207 Foundations I (Term 2) Week 7 to Final Study Cards

Question 1

Define care coordination

Answer 1

The deliberate organization of patient care activities between two or more participants (including the patient) involved in a patient’s care to facilitate the appropriate delivery of healthcare services. Organizing care involves the marshalling of personnel and other resources needed to carry out all required patient care activities and is often managed by the exchange of information among participants responsible for different aspects of care”

Question 2

Explain and identify the rights of medication administration.

Answer 2

Right patient Right drug Right dosage Right reason Right assessment Right route Right time Right patient education Right to refuse Right evaluation (follow up) Right documentation

Question 3

What are the 7 essential components of a medication order?

Answer 3

1. Patient’s full name 2. Date and time the order was written. 3. Name of medication 4. Dosage 5. Route 6. Time and frequency 7. Signature of prescriber

Question 4

Describe the scope of care coordination

Answer 4

Care coordination not needed ————— extensive care coordination needed

Question 5

What are the attributes of care coordination?

Answer 5

• Patient-centered/individualized plan of care
• Evidence-based care
• Efficiency
• Improved health outcomes
• Value-based care delivery
• Interprofessional team-based care

Question 6

What are some different roles of the nurse relative to care coordination?

Answer 6

1) Nurse Navigator Although their role may vary by setting, nurse navigators promote and facilitate continuity of care across care settings and between care providers by sharing information on the client’s current situation, plan of care and goals. Offer support, education, information and resources. 2) Case Manager A nurse case manager is usually a registered nurse in a health and/or social service practice setting who takes a leadership role in coordinating the case management process. The case manager provides assessment, service planning and implementation, coordination, monitoring, reassessment, advocacy, evaluation of outcomes and discharge planning for clients. 3) Telehealth Nurse Telehealth is defined by the Canadian Nurses Association (CNA, 2007) as “the use of information and communication technology to deliver health services, expertise and information over distance.”

Question 7

Where are cultural considerations and differences most often seen?

Answer 7

• pregnancy and birth practices - child rearing - health/illness - death and dying

Question 8

What are characteristics that describe an external locus of control?

Answer 8

Fate; Family dynasty, Outside factors Believe these factors can dictate life direction and that they are not in control of themselves. Can lead to loneliness through illness.

Question 9

What are characteristics that describe an internal locus of control?

Answer 9

A person perceives that they have control over their life events Control over their health; When individual have strong internal locus of control, there are protective features for mental health

Question 10

What model postulates that each individual is culturally unique and should be assessed according to six cultural phenomena: (a) communication, (b) space, (c) social organization, (d) time, (e) environmental control, and (f) biological variations.

Answer 10

Giger and Davidhizar Transcultural Model

Question 11

What six cultural phenomena does the Giger and Davidhizar Transcultural model identify?

Answer 11

1) Communication 2) Space 3) Social Organization 4) Time 5) Environmental Control 6) Biological Variations

Question 12

Describe the cultural phenomena of communication as described by Giger and Davidhizar?

Answer 12

• language spoken - pronunciation - use of silence - voice quality - use of nonverbal communication Communication often presents the most significant problem in working with clients from diverse cultural backgrounds.

Question 13

Define transcultural nursing.

Answer 13

A culturally competent practice field that is client centered and research focused.

Question 14

What aspects of a stressor influence the stress response?

Answer 14

• intensity - scope - duration - number and nature of other stressors - past exposure to serious stressors - predictability

Question 15

What characteristics of the individual influence the stress response?

Answer 15

• age - gender - perception of personal control or inescapability - availability of social supports - feelings of competence - cognitive appraisal

Question 16

What are the three levels of of care related to stress according to Neuman?

Answer 16

• primary - secondary - tertiary

Question 17

What is involved in the primary level of care for stress?

Answer 17

goal is to promote patient wellness by stress prevention and reduction of risk factors

Question 18

What is involved in the secondary level of care for stress?

Answer 18

Occurs after symptoms appear. The nurse helps the patient determine the meaning of the illness and stress and find resources available to handle them.

Question 19

What is involved in the tertiary level of care for stress?

Answer 19

Begins when the patient is becoming more stable and recovering. The nurse supports rehabilitation processes involved in healing, moving the patient back to wellness, and the primary level of disease prevention.

