present-oriented; take one day at a time, value cooperation over competition, share resources, value families (form kinship systems), believe health exists when person is in harmony with nature, traditional health practices important (shaman).

Care Manager

prevent duplication of services, maintain quality and safety, and reduce costs.

Levels of Prevention

primary, secondary, tertiary, and passive

Tai Chi (Mind-body Interventions)

Incorporating breath, movement, and meditation to cleanse, strengthen, and circulate vital life energy and blood; stimulate the immune system; and maintain external and internal balance

Matrix of domination

Instead of thinking about race, gender, immigration status, class, and other axes of identity as descriptive categories only, it is important to understand them within the context of the larger system of power and privilege that permeates society

Evidence-Based Practice

Integrate best current evidence with clinical expertise and patient/family preferences and values for delivery of optimal health care. Examples: Demonstrate knowledge of basic scientific methods. Appreciate strengths and weaknesses of scientific bases for practice. Appreciate the importance of regularly reading relevant journals.

Dance Therapy (Movement Therapy)

Intimate and powerful medium because it is a direct expression of the mind and body; treats people with social, emotional, cognitive, or physical problems

Purpose of The Code of Ethics for Nurses with Interpretive Statements

It is a succinct statement of the ethical values, obligations, duties, and professional ideas of nurses individually and collectively; it is the profession's non-negotiable ethical standard; it is an expression of nursing's own understanding of its commitment to society.

Probiotics (Biologically Based Therapy)

Live microorganisms (in most cases, bacteria) that are similar to beneficial microorganisms found in the human gastrointestinal system; also called good bacteria

Massage therapy (Manipulative and Body-Based Methods)

Manipulating soft tissue through stroking, rubbing, or kneading to increase circulation, improve muscle tone, and provide relaxation

Chiropractic Medicine (Manipulative and Body-Based Methods)

Manipulating the spinal column; includes physiotherapy and diet therapy

overinclusion and underinclusion

Many groups have been overlooked in research and the design of interventions. For example, much of what is currently known about racial and ethnic disparities is drawn from national information sources and combines both sexes, despite the large body of evidence of sex and gender differences in the prevalence of health conditions and the use of health services

Pilates (Movement Therapy)

Method of body movement used to strengthen, lengthen, and improve the voluntary control of muscles and muscle groups, especially those used for posture and core strengthening

Safety

Minimize risk of harm to patients and providers through both system effectiveness and individual performance. Examples: Examine human factors and basic safety design principles and commonly used unsafe practices. Value own role in preventing errors.

Native Americans/Alaskan Natives background

Native to North/South America for thousands of years and experience minority group status; lower education and income levels compared to other groups.

Accompanying interpretive statements

provide addtional, more specific, guidance in the application of this obligation to current nursing practice; subjective to more frequent revision

Consultant

provide knowledge about health promotion and disease prevention to individuals and groups

Community-based care

provided in nontraditional health care settings in the community

cost-efficiency analysis

purpose is to be efficient and budget a limited amount of money toward achieving as much of the desired outcome as possible

Morbidity

refers to a diseased state or disability from any cause

Evidence-based practice

searching for the best evidence with which to answer clinical research questions;nurses assume a more active involvement in the prevention of disease and the promotion of health

Family

significant and affects who is included on health insurance policies, who has access to children's school records, who files joint tax returns, and who is eligible for sick-leave benefits or public assistance programs

Alternative Therapies

sometimes include the same interventions as complementary therapies; but they become the primary treatment example: person with chronic pain uses yoga to encourage flexibility and relaxation at the same time that nonsteroidal antiinflammatory or opioid medications are prescribed

Braun and colleagues

studied the burdens of end-of-life decision-making in a sample of African American, Caucasian, and Hispanic surrogates

Epidemiology

study of the distribution and determinants of health-related states in specified populations, and the application of this study to control health problems (and is used to) plan and evaluate strategies to prevent illness and as a guide to the management of patients in whom disease has already developed

Quality of life

subjective and individual evaluations may differ example: not all people equally perceive the disability resulting from a disease; some make adjustments and cope, whereas others do not

Trauma

sudden, unplanned, and sometimes life-threatening

Competent

A nurse who has been in the same clinical position for 2 to 3 years. This nurse understands the organization and specific care required by the type of patients (e.g., surgical, oncology, or orthopedic patients). He or she is a competent practitioner who is able to anticipate nursing care and establish long-range goals. In this phase the nurse has usually had experience with all types of psychomotor skills required by this specific group of patients.

