Random

Question 0

Piaget formal operations stage

Answer 0

11-17yr, cooperative, beginning to see others point of view. Think they are invincible. Bring in role models: peer group works best, not a parent

Abstract reasoning, logical, can see possibilities beyond reality

Question 1

Recommended lesson plan times for lower elementary school

Answer 1

15min preschoolers
30min 1-3 grade
45min 4-5grade
60min middle schoolers

Question 2

Piaget concrete operational phase

Answer 2

7-11 yr
What they see is reality to them. Not abstract. Very visual. “Grandma died bc I was bad”

Egocentric/literal interpretation

Question 3

Lower elementary students

Answer 3

Preschool thru 2’s grade.

Love stories, pictures, poems, songs. Very visual and go by rule governed thought.

Question 4

Middle school and high school students

Answer 4

Eriksons stage - Identity vs role confusion: 12-18 years old. “See themselves as immune to consequences, and self as special unique and exceptional. Peer teaching is most effective. “Everybody’s doing it” need to combat this with normative education.

Question 5

Middle and high schoolers

Answer 5

Teach short and long term but focus on short term that can happen immediately do they will identify more.
Smoking= talk about $$, smell more. (Short term). Not about lunch cancer (long term)

Question 6

Animistic thinking

Answer 6

Naming toothbrush or puppets. Assigning human attributes to inanimate objects.

Question 7

Middle and high schoolers

Answer 7

Better able to problem solve but don’t always do so, peer pressure.

**practice role playing and decision making with refusal skills in a safe environment so they can recall what they’ve practiced. —practice!! Give them the instincts to say no.

As nurse, don’t butt in as a facilitator; let them learn from each other. Informal situation so they can be comfortable.

Question 8

Concrete stage teaching examples

Answer 8

Lower elementary students.

visual “jar of tar” to show how much from smoking one pack a day

Using black light to show how well they washed hands.

Hairy meets Horace the health hound and Merle the shy turtle (animistic thinking

Dental diary/worksheet or snack attack pledge

Question 9

Upper elementary school students

Answer 9

3-5th grade. Can still be egocentric but with role play can get better at seeing other viewpoints, still not perfectly though. Use role play to practice stating their own feelings, basic refusal skills.

Question 10

Upper elementary school students

Answer 10

Erikson stage industry vs inferiority

Try to come up with activities they can do, make, perform. Construct models, experiments, present plays or songs, draw ads for health or organize campaigns. Writing own songs/performing it so it’s meaningful.

Question 11

Upper elementary students

Answer 11

Have them give you the issue they want to talk about, keep them more interested! at this age, they can begin to understand cause and effect and to problem solve.

–pull in values, have them choose what’s important to them

Question 12

Upper elementary

Answer 12

Use exercises that help kids realize effort media has on our perceptions of so many things.

• this age is highly affected by movies, TV and magazines
• at his age, always include concept of peer pressure

Question 13

Purpose of health promotion

Answer 13

Health maintenance and wellness
Prevention of illness
Restoration of health
Coping with impaired functioning

Question 14

Benefits of teaching/health promotion

Answer 14

Quality control- when you teach you increase quality of. Care. When you increase quality of care you increase quality of life.

Cost control- teaching will prevent illnesses that may mean expensive care. Prevents readmission. Helps them recognize problems early and seek prompt care. Prevents long hospital stays by increasing self care that can be done at home.

Question 15

Never events

Answer 15

Teaching prevents never events!!

Ex. Hospital acquired infections, falls or trauma, bed sores, or wrong side amputation

Encourage patient to speak up for their health to also help prevent never events

Question 16

Ineffective behavioral change strategies

Answer 16

Fear (you’re gunna fiend you don’t xyz…) coercion/confrontation, paternalism (giving advice or telling client what is best)

Question 17

Effective behavioral change strategies

Answer 17

1. Stage of change based interventions. 2. Motivational interviewing ( helping client resolve ambivalence about change). 3. Cognitive behavioral therapy

Question 18

3 learning domains

Answer 18

1 cognitive (understanding). 2. Affective (attitudes) 3. Psychomotor (motor skills)

Question 19

Cognitive domain

Answer 19

The thinking domain/understanding.
Ability to make sense of and use information. (Learn and apply then comprehends) *like us students.