Question 20

What are the stages of the Kubler-Ross model of grief?

Answer 20

Denial Anger Bargaining Depression Acceptance Remember ‘DABDA’

Question 21

What is disenfranchised grief?

Answer 21

Also known as marginal or unsupported grief. A loss experienced and cannot always be openly acknowledged, socially sanctioned, or publicly shared due to stigmatization. Examples are loss of partner from accidental fentanyl overdose, loss of child in utero or at birth, loss of family member due to suicide.

Question 22

Define sleep

Answer 22

Sleep is natural, necessary, involves a shift in physiologic and neurologicactivity, and is intended to be restorative.

Question 23

Describe the scope of sleep.

Answer 23

Process of achieving optimal sleep.

• Restorative sleep
• Intermittent/situational poor sleep
• Chronic poor sleep/sleep disorder

Question 24

Describe the scope of caregiving.

Answer 24

No caregiver role —–> Limited-Duration/Temporary Caregiver Role ______> Long-term/Permanent caregiver role

Question 25

What stage of sleep is characterized by the following:

Lightest level of sleep

Person unresponsive but easily aroused by sensory stimuli

Physiological activity begins to diminish, followed by gradual fall in vital signs and metabolism

Muscle tone is present

If awakened, person feels as though they have been daydreaming

Lasts only a few minutes

2-5% of sleep in adults

Answer 25

Stage 1 - Nonrapid Eye Movement

Question 26

What stage of sleep is characterized by the following:

Period of sound sleep

Relaxation progresses

Body functions continue to slow

Muscle tone remains present

Eye movements are absent

45-55% of total sleep in adults

Answer 26

Stage 2 - Nonrapid Eye Movement

Question 27

What stage of sleep is characterized by the following:

Deepest period of sleep

People are difficult to arouse

Muscle become completely relaxed

Vital signs significantly lower than waking hours

10% and most predominant in first half of sleep

Answer 27

Stage 3 - nonrapid eye movement

Question 28

What stage of sleep is characterized by the following:

Rapid eye movements are present

Respirations are irregular and shallow

Variable heart rate and blood pressure

Vivid and elaborate dreams

Dreams more frequently

Usually begins 90 minutes after sleep has occurred

Loss of skeletal muscle occurs

Gastric secretions increase

Person difficult to arouse

Duration of REM sleep increases with each cycle

25% of total sleep in adults

Answer 28

Rapid Eye Movement Sleep

Question 29

How many sleep cycles approximately per night?

Answer 29

5

Question 30

What is going without sleep for 18 hours similar to?

Answer 30

You would operate the same as someone who has blood alcohol of 0.08 (legally intoxicated)

Question 31

True or false. Individuals require less sleep as we age.

Answer 31

True

Question 32

Define primary sleep disorders.

Answer 32

Those that exist as an independent condition. The most common categories of primary disorders include insomnia, sleep-related breathing disorders, sleep-related movement disorders, parasomnias, circadian rhythm sleep disorders, and hypersomnia.

Question 33

What are the most common categories of primary disorders?

Answer 33

• Insomnia
• sleep-related breathing disorders
• sleep-related movement disorders
• parasomnias
• circadian rhythm sleep disorders,
• hypersomnia.

Question 34

Characterized by excessive sleepiness or falling asleep at inappropriate times. Narcolepsy is an example.

Answer 34

Hypersomnia

Question 35

Occur when the drive to sleep does not occur according to what would be considered a normal sleep-wake pattern, such as someone who stays awake until early morning and does not have the drive to fall asleep as nighttime progresses.

Answer 35

Circadian rhythm sleep disorders

Question 36

Include a variety of behaviors, such as sleepwalking, sleep terror, and REM behavior disorder.

Answer 36

Parasomnias

Question 37

What disorder: Restless leg syndrome and periodic limb movement disorder.

Answer 37

Sleep-related movement disorder

Question 38

Exists when there is difficulty falling asleep or staying asleep.

Answer 38

Insomnia

Question 39

Define secondary sleep disorders.

Answer 39

• Occur as the result of some other situation, and correcting that situation should resolve the problem with sleep. Secondary disorders are often caused by medical conditions, mental health conditions, and side effects of medical treatments.
• A secondary sleep disorder also may be associated with the use of any medication that has either a sedative or a stimulating effect because either of these actions can interfere with restorative sleep.
• Prematurity in infants also may lead to problems with sleep secondary to the state of neurologic or cardiovascular development.

