Lifestyle Improvements Flashcards
(138 cards)
1
Q
Steps for readiness for change
A
Pre-contemplation
Contemplation
Preparation
Action
Maintenance
2
Q
Readiness for change can be _________
A
bidirectional
3
Q
A patient may be ______ to change but that may not be ________ to change
A
ready, motivated
4
Q
What is the key for readiness to change with patients?
A
Discovering what will move them from readiness to action
5
Q
Motivational Interviewing Approach
A
DARN CAT
6
Q
What is D in DARN CAT
A
Desire to change
7
Q
What is A in DARN CAT
A
Ability to change
8
Q
What is R in DARN CAT
A
Reasons to change
9
Q
What is N in DARN CAT
A
Need to change
10
Q
What is C in DARN CAT
A
Commitment to change
11
Q
What is second A in DARN CAT
A
Action, intention to act
12
Q
What is T in DARN CAT
A
Taking steps to change
13
Q
What are the two phases in readiness to change?
A
Preparing for change and mobilizing for change
14
Q
What is involved in preparing for change?
A
Desire to change
Ability to change
Readiness to change
Need to change
DARN
15
Q
What is involved in mobilizing for change
A
Commitment to change
Action, intention to act
Taking steps to change
CAT
16
Q
What is OARS?
A
Open ended questions
Affirmations
Reflective listening
Summaries
17
Q
What is O in OARS?
A
Open ended questions
18
Q
What do open ended questions do in OARS
A
Require patient to start the process of self-examination
19
Q
What is A in OARS?
A
Affirmations
20
Q
What do affirmations do in OARS?
A
express acceptance, affirm strengths, express optimism
21
Q
What is the R in OARS?
A
Reflective listening
22
Q
What does reflective listening do in OARS?
A
paraphrase what patient says to show you are listening
23
Q
What is the S in OARS?
A
Summaries
24
Q
What do summaries do in OARS?
A
combine all the information for clarification with focus on content and feelings
25
______, ______, ________ approach
ask, tell, ask approach
26
Motivational interviewing is a _______ approach between the patient and provider
collaborative
27
MI helps: recognize the ______ of the patient
expertise
28
MI helps: elicit or draw from patients rather than ______ on them
imposing
29
MI helps: express _________
empathy
30
MI helps: _______ the problem from the patient's perspective
understand
31
MI helps: direct the conversation towards topics that are likely to increase the patients _______ ______ _______
readiness for change
32
Cigarette smoke contains ________ chemicals, _____ are known to cause cancer
7000, 69
33
Smoking is responsible for ______ or lung cancer deaths and _____ of deaths caused by COPD
90%, 80%
34
Smoking is linked to ________ and ______ ______
emphysema, chronic bronchitis
35
78% of adults smoked their first cigarette by ____
18 years old
36
Smoking harms nearly every _____ in the body
organ
37
Why do we care if patients smoke?
cancer, cardiovascular disease, COPD, slows HPV clearing, decrease sperm count, increase erectile dysfunction, dental disease, slowed wound healing, suppressed immune system
38
which gender smokes more?
Men
39
Prevalence of smoking is highest in
American Indians/Alaska natives
40
Lowest prevalence of smoking in the US is
Asian-Americans
41
7.6% of ____ ______ students current cigarette smokers
high school
42
2.1% ______ _____ students current cigarette smokers
middle school
43
Second hand smoke is a _________ cause of stroke
definitive
44
There is no risk-free level of exposure to ______ ______
secondhand smoke
45
Brief exposure to secondhand smoke can trigger a ______ ______
heart attack
46
Secondhand smoke is especially harmful to _____ ______
young children
47
Secondhand smoke is linked to ____ _____ _____ _____
Sudden Infant Death Syndrome
48
Patients with non-small cell lung cancer who are exposed to secondhand smoke have _____ outcomes
worse
49
Lung cancer patients who are exposed to secondhand smoke are ________ likely to die than patients not exposed
more
50
Menthol smokers are _____ ______ than non-menthol smokers to _______
less likely, quit
51
Menthol cigarettes increase both _____ and ______ of addiction
likelihood and degree
52
The minty taste of menthol can mask the ___ _____ ______ of smoking-induced _____ _____
early warning signs, respiratory problems
53
Menthol cigarette use is more prevalent in _________ community
prevalent at 50%
54
Menthol use in heterosexuals
38%
55
What does ENDS mean?