Acquiring knowledge, able to analyzed synthesize and evaluate based on knowledge obtained

Question 20

Affective domain

Answer 20

The “feeling” domain. Includes feelings values and beliefs associated with info received:

• willing to listen/discuss feelings. Moves clients to attach worth to information, shown by choosing a particular action from a month alternatives

Ex. Lifeboat - which 10 get in lifeboat?

Question 21

Psychomotor domain

Answer 21

The skull domain. Includes physical and motor skills. Uses cues from environment.

Performance of skill moves from imitation to creation of a new way to perform skill. Must have physical, mental and emotional readiness. Still have to know cognitive but also involves skill. Similar to lab

Learning to give meds, or start IV, or catheterize someone..

Question 22

Cognitive verbs

Answer 22

“Client will list side effects” client will describe symptoms.

Categorize explain, identify, label, name, prepare, write, define. Differentiate

Question 23

Planning objectives

Answer 23

Specific statements used to evaluate learning. avoid vague terms. Client centered. More short term than goals. Include only one behavior per objective

Question 24

Planning goals

Answer 24

More long term and broader than objectives. Set in terms of "the client will"

Question 25

Problem identification

Answer 25

1 deficient knowledge 2. Altered or deficient health maintenance - difficulty adapting behavior or managing healthy behaviors. Not seeing Dr regularly 3. Health seeking behavior. Client needs to alter health habits, may need to modify or avoid environmental factors

Question 26

Older adults and teaching

Answer 26

Intelligence same, just need more time to process and respond. Simple instructions, teach only what is necessary and keep seasons 30 min or less. Teach one thing at a time and get something in writing. Teach when alert and rested

Question 27

Principles of teaching and learning

Answer 27

Deal with any anxiety before teaching!!!!! Patient can't learn if anxious. Teach in order of maslows hierarchy Establish therapeutic relationship first. Start simple then more complex. Repetition. Match with learning style. Active participation. Relate teaching to prior life experiences (specially for older adults)

Question 28

Teaching young and middle adults

Answer 28

Try to keep sessions under 1 hour. Learning must be practical and relevant. Learner must see the need. Give time to practice skills in private. Often motivated by social task mastery so relate to those (work play or relationships)

Question 29

Appropriate teaching methods for cognitive learning

Answer 29

Discussion lecture question and answer session Role play/ discovery Independent project or field experience

Question 30

Teaching methods for affective learnig

Answer 30

Role play (allows expression of values and feelings). discussion groups, (support groups for women who are victims of domestic violence) discussion one on one.

Question 32

Teaching for psychomotor learning

Answer 32

Demonstration like lab, practice, return demonstration , independent project or games

Question 33

Precontemplation

Answer 33

sees no need for a change. Not ready to make a change for 6 months. May not realize the need. Tasks: goal is to get them ready/motivate and encourage them to think about making a change. 1. Awareness of need to change. 2. increase concern about current behavior. 3. envision change as a possibility. Emotional Arousal: "Your wife has COPD and is getting sicker from the second hand smoke." Help client identify benefits to changing. (save money by not having to buy cigs!)

Question 34

Contemplation

Answer 34

Sees the need for some change and has some desire. Ready to make a change in the next 6 months. Tasks: 1. Analyze pros and cons of current behavior. 2. Weigh costs and benefits. 3. Struggle with ambivalence. Interventions: self assessment and environmental evaluation, pros over cons (how quitting fits with values and life goals), help consider barriers and ways they can over come them! social liberation: realization that behavior change is acceptable in larger society

Question 35

Preparation

Answer 35

Intending to make a change in immediate future: within next 30 days! Plans to make a change soon, may even make small attempts at change. "Am I going to be successful?" Tasks: increase commitment to change and design a plan for change. Interventions: identify connection between stimulus and behaviors, contracting with self to stop, help client recall past successes, provide info on effective ways to make change. Helping relationships in community, and help client stop negative thoughts!

