Exam 1 Flashcards

(89 cards)

1
Q

What is the backbone of nursing?

A

Health + Health promotion

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2
Q

How are we doing as a country as far as health promotion goes?

A

Good workout culture: exercise is more important now

screenings + reminders to be proactive with health

better vaccines

seatbelt wearing + Better DUI reminders

Smoking is less common (cant smoke just anywhere)

Bad:
decrease in diet + quality foods (childhood obesity)

sedentary lifestyles

increase in domestic, gun violence

increase in teen pregnancy: infant mortality; STD

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3
Q

Cause of death: early mid 1900s

A

infectious disease; young adults + children

Health was the absence of disease

people did not live long enough to die from other disease

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4
Q

Cause of death: Today

A

large change to healthcare delivery system

person centered care = teaching pts about lifestyle

heart disease, chronic conditions, diabetes, cancer

50% of early death = lifestyle

chronic = older

accidents = younger

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5
Q

What is the nursing role?

A

health promotion and disease and more important than ever

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6
Q

What are the nursing roles?

A

Interprofessional practice = nurse play a variety of roles

Educator: risk, managing

Advocacy: helps individuals obtain what they are entitled to receive from health care system, tries to make the system more responsive to individual and community needs, helps persons develop the skills to advocate for themselves (voice for someone else)

Care Manager: act to prevent duplication of services and cost; navigating health care

consultant: sharing specialized knowledge/ expertise to promote health and prevent disease to individuals/ groups

delivererer of services: health education, influenza vaccine, counseling in health promotion, screenings (BP + cholesterol)

Healer: integrate + balance parts of lives

Researcher: interpret research finding (evidence- based findings)

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7
Q

What are the 4 concepts of health?

A

Clinical

Role Performance

Adaptive

Eudaimonistic

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8
Q

What is the clinical concept of health?

A

health is the absence of disease: signs + symptoms

Illness = presence of signs + symptoms of disease

do not use preventative health services/ wait until they are very ill

conventional model of discipline of medicine

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9
Q

What is the role performance concept of health?

A

if you can perform your role in society you are “healthy”

role performance = work, family, social role

illness= failure to perform roles of other in society

basis = occupational, school, physical, physician- excused

“sick role” = vital component of role performance model

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10
Q

What is the adaptive concept of health?

A

“health” is the ability to adjust positively to social, mental, and physiological changes

illness= person fails to adapt/ maladaptive changes

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11
Q

What is the Eudaimonistic concept of health?

A

“health = wellbeing” interaction between physical, social, psychological, and spiritual aspects of life + enviroment

illness= denervation/ langusihing; lack of involvement

people dying of cancer = healthy of they find meaning

“holisitic health”

acupunture, chiropractor

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12
Q

What is the definitions of health?

A

health is now defined as a state of physical, mental, spiritual and social functioning that realizes a person potential and is experienced in a developmental context

WHO: health is a state of complete physical, mental, and social wellbeing and not merely the absence of disease

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13
Q

What is the primary level of prevention?

A

things that are done before a disease sets in, serves to prevent disease. Interventions that prevent and defend the body; decreases chance of getting disease

health education

immunizations

specific nutrients

protection from carcinogen

thing that build up defenses, make pts stronger

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14
Q

What is secondary level of prevention:

A

goal is to find a disease early; interventions that serve to identify and detect disease at an early state; involves cure therapy

to find out; (something is starting)

screenings; breast exams

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15
Q

What tertiary level of prevention:

A

restore and rehabilitate when disability is permanent; maximize what is left

optimize functioning

if patient has chronic disease

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16
Q

What is the primordial stage of prevention?

A

using policy to prevent actual risk factors themselves

actions taken to modify the social and enviromental conditions which foster the risk factor

primary + policy

time frame before risk factor develops and before disease occurs

healthy eating school-based programs, reduction of sodium in food supply, creating bike + walking path

begins in early childhood/ prenatally

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17
Q

What is healthy people 2030?

