Test 1 Flashcards
(142 cards)
1
Q
What does health promotion focus on and include?
A
Focused on health rather than illness
Includes understanding health is multidimensional
Includes understanding health can also be affected by factors outside of the person’s control
2
Q
What was the transformation of the US health care system?
A
From a disease focused healthcare system to one focused on wellness, health promotion, and disease prevention
3
Q
What is health?
A
State of complete physical, mental, and social wellbeing; is not merely an absence of disease
4
Q
What is wellness?
A
Positive state of health that is continually changing
5
Q
What is disease?
A
Functional or structural disturbance
6
Q
What is illness?
A
Physical manifestations and subjective experiences
7
Q
Describe the scope of health promotion?
A
Behaviors that promote optimal health across the lifespan. Includes individual, family, community, population, environment
8
Q
What are the three categories of health promotion?
A
Primary Prevention
Secondary Prevention
Tertiary Prevention
9
Q
What is primary prevention?
A
Preventing. Optimize health to prevent illness
10
Q
What is secondary prevention?
A
Screening, identify early stage of illness to initiate treatment
11
Q
What is tertiary prevention?
A
Disease management, prevent complications, and minimize disability
12
Q
When do you apply the concept of health promotion?
A
Following an assessment. The assessment provides the basis for establishing a health promotion plan
- individual assessment
- family assessment
- community assessment
13
Q
What is included in an individual assessment?
A
Age, health status, presence of risk factors, health preferences and values, and social relationships
14
Q
What is included in a family assessment?
A
Risk factors, family strengths, relationships among family members, and genetics
15
Q
What is included in a community assessment?
A
Structure of community, community census, population demographics, mortality statistics, community resources
16
Q
What are the 5 health promotion interventions?
A
Education Immunization (cdc) Screenings (there is a task force us prevents services task force) Physical activity Pharmacological agents -drugs used for smoking cessation -drugs used for weight loss
17
Q
Grade A US preventive services task force
A
Strongly recommends, high certainty that the net benefit is substantial
18
Q
Grade B Us preventive services task force
A
Recommends, high certainty that net benefit is moderate or there is moderate certainty that net benefit is moderate to substantial
19
Q
Grade C
A
No recommendations for or against, there are considerations that support providing interventions for an individual patient but not for general population. There is moderate certainty that the net benefit is small
20
Q
Grade D
A
There is moderate to high certainty that the intervention has no net benefit or that the harm outweighs the benefits
21
Q
What is the ANA code of ethics provision 5?
A
Duty to self and others
Promotion of personal health, safety, and wellbeing
Preservation of wholeness character
Preservation of integrity
22
Q
What are the five stages of change?
A
Precontemplation- I can’t or I won’t
Contemplation-both good reasons for and against change
Preparation- want to but…
Action- doing it
Maintenance/relapse- now a habit or risk of lapse
23
Q
Describe contemplation
A
Cons of changing help the nurse to understand the person and their mind set. Pros of changing what will the person get out of quitting?
24
Q
What is the scope of motivation?
A
Intrinsically motivated and extrinsic ally motivated
25
What is motivation?
The art of getting people to do what you want them to do because they want to do it.
26
Define the concept of communication
Is a process of interaction between people in which symbols are used to create, exchange, and interpret messages about ideas, emotions, and mind states.
Single biggest problem in health care
27
Why is effective interpersonal communication between the nurse and patient most important?
To improve satisfaction, compliance, and health outcomes
Communication is a contributing factor in 70% healthcare mistakes
28
What are the IOM quality domains?
```
Safe
Effective
Patient centered
Timely
Efficient
Equitable
```
29
What is the safe domain?
Avoiding harm to patients from the care that is intended to help them
30
What is the effective domain?
Providing services based on scientific knowledge to all who could benefit and refrain from providing services services to those who will not benefit
31
What are patient centered domains?
Providing care that is respectful of and responsive to individual patient preferences, needs, and values and ensuring that patient values guide all clinical decisions
32
What is the timely domain?