Question 36

Action

Answer 36

Has made a behavior change within the past 6 months. VISIBLE commitment to change. Tasks: Implement strategies for change, revise or change plan, sustain commitment in the face of difficulties. Interventions: help monitor change (journal), rehearse approaches to problems, reinforcement management (change environment, no smoke break with friends,) Continue to point out benefits and be supportive and point to resources. *Help them with how to sub newer healthier behaviors for old bad behaviors!

Question 37

Maintenance

Answer 37

Change lasted 6 months. Tasks: sustain change, avoid relapse, integrate new behavior into life. Intervention: applaud continuation, help client relabel, continue supportive relationship. Messages should begin to focus on skills needed o create and maintain action plan for change. *Pt aware of situation that could cause relapse!*

Question 38

SPICES

Answer 38

Overall assessment tool for elder adults. S- sleep disorders. P- problems with eating and feeding. I- incontinence - (nocturia/toileting regimen) C- confusion - (from pain or meds) E-evidence of falls, (gait, assistive devices, walking with furniture, S - skin breakdown (ulcers or thin skin or bruises)

Question 39

Factors influencing aging

Answer 39

heredity, environment, lifestyle, nutrition, medical history, psych factors, support system, socioeconomic resources, education bc it impacts income

Question 40

Aging in the US

Answer 40

> 65 = older adult Women tend to live longer! Top two causes of death, 1. cardiovascular disease. 2, cancer. Prevention of death: health promotion and management of chronic disease Never too old for a change!

Question 41

Frail adult

Answer 41

Having any of the combo of the following two things *Vulnerable and may need help or outside interventions!! ``` -over 75 falling frequently, losing weight or poor nutrition mild memory loss no close family in community depressed bc of losses hospitalized 3x's in 2mo taking >5 meds regularly and getting confused needs health teaching ```

Question 42

Goals of elder assessment

Answer 42

Maintain health, minimize hospitalizations, establish diagnosis's that are often overlooked, and decrease over prescription of meds.

Question 43

Elder assessment

Answer 43

holistic, person centered, individualized, multidisciplinary "How do you manage to cook 3 meals a day?" NOT "How do you cook dinner?" Focus on functional ability!!!

Question 44

Elder Assessment

Answer 44

Start with a persons concern, plan time and match pace with the person. Be aware of energy level. Get rid of anxiety first! This will affect teaching. Establish rapport. Most have more than one problem. Screen for high prevalence problems and be alert for typical signs and symptoms of illness.

Question 45

Elder Assessment

Answer 45

Modify environment: NOT CLIENT. Reduce noise, temp, lighting, privacy, turn radio off for hearing/distraction consider persons comfort: provide assistive devices, dont rush things, allow time to answer. face them bc they may have hearing problems. have person demonstrate activity: GOOD OBJECTIVE DATA! observe gait/communication with others ^all the most reliable method of data collection. If you cant ask them to do the above, ask them to take off their shoes = its a good indicator of functional ability

Question 46

Why is there an increase of elder adults?

Answer 46

Improved nutrition, improved standard of living, progress of medical care, and increased health consciousness due to health promotion efforts

Question 47

Who is old?

Answer 47

65 is the standard for old. (Chronological age!) Functional age considers functional health or ability to self care. Its better to use this to assess. Categories: ABLE - to take care of themselves. FRAIL - >75 and have a variety of health concern and increasing vulnerability to disease.

Question 48

Categories of Old age:

Answer 48

Young Old - 65-74 Middle Old - 75-85 Old Old - 85 +

Question 49

Young Old

Answer 49

65-74, live independently, involved in community, employed or volunteer, usually financially stable and travel. **BIG CONSUMER OF AMBULATORY HC** benefit the most from preventative healthcare!

