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Flashcards in Transition/stress/nutrition Deck (80):
0

What is loss?

When something valued is changed or no longer available

1

What is maturational loss/stressor?

Part of life process, anticipated, sociocultural preparation (crisis potential)

2

What is unanticipated change with trial & error preparation (potential crisis)

Situational loss/stressor

3

What is anticipatory loss

Prepare for uncertain future, before the actual loss occurs

4

Significance of loss depends on:

Loss of: Aspect of ones self
An object external to oneself
Separation from an accustomed environment
Loss of live or valued person

5

7 tasks of chronic illness:

1)prevent manage crisis
2) carry out prescribed tx
3) controlling symptoms
4) reordering time
5) adjust to change in disease course
6) preventing social isolation
7) normalize interaction with others

6

Ambulatory care settings example

Dr office
Ambulatory care centers
Occupational health clinics
urgent care centers

7

Acute care setting example

Hospitals
ER
(1st point contact with HC system in older adults)

8

Examples: healthy promotion activities, immunization, healthy wt & diet

Primary prevention
*before disease or dysfunction

9

Examples of tertiary prevention

Rehab; restorative, palliative care

*begins after illness determined irreversible

10

What is secondary prevention

Early detection of disease
Prompt intervention /tx
Preventin of complications & disabilities

11

What role does "locus of control" play in health promotion activities

If pt engages in his own health status -believes that health is largely self-determined,
NUrse uses LOC to plan internal reinforcement training to assist pt to improve health

12

Define frailty

3 or more of following:
>10lb wt loss/yr
Weakness, poor endurance,slowness , low activity

13

What is transitional care?
(Subacute care)

Between acute care and home
Focus on recuperation &healing

14

Describe geriatric rehabilitation

Focus on adapting to or recovery from disability

15

5 stages of acute illness

Symptom experience
Assumption of sick roll
Medical care contact
Dependent client role
Recovery /rehabilitation

16

Chronic illness trajectory: (8 "steps")

Onset
Stable
Acute
Comeback
Crisis
Unstable
Downward
Dying

17

What is a stressor

Any factor that disturbs the body's equilibrium, can be physical, physiological, emotional, intellectual , spiritual

18

Degree of stress response varies based on:

Intensity of stress
Duration of stressor
Perception of stressor by the
individual

19

Factors influence transition

Health status
Determinants of health
Support system

20

List 3 levels of social support:

-Family/kin
-Clubs/church/neighbors/senior ctrs
-formal system of social welfare agencies/healthcare facilities/government support

21

What may influence the perception of patient experience?

TIMING

22

What influences the wAy an individual responds to stressor?

Stress perception & personal meaning attached to potential stressor

23

What is resilience

Being resourceful, flexible, having available source of problem solving strategies

24

What is family

Basic unit of society. Recognize impact of family on health, values, productivity.

25

What is illness behavior

Perceived susceptibility of illness.

26

Stage of Development-Erikson for older adult?

Integrity vs.despair

27

Factors influence family health

Position in society
Distribution of wealth
Education attainment

28

Internal variables of transition

Biological
Psycho logic
Cognitive

29

5 cultural competences

Awareness
Skill
Knowledge
Encounter
Desire
(ASKED)

30

3 types of self management tasks

1 care of body & manage condition
2 adapting
3 dealing with arising emotions
4 adequate training of task (IOM)

31

Health are delivery is effected by

Evidence based practice

32

Medicare A covers:

65+ or <65 disabled:
Hospital, homecare, hospice

33

What does Medicare B cover?

65+ or <65 disabled:
Outpatient, physicians

34

What does Medicare D cover?

65+ or <65 disabled:
Prescription drug plans

35

What type of inference can be corrected or cured?

Temporary

36

Name 3 types of inferences

Temporary
Permanent
Progressive

37

How to make change of location transition smoother?

Written discharge/transfer summary
SBAR
Orders carried over
Welcome
Assessment
Orient to routines
Individualize care

38

What type of preventative care is a mammogram/pap smear?

Secondary

39

During stress what happens in posterior pituitary, the ADH does...?

Reabsorption of H2O (increase)
Reabsorption of Na+ (increase)
Urine output decreases

40

What is the illness/death stage of GAS?

Exhaustion

41

What happens in alarm stage of GAS?