Advanced Beginner

A nurse who has had some level of experience with the situation. This experience may only be observational in nature, but the nurse is able to identify meaningful aspects or principles of nursing care

Integrative nursing

"a way of being-knowing-doing that advances the health and well-being of people, families, and communities through caring-healing relationships; these nurses use evidence to inform traditional and emerging interventions that support "whole person/whole systems healing"

What is the Per Capita for Canada?

$4,000

What was the Per Capita Expenditure for Health Care in 2010

$8,402

Expert

A nurse with diverse experience who has an intuitive grasp of an existing or potential clinical problem. This nurse is able to zero in on the problem and focus on multiple dimensions of the situation. He or she is skilled at identifying both patient-centered problems and problems related to the health care system or perhaps the needs of the novice nurse.

Proficient

A nurse with more than 2 to 3 years of experience in the same clinical position. This nurse perceives a patient's clinical situation as a whole, is able to assess an entire situation, and can readily transfer knowledge gained from multiple previous experiences to a situation. This nurse focuses on managing care as opposed to managing and performing skills.

Intellectual Background

A person's beliefs about health are shaped in part by the person's knowledge, lack of knowledge, or incorrect information about body functions and illnesses, educational background, traditions, and past experiences

Developmental Stage

A person's thought and behavior patterns change throughout life

Naturopathic medicine (Whole medical systems)

A system of therapeutics focused on treating the whole person and promoting health and well-being rather than an individual disease. Therapeutics include herbal medicine, nutritional supplementation, physical medicine, homeopathy, lifestyle counseling, and mind-body therapies with an orientation toward assisting the person's internal capacity for self-healing (vitalism).

cultural skills

Ability to assess social, cultural, and biophysical factors that influence patient treatment and care

Healthy People 2020 Focus Areas

Adolescent Health; Blood Disorders and Blood Safety; Dementias, Including Alzheimer's Disease; Early and Middle Childhood; Genomics; Global Health; Healthcare-Associated Infections; Health-Related Quality of Life and Well-Being; Lesbian, Gay, Bisexual, and Transgender Health; Older Adults; Preparedness; Sleep Health; and Social Determinants of Health

Traditional Chinese medicine (TCM) (Whole medical systems)

An ancient healing tradition identified in the first century AD focused on balancing yin/yang energies. It is a set of systematic techniques and methods, including acupuncture, herbal medicines, massage, acupressure, moxibustion (use of heat from burning herbs), Qi gong (balancing energy flow through body movement), cupping, and massage. Fundamental concepts are from Taoism, Confucianism, and Buddhism.

Health Ecology

An evolving view of health recognizes the interconnection between people and their physical and social environments EX: People are likely to go walking where there are sidewalks (within the community)

cultural awareness

An in-depth self-examination of one's own background, recognizing biases, prejudices, and assumptions about other people

Acupressure (Manipulative and Body-Based Methods)

Applying digital pressure in a specified way on designated points on the body to relieve pain, produce analgesia, or regulate a body function

Craniosacral therapy (Manipulative and Body-Based Methods)

Assessing the craniosacral motion for rate, amplitude, symmetry, and quality and attuning/aligning the spinal column, cerebrospinal fluid, and rhythmic processes, releasing restrictions or abnormal barriers to motion

International Council of Nurses (ICN) definition of nursing

Nursing encompasses autonomous and collaborative care of individuals of all ages, families, groups, and communities, sick or well, and in all settings. Nursing includes the promotion of health; prevention of illness; and the care of ill, disabled, and dying people. Advocacy, promotion of a safe environment, research, participation in shaping health policy and in patient and health systems management, and education are also key nursing roles.

