Theory 2 Final Exam Flashcards by Elaina Pontarelli

What is medicare?

A key component of Canada’s social safety net for citizens is the provision of hospital & medical insurance, known as Medicare, which is funded by the general taxation.

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What are the nursing shortage (most common causes)?

Aging workers
High retirement rate
Lack of full time positions
Constitute large % of health care budget

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What are the 5 principals of health canada act?

Public Administration
Comprehensiveness
Universality
Portability
Accessibility

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Principles of Canada Act - Describe Public Administration:

Public Administration- provincial insurance programs are publicly accountable for the funds they spend & the province determines the amount of coverage of insured services

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Principles of Canada Act -Describe Comprehensiveness:

*Comprehensiveness-Provincial health insurance must cover all medically necessary services for the purpose of maintaining health, preventing disease, dx or tx an illness, injury or disability

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Principles of Canada Act -Describe Universality:

Universality- provincial health programs must insure Canadians for all medically necessary hospital and physician (NPs also) care

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Principles of Canada Act -Describe Portability:

Portability- People are covered by their provincial insurance during short absences from their province

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Principles of Canada Act -Describe Accessibility

Accessibility-Canadians must have reasonable access to insured services without charge or paying user fees

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What contributes to spending in healthcare?

Canadians pay directly, or indirectly, for every aspect of our healthcare system through a combination of taxes, payments to government, private insurance, and direct out-of-pocket fees of varying types and amounts
* Escalating costs are driving health care reform effects, challenging health care institutions to deliver quality care more efficiently.

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Describe the key points to the Romanow Commission, 2002:

concluded that Medicare is sustainable and must be preserved
represents Canadian’s core values
recommended changes to Canada Health Act
did not make recommendations for cost
emphasized accountability for funding

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Describe the key points to the Kirby Report, 2002:

Kirby Report, 2002

concluded that Medicare is not sustainable
advocated for private sector involvement
clarified the impact of spiraling health care costs

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What is primary health care?

Primary health care (PHC) is a foundation of Canada’s Health care system, providing entry point of contact into the health care system, as well as the vehicle for continuity of care. The PHC is a philosophy and model for improving health that supports essential health care services (promotive, preventive, curative, rehabilitative, and supportive) with a strong emphasis on the principles of health promotion and disease prevention.

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What are the settings for healthcare delivery?

INSTITUTIONAL SECTOR
*Hospitals
*Long-Term Care Facilities
*Psychiatric Facilities
*Rehabilitation Centres
COMMUNITY SECTOR
*Public Health
*Physicians Offices
* Community Health Centres (CHCs) &  
   Clinics
*Assisted Living
*Home Care
*Adult Day Care Centres
*Community and Voluntary Agencies
* Occupational Health
*Hospice and Palliative Care
*Parish Nursing

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What are the 5 levels of care?

5 Levels of Care

Level 1: Health Promotion
Level 2: Disease & Injury Prevention
Level 3: Diagnosis & Treatment
Level 4: Rehabilitation
Level 5: Supportive Care

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What is primary care?

Primary care is the first contact of a client with the health care system that leads to a decision regarding a course of action to resolve any actual or potential health problems. PC providers include physicians and nurse practitioners.

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What is secondary care?

Occurs usually in a hospital or home setting, involves provisions of a specialized medical service by a physician specialist or a hospital on referral from a PC practitioner.

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What is tertiary care?

Tertiary care is specialized and highly technical care in diagnosing and treating complicated or unusual health problems. Clients have extensive, often complicated pathological conditions.

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What are health care cost acclerators?

technologies - e-health & nursing informatics
demographics - aging population, increase in maternal age
consumer involvement - demand higher quality care

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What is the canadian patient safety institute

canadian patient safety institute is charged with providing leadership in building and advancing a safer health care system.

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hospital infections

Preventable adverse events occur annually in Canadian hospitals, one per nine clients contract an infection while in the hospital, and the same number experiences a medical-related error.

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Define population:

Is a collection of individuals who have in common one or more personal or environmental characteristics. Examples- high-risk infants, older adults, or a cultural group such as aboriginals.

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Define community:

Is a group of people who share a geographic (locational) dimension and a social (relational) dimension.

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What are the healthy characteristics of healthy community?

The key characteristics of a healthy community include a collective capacity to solve problems; adequate living conditions; a safe environment; and sustainable resources such as employment, health care, and educational facilities.

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What does community health nursing involve?

Community health nursing includes public health nursing, home health (community-based) nursing, and community mental health nursing, as well as a variety of other specialities such as street health, telehealth, and parish nursing.

COMMUNITY NURSING
•Delivery of health care where people live, work & learn
•Essential for improving health for the general public

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4 GOALS OF COMMUNITY NURSING

1. Keep people healthy 2. Encourage client participation & choice in care 3. Promote health-enhancing social environments 4. Provide in-home care for ill or disabled

What are vulnerable populations?