Increased:BP,BG, Na+,K+, CO
Decreased peristalsis

42

What is the idea behind diagnostic reasoning -critical thinking NP

RESTORE BALANCE/HEALTH

43

RN Roles:

Limit disability
Promote comfort
Promote self/care
Promote self esteem
Support coping skills

44

During neuroendocrine response to a stressor, what is hypothalamus responsible for simultaneously:

Sympathetic nervous system (epinephrine & norepinephrine release)
Adrenal/Anterior Pituitary (cortisol & aldosterone)
Posterior pituitary

45

Exchanging,perceiving,valuing & feeling are:

Affected response patterns

46

Definition of therapeutic communication

To express or explore patients feelings

47

What is active listening

Restatement, reflection, opened ended questions

48

Diseases that are prolonged, do not respond spontaneously and are rarely cured completely

Chronic illness
Chronicity

49

What is meant by transition in healthcare

Passage from one state/position to another; from one part to another: requires adaptation within self, group &/or environment

50

What is RN responsibility when transferring a patient

Carry over orders/check for
correctness of orders
Inform oncoming HC providers
Orient to room
Notify Dr of person being there
Assess room safety issues

51

3 Factors contributing to placement in LTC

1)rapid deterioration
2)caregiver burnout
3) alteration in or loss of family support

52

What is nutrition?

Science that studies relationship of humans to food based on research

53

Role of Nutrition:

PREVENTION OF DISEASE
Prevent/correct deficiencies
Prevent malnutrition
Mngmnt of chronic diseases
Prevent dehydration
Provide correct texture

54

What is the study of the interaction of foods with specific genes to increase risk of common chronic diseases

Nutrigenomics

55

3 function of nutrients

1) source of energy or heat
2) support growth & maintenance of tissue
3) aids in regulation if basic body processes

56

Carbs, fats & lipids are which type of nutrient?

Essential

57

What kind of nutrient can the body manufacture from raw materials?

Non-essential
Ex: amino acid alanine

58

List 6 essential nutrients:

Carbs (CHO)
Protein
Fats (lipids)
Vitamins
Minerals
Water

59

Name the thermic effect of :
CHO
PRO
FAT

CHO=4
PRO=4
FAT=9

60

AMDR stands for ________________ & is Set By ___________________,
Changes to AMDR are based on ______________.

Acceptable Macronutrient
Distribution Range
Set by: External Agency
Based on: Cultural norms

61

True or false?
Fats are metabolized more effectively than PRO & CHO

True

62

What is the process in which energy expenditure adapts to increases or decreases of food intake & energy expenditure over several days time.

Adaptive thermogenesis
(Feast or famine)

63

Describe high nutrient dense foods

High vitamin /nutrient content with lower calories

64

Metabolism increases or decreases after eating?

Increases.
(Thermic food effect)

65

What is REE?

(Resting Energy Expenditure)
Amount of energy required to be consumed in order to maintain bodily functions while at rest.
Genetic specific.

66

Name 3 monosaccharides:

Glucose
Fructose
Galactose

67

Name 3 disaccharides

Sucrose
Lactose
Maltose

68

Functions of protein:

Provision of structure
Growth, cell maintenance
Regulation of body processes
Immune system response
Fluid, Electrolyte regulation
Acid-Base balance
Transportation

69

What are the major macrominerals

Calcium
phosphorus
Magnesium
Sulfur
Sodium
Potassium
Chloride

70

What is the conduit for electrolytes ?(both positive & negative)

WATER

71

What is the recommended source if energy that spares muscle mass & protein?

Carbohydrates

72

Function of carbohydrates

Provide fuel
Spare body protein
Prevent ketosis
Enhance learning & memory

73

Name complex carbs

Polysaccharides (starches & fiber)
Glycogen

74

Name simple carbs

Monosaccharides
Disaccharides

75

What may nurse use to determine where patient may need to be as far as level of care?

Maslow's hierarchy of needs

76

The sympathetic nervous system is stimulated in which stage of GAS?

Alarm stage
(Fight or flight)

77

Which stage of GAS does the persons parasympathetic system kick in & hormone levels start to decrease?

Resistance stage

78

What responses would you expect when patient moves from acute to chronic health status?

Depression, Anger, Bargaining, Acceptance

79

What may influence the perception of patient experience?

TIMING