Electronic Nicotine Delivery System
56
What are the most commonly used tobacco products in children?
ENDS/electronic nicotine delivery system
57
Two primary ingredients in ENDS
propylene glycol (antifreeze) and vegetable glycerin
58
If a youth uses ENDS does it increase the risk of using traditional cigarettes?
substantial evidence
59
What causes addiction in cigarettes?
Nicotine
60
Quitting for good requires _______ ______
multiple attempts
61
How often do you mention smoking cessation?
personal preference, some say even visit
62
What are opportunities to talk about quitting?
persistent health concerns related to smoking, new motivation (baby), financial concern
63
Example of motivators for quitting
money jar, redirect, hypnosis, medications
64
Wellbutrin (bupropion) for smoking is
Zyban
65
Chantix is a
nicotine receptor binder
66
NRT means
Nicotine replacement therapy
67
Most effective NRT
patch + gum
68
What do you need to educate patients on with NRT?
Overdose
69
Benefits of NRT
easy to control levels of nicotine, easy to adjust, cheap
70
Benefits of the nicotine patch
easy, once a day, few side effects, constant levels
71
Side effects of nicotine patch
skin irritation, less flexible dosing, slow onset
72
Benefits of nicotine lozenge
easy, higher delivery than gum
73
Side effects of nicotine lozenge
no food/drink 15 minutes before/during, nausea, no chewing or swallowing
74
Which NRT are OTC?
gum, patches, lozenges
75
which NRT are prescription?
spray and inhaler
76
Benefits of nicotine gum
flexible dosing, fast delivery
77
Side effects of nicotine gum
do not use with dental issues, no food/drink 15 minutes before or during, need to use frequently
78
Benefits of nicotine nasal spray
flexible dosing, fast delivery
79
Side effects of nicotine nasal spray
nose/eye irritation common (disappears in a week), frequent use in day
80
Benefits of nicotine inhaler
flexible dosing, mimics hand to mouth, few side effects
81
side effects of nicotine inhaler
request use in the day, mouth/throat irritation
82
Benefits of Wellbutrin
easy, pill, few side effects, can be used with NRT
83
side effects of Wellbutrin
contraindicated with some meds or disease
84
benefits of chantix
easy, pill, no drug interactions
85
side effects of chantix
people need to actually take it consistently for 3 months, nightmares, mood change, nausea
86
benefits of nortriptyline
TCA antidepressant, cheap, pill, can use with NRT
87
side effects of nortriptyline
high side effect profile because TCA
88
What therapy is most effective for quitting smoking
combination therapy
89
Contraindications for NRT
severe HTN, PVD, pregnancy, lactation, under 18, MI within the last month, arrhythmia, angina, active hyperthyroid, active PUD
90
It takes most people ____ times to quit
3
91
What else should people have in addition to medication for quitting?
behavioral therapy
92
What is an important consideration for quitting smoking?