A

follows healthy people; call to action by US dept of health

set national goals aimed at improving health of country, focus on health promotion activites

health care not illness care

consist of several focus areas, objectives are very specific + measureable

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18
Q

Overarching goals for healthy people 2030:

A

attain healthy, thriving lives and well-being free of preventable disease, disability, injury, and premature death

eliminate health disparites, achieve healthy equity, and attain health literacy

create social, physical, and economic enviroments that promote attaining the full potential for health and well-being for all

promote healthy development, healthy behaviors, and well-being across all life stages

engage leadership, key consituents, public across multiple sectors to take action, and design policies that improve health and well- being

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19
Q

disease:

A

something that cause Dis Ease, an imbalance of sort, affecting the mind or body in some negative way: failure of person adaptive mechanism

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20
Q

Illness:

A

when a person has some type of disease and know it and is affected negatively by it; subjective experience associated with disease

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21
Q

What level of prevention is health screenings:

A

secondary; to find out

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22
Q

screening test:

A

to prevent or delay disease in early stages (before symptoms being) deter progression

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23
Q

Validity:

A

how well the test distinguishes between disease and non-diseased states…. ideal test is 100% valid

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24
Q

sensitivity:

A

proportion of people with a conditions who correctly test positive

if test has poor senstivity, more false negatives

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25
Specificity:
proportion of people without a condition who correctly test negative if the test has poor specificity there will be a lot of false positives
26
Reliability:
an assessment of reproductivity of test results when different test at different times + conditions " how likely will the results will stay the same"
27
What to consider when selecting of a screenable population:
Age: risk changes with age Gender: risk different for males + females men= prostate + women= mammogram Ethnic Group: hypertension for African American men hispanic = diabetes Education/Income level: disadvantaged need more screenings Also consider: how common is the condition
28
Epidemiology:
the study of the distrubution (frequency, rate, incidence, prevalence- the where, who, the when) and detrminants (cause + WHY)
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Incidence:
number of new cases
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Prevalence:
number of existing cases
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Morbidity:
disease + disability rates
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Mortality:
death rates
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Who recommends screening criteria?
Organizations put guidelines out American Cancer Society CDC American Heart Organization
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What is the gold standard?
U.S preventable services task force.... recommendations based on available evidence a, b, c, D, I
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Breast cancer screening:
most common cancer among American women Risk: strong family history early 1st menstrual cycle; late menipause first baby after 30 American Cancer society (ACA) recomendations: Average risk: yearly mammogram by age 45 but if higher risk talk to doctor Age 55 + every 2 years but talk to doctor if high risk USPSTF: 40-49 individual decision with PCP 50-74: every 2 years over 75: no recommendation Mammogram: secondary prevention
36
Cervical Cancer screening:
screened by pap test Risks: early 1st intercourse; multiple partners, smoking, HPV virus Screening recommendations ACOG + USPSTF: start at 21, then every 3 years ACA: start at 25
37
Colorectal Cancer screening:
third leading cause of cancer deaths Risk: strong family history chrohns disease American Cancer Society; normal: periodic routine screening at age 45-75 75-85: depends (talk with doctor) Home FOBT: fecal occult blood test q yr Home FIT test: more sensitive Colonscopy q 10 years Or virtual coloscopy or flex sig q 5 years
38
Prostate Cancer screening:
2nd leading cause of cancer deaths in males Risk: positive family history, African American, Advancing age Screening Recs: no longer widely recommended for asymptomatic and/or low risk men ACA: discuss with PCP 50: if average risk 45: high risk 40: if higher risk DRE (digital rectal exam) PSA (prostate specific antigen) poor specificity
39
Cholesterol screening
a major modifiable risk factor for CHD TC=total cholesterol (less 200) HDL: high density lipoprotein (40 for men; 50 for women) LDL: low density lipoprotein (less than 100) Triglycerides: less than 150 Screening: CDC every 4-6 years begin earlier if risk.. diabetes, heart disease, hypertension, family history, sedentary lifestyle
40
HTN screening:
leading cause of CHF, heart failure, CVA, MI, kidney disease, Screening: over 40 get blood pressure taken
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HIV screening:
goal to detect at earliest stage possible, decrease transmission assess patient for risk CDC guidelines screen everyone 13-64 regardless of risk
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Diabetes Type 2
can go years w/out being diagnosed POC testing Fasting blood sugar Risk: obesity sedentary lifesyle poor diet family history age hispanics
43
