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NUR 51100 Concepts and Applications of Health Promotion for Advanced Practice Nursing > Exam 2 > Flashcards

Exam 2 Flashcards

1
Q

BMI

A

body mass index using weight and height to determine overweight and obesity ranges.

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2
Q

Overweight

A

BMI between 25 & 29.9

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3
Q

Obesity

A

BMI between 30 & 40

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4
Q

Morbid Obesity

A

BMI of 40 and higher

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5
Q

Overweight in Children

A

BMI in the 85th percentile and lower than the 95th percentile for children of the same age and sex

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6
Q

Obesity in Children

A

BMI in or above the 95th percentile for childen of the same age

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7
Q

Indiana

A

10th highest in obesity rates at 32.5% in 2016

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8
Q

Causes of Obesity

A 
age
gender
genetics
environmental factors
physical activity
psychological factors
illness
medication
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9
Q

Comorbid Conditions

A 
Coronary heart disease
DM2
cancers (endometrial, breast, colon)
HTN
HLD
CVA
Sleep apnea and resp 
gynecological problems (abnormal menses, infertility)
liver and gallbladder disease
OA
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10
Q

Childhood Obesity Health Risks

A 
HTN
Resp/Asthma
DM2
MS
GI
social/psychological
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11
Q

Metabolic Syndrome

A 
Abdominal Obesity (waist Circumference.  >40 inch in men, >35 inch in men)
Elevated Triglycerides
HDL
B/P
FBS (DM)
Thyroid
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12
Q

Readiness for Change

A

suggest healthy eating - not diet. What have then done in the past?
identify barriers
goals
plan

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13
Q

1 - 2 pound/week wt loss

A

500 - 1000 calories less per week

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14
Q

short term goal of 5 - 10% wt loss

A

6 months

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15
Q

6 month Short Term wt loss goal

A

5 - 10%

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16
Q

500 - 1000 calories/week

A

1 - 2 pound/week wt loss

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17
Q

Nutritional Intake Assessment

A
  • Frequency of eating outside the home
  • Sweetened beverages
  • breads & Pastas
  • Portion size/refills
  • frequency & quality of breakfast consumption
  • energy density foods
  • fruits and vegetables
  • meal frequency & snacking pattern
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18
Q

LCD

A

Low Calorie Diet

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19
Q

Low Calorie Diet

A

recommended for weight loss.
Protein - 4 calories/gram
Cho - 4 calories/gram
Fat - 9 calories/gram

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20
Q

Reduce total body weight

A

by 8% in 6 months

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21
Q

Very LCD

A

<800 calories produce greater initial weight loss, but faster is not necessarily better. Long term is better.

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22
Q

Low Calorie Step 1 Diet

A

Calories 500 - 1000 reduction per day

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23
Q

Physical Activity

A
  • modestly contributes to wt loss
  • may decrease abd fat
  • increases cardio-respiratory fitness
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24
Q

Benefits of Physical Activity in relation to wt loss

A
  • increases energy expenditure
  • protects and builds lean body mass
  • improves psychological factors
  • reduces risk of mortality and morbidity
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25
Q

Physical Activity Impact of Co-Morbidities

A
  • improves cardio-respiratory
  • lower lipids
  • lowers b/p
  • increases insulin sensitivity
  • improves blood glucose control
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26
Q

Behavior Therapy Strategies

A
  • self monitoring
  • stress management
  • stimulus control
  • problem solving
  • contingency management
  • cognitive restructuring
  • social support
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27
Q

Self Monitoring & Stimulus Control

A

Keep a Diary
Behavior change techniques
Use rewards for specific actions

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28
Q

Keep a Diary

A
  • Amount &types of food eaten
  • Frequency, intensity & type of physical activity
  • Time, place and feelings
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29
Q

Behavior Change Techniques

A
  • Learn to shop for healthy foods
  • Keep high caloir foods out of the home
  • Limit the times and places of eating.
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30
Q

Stress Management

A
  • Defuse situations that lead to overeating
  • Coping strategies
  • Mediation
  • Relaxation techniques
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31
Q

Problem Solving

A
  • Self correction of problem areas related to eating and physical activity
  • identify wt related prloblems
  • brainstorm solutions
  • plan and implement healthier alternatives
  • evaluate outcomes
  • encourage pt reevaluation of “setbacks”.
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32
Q

Cognitive Restructuring

A
  • Rational thoughts designed to replace negative thoughts.
33
Q

Support

A
  • Maintain motivation and positive reinforcement

- Family, Friends, Colleagues

34
Q

Drug Therapy

A

non-drug interventions should be attempted for at least 6 months prior to considering Rx tx

35
Q

Who is Drug Therapy appropriate for?