Homeopathic medicine (Whole medical systems)

Developed in Germany and practiced in the United States since the mid-1800s. It is a system of medical treatments based on the theory that certain diseases can be cured by giving small, highly diluted doses of substances made from naturally occurring plant, animal, or mineral substances that stimulate the vital force of the body so it can heal itself.

Holistic nursing

the mind-body-spirit of patients, using interventions such as relaxation therapy, music therapy, touch therapies, and guided imagery

Code of Ethics

the philosophical ideals of right and wrong that define the principles you will use to provide care to your patients

Health Promotion - Krueter and Devore

the process of advocating health in order to enhance the probability that personal (individual, family, and community), private (professional and business), and public (federal, state, and local government) support of positive health practices will become a societal norm

Prevalence

the proportion of a given population with the disease or condition at any one point in time

Nursing

the protection, promotion, and optimization of health and abilities; prevention of illness and injury; alleviation of suffering through the diagnosis and treatment of human response; and advocacy in the care of individuals, families, communities, and populations (ANA 2010b)

Beneficence

the quality or state of doing or producing "good."; duty to maximize the benefits of actions while minimizing harms

Health Promotion - O'Donnell

the science and art of helping people change their lifestyle to move toward a state of optimal health. -

World Health Organization (WHO) Health Definition

the state of complete physical, mental, and social well-being and not merely the absence of disease and infirmity, but moves beyond this definition to encompass spiritual, developmental, and environmental aspects over time. Example: a person with diabetes may be considered healthy if she is able to adapt to her illness and live a meaningful, spiritually satisfying life

Relaxation response

the state of generalized decreased cognitive, physiological, and/or behavioral arousal; also involves arousal reduction; the process elongates the muscle fibers, reduces the neural impulses sent to the brain, and thus decreases the activity of the brain and other body systems; elps individuals develop cognitive skills to reduce the negative ways in which they respond to situations within their environment.

The President's commission (1982)

was formed to study health care decision-making and noted that the minimal capacities needed for competent decision-making are: (1) Possession of a set of values and goals; (2) the ability to communicate and to understand information (3) the ability to reason and deliberate about one's choice"

Family function

what a family does; focuses on the processes used by the family to achieve its goals

Duty highlighted by by the landmark Tarasoff case

when health care providers have a duty to warn others who are unknowingly endangered

Cultural competent organizations should..

• Value diversity • Conduct a cultural self-assessment • Manage the dynamics of difference • Institutionalize cultural knowledge • Adapt to diversity

Healthy People 2020 Main Goals

•Attain high quality, longer lives free of preventable disease, disability, injury, and premature death. •Achieve health equity, eliminate disparities, and improve the health of all groups. •Create social and physical environments that promote good health for all. •Promote quality of life, healthy development, and healthy behaviors across all life stages

Healthy People 2010 Main Goals

•Increase quality and years of healthy life. •Eliminate health disparities.

Healthy People 2000 Main Goals

•Increase the span of healthy life. •Reduce health disparities. •Create access to preventive services for all.

The privacy rule rights to individuals

•To access their own information •To limit who may receive their information •To request corrections for errors •To receive an accounting of how their information has been used •To request special confidential reporting of their information to them at a location of their choosing (this may be especially important for individuals at risk for intimate partner violence) •To pursue complaints with the Department of Health and Human Services Office for Civil Rights

The Percentage of 305.2 Americans whom were uninsured

16%

The Percentage of the 305.2 million Americans which were enrolled in medicaid.

17%

Percentage of Health Spending in 2010

17.9% of the gross domestic

Percentage of Health Spending by 2019 projected to be

19.3%

The first nursing code of ethics was adopted by the ANA in this year

1950

Health

a state of physical, mental, spiritual, and social functioning that realizes a person's potential and is experienced within a developmental context

Functional Health

The ability to function: can be characterized as being present or absent, having high-level or low-level wellness, and being influenced by neighborhood and society

Confidentiality

The ability to maintain privacy in one's life is an expression of autonomy

The Rate of Growth in Per Capita Health expenditure in the United States is..

much steeper than that of other countries

cultural desire

The motivation and commitment to caring that moves an individual to learn from others, accept the role as a learner, be open to and accepting of cultural differences, and build on cultural similarities.