Question 40

At what stage do vivid dreams occur?

Answer 40

REM

Question 41

What are some helath promotion areas for improving sleep?

Answer 41

• Consistent sleep and wake times
• Reducing alcohol, simulants, eating a heavy meal, etc. 4-6 hours before sleep
• Ensure comfortable sleep environment
• Reducing daytime naps
• Reducing screen time before bed
• Use medication as a last resort
• Healthy diet
• Stress Reduction
• Limiting exercise right before bed

Question 42

What is primary prevention related to sleep?

Answer 42

• good sleep hygiene education
• actions that prevent sleep problems from occuring

Question 43

What are some negative effects of impaired sleep?

Answer 43

• increased heart disease
• increased wear and tear on cardio system
• increased hypertension
• mood impacts
• impaired cognition

Question 44

Define caregiving.

Answer 44

Providing unpaid care to a relative or friend to help them take care of themselves.

Made up of actions one does on behalf of another individual who is unable to do those actions for himself or herself

Question 45

What are 4 types of caregiver roles?

Answer 45

1) spousal caregivers
2) adult children caregivers
3) grandparent caregivers
4) Parental caregivers

Question 46

Describe spousal caregivers.

Answer 46

• Commonly caring for their spouse with significant physical and/or cognitive disorders yet have their own significant health issues.
• Typically, spousal caregivers are older, have lower educational levels and income, and are less employed than nonspousal caregivers.

Question 47

Describe adult children caregivers.

Answer 47

• Often caregivers for their elderly parents. The increase in this phenomenon is due, in part, to medical and technological advances that have extended life expectancy.
• The impact of the caregiving role can be overwhelming for adult children caregivers who have to assume multiple roles and responsibilities while juggling employment and family responsibilities. They have to change their lives to meet the needs of their parent(s).
• Most adult children caregivers are in the “sandwich generation”—they must care for their children as well as their parents, either in their own home or in the home of their parents. Adult children caregivers also may experience forms of loss, including the following:

Loss of their parent(s) as they knew him or her before the illness

Loss of their jobs (or needing to cope with job changes)

Change in their social networks

• Adult children caregivers may be at higher risk of impaired health behaviors because their role as caregivers hinders the amount of time available for engaging in personal and preventative health behaviors.

Question 48

Describe grandparent caregivers.

Answer 48

• Many grandparents are raising their grandchildren and providing care in a variety of ways.
• Grandparents are often overwhelmed in the role of caring for their grandchildren. This feeling of being overwhelmed may occur because they are
• raising their grandchildren on a fixed income and facing financial hardships;
• experiencing the effects associated with normal aging and/or the health problems that make caring for their grandchildren difficult;
• worrying about who will be the caregivers when they die or are physically unable to provide care; or
• raising children who may have mental, behavioral/emotional, or physical problems.
• A more subtle stressor occurs when grandparents become primary caregivers of children in that they lose the special relationship and unique role of being the grandparent.

Question 49

Describe parent caregivers.

Answer 49

• Taking care of a child because of a medical, behavioral, or other disability.
• A primary role of parents is the provision of care for their children. However, parents become “caregivers” for their children when the children are at an age at which they would normally be expected to care for themselves. This can be due to a disability such as severe physical or cognitive limitations.
• It can also happen later in life from an accident (e.g., a spinal cord injury), a debilitating illness, or severe physical or emotional trauma experienced in military combat.

Question 50

Identify the attributes and criteria of caregiving.

Answer 50

• The need for love, affection, empathy, compassion, and holistic care are identified as requisite emotions or antecedents to the concept of caregiving.
• The attributes of the caregiver are specific to the person and are contextually based dependent on the caregiver/care recipient relationship and other relationships in the family. Caregivers have the following attributes or characteristics:
• Having the ability to care
• Adapting to a situation
• Being a good listener
• Showing affection
• Being responsible for someone other than self
• Being strong, protective, organized, patient, and understanding
• Serving as an advocate
• Assisting with activities of daily living
• Providing emotional and social support
• Managing and coordinating healthcare services