Question 50

Middle Old

Answer 50

75-85, incidence of chronic disease is higher, may move in or closer to children or family, or into retirement communities in preparation of getting older and increasingly frail. Only 5% in nursing homes. Many are still active and drive, active in senior clubs and churches. Women at this stage outnumber 3:2, starting to see losses that can lead to depression. **HEAVY USE OF HOME HEALTH CARE** *Dementia starts

Question 51

Old Old

Answer 51

85+ years, older than average! Generally have good genetics and typically have avoided smoking and had healthy diet, and social support base. About half will suffer from some kind of dementia

Question 52

Developmental Tasks of Older adults 65-74

Answer 52

Adjusting to: 1. Decreasing physical strength and health. 2. Retirement and lower/fixed income. 3. Death of parents, spouses, and friends 4. New relationships with adult children 5. Leisure time 6. Slower physical and cognitive responses 7. Keeping active and involved 8. Making satisfying living arrangements

Question 53

Developmental Tasks of older adults 75+

Answer 53

1. Adapting to living alone 2. Safeguarding physical and mental health 3. Adjusting to the possibility of moving into nursing home 4. Remaining in touch with other family members 5. Finding meaning in life 6. Adjusting to ones own death

Question 54

Dementia

Answer 54

Caused by physical issue, most common: Alzheimers. Frequent healthcare problem for elderso

Question 55

Functional status

Answer 55

abililty to perform ADL (bathing, toileting) and IADLS (instrumental; keep them living independently like paying bills, grocery shopping, cook, clean) ability to adapt to stressors: can they change to deal and cope with stress? Functional decline: slowly lose ability to care for themselves independently

Question 56

Elder Risk for Falls

Answer 56

Risk greater for senior who has multiple medical problems or functional disabilities! Other risk factors: confusion, corrective lenses, nocturia, gait problems, use of assistive devices, or history of falls, and polypharmacy Observe their gait - do they use furniture to walk? Ask them what do you think happened to make you fall? May be able to tell cause of fall by the type of injury: if hand/wrist, balance issue. head or face = syncope.

Question 57

Quality of Life Triangle

Answer 57

As CHRONIC DISEASE goes up and PHYSICAL HEALTH declines, there is an increased risk for FUNCTIONAL IMPAIRMENT (status) and quality of life is threatened.

Question 58

Elder Assessment

Answer 58

Goal: Improve QOL, decrease polypharmacy, minimize hospitalizations, and maintain health! Identify their strengths and weaknesses and develop a plan of care that corrects problems.

Question 59

Frequently overlooked Diagnosis in Older Adults

Answer 59

Hearing impairment, vision deficits, early dementia, depression, poor nutrition, and falls

Question 60

Frequent HC Probs for Older Adults

Answer 60

Safety: falls/accidents, fire, carbon monoxide poisoning, drowning, seatbelt use, vision when driving Polypharmacy- they are on multiple meds and make them more sensitive and prone to adverse reactions. This also increases their risk of falls and accidents, and also medication errors from improper storage., vision problems, or memory loss. EVEN OTC MEDS NEED TO BE CHECKED IN WITH THE DR. Immobility - this is a nursing goal, keep them mobile! teach about fall prevention or rehabilitation afterward. Stroke (increase risk of bedsores and constipation) Short term immobility: broken hip. Long term: stroke. Nutrition: #1 cause of malnutrition is socially caused, or poverty. Lack of ability to self care or transport self to buy food, or just psychological/depressed with decreased appetite. Stroke, difficulty chewing with lost teeth or ill fitting dentures

Question 61

Anorexia of aging

Answer 61

lose senses/decreased senses so they lose interest in eating

Question 62

Growth and Development

Answer 62

Growth: change in cell # or cell size or physical size. changes in height, weight, BP Pulse etc. Development: Change in capacity to function enhancement of skill Maturation: enhancement in competence and adaptability. --all occure simultaneously and ongoing thru lifetime.