Collaboration

The registered nurse collaborates with health care consumer, family, and others in the conduct of nursing practice.

Assessment

The registered nurse collects comprehensive data pertinent to the patient's health and/or the situation.

Passive Primary

Things you do not necessarily do on purpose but it is there for you example: Vitamin D in milk; Drinking milk.

Proxy-Decision Making

1. Autonomy Based: person's previously articulated desires 2. Best Interest 3. Reasonable person standard

Health disparity

a particular type of health difference that is closely linked with social, economic, and/or environmental disadvantage

Wellness

a positive state in which incremental increases in health can be made beyond the midpoint

Daniel Chambliss

a sociologist who studied nurses in acute care institutional settings, asserts that organizations such as hospitals often give rise to "practical problems, not individual dilemmas"

Percentage of Costs of Prescription Drugs of National Health Expenditure

10% increased by 5.2% in 2009 to $246 billion will grow at a rate of 6.3% per year over the next decade

The standards of practice

1. Assessment 2. Diagnosis 3. Outcomes Identification 4. Planning 5. Implementation 6. Evaluation 7. Ethics 8. Culturally congruent practice 9. Communication 10. Collaboration 11. Leadership 12. Education 13. Evidence-based practice and research 14. Quality of practice 15. Professional practice evaluation 16. Resource utilization 17. Environmental health

The Percentage of the 305.2 Million Americans Which Were Enrolled in Medicare

12%

Components of The Code of Ethics for Nurses with Interpretive Statements

1. The provisions 2. Accompanying interpretive statements

The process of health care professionals redesigning health in the United States

1. potential or real problems need to be identified and analyzed, often in collaboration with others 2. appropriate actions need to be formulated and their likely consequences considered 3. obstacles to action should be recognized and addressed 4. actions are carried out and evaluated

Consider these steps when when recommending complementary therapies

1. the history of each 691therapy (many have been used by cultures for thousands of years to support health and reduce suffering) 2. history and experience of nursing with a particular therapy 3. outcomes and safety data, including case study and qualitative research 4. the cultural influences and context for certain patient populations.

Goals of Health Education

1. to inculcate a sense of responsibility in individuals for their own health and a shared sense of responsibility for avoiding injury to the health of others example: encouraging child-rearing practices that foster normal growth and development (personal, social, and physical) addresses both the individual parent and the needs of society 2. to understand the appropriate use of health services example: a semiannual visit to a dentist may teach a child better oral health habits and to visit the dentist regularly, although this is not the primary purpose of the visit

Percentage of Hospital Spending of National Health Expenditure

31% and is expected to grow at a rate more than 6% per year over the next decade

The Percentage of the 305.2 Million Americans That Had Employer Based Health Insurance

49%

The Percentage of the 305.2 Million Americans That Had Private Health Insurance

5%

cultural encounters

: Cross-cultural interactions that provide opportunities to learn about other cultures and develop effective intercultural communication

ASKED (mnemonic) for implementation of culturally congruent practice

Awareness Skill Knowledge Encounters Desires

Novice

Beginning nursing student or any nurse entering a situation in which there is no previous level of experience (e.g., an experienced operating room nurse chooses to now p

Reiki Therapy (Energy Therapy)

Biofield therapy derived from ancient Buddhist rituals; practitioner places hands on or above a body area and transfers "universal life energy," providing strength, harmony, and balance to treat a patient's health disturbances

Therapeutic Touch (Energy Therapy)

Biofield therapy involving direction of a practitioner's balanced energies in an intentional manner toward those of a patient; practitioner's hands lay on or close to a patient's body

Guided Imagery (Mind-body Interventions)

Concentrating on an image or series of images to treat pathological conditions

Latin American traditional healing (Whole medical systems)

Curanderismo includes a humoral model for classifying food, activity, drugs, and illnesses and a series of folk illnesses. The goal is to create a balance between the patient and his or her environment, thereby sustaining health.