PKU
baby lacks enzyme to metabolize an important amino acid called phenylalaine if you cant metabolize it builds up in the brain + causes brain damage Screening between 24- 7 days of life If first test is less than 24 hours rescreen in 2 weeks
44
What is family health?
As a dynamic state of wellbeing which includes the biological, psychological, spiritual, sociological, and cultural factors of individual member of whole family
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What are characteristic of a healthy family?
good communication express feelings spend time together role modeling express appreciation support each other role flexability listen trust share responsiblity moral compass ritual/traditions privacy humor achknowledge problems
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why do we study the family?
family greatly influences an individuals state of health the individual greatly influences the family state of health health and illness are FAMILY events
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types of family:
extended family traditional/nuclear family single parent family adoptive family same sex family foster family blended family dual income; no kids
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Family definition
two or more individuals that .... believe they are family have some degree of interdependence with each other in regards to needs
49
Family systems Theory:
looking at family from a "system" point of view all rely on one another to function patterns of living among individuals within family unique culture, value system, history all parts are connected (interacting parts) works together to function (role flexability)
50
Developmental Theory:
looking at family from developmental point of view focus on different stages family go through stages build on each other failure in earlier stages may lead to difficulty in later stages does not account for diversity family stress is greater in transition phase
51
Risk Factor Theory:
looking at family from a risk factor point of view lifestyle: active, nutrition, smoking biological: genetic makeup enviromental: safe water, air, housing (lead) social, psychological, culture, spiritual: abuse, isolation, no support healthcare system: insurance, access issue assessing risks
52
What family health responsibilites:
family provides most care develop members sense of identity and self worth emotional support and guidance during life cycle transitions sociallization of family members to both value and maintain health education about when and how to use health care system care provisions and management for chronically ill, disablied, and aging family member
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Role of nurse (family)
help family attain, maintain, regain, highest level of health possible
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Family Assessment
gathering data so that nurse gains insight into family process after assessment: nurse can determine how well the family is meeting family health respobsibility can generate a family nursing diagnosis and plan interventions geared toward improving overall health
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Ways to gather data from famiilies:
Gordon's functional health patterns health perception/health management nutrition/ metabolic elimination activity/ exercise sleep-rest cognitive-perceptual self perception/self concept sexuality/ reprodutvie coping-stress values- belief
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Considering enviroment with family assessment
important quality of housing temp of the house phones bugs pools sleeping situation smoke detector
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3. planning: (family assessment)
planning process should always include family provides direction for implementation and framework for evalution should include.... prioritizing problems or potential problems identification of items that can be handled by the nurse and family and those that need to be referred out actions and expected outcomes
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4: intervention (family assessment)
home visits referrals education empowerment advocacy counseling
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5: evalution ( family assessment)
determine how the family responded to interventions and if they were successful five measures can be used to determine effectiveness... changes in interaction patterns effective communication ability to express emotions responsiveness to need of members problem solving ability
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goals of health education:
help individuals, family, communites, achieve through own actions optimize states of heath; better health outcomes
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4 steps in teaching process:
1. assess the learners 2. determine expected outcomes; setting goals involve learner, measureable, "smart goals" 3 domains of learning 3; selecting content + learning stratigies 4: evaulate teaching + learning process
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What comes into play when nurse engage health promtion?
knowledge + motivation
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Step 1 in health education:
assessing the learner and his/her needs age, developmental stage, level of education health beliefs motivation, readiness to learn health risk current knowledge and skills
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Health belief model:
peoples belief about something influence their behavior used to predict + explain health behavior explains role + beliefs HBM great framework to use to assess learner helps choose effective educational stratigy guides nurses in education plan components: perceived susceptability to health problem perceived seriousness of disease level percieved benefits of making change percieved barriers to making action cues to action: triggers someone to make change self efficacy: individual belief in his or her capacity