Reducing waits and sometimes harmful delays for both who receive and those who give care
33
What is the efficient domain?
Avoiding waste, including waste of equipment, supplies, ideas, and energy
34
What is the equitable domain?
Providing care that does not vary in quality because of personal characteristics such as gender, ethnicity, geographical location, and socioeconomic status
35
What is the scope of communication?
The scope ranges from effective communication to ineffective communication to absence of communication. There really isn't such a thing as no communication
36
What is linguistic communication?
Spoken words or written symbols. Can enhance communication using general terms. Can hinder communication using medical terminology
37
What is paralinguistic?
Nonverbal messages. You can enhance communication using positive body language and can hinder it by crossing your arms
38
What is metacommunication?
Context messages. Can enhance communication with trust and can hinder it with distrust
39
What does nonverbal communication convey?
Messages without words and is under less conscious control than verbal statements. When a persons words and behavior are incongruent, nonverbal behavior most likely reflects the persons true feelings.
40
What is complementary exchange?
Each participant is either a sender or a receiver. Each transmission is completed, the receiver perceives the message, interprets the symbols, and responds using symbols
41
Context (metacommunication)
```
Context is important to the quality of the meaning derived by participants during the process of complementary exchange
Characteristics of environment
Internal mood states
Mental and physical conditions
Experiences and education
Culture
Relationship between participants
```
42
Communication is a learned skill
It takes time
Unique communication patterns within the healthcare environment
Medical terminology, health care culture, communicating with patients, envoy vine mechanisms for communication
43
What is communication competence?
Means that communication by the nurse is effective and appropriate
44
What does communication competence includes?
Skills for communicating clearly and accurately with the patient and family, other nurses, and other members of the Heath care team
45
How does communication competence evolve?
With experience and professional development throughout a nursing career
46
What is health promotion?
Process of enabling people to increase control over and to improve their health
47
How many medical errors occur each year?
98,000 medical errors occur each year in the US that lead to patient injury or death
48
What is SBAR?
Situation, background, Assessment, and Recommendation. It is used for communication
49
When using SBAR, the nurse will do what?
Describe the situation
Explain the background information relevant to the situation
Provide an assessment
Provide a recommendation for action
50
What is the purpose of an electronic medical record?
- Accurate and timely documentation in the patient record
- Important source of information and a major means of communication between members of the team
- Legal Document
- Evidence of providers actions
51
What does advocacy mean?
- Speaking up for the patient to ensure that health care needs are met and is an expectation within the scope of professional nursing practice
- The ability to speak assertively, credibly, and authoritatively is a high valued communication skill critical for effective advocacy
52
What is assertiveness?
It is the key to successful relationships for the clients, family, nurse, and other colleagues. It is the ability to express your thoughts, ideas, and your feelings without undue anxiety without any expense to others.
53
Give examples of being aggressive.
Loud, forceful, confrontational, out of proportion
54
Give examples of being assertive.
Clear, respectful, confident, comfortable, and active
55
Give examples of nonassertive.
Disregard, lacking, and passive
56
What are the assertive rights (10)?
- to be treated with respect
- to a reasonable workload
- to an equitable wage
- to determine your own priorities
- to ask for what you want
- to refuse without making excuses or feeling guilty
- to make mistakes and be responsible for them
- to give and receive information as a professional
- to act in the best interest of the patient
- to be human
57
What does DESC stand for? What is it used for?
- describe the situation, express what you think and feel, specify your request, and consequences
- It is used as a script for being assertive
58
Describe the behaviors of an assertive nurse
-appears self confident and composed
-maintains eye contact
-uses clear, concise speech
-speaks firmly and positively
-speaks genuinely, without sarcasm
-is non apologetic
takes the initiative to guid situations
-gives the same message verbally and nonverbally
59
The language of caring:
Caring communication is caring made visible. The goal with patients and their families is to ease their anxiety and earn their confidence, engagement, and cooperation
60
What are some examples of good body mechanics that show you are listening to a patient?
arms open, eye contact, leaning in, focus on what is being said.