Picking the right time, do not quit during major life stressors
93
What is the countdown to quit?
set a date 1-2 weeks in the future
94
Why do people fain weight when they quit smoking?
food tastes better, comfort effect with the movement of hand to mouth, metabolic changes (smoking increases your metabolism)
95
What is BMI
Body mass index
96
Normal BMI
18.5- 24.9
97
What # is obese on BMI
30
98
wait circumference predisposition metabolic concerns
women >35 inches
men >40 inches
99
Obesity increases risk for
HTN, hyperlipidemia, LDL, diabetes
100
Weight management
Diet, exercise, weight loss, support groups, counseling, surgery, medications
101
Medications for obesity are best used
as an adjunct with changes in diet choices and exercise program
102
RX drugs approved for long term use (12 months)
bupropion-naltrexone (Contrave), liraglutide (Saxenda), Orlistat (Xenical/Alli), pentermine-topiramate (Qsymia)
103
Healthy diet highlights
limit saturated & trans fats, sodium, added sugars
104
Realistic expectations for weight loss
1-2lbs per week may be better long term goal
105
For a weightless for 1-1.5lbs per week, daily intake should be reduced by _________ calories/day
500-750 calories per day
106
General diet/nutrition suggestions
eat low in the food chain (fruits, vegetables)
Portion and stimulus control
Beware of fluids (soda/beer/wine/etc.)
Exercise
107
Excess sodium clinically significant role in
hypertension
108
Lowering sodium intake in some populations is effective in BP management
elderly, Black, medication resistant HTN
109
Recommended sodium intake
2,300 mg/day US dietary guidelines
1,500mg/day American Heart Association
110
Where is most sodium intake from?
packaged foods and restaurants
111
Caffeine is the worlds most widely consumed
psychoactive drug
112
What is the safe/moderate dose for caffeine
400mg/day
113
What is the most caffeinated drink?
Tea
light tea- the first thing that comes out is caffeine
114
The darker the color the tea the less _____ it is
caffeinated
115
Caffeine and pregnancy if moderate ________ is not a major contributor to miscarriage or preterm birth
<200mg
116
Caffeine with kids is more closely tied to
sugary drinks/energy drinks
117
Kids are more at risk for what when drinking Mountain Dew
caffeine intoxication
118
Sedentary lifestyle is related to
mental health issues, increased risk of diabetes, increase in weight/obesity, increase in heart disease, lethargy, increased risk of hypertension
119
Sedentary lifestyle is also known as
sitting disease
120
Exercise general considerations: type
ortho/medical concerns, personal preference, availability of exercise facilities, locations
121
Exercise goal considerations: intensity
target HR= 70-80% of maximum HR
122
Maximum HR calculation
220-age
123
Exercise goal considerations: duration
20-60 minutes, gradual buildup
124
Exercise goal considerations: frequency
3-5 times per week
125
A program of regular exercise that includes cardiopulmonary resistance, flexibility, and neuromotor exercise training beyond activities of daily living to improve and maintain physical fitness and health is essential for most adults.
American College of sports Medicine definition of exercise
126
ASCM moderate intensity recommendations
cardiopulmonary exercise training
30> minutes/day for 5> days a week for 150 minutes/week
127
ASCM vigorous intensity recommendations
cardiorespiratory exercise training
20> min/day for 3>days/week for 75minutes/week
128
ASCM moderate intensity Heart rate goals
50-70% of maximum HR
129
ASCM vigorous intensity heart rate goals
70-85% of maximum HR
130
Benefits of exercise
lower heart rate and blood pressure, improvement aerobic capacity, improved strength and endurance
131
Ratings of perceived exertion on a scale of 1-10 moderate intensity
moderate-intensity aerobic activity is a 5-6 on a scale of 1-10
132
Ratings of perceived exertion on a scale of 1-10 vigorous intensity
vigorous intensity aerobic activity is a 7-8 on a scale of 1-10
133
Adults should also perform ____ _______ for each of the major ____ _____
resistance exercises, muscle groups
134
Adults should perform ______ ______ involving balance, agility and coordination
neuromotor exercise
135
Maintaining joint ROM, complete _____ ________ for each major muscle-tendon group
flexibility exercises
136
Adults who are unable to meet exercise targets can still benefit by
engaging in amounts of exercise less than recommended
137
You should promote what in all patients
smoking cessation, healthy eating and physical activity
138
It is important to promote _____ _____
realistic expectations