A
  • BMI 30+ w/o co-morbities

- BMI 27+ w/ co-morbitieis (HTN, HLD, CHD, DM, Sleep apnea)

36
Q

Orlistat

Xenical

A
  • 120 mg TID AC meals (>12)
  • decreases fat absorption
  • can be taken up to 4 years
  • SE: GI
  • 5% loss of body weight w/ diet & exercise
  • OTC
37
Q

Adipex

amphetamine

A
  • 37.5 mgp day X 4 weeks
  • resting EKG & Lipids prior to initiation
  • weekly wts w/ diet & exercise (script for 1 week only)
  • SE: HTN, tachycardia, insomnia, palpitations, anxiety
38
Q

Osymia

Pentermine & Tompiramate

A
  • phentermine: appetite suppressant
    Topiramate: stimulant, promote saiety
    SE: Phen: insomnia, palpitations, anxiety, risk of birth defects. Topiramate: drowsiness
39
Q

Contrave

bupropion & naltrexone

A
  • bupropion - antidepressant that decreases hunger but also increases certain opioids in the brains that block satiety.
    Naltrexone - opiod inhibitor-blocks affects of buproprion on opioids in brain.
    SE: nausea, increase suidcide resk w/ bupropion and lowers seizure threshold.
40
Q

Criteria for Wt Loss Surgery

A
  • BMI > 40 or >35 w/ co-morbid conditions
  • for pt whom medical therapy has failed
  • gastric restriction or gastric bypass
41
Q

Gastric Bypass Surgery Complications

A 
Vit B 12 deficiency
incisional hernia
dpression
gastritis
cholecystitis
dehydration
malnutirition
dilated pouch
42
Q

Who Smokes?

A
  • more people quitting
  • not fewer people starting
  • highest rate is black males
  • 26% of all Americans >18 years of age smoke (2007)
43
Q

Why Start Smoking?

A
  • alleviate stress
  • peer pressures
  • family hx, parental modeling
  • poor
  • want to appear mature
  • risk takers
  • extroverted peeps
  • alleviation of depression
  • substance abuse (ETOH)
44
Q

Child & Adolescent Smokers

A

3000 teens start smoking everyday

45
Q

Women & Smoking

A
  • smoking helps w/ depression and appetite suppression
  • typically gain 5 - 10 pounds w/ cessation
  • easier to control from the beginning of cessation
46
Q

Smoking Cessation

A
  • 50% of smokers want to quite
  • –it is expensive, $3, 391/yr
  • discuss previous attempts
  • –2/3 unsuccessful w/ 1st try
  • –what went well?
  • –why relapse
  • success rates are low
47
Q

5 A’s,

Smoking Cessation Steps

A

1) ask about tobacco use
2) advise to quit
3) assess willingness to quit
4) assist in quit attempt
5) arrange for f/u

48
Q

Pack years

A

of years X # of packs/day

49
Q

5 R’s

Assist w/ motivation

A

1) Relevance
- —kids
2) Risks
- —COPD, smell, walls
3) Rewards
- —better health, more money
4) Roadblocks
- —wt gain, depression, routine is changed
5) Repetition
- —enforce every visit and encourage

50
Q

Health Belief Model & Smoking Cessation

A
  • more likely to quit if…
  • –believe they could get smoking-related disease
  • —believes they can make an honest attempt
  • —believes the benefits of quitting outweigh the benefits of smoking
  • —know someone who has health problems from smoking
51
Q

Transtheoretical Model & Smoking Cessation

A
  • Pr-contemplator
  • —not ready
  • contemplator
  • —excuses but thinking about it
  • Preparation
  • —seriously intend to quit in the next month
  • Action
  • —first 6 months of not smoking
  • Maintenance
  • —6 months to 5 years for relapse
52
Q

Quitting Advice

A
  • pick a quit date
  • tell family and friends
  • prepare
  • —gum, healthy snacks
  • pick a strategy
  • —patch, gum, vaper
  • find support
53
Q

Types of Nicotine Replacement

A
  • transdermal
  • gum
  • nicotine nasal spray
  • inhalers
  • oral agents
54
Q

Nicotine Patch

A
  • measured dose through the skin
  • no prescription needed
  • start full-strength 15 - 22 mg QD for 4 weeks
  • then 5 - 14 mg QD for 4 weeks
  • FDA recommends 3 - 5 months. some show 8 wks is sufficient
55
Q

Nicotine Gum

A
  • fast acting
  • OTC
  • 2 - 4 mg doses
  • no more than 20 mg/day
  • use for up to 6 months
  • can form long term dependence
  • also have Commit lozenge
56
Q

Nicotine Nasal Spray & Inhalers

A
  • fast acting
  • prescription only
  • FDA says addictive 3 - 6 months only
  • do not use for asthmatics and/or sinus problems
57
Q

Bupropion

for smoking cessation

A
  • wellbutrin/zyban
  • can be used w/ nicotine replacement
  • higher quit rates
  • can’t take if hx of seizure, anorexia, ETOH use or head injury
58
Q