Vulnerable populations of clients are those who are likely to develop health problems as a result of excessive risk, who experience barriers when trying to access health care services, or who are dependent on others for care.

cultural competency & sensitivities

???

Steps in assessing vulnerable populations:

1)SETTING THE STAG 2)NURSING HISTORY OF AN INDIVIDUAL OR A FAMILY 3) PHYSICAL EXAMINATION OR HOME ASSESSMENT see pg. 47 box 4-4 for more detail

What are the 7 Roles of Community Health Nurses?

7 Roles of Community Health Nurses: 1. Understand roles agencies, regulations & laws 2. coordinate services to address needs of community 3. Set up screening programs 4. Educate local health providers 5. Work to improve condition of housing 6. Educate the public 7. Assessment & referral

Describe risk behaviours:

Potentially stigmatizing risk behaviours include substance abuse and unsafe sexual practices.

What would a community assessment involve?

As a community health nurse, you must assess the community- the environment in which people live and work. The community can be seen as having three components: the locale or structure, the social systems, and the people.

What is harm reduction nursing?

Harm reduction nursing exemplifies community nursing practice guided by primary health care, health promotion, empowerment, and ethical principles. An example would be a needle exchange program.

List the 5 types of loss:

1. necessary loss 2. actual loss 3. perceived loss 4. maturational loss 5. situational loss

TYPE OF LOSS? integral part of each person's life eg. death of loved one, divorce, loss of independence

NECESSARY

TYPE OF LOSS? - loss of person or object that can no longer be felt, heard, known or experienced - loss of a body part, child, relationship or role at work

ACTUAL

TYPE OF LOSS? - any loss that is defined uniquely by the grieving client - eg. loss of confidence or prestige

PERCEIVED

TYPE OF LOSS? - includes any change in the developmental process that is normally expected during a lifetime - eg. parents feeling loss as a child goes to school for the first time

MATURATIONAL

TYPE OF LOSS? - includes any sudden, unpredictable external event - often includes multiple losses rather than single loss - eg. car accident

SITUATIONAL

____________ IS THE ULTIMATE LOSS

DEATH

Kubler-Ross’s 5 stages of dying

1. Denial 2. Anger 3. Bargaining 4. Depression 5. Acceptance

Bowlby’s 4 phases of mourning

1. Numbing 2. Yearning and searching 3. Disorganization and despair 4. Reorganization

4 Types of Grief:

1. normal grief 2. anticipatory grief 3. complicated grief 4. disenfranchised grief

WHICH TYPE OF GRIEF? - normal feelings, behaviours, and reactions to loss - resentment, sorrow, anger, crying, loneliness, temporary withdrawal from activities

NORMAL

WHICH TYPE OF GRIEF? - process of disengaging or "letting go" before an actual loss or death has occurred - beginning the process of saying goodbye and settling life affairs after a terminal diagnosis is received - family members may withdraw emotionally too soon, leaving client with no emotional support as death approaches

ANTICIPATORY

WHICH TYPE OF GRIEF? - when a person has difficulty progressing through normal stages of grieving - includes 4 types: chronic, delayed, exaggerated, masked

COMPLICATED

WHICH TYPE OF GRIEF? - grief experienced when a loss cannot be openly acknowledged, socially sanctioned, or publicly shared - eg. loss of partner to AIDS, stillborn

DISENFRANCHISED

TYPE OF GRIEF? | - people verbalize an inability to "get past" the grief

COMPLICATED - CHRONIC

TYPE OF GRIEF? | - active grieving is held back, only to resurfaces later, usually in response to a trivial loss or upset

COMPLICATED - DELAYED

TYPE OF GRIEF? - grief overwhelms some people to the point where they cannot function - may be reflected in the form of severe phobias or self-destructive behaviour: addiction or suicide

COMPLICATED - EXAGGERATED

TYPE OF GRIEF? - lack of awareness by survivors that behaviours that interfere with normal functioning are a result of loss - eg. altered sleeping or eating patterns

COMPLICATED - MASKED

7 factors that influence loss and grief

1. Human development 2. Psychosocial perspectives of loss and grief 3. Socioeconomic status 4. Personal relationships 5. Nature of the loss 6. Culture & ethnicity 7. Spiritual beliefs

2 GRIEF-RELATED ROLES OF THE NURSE

1. Facilitating grief process effectively | 2. Assist clients to peaceful dignified death

TRUE OR FALSE? | Nurses must develop an understanding of own feelings towards death

TRUE

5 Potential Nursing Diagnoses related to grief

1. HOPELESSNESS related to failing physical condition 2. INEFFECTIVE INDIVIDUAL COPING related to low mood, and inability to manage loss 3. POWERLESSNESS related to perceived poor outcomes 4. SELF-CARE DEFICIT related to inability to perform activities of daily living 5. SOCIAL ISOLATION related to inability to cope with loss

THE FOCUS OF CARE PLANNING IN DEATH & DYING:

- support the client physically, emotionally, developmentally, and spiritually in the expression of grief

When caring for the dying client, it is important to devise a plan that helps the client die with ______________ and offers family members the ________________ that their loved one is cared for ______________.

dignity, assurance, compassionately

The care planning process is highly _____________ to the client and family. Both must be included as active participants in planning, goal setting, and development of realistic _______________ & ______________.

individual interventions timelines

What is the aim of palliative care?