- Relax
- be present in the moment
- be aware of verbal and nonverbal communication
61
What are some therapeutic communication techniques?
- listening/ remaining silent
- establishing guidelines
- making open-ended comments
- reducing distance
- Acknowledging/ restating/ reflecting
- seeking clarification
- seeking consensual validation
- focusing/summarizing/ planning
62
What are some non therapeutic communication techniques?
- failing to listen
- failing to probe
- parroting
- being judgmental
- reassuring
- rejecting
- defending
- getting advice
- making stereotyped responses
- "Why" questions
- changing topics
63
What are some interrelated topics to communication?
Culture, motivation, collaboration, and health promotion
64
What are the three phases of the interview?
1. Introduction- introduce sell, hand washing
2. Discussion- restating and reflecting
3. Summary- summarize in own words the problem areas, plans, and whats going on
65
What are some factors that affect the interview and communication process?
- Physical setting
- Communication skills of the nurse
- Professional nurse behavior
- Patient- related variables
- Questions: type of questions asked, how they are asked, and nature of information being discussed.
66
What are open-ended questions?
Focus on questions about the patients health and may need to refocus questions if patient cannot focus on topic
67
What do closed ended questions do?
They yield more precise date and give patients options for response
68
What do directive questions do?
They lead patient to focus on one set of thoughts. They are used most often in reviewing systems and evaluating functional status
69
How do you manage answering personal questions?
- Brief direct answer
- Share experiences that support patients
- Enhance relationship and increase credibility
70
How do you manage silence?
It is necessary for the patient to reflect and gather, courage to address painful topics or issues. Give the patient feedback that they might not be ready to discus or that the approach needs to be evaluated
71
How do you manage crying?
Postpone further questioning until the patient is ready and give a compassionate response to enhance the relationship
72
How do you manage anger?
Deal with it directly, identify source of anger, discuss approaches and acknowledge feelings
73
How do you manage overly talkative patients?
Refocus the interview on events relative to the present, redirect using closed ended questions this may help reduce distractions
74
How do you as a nurse manage other people in the room during an interview?
- Do not assume relationships
- Parents or guardians may answer for a child
- Interview adolescents directly
- for adults unable to answer, another person may answer
75
How do you manage a language barrier during an interview?
- Interpreter should be objective observer, of same gender, but not a family member
- Takes more time to obtain the most important data
76
What is holistic health care based on?
The concept of "whole"
77
What does holistic health care mean?
Understanding clients in relation to their work, family, social environments, this encourages caregivers to consider many needs and tailor individualized interventions
78
How are goals of care developed within a holistic framework?
They are mutually developed. Interventions are designed for the individual, and clients receive the services most important and relevant to them. SPIRIT MIND BODY
79
What is in the comprehensive health history during a holistic assessment?
- They physical, social, cultural, intellectual, emotional, and spiritual areas have an impact on health
- Without knowledge of these six aspects, health care providers become narrowed and limited in their effectiveness
- Information collected from assessment activities serve as part of the database from which medical, nursing, and other treatment decisions are made
80
What is comprehensive health history?
It established complete database
81
What is problem-based or focused health assessment?
Includes data limited to the scope of problem
82
What is an episodic or follow-up assessment?
Focuses on specific problems for which patient is already getting treatment
83
What are the components of the comprehensive health history?
- Biographic data: initial visit
- Reason for seeking care
- Present health status
- Past medical history
- Family history
- Personal and psychosocial history
- Review of all body systems
84
What is the history of present illness?
- Chief complaint of presenting problem:
- Brief statement regarding purpose for visit
- Recorded in direct quotes from the patient
- Multiple reasons: List and prioritize
- Patient may not give reasons until comfortable
- Patient condition determines next step: urgencies, bibliographic data delayed, and data analysis
- Include all of the following: onset, location, duration, related and alleviating factors, attempts at self treatment
85
What is included in the Present health status?