Bupropion
for smoking cessation
dosing

A
  • take 7 - 12 weeks
  • take 10 - 14 days prior to stopping smoking
  • 150 mg q day x 3 days then 150 mg bid
59
Q

Chantix

for smoking cessation

A 
- set stop date
start one week prior to stop date
- take after eating and w/ full glass of water
- contradicted in unstable depression
- 0.5 mg QD X 3 days
- 0.5 mg BID X 7 days
- 1 mg BID X 12 weeks
60
Q

Cephalcaudal Growth Pattern

A
  • a child’s pattern of growth

- head-to-toe direction

61
Q

Proximodistal Growth Pattern

A
  • also a child’s growth pattern

- an inward to outward direction

62
Q

Domains Assessed in Child development assessment

A 
cognitive
motor
language
social/behavioral
adaptive
63
Q

Gross Motor Skills

A
  • precedes fine motor skills
    occurs in cephalocaudal fasion (head-to-toe direction)
    —-head contorl preceding arm and hand control
    —-followed by leg and foot control
64
Q

Gross Motor Development of 6 Month old

A

easily lifts head, chest and upper abd and can bear weight on arms.

65
Q

Development Assessment, Sitting Up

A
  • 2 mo: needs assist
  • 6 mo: can sit alone in tripod position
  • 8 mo: can sit w/o support and engage in play
66
Q

Development Assessment,

Ambulation

A

9 mo: crawl
1 yr: stand independently from a crawl position
13 mo: walk and toddle quickly
15 mo: able to run

67
Q

Development Assessment,

Fine Motor of an Infant

A
  • objects involuntarily grasped and dropped w/o notice
  • 6 mo: palmar grasp, uses entire hand to pick up an object
  • 9 mo: pincer grasp, can grasp small objects using thumb and forefinger
68
Q

Development Assessment,

Speech Milestones

A

1-2 months: coos
2-6 months: laughs and squeals
8-9 months babbles: mama/dada as sounds
10-12 months: “mama/dada specific
18-20 months: 20 to 30 words – 50% understood by strangers
22-24 months: two word sentences, >50 words, 75% understood by strangers
30-36 months: almost all speech understood by strangers

69
Q

Development Assessment,

Hearing

A

BAER hearing test done at birth
Ability to hear correlates with ability enunciate words properly
Always ask about history of otitis media – ear infection, placement of PET – tubes in ear
Early referral to MD to assess for possible fluid in ears (effusion)
Repeat hearing screening test
Speech therapist as needed

70
Q

Development Assessment,

Red Flags in infant development

A
  • unable to sit alone by 9 mo
  • unable to transfer ojects from hand to hand by 1 year
  • abnormal pincer grip by age 15 mo
  • unable to walk alone by 18 mo
  • failure to speak recognizable words by 2 years
71
Q

Development Assessment,
Fine Motor
Toddler

A
  • 1 yr: trasfer objects from hand to hand
  • 2 yr: able to hold a crayon and color vertical strokes
  • —turn the page of a book
  • —build a tower of six blocks
  • 3 yr: copy a circle and a cross
  • 4 yr: use scissors, color within the borders
  • 5 yr: write some letters and draw a person w/ body parts
72
Q

Development Assessment,

issues in parenting toddlers

A
  • stranger anxiety
  • —dissipate by age 2.5 - 3 yr
  • temper tantrum
  • —dissipate by age 3 yr
  • sibling rivalry
  • thumb sucking
  • toilet training
73
Q

Development Assessment,
Fine Motor Skills
Pre-School

A
  • buttoning clothing
  • holding a crayon/pencil
  • building with small blocks
  • using scissors
  • playing a board game
  • draw a picture of themselves
74
Q

Development Assessment,

Red Flags in Pre-School development

A
  • inability to perform self-care tasks (hand washing, simple dressing)
  • lack of socialization
  • unable to play w/ other children
  • able to follow directions during an exam
  • performance eval of pre-school teacher for kindergarten readiness
75
Q

Development Assessment,
Fine Motor Skills
School Age Children

A
  • writing skills improved
  • refined fine motor skills
  • —building
  • —sewing
  • —musical instrument
  • —painting
  • —typing skills
  • —technology: computers
76
Q

Development Assessment,

Red Flags in School Age Child development

A
  • school failure
  • lack of firends
  • social isolation
  • aggressive behavior
  • —fights, fire setting, animal abuse
77
Q

Incidence of Illicit drug use

A
  • 6.1% of Americans >12 yr have used in previous month

- 1 in 20 HS seniors use marijuana QD

78
Q

Incidence of OTC Prescription drug abuse

A
  • sleeping medications

- health care professionals are at higher risk for prescription drug abuse

79
Q

Screening Tools for Substance Abuse

A
  • CAGE
  • AUDIT
  • —ETOH abuse

NUR 51100 Concepts and Applications of Health Promotion for Advanced Practice Nursing (3 decks)

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