65
Transtheoretical Model of change:
another useful model to consider when working with patients making a change helps determine where person is in relation to making behavior change assesses client readiness for change stages: precontemplation: not considering change contemplation: seriously considering specific behavior change in next 6 month planning: starting to change or seriously thinking about making change in next month Action: made behavior change; persisted for 6 month maintance: 6 months after action started, continuing indefinetly incorporates cues to action + self-efficacy
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Step 2 (health education)
set goals, determine outcomes, involve patient goals should be measureable and specific Smart goals
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SMART Goal outline
S: specific M: measurable A:attainable R: relevant T: time bound
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Domains of learning:
cognitive (thinking); knowledge Affective (feeling) Psychomotor (acting.doing) physical doing/ motor skills
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Step 3 (health education)
select content and strategies/ resources begin process of working together with your client to reach goal use methods that simulate variety of sense involve person in learning process establish a comfortable learning enviroment given info that is clear and understandable credible sources: website, pamphlets, apps, youtube making learning fun and engaging providing info that is clear and easy to understand use those cues to action consider health literacy motivational interviewing as specaility strategy
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Motivational interviewing:
tool to use when we work with our client to help with behavior change MI is not telling patient what to do MI is based on empathy Open ended question affirmation reflection summary
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Health literacy:
the ability to fully understand medial language, instruction, dosage viewed as strong predictor of health and wellness, more than age, income, eduation levels alone health insurance is confusing consent forms understanding diagnosis
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Implications of poor health literacy:
patients are less likely to seek care med administration errors problems describing PMH, FH, meds, symptoms accurately consent issue missed appointments
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Step 4 evalution (health education)
ways: measurements teach back journal/ progress not quiz observations review conversations
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Web based learning
evaluating health information on internet be sure the site makes it clear who is responsible for site and information sites should provie information regarding credentials of those who prepared and review content sources of information should be included if site personnel themselves did not write it purpose of the site references how current is the information
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What is infancy?
Birth - 18 months
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What are normal respirations + Heart rate for infants + blood pressure?
120-160 Heart rate 30-60 respirations 80/40 BP
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What are normal growth rates for infants?
baby increase by 1 inch every month increasing by 50% in first 6 months triples by 12 months
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Developmental Landmarks
1 Month: lifts head when prone Month 2: has social smile Month 4: squeals Month 5: rolls from front to back Month 8-9: uses pincer grasp to feed self Month 10: pulls self to standing position 11-12: initiations vocalization 12-15; walk 15: drinks from cup 18: mimics household chores
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Psychosocial Development Erikson:
trust vs mistrust trust influences future reationships infant needs maximum gratification/miminum frustration
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Cogntive development: (pigets)
sensiormotor period mastering simple coordination activities through senses + motor ability - allows interaction (learn from senses + motor skills)
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What supplements do infants need?
Iron after 6 months of age can be found in infant cereal
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What can infants not eat?
Honey before 1 year cows milk until 1 year (needs to be whole milk)
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What bowel movements are normal for infants?
develops pattern within 2 weeks breastfed infant: loose, golden poop: Bottle: firm, smelly, go less often
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Sleep Infants:
parents promote sleep patterns needs to correlate to rate of growth 80% at birth 12 hours daily at 12 months
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Vision Infants:
inital: eye muscles weak, vision unfocused, without meaning eye movement corrdinates at 3 month mature by 6 months
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Hearing Infants
acute ability, sound discrimination important developmentally
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Smell Infants
fully developed; can differentiate odor for mother milk at 2 weeks
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Taste infants
present at birth; salvation at 3 months
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Touch Infants
tactile sensation well developed relieves infant tensions can feel pain explore world through mouth