- relieve suffering, and improve the quality of living and dying

When can someone receive palliative care?

for any age, any diagnosis, at any time, and not just during the last few months of life

7 treatments provided with palliative care:

1. RELIEF from pain and other distressing symptoms 2. AFFIRM life and REGARD dying as normal process 3. neither HASTEN nor POSTPONE death 4. INTEGRATE psychological and spiritual aspects of client care 5. HELP CLIENTS LIVE as actively as possible 6. HELP FAMILIES COPE 7. ENHANCE quality of life

MASSIVE VAGUE QUESTION ABOUT pg. 465 box 29.8...... * nursing care planning with dying patients * dealing with and treating the symptoms * from a symptoms perspective

NO IDEA.

symptoms displayed in the terminal stages

- discomfort - fatigue - nausea - constipation - diarrhea - urinary incontinence - inadequate nutrition - dehydration - INEFFECTIVE BREATHING PATTERNS (air hunger, shortness of breath) - confusion

management of air hunger:

- oxygen therapy | - morphine and antianxiolytics

treatment for TERMINAL STAGE discomfort:

- skin care - special mattress - oral care - artificial tears to reduce corneal drying

treatment for TERMINAL STAGE fatigue

- help client identify priority tasks - help client conserve energy for those tasks - time and pace care activities - encourage use of energy-saving devices

treatment for TERMINAL STAGE nausea

- nutritional supplements | - clear liquid diet

treatment for TERMINAL STAGE constipation

- increase fluid & fiber intake | - laxatives

treatment for TERMINAL STAGE diarrhea

- medication | - low-residue diet

treatment for TERMINAL STAGE urinary incontinence

- protect skin | - catheter or brief

treatment for TERMINAL STAGE dehydration

- mouth care | - ice chips

treatment for TERMINAL STAGE ineffective breathing patterns

- oxygen therapy - medications - semi-fowlers position - comfort and reassurance

treatment for TERMINAL STAGE confusion

- ensure safe environment - monitor client frequently - reorient client as needed

PREPARING THE DYING CLIENT'S FAMILY objectives

improve family's ability to provide: - appropriate physical care - appropriate psychological support

PREPARING THE DYING CLIENT'S FAMILY teaching strategies

demonstrate: - feeding technique - bathing, mouth care - safe transfer techniques instruct family on need to take rest breaks teach family to recognize signs & symptoms of worsening conditions answer questions & provide info as needed

TRUE OR FALSE? | Cultural beliefs are not important in post-mortem care

False

Maintaining the integrity of rituals and mourning practices helps families ____________ the client's death and achieve inner ____________

accept | peace

WHO? | * Premier of Saskatchewan

TOMMY DOUGLAS

WHO? | * 1961 - Introduced first hospital insurance plan in Saskatchewan

TOMMY DOUGLAS

WHO? | * Well-known founder of both Medicare & Canada’s social democratic movement

TOMMY DOUGLAS

WHO? | * One of nation’s most eloquent orators

TOMMY DOUGLAS

differences in care between volunteer & professional person

- volunteers can offer emotional support | - professionals can provide hands-on care

3 major environmental threats

1. Indoor air pollution 2. Outdoor air pollution 3. Unsafe water, sanitation, and hygiene

Environmental agents that trigger changes, or mutations, in the genetic material (DNA) of living cells are called ______________

mutagens

______________: mutagen that causes cancer

Carcinogen

8 Community Environmental Concerns:

1. Pollution 2. Water 3. Food 4. Pesticides 5. Chemical weapons 6. Cosmetic chemical 7. Radiation 8. Noise pollution

____________ ______________ can cause floods, heat waves, changes in patterns of infectious diseases, water supplies, and food availability

Climate change

This is known as any long term significant change in the “average weather” that a region experiences

Climate change

____________ ____________: small amounts of solar radiation pass through the Earth’s atmosphere so heat is generated – rest of the solar radiation bounces back into space

greenhouse effect

6 greenhouse gases

1. water vapor, 2. carbon dioxide, 3. nitrous oxide, 4. methane, 5. chlorofluorocarbons1, 6. ozone

____________ ____________ an agreement among the industrialized nations of the world to reduce emissions of six greenhouse gases over a certain period of time

kyoto protocol

Theory 2 Final Exam Flashcards

(90 cards)