Yoga (Mind-body interventions)

Focuses on body musculature, posture, breathing mechanisms, and consciousness; goal is attainment of physical and mental well-being through mastery of body achieved through exercise, holding of postures, proper breathing, and meditation

Teamwork and Collaboration

Function effectively within nursing and interprofessional teams, fostering open communication, mutual respect, and shared decision making to achieve quality patient care. Examples: Recognize the contributions of other health team members and patient's family members. Discuss effective strategies for communicating and resolving conflict. Participate in designing methods to support effective teamwork.

Marginalization

Groups are left out

social inequality

Groups have unequal access to resources, services, and positions

Biofeedback (Mind-body Interventions)

Process providing a person with visual or auditory information about autonomic physiological functions of the body such as muscle tension, skin temperature, and brain wave activity through the use of instruments

Patient-Centered Care

Recognize the patient or designee as the source of control and full partner in providing compassionate and coordinated care based on respect for patient's preferences, values, and needs. Examples: Involve family and friends in care. Elicit patient values and preferences. Provide care with respect for diversity of the human experience.

Meditation (Mind-body Interventions)

Self-directed practice for relaxing the body and calming the mind with focused rhythmic breathing

Psychosocial and Economic

Socioeconomic and psychosocial factors increase the risk for illness and influence the way that a person defines and reacts to illness; include the stability of the person's marital or intimate relationship, lifestyle habits, and occupational environment

Spiritual Factors

Spirituality is reflected in how a person lives his or her life, including the values and beliefs exercised, the relationships established with family and friends, and the ability to find hope and meaning in life

cultural knowledge

Sufficient comparative knowledge of diverse groups, including the values, health beliefs, care practices, world view, and bicultural ecology commonly found within each group

Emotional Factors

The patient's degree of stress, depression, or fear can influence health beliefs and practices

Trust

The professional has the knowledge and skills to meet an individual's needs or the needs of a group; the potential recipients of services lack the knowledge or ability to anticipate or meet their own needs but trust that the professional will keep their best interests as the primary goal and will strive to meet their needs example: in the current health care environment in the United States, people may have trouble accessing a specialist provider because of their particular insurance coverage or the inability to afford health care insurance or to pay on their own

Diagnosis

The registered nurse analyzes the assessment data to determine the diagnoses or issues.

Education

The registered nurse attains knowledge and competency that reflects current nursing practice.

Communication

The registered nurse communicates effectively in all areas of practice.

Quality of Practice

The registered nurse contributes to quality nursing practice.

Leadership

The registered nurse demonstrates leadership in the professional practice setting and the profession.

Planning

The registered nurse develops a plan that prescribes strategies and alternatives to attain expected outcomes.

Professional Practice Evaluation

The registered nurse evaluates her or his own nursing practice in relation to professional practice standards and guidelines, relevant statutes, rules, and regulations.

Evaluation

The registered nurse evaluates progress toward attainment of outcomes.

Outcomes Identification

The registered nurse identifies expected outcomes for a plan individualized to the patient or the situation.

Implementation

The registered nurse implements the identified plan. Coordination of Care: The registered nurse coordinates care delivery. Health Teaching and Health Promotion: The registered nurse uses strategies to promote health and a safe environment. Consultation: The graduate level-prepared specialty nurse or advanced practice registered nurse provides consultation to influence the identified plan, enhance the abilities of others, and effect change. Prescriptive Authority and Treatment: The advanced practice registered nurse uses prescriptive authority, procedures, referrals, treatment, and therapies in accordance with state and federal laws and regulations.

Evidence-based Practice and Research

The registered nurse integrates evidence and research findings into practice.

Environmental Health

The registered nurse practices in an environmentally safe and healthy manner

Resources

The registered nurse uses appropriate resources to plan and provide nursing services that are safe, effective, and financially responsible.