It focuses on the patients acute and chronic conditions
- Current health conditions
- Medications reconciliation
- Allergies
86
What is included in Past health status?
- Childhood illnesses
- Surgeries
- Hospitalizations
- Accidents or injuries
- Immunizations
- Obstetric history
- Last examinations
87
What is included in family history?
- Blood relatives: biological parents, aunts, uncles, siblings, children, and spouse
- Identify genetic, familial, environmental factors that might affect current or future health status
88
What specific things do you ask about during the family history?
- Alzheimers
- Cancer
- Diabetes mellitus
- Coronary artery disease, including myocardial infarctions
- Hypertension
- Stroke
- Seizures
- Mental illness, including depression, bipolar
- Alcoholism
- Endocrine diseases
- Kidney disease
89
What is included in the psychosocial status?
- Personal status: general statement of feelings about self
- Family and social relationships
- Diet and nutrition
- Functional ability
- Mental health
- Personal habits:tobacco, alcohol, illicit drugs
- Health promotion activités
- Environment
90
What is included in the review of systems?
- Past and present health of each body system
- Conduct symptom analysis when patient indicates presence of symptoms
-Define medial terms
-Additional health promotion data
-
91
What is the definition of culture?
Culture is a pattern of shared attitudes, beliefs, self-definitions, norms, roles, and values
92
Who does culture occur among?
those who speak in a particular language and those who live in a defined geographic region
93
What is enculturation?
Process by which a person learns norms, values, and behaviors of another culture.
94
What is Acculturation?
Process of acquiring new attitudes, roles, customs, or behaviors
95
What is assimilation?
Process by which a person gives up his or her original identify and develops a new cultural identity by becoming absorbed into the dominant cultural group
96
What is biculturalism?
Duel pattern of identification
97
What is ethnicity influenced by?
Culture and common ancestry
98
What is race influenced by?
Physical or biologic characteristics
99
What is the scope of concept?
- Casual beliefs about health
- Illness expression
- Symptoms of illness
- Taboos
100
What are the concept attributes?
- Culture is learned
- Culture is changing and adapting
- Values, beliefs, and behaviors are shared by members of the cultural group
101
Describe what cultural competence is in nursing
- Expected component of professional nursing practice
- Requires underlying acceptance of patient's health beliefs
- Requires adapting care to meet unique needs and perspectives of individual
102
What are some examples of being biased?
Stereotyping people
| Tendency to act, think, or feel in a certain way toward other people
103
What is stigma?
Refers to a mark of disgrace
104
What are conveyed acceptance and nonacceptance?
-Verbal and nonverbal communication demonstrates acceptance or non-acceptance
105
What is the definition of collaboration?
a development of partnerships to achieve the best possible outcomes that reflect the particular needs of the patient, family, or community, requiring an understanding of what others have to offer
106
What is the word collaboration derived from?
Latin word collaborate which means to labor together or to work with others in an intellectual endeavor
107
What does collaboration involve?
joint responsibility for patient outcomes
108
What are the four overarching categories of collaboration?
1. Nurse-patient
2. Nurse- Nurse
3. Inter-organizational
4. Interprofessional
109
What are the six levels of Nurse-Patient collaboration?
1. Assessment
2. Diagnosis
3. Outcomes identification
4. Planning
5. Implementation
6. Evaluation
110
Describe interprofessional collaboration:
- Working across professional disciplines to optimize patient care is an expectation in health care delivery
- Expertise and diverse perspectives influenced by professional orientation, are valued and contribute to the delivery of care
111
Describe inter-organization collaboration:
- Is important in today's health care environment
| - Pooling resources and information benefits both patients and communities
112
What are 4 attributes of effective inter professional collaboration?
1. Values and ethics
2. Roles and responsibilities
3. Communication
4. Teams and teamwork
113
What role does the QSEN have in collaboration?
The Quality and Safety Education in Nursing initiative anticipates that collaboration will have a huge impact on positive patient outcomes and improve quality of care
114
What does the institute of medicine identify?