Question 63

cephalocaudal pattern of growth and development

Answer 63

Head to toes - you have to hold head up straight before you can sit up, before you can walk... precedes proximodistally

Question 64

proximodistal pattern of growth and development

Answer 64

from the middle to the extremities, babies gain control of trunk before arms, and control of arms before fingers.

Question 65

Differentiation pattern of growth and development

Answer 65

Simple operations before complex, i.e. babies coo, then babble, then words, then sentences

Question 66

Developmental stages - Infancy

Answer 66

0-12m | neonatal - 0-1m, infancy 1-12m

Question 67

toddler period

Answer 67

1-3 yr

Question 68

preschool period -

Answer 68

3-6yr

Question 69

school age period

Answer 69

6-12 yr

Question 70

adolescence period

Answer 70

12-18yr

Question 71

young adult period

Answer 71

18-35

Question 72

middle age adult period

Answer 72

35-65

Question 73

older adult period

Answer 73

> 65

Question 74

growth charts

Answer 74

0-3 yr, weight height and head circumference 2-20yr, height, weight, BMI Age, gender, and sometimes ethnic specific. Middle line on chart is average for that age`

Question 75

CDC weight classifications

Answer 75

or = 95% is obese

Question 76

Erik Erikson Psychosocial theory

Answer 76

*Believed that development is lifelong. Emphasized that at each stage, the child acquires attitudes and skills resulting from the successful negotiation of the psychological conflict. -Identified into 8 stages, each stage has a task. Infancy: trust vs. mistrust (faith and optimism) Toddler: autonomy vs shame and doubt (self control and willpower)

Question 77

Jean Piaget Cognitive Development Theory

Answer 77

important int he field of education, learn how to teach kids in a cognitive way/how kids think and learn, how they use assimilation and accommodation (Adapt). Up to age 15

Question 78

Kohlbergs Theory of moral reasoning

Answer 78

Why do people do the right thing? Based on interviews with people at various age groups. Develops during school age and progresses through adult years. Focus is on moral thinking and judgement

Question 79

Albert Bandura Social Learning Theory

Answer 79

Kids learn what they observe and imitate! They learn by observation. Positive reinforcement - good and bad - leads to repeat of those behaviors. Self efficacy: give kids the expectation that they can do it, the more likely they are able to do it.

Question 80

Infants growth and development

Answer 80

Growth is very rapid during first year! 5-7oz weight gain per week (1-6m) 3-5oz weight gain per week (6-12m) *DOUBLE BIRTH WEIGHT BY 6M, TRIPLE BIRTH WEIGHT BY 1 YEAR. Height increases by 1 inch per month. 0-12m

Question 81

Maturation of infants systems

Answer 81

More disposed to respiratory issues/small airway. Receive immunity from mom till 3 month - there is a gap before they get their own immunity from like 3-6 months so they are likely to get colds. -By 4m they used up all iron stores from mom, so they need iron in their diet if breastfed. -Swallow anything at birth is a reflect, about 6 month start to spit back at you.

Question 82

Fontanels

Answer 82

Anterior/Front closes 18m, posterior/back closes at 2mo.

Question 83

Sensory Infants

Answer 83

vision 20/100-20/400., by age 12m 12/40. Hold them close so they can see you! Binocularity- by 6m, see one image/coordinate vision and pupils line up. Hearing: acuity similar to adult, localization and discrimination lacking. Touching: hands, face, and soles of feet most sensitive.

Question 84

Childrearing practices related to temperament

Answer 84

If difficult: structured routines. Highly distractible: additional soothing measures. High Activity: more opportunities for gross motor activities and extra watching. Slow to warmup: gradual and frequent preparation to new situations Easy: may need to be awakened to eat.