Perception of Functioning

The way people perceive their physical functioning affects health beliefs and practices

Family Practices

The way that patients' families use health care services generally affects their health practices

Healthy People Five Main Goals

To continue to improve infant health, and, by 1990, to reduce infant mortality by at least 35%, to fewer than 9 deaths per 1000 live births •To improve child health, foster optimal childhood development, and, by 1990, reduce deaths among children ages 1 to 14 years by at least 20%, to fewer than 34 per 100,000 •To improve the health and health habits of adolescents and young adults, and, by 1990, to reduce deaths among people ages 15 to 24 by at least 20%, to fewer than 93 per 100,000 •To improve the health of adults, and, by 1990, to reduce deaths among people ages 25 to 64 by at least 25%, to fewer than 400 per 100,000 •To improve the health and quality of life for older adults, and, by 1990, to reduce the average annual number of days of restricted activity attributable to acute and chronic conditions by 20%, to fewer than 30 days per year for people 65 and older

Native American traditional healing (Whole medical systems)

Tribal traditions are individualistic, but similarities across traditions include the use of sweating and purging, herbal remedies, and ceremonies in which a shaman (a spiritual healer) makes contact with spirits to ask their direction in bringing healing to people to promote wholeness and healing.

Quality Improvement

Use data to monitor the outcomes of care processes and use improvement methods to design and test changes to continuously improve the quality and safety of health care systems. Examples: Use tools such as flow charts and diagrams to make process of care explicit. Appreciate how unwanted variation in outcomes affects care. Identify gaps between local and best practices.

The Scope of Nursing practice describes..

What - the definition of nursing Who - RNs & APRNs have been educated, titled, and maintain active licensure to practice nursing When - Nursing occurs whenever there is a need for nursing knowledge, wisdom, caring, leadership, practice or education anytime, anywhere,. Where - Nursing occurs in any environment where there is a healthcare consumer in need of care, information, or advocacy How - defined as the ways, means, methods, and manners that nurses use to practice professionally. Why - characterized as nursing response to the changing needs of society to achieve positive healthcare consumer outcomes in keeping with nursing's social contract with an obligation to society.

Active Primary

You are personally involved example: Working out to prevent obesity.

Patient Self-Determination Act (PSDA) of 199

a competent person has the right to refuse treatment

Racism

a devaluing of the beliefs, values, and customs of others

Wellness-Illness Continuum

a dichotomous depiction of the relationship between the concepts of health and illness

opression

a formal and informal system of advantages and disadvantages tied to our membership in social groups, such as those at work, at school, and in families

Chronic illness

a global health problem and present continuous challenges for families

The Code of Ethics for Nurses With Interpretive Statements

a guide for carrying out nursing responsibilities that provide quality nursing care; it also outlines the ethical obligations of the profession

Quality Adjusted Life Year (QALY)

a measurement of quality of life;it is defined as perfect health minus the Disability Adjusted Life Year (DALY)

Maslow's Hierarchy of Needs

a model that nurses use to understand the interrelationships of basic human needs

Career Opportunities for Nurses

advanced practice registered nurses (APRNs), nurse researchers, nurse risk managers, quality improvement nurses, consultants, and even business owners.

Nursing Roles in Health Promotion and Practice

advocate, care manager, consultant, deliverer of services, educator, healer, and researcher

Quantity of life

affected by the disease are more readily obtainable

Age Risk Factors

affects a person's susceptibility to certain illnesses and conditions example: premature infants and neonates are more susceptible to infections

Advocacy

aggressive action taken on behalf of an individual, or perhaps a group viewed as an individual entity, to protect or secure that individual's rights

Affordable Care Act Law

aimed at reducing the number of uninsured Americans.

Preventive ethics

aims to forestall ethical problems before they develop

Communicator

allows you to know your patients, including their strengths, weaknesses, and needs

Per Capita Expenditure for Health Care

amount of money on average spent on each individual in the United States

Reliability

an assessment of the reproducibility of the test's results when different individuals with the same level of skill perform the test during different periods and under different conditions

Autonomy

an essential element of professional nursing that involves the initiation of independent nursing interventions without medical orders

Justice

an ethical principle of major importance in health-promotion settings

cost-effectiveness analysis

determines the optimal use of resources to reach a predetermined, constant end point or the desired health outcome

Components of consent process include

determining the person's competency to consent

Veracity

devotion to the truth; another principle that supports health-promotion activities

Native Americans/Alaskan Natives barriers to care

difficulties access to care and underserved population

Applied Research

done to directly affect clinical practice

Secondary

early diagnosis, prompt treatment, and disability limitation. example: Women who are at a high risk of breast cancer due to their age group should go in for screenings.