Effectively working together as an important professional competency.
115
What did the joint commision cite?
Cited the breakdown in communication among team members as the primary factor in sentinel events
116
What does strong teamwork culture promote (4)?
- Job retention
- Decreased resignation rates
- Improved perceptions of RN-physician communication
- Improved communication skills
117
What is the educational impact of collaboration?
- Decreased length of stay for patients
| - Increased economic benefits to health care organizations
118
What is the research impact of collaboration?
- Health sciences research is moving away from the private investigator model to a collaborative model represented by inter- professional collaborators
- Funding agencies are increasingly mandating collaboration as a requirement for grant funding
119
What are the seven principles of quality health care?
1. Do NO harm
2. Accept each client as a whole person
3. Develop a mutual trust
4. Explore behaviors and emotions
5. Encourage responsibility
6. Encourage effective adaptation
7. Provide consistency
120
Explain "Do no harm"
- Responsibility to protect clients
| - No matter what, avoid any action that amy result in harm to the patient
121
Explain "accept each client as a whole person"
- diffferences do not need to be understood, but accepted
- holistic heath care is based on concept of "whole"
- Viewing clients holistically also involves acceptance of their lifestyle, attitudes, social interactions, and living conditions
- Accepting clients does not necessarily include approving of their behaviors
122
Explain "Develop Mutual Trust"
- Trust implies cooperation, support, and willingness to work together
- For a careprovider trust is the foundation of therapeutic relationships
123
What three concepts are involved in trust between caregiver and client?
Caring
Empathy
Advocacy
124
Explain "Explore Behaviors and Emotions"
- every behavior serces a purpose and has meaning
- by sharing perceptions, the health care provider can help clients see how their behavior messages are being received by other people
125
What are the four components of behavior?
- Perception
- Thinking
- Feeling
- Acting
126
Explain "Encourage Responsibility"
-Anyone under stress can exhibit unsuccessful coping behaviors
127
What do health care providers encourage?
One step at a time and learning of coping mechanisms
128
When does recovery begin?
When attempts to cope with the problem result in success
129
What does consistency of behaviors imply?
Being steady, regular, and dependable
130
Where is consistency usually addressed?
in the client's plan of care
131
What are the guidelines for providing consistency?
Setting limits and focusing on the positive changes that clients are making
132
What is empathy?
Ability to recognize and share the emotions of another person without actually experiencing them
133
What are five behaviors associated with caring?
1. Accepting
2. Comforting
3. Being honest
4. LIstening attentively
5. Having sensitivity
134
What are some therapeutic actions associated with caring?
- Address client by Mr./Mrs. unless told otherwise
- Respect client's unique personality
- Dont judge client's behaviors or attitudes
- Share often that every person has potential to change
- Customize information to pts level of understanding
- Watch for nonverbal messages
- Be encouraging
- Assess your own interactions, nonverbal actions and communications
135
What is the definition of empathy?
- The act of communicating to our fellow human beings that we understand something about their world
- Free of the judgement of condolence
- Value-free message showing that you understand the other person point of view
136
What is preverbal aspect of empathy?
Understanding to tension/discomfort to nurse wants to be helpful
137
What are the verbal aspects of empathy?
Uses therapeutic technique of reflection
- Accuracy
- Specificity
- Naturalness
138
What is the nonverbal aspects of empathy?
Warmth and genuineness
139
Professional boundaries:
Be defined by caregivers, crossed when caregivers become too helpful or controlling, and must be balanced because one cannot focus on the client and the self at the same time
140
What are the guidelines for appropriate self- disclosure?
- Anything being revealed about yourself should be done to benefit the patients
- Should never burden the patient
141
How can you develop a positive attitude?
- Listen to yourself talk
- Change recurrent negative themes
- Be your own cheerleader
- Visualize future successes
- Act the part
142
What is entailed to nurture yourself?
- Be responsible and accountable for your actions
- Be open to new ideas
- Connect with others
- Take pride in yourself
- Like what you do