Question 85

INFANCY Pyschosocial

Answer 85

erikson trust vs mistrust - if infant cant develop trust, will have mistrust for the rest of life - he will have trust as long as needs are met and interacted with in a positive manner. If not, risk of reactive attachment disorder (lifelong problems of being unable to form relationships)

Question 86

infancy cognitive development

Answer 86

Piaget - sensorimotor phase 1. Birth -1m: reflex stage (nothing deliberate!) 2. 1-4m: primary circular reactions (starts to replace reflex with voluntary reaction; will hold rattle) 3. 4-8m- seondary circular; (will imitate, start to play/have an affect) infant will shake rattle to make noise. 4. 8-12 coordination of secondary reactions, pick up rattle and shake it, then shake other toys to see if it also makes a noise.

Question 87

Toddler growth

Answer 87

4-6lb a year. Quadruple birth weight by 2.5. Height increases 2-4inch a year At 2 year, typically attained half of adult height 12-36m

Question 88

Voluntary control of elimination

Answer 88

Sphincter control at 18:24 m, when myelinazation of spinal cord is complete

Question 89

Erikson toddler stage

Answer 89

Autonomy vs shame and doubt. Like ritualism. Negativism, say no a lot. Play is parallel, play alongside each other but not with each other. Transitional objects become important.

Question 90

Toddler 19-24m

Answer 90

Object permanence solidifies, actively searches for an object. Imitation of behaviors , domestic mimicry, no concept of time

Question 91

Transductive reasoning toddler preconceptual

Answer 91

Reasoning from the particular to the particular. (Lady in White coat gives shots, so everyone in white coat must give shots)

Question 92

Global organiZation

Answer 92

A change in any one part changes the whole. If you move bed or get new curtains, it's not their room anymore.

Question 93

Centration

Answer 93

Focus on one aspect of a situation rather than considering all factors. Gave red medicine and it tasted bad, won't drink anything period that's red

Question 94

Tertiary circular reactions Piaget

Answer 94

Pick this up and see if it makes a noise bc the other one made a noise. Awareness of causal relationships. 13-18 months

Question 95

Vaccines

Answer 95

Live - more effective but can be dangerous. | Killed- have to give more doses for it to be effective.

Question 96

When to withhold shots?

Answer 96

Serious illnesses only, neurological unstable conditions or prior allergic reaction. Withhold live vaccines from immunosuppressed people.

Question 97

Flu shot

Answer 97

No nasal flu shot until 2yr. Can get regular flu shot at 6months. 2-50yr old bc nasal is live!

Question 98

Live vaccines

Answer 98

Rotavirus, varicella , mmr, flu. Can't give to kids with compromised immune system

Question 99

Infant nutrition

Answer 99

4-6 m need iron and fluoride supplement. BF kids need vitamin D supplement. No extra water. No juice for 6m and then no more than 4oz a day. Solids at 4-6m. Meats at 10m. 5/6m weaning/introduce cups

Question 100

Infants and sun

Answer 100

Out when Sunnis hottest, 10-3. After 6m can use sunscreen that's PABA free and > SPF 15

Question 101

Car seats

Answer 101

rear face till two, but if you do switch, minimum of 12m and 20lbs. 40lb for booster

Question 102

Lead explosure

Answer 102

Homes constructed before 1960.dirt, soil, water, toys. Boil water for 20 min before giving to infant

Question 103

Passive immunities

Answer 103

When you inject blood from a persons or animals and give them to a person who's been exposed to disease. (Lasts 6m,) mom/newborn/breastsmilk, tetanus or varicella. Temporary!!!

Question 104

Attenuated vaccine

Answer 104

Live! Use pathogens that a re active but have reduced virulence so they don't cause disease. The process of reducing virulence us attenuation. Can cause mild infections but no disease. With live, vaccinated peeps can infect those around them providing herd immunity Not good for immunosuppressed proper or pregnant woken bc it might cause disease

Question 105

Inactivated vaccines

Answer 105

Killed. safer than live but don't cause as strong of an immune reaction. Do not stimulated herd immunity! Produce less strength of immune response so need more doses. More high doses means more adverse reactions. May stimulate inflammatory response(more local and allergic reactions)