Clinical Application of Relaxation

effectively lower blood pressure and heart rate, decrease muscle tension, improve well-being, and reduce symptom distress in people experiencing a variety of situations

Integrative Health Care

emphasizes the importance of the relationship between practitioner and patient; focuses on the whole person; is informed by evidence; and makes use of appropriate therapeutic approaches, health care professionals, and disciplines to achieve optimal health; an integrative health care system consumers are treated by a team of providers consisting of both biomedical and complementary practitioners.

Nonmaleficence

enjoins people not to harm other people; constrains people from autonomous actions that are likely to harm others.

Disadvantages of screening

errors examples: false positives

Florence Nightingale

established the first nursing philosophy based on health maintenance and restoration; the first practicing nurse epidemiologist; volunteered during the Crimean War in 1853 and traveled the battlefield hospitals at night carrying her lamp; thus she was known as the "lady with the lamp.

The Code of Ethics for Nurses with Interpretive Statements

establishes the ethical standard for profession and provides a guide for nurses to use in ethical analysis and decision-making; addresses individual as well as collective nursing intentions and actions; it requires each nurse to demonstrate ethical competence in professional life.

Arab Americans largest groups

labanese, syrians, egyptians

Latino/Hispanic Americans background

largest ethnic group, largest diversity withing Latino population

refugees

leave negative homeland threat of injury/loss of life

Nursing diagnosis

life processes as well as actual or potential health problems.

Native Americans/Alaskan Natives health concerns and care issues

linked to social and economic conditions, smoking substance abuse, deaths are unintentional injuries; cirrhosis, homicide, suicide, pneumonia, diabetes.

Health Insurance Portability and Accountability Act (HIPPAA)

meant to protect the privacy of individually identifiable health information in the face of advances in electronic technology and to limit the ways in which "health plans, pharmacies, hospitals, clinics, nursing homes and other covered entities

Sensitivity

measures the first component; refers to the proportion of people with a condition who correctly test positive when screened

Specificity

measures the test's ability to recognize negative reactions or nondiseased individuals

Latino/Hispanic Americans largest groups

mexicans, puertoricans, and cubans

The study of ethics is also referred to as

moral philosophy and moral theology

Ethics

refers to the formal study of that mortality from a wide range of perspectives including semantic, logical, analytic, epistemological, and normative.

Significance of a disease

refers to the level of priority assigned to the disease as a public health concern

Validity

reflects the accuracy or truthfulness of the test or instrument itself

ethnic group

religion; socioeconomic status; gender; age; mental health; cognitive, sensory, or physical disability; sexual orientation or gender identity; geographic location; or other characteristics historically linked to discrimination or exclusion

Arab Americans barriers to care

religious beliefs and practices, cultural norms and modesty, gender issues regarding providers, communication difficulty, folk remedies, lack of culturally competent providers.

Informed consent

research, treatments, or health-promotion endeavors is a process of ensuring that a person has all of the appropriate information necessary to reach a decision about participation that facilitates autonomous action

relapse

reverted back to old behavior

Arab Americans selected health related cultural aspects

role of religion, importance of family; male dominated family structure, present-oriented

Health Promotion Activities

routine exercise and good nutrition help patients maintain or enhance their present levels of health; motivate people to act positively to reach more stable levels of health

Complementary therapies

teach behavioral modifications that often alter physical responses to stress and improve symptoms such as muscle tension, gastrointestinal discomfort, pain, or sleep disturbances

Progressive Relaxation

teaches an individual how to effectively rest and reduce tension in the body; the person learns to detect subtle localized muscle tension sequentially, one muscle group at a time (e.g., the upper arm muscles, the forearm muscles); involves use of slow, deep abdominal breathing while tightening and relaxing an ordered succession of muscle groups, focusing on the associated bodily sensations while letting go of extraneous thoughts example: begin with the muscles in the face, followed by those in the arms, hands, abdomen, legs, and feet; or begin with the feet and work up the body

