Clinical FINAL Flashcards
(37 cards)
What are the 6 stages of the Change Theory?
- pre-contemplation
- contemplation
- preparation
- action
- maintenance
- relapse
What is the emotional management tool used for?
identify the purpose of their unhealthy behaviour (e.g. smoking, emotional eating) and support a replacement function
What is the motivational enhancement tool used for?
- determining clients readiness for change
- explore pros and cons of staying the same and changing the behaviour
What is the behaviour change tool used for?
- Developing a SMART goal
- stimulus control
- reinforcement that it takes lots of time to change behaviours
How does exercise training help those with CHF?
- helps to improve skeletal muscle function
- Pts are able to complete activities with reduced SOB and fatigue!!!
What kind of exercises are recommended for HF?
- aerobic, anything to increase heart rate (e.g. walking)
- Walking or stationary bike with NO resistance (perfect for beginners)
- 10-15 mins, up to 30 - include warm up and a cool down!!! (stretching)
- strength-training
What is a good tip for HF pts during exercise if they are unable to complete an activity that is 15 mins?
try 2-3 sessions of 5 minutes instead
- toleration of sets is improved rather than increased time… they need breaks!
What is the “walk so you can talk” rule?
SOB is normal. If you find you cannot complete a sentence, you must slow down.
What activities must be avoided until approved by specialist?
- lifting over 10lbs
- shovelling snow
- stretching both arms over head
- saunas or hot tubs
What are some general exercise tips for those with HF?
- avoid exercise after large meals
- schedule exercise for when you feel the best
- record exercise to monitor progress
- avoid exercise in extreme temps or windy weather
What is ambivalence?
wanting to stop but also not wanting to stop
- common in addictions
What are the 5 general principles of motivational interviewing?
- empathy
- determine discrepancy between clients goals and their behaviour
- avoid argument or confrontation
- adjust to client resistance
- support self-efficacy and optimism
What does LEARNS model stand for and what is it for?
- listen
- establish
- adopt
- reinforce
- name
- strengthen
facilitating client-centered learning
What is the most common chronic condition in children?
diabetes mellitus
What are some people that may be included in diabetes education for a child with T1DM?
- dietician
- pediatrician with diabetes expertise
- mental health professional
- social worker
- diabetes nurse educator
What are some education topics that should be considered when providing education to a child with T1DM and their family?
- insulin and administration
- blood glucose and ketone monitoring
- prevention of DKA
- diet and nutrition
- prevention/detection of hypoglycemia
What child is suggested to have a slightly better outcome (less DKA risk, better mgmt skills))?
- child with new onset of T1 presenting to hospital with DKA in which required a short stay at the hospital
- outpatient education for a child with new onset of T1
Outpatient education!
- less expensive than inpatient education and seems to have the more improved outcomes. Perhaps due to independency.
What are the recommended glycemic targets for child/teen with T1?
less than 7.5%
How can we reduce the progression of diabetes-related complications in those with T1?
- sufficient knowledge of glycemic targets
- tight glycemic control
What is the “honeymoon” period of T1DM?
the first 2 years after diagnosis, in which seems to be the time where glycemic control is easiest.
- after 2 years, tighter mgmt is required
What is consisted of basal-bolus insulin regimens?
- long-acting basal insulin (scheduled) and rapid-acting bolus (sliding scale)
What is continuous subcutaneous insulin infusion (CSII)?
- insulin pump, known for improved control and reduction of hypoglycemic episodes
Which is better: basal-bolus insulin regimens or CSII pump?
both have their pros and cons, neither one is better than the other
If a child is hypoglycemic and refuses oral fluids….
IV dextrose or mini doses of glucagon