Wellness education

teaches people how to care for themselves in a healthy way and includes topics such as physical awareness, stress management, and self-responsibility; help people achieve new understanding and control of their lives

Ethics (ANA standard)

the RN practices ethically

health equity

the accomplishment of the highest level of health for all people

Multiple test screening

the administration of two or more tests to detect more than one disease example: a blood sample can be assessed for many components including elevated glucose and cholesterol levels

Culturally congruent practice

the application of evidence based nursing that is in agreement with the preferred cultural values, beliefs, worldview, and practices of the healthcare consumer and other stakeholders.

social determinants of health

the conditions in which people are born, grow, live, work and age...shaped by the distribution of money, power and resources at global, national, and local levels

Metaethics

the domain that studies the nature of ethics and moral reasoning

Disease

the failure of a person's adaptive mechanisms to counteract stimuli and stresses adequately, resulting in functional or structural disturbances

Covered entities

those covered by the Privacy Rule

Ethnocentrism

to be aware of their own beliefs, values, and customs and how these ideas translate into behavior

Passive relaxation

to still the mind and body intentionally without the need to tighten and relax any particular body part; incorporates slow, abdominal breathing exercises while imagining warmth and relaxation flowing through specific body parts such as the lungs or hands

Asian Americans/Pacific Islanders waves of immigration

two waves of immigration

Researcher

use evidence-based findings as their foundation for clinical decision-making

Complementary Therapies

used in addition to or together with conventional treatment recommended by a person's health care provider; complement conventional treatments. Many of them such as therapeutic touch contain diagnostic and therapeutic methods that require special training. Others such as guided imagery and breathwork are easily learned; include relaxation; exercise; massage; reflexology; prayer; biofeedback; hypnotherapy; creative therapies, including art, music, or dance therapy; meditation; chiropractic therapy; and herbs/supplements

Morality

used to refer to what would be called personal values, character, or conduct of individuals or groups within communities and societies.

Asian Americans/ Pacific Isanders selected health related cultural aspects

value of collectivism vs. individualism, family most important social institution; respect for elders, cultural value of passivity to avoid conflict, taoism: foundation of Chinese medicine "achieving harmony", use of folk medicine/alternative treatment modalities common

Privacy Rule

was developed as a result of the Health Insurance Portability and Accountability Act (HIPAA); its intent was to ensure that individuals' health information is properly protected, while allowing the flow of information needed to provide and promote high-quality care (including using information about the person receiving care for research) and to protect the public's health and well-being.

intraobserver reliability

when the same individual is able to reproduce the results several times

interobserver reliability

when the same result emerges when two individuals perform the test

Environment Risk Factors

where we live and the condition of that area (its air, water, and soil) determine how we live, what we eat, the disease agents to which we are exposed, our state of health, and our ability to adapt; the physicals of this risk factor in which a person works or lives can increase the likelihood that certain illnesses will occur example: some kinds of cancer and other diseases are more likely to develop when industrial workers are exposed to certain chemicals or when people live near toxic waste disposal sites

Applied Ethics

wrestles with questions of right, wrong, good, and evil in a specific realm of human action, such as nursing, business, or law

Accountability

you are responsible professionally and legally for the type and quality of nursing care provided

Cognitive skills

• Focusing (the ability to identify, differentiate, maintain attention on, and return attention to simple stimuli for an extended period) • Passivity (the ability to stop unnecessary goal-directed and analytic activity) • Receptivity (the ability to tolerate and accept experiences that are uncertain, unfamiliar, or paradoxical).

Health Promotion Assessment Questions

• How do you define health? • What does health mean to you? • How would you describe your health now? • Do the choices you make and actions you take affect your health? • Can you give examples when choices and actions created a positive change in health for you? • Can you give examples when choices and actions created a negative or unsafe change in health for you? • What factors facilitated choices and actions that created a positive change in health? • What factors created barriers to choices and actions that led to a negative or unsafe change in health? • Are there any supportive personal influences in your life that would assist you in choices and actions that would create a positive change in your health (i.e., family, friends, and health care providers)? • Are there any supportive situational influences, such as more than one plan of action, pertaining to the health change available to you?