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37 Cards in this Set
- Front
- Back
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Immunizations
19-26 years |
HPV (females)
Influenza (annually) Pneumococcal, Hep. A & B, Meningococcal if risk factors present |
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Immunizations
27- 49 years |
Influenza (annually)
Pneumococcal, Hep. A & B, Meningococcal if risk factors present |
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Piaget
Young Adult |
Formal Operations
Combines a number of steps to task mentally Considers multiplicity and relativism of issue Integrates ideas or information into memory, beliefs, or solutions Differentiates among many perspectives Objective and realistic Less egocentric |
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Erickson
Young Adult |
Intimacy vs. Isolation
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Healthy People 2010
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3 Leading Health Indicators
Tobacco Use Objective 26-13: Increase smoking cessation attempts by adult smokers. Substance Abuse Objective 27-5: Reduction in Adults Exceeding Guidelines for Low-Risk Drinking Injury and Violence Objective 15-37: Reduce physical assaults. |
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5 A’s
Health Promotion and Intervention |
Ask
Advise Assess Assist Arrange |
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Alcoholism
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Physical
Blackouts Weight loss Unexplained upset stomach Redness in face or cheeks Numbness or tingling of hands or feet Mental Unable to control – “one drink” leads to more Increased irritability, anger, lower threshold for violence Unexplained absences or difficulty keeping commitments Oversleeping or difficulty sleeping |
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Intimate Partner Violence (IVP)
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Physical
Sexual Threats Emotional |
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Signs and Symptoms (IVP)
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Depression, Anxiety, Chronic pain, Fatigue
Substance abuse Distant or vague answers to questions Repeated use of emergency services Flat affect or withdrawn Quiet or subdues with partner Nervous about leaving hospital Bruises or other injuries More common with pregnancy |
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Screening (IVP)
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Done on inpatient admission or with clinic visits
Must be done in private, without other adults present If children are present and greater than 2, must wait Screening question: “Because violence is an issue for so many families and can be harmful to children, we ask everyone about their exposure to violence. Do you have concerns about your safety, your child’s safety, or your family’s safety?” |
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Positive (IVP)
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Done on inpatient admission or with clinic visits
Must be done in private, without other adults present If children are present and greater than 2, must wait Screening question: “Because violence is an issue for so many families and can be harmful to children, we ask everyone about their exposure to violence. Do you have concerns about your safety, your child’s safety, or your family’s safety?” Unless the children are being abused, it is the right of the individual to refuse treatment. Do not document a positive screen in chart Remind them that violence is against the law and they have a right police protection Give resources that are small so can be hidden from abuser Review a safety plan WI is not a mandatory reporting state for IPV |
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Physical- Young Adult
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At peak for strength, energy, and endurance
19-30 yrs Maintain longer with diet, exercise, & moderation Musculoskeletal Early 40’s- decreased bone mass and density Prevent with diet and exercise Cardiovascular P – 72 B/P – 100-120/60-80 |
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Smoking Cessation
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Smokers advised to quit and receiving cessation counseling are 50% more likely to attempt quitting than those with no counseling.
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Benefits of Smoking Cessation
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20 min. after last cigarette
↓ B/P & Pulse; ↑temp of hands & feet 24 hrs. after quitting Chance of MI ↓ 2 weeks to 3 months after quitting ↑circulation & lung function; walking easier After 1 year Risk of heart disease half that of a smoker After 5-15 years ↓stroke risk to that of people who’ve never smoked |
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Work – Important Role in life
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Defines self; self-esteem
Gives sense of purpose Provides opportunities for mastery Gives life structure Provides financial standing Provides residence Contributes to friendships Affects exercise and leisure |
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Screening
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Skin – monthly exam
Colon/Rectum – any changes in stool color or bowel pattern. Fecal Occult Blood test annually Breast – SBE – monthly Clinical BE every 2-3 yrs until 40, then yearly Mammogram yearly starting at age 40 PAP every 2 years if always WNL Cervical cancer screening every 3 years after start of sexual intercourse or age of 21 Testicular self-exam monthly Clinical exam if one testicle larger or harder than other or if lump Prostate exam |
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Emotional Intelligence
Young Adult |
Understand and regulate personal feelings
Respond empathetically and effectively to feelings of others |
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Middle Age
Physical Changes |
Hair thins and grays
Presbycusis (hearing loss) for higher tones Decreased skin moisture and elasticity Decreased functional aerobic capacity Decreased cardiac output Decreased bone density and mass – 1-4 inch decrease in height |
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Leading Causes of Death in Middle Age
Age 45 - 54 |
Cancer (lung, colorectal, breast/prostate)
Heart Disease Unintentional Injury Liver Disease Suicide Cerebrovascular Disease Diabetes Mellitus HIV |
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Leading Causes of Death in Middle Age
Age 55-64 |
Cancer (lung, colorectal, breast/prostate)
Heart Disease Chronic Low Respiratory Dz. Unintentional Injury Diabetes Mellitus Cerebrovascular Disease Liver Disease Suicide |
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Five Grades used by the USPSTF
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A.— strongly recommends that clinicians provide [the service] to eligible patients.
B.— recommends that clinicians provide [this service] to eligible patients. C.— no recommendation for or against routine provision of [the service]. D.— recommends against routinely providing [the service] to asymptomatic patients. I.— the evidence is insufficient to recommend for or against routinely providing [the service]. |
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Prostate Screening
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The U.S. Preventive Services Task Force recently concluded that there is insufficient evidence to assess the balance of benefits and harms of prostate cancer screening in men younger than age 75 and recommended against prostate cancer screening in men age 75 and older.
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Lung Cancer
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Lung cancer is the leading cause of cancer deaths in U.S. men and women.
Causes: Tobacco, Second-hand smoke, exposure to asbestos, radon, or air pollution, alcohol Protective action: don’t smoke, get regular exercise, consume a diet rich in fruits and vegetables |
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Lung Cancer Screening
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Screening: Sputum cytology, chest x-ray, spiral CT scans
25% of patients have no symptoms Symptoms related to cancer invasion of tissue are SOB, pain, cough, hemoptysis, or frequent respiratory infections General cancer-related symptoms include weight loss, fatigue, and weakness |
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Menopause
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Usually occurs around age 51-52
Decreased estrogen/progesterone causes vaginal dryness, hot flashes, insomnia, hair loss Loss of period for one year HRT replacement for some but risks and benefits must be weighed. |
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Obesity
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61% of adults are overweight and 30% of adults are obese. This causes an increased risk of:
HTN High Cholesterol Type 2 diabetes Heart Disease Stroke Gallbladder disease Arthritis, Sleep apnea see p. 592 Colon Cancer |
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Metabolic Syndrome
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The main features of metabolic syndrome include insulin resistance, hypertension (high blood pressure), cholesterol abnormalities, and an increased risk for clotting. Patients are most often overweight or obese.
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Definition of Metabolic Syndrome
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Abdominal obesity: a waist circumference over 40 inches in men and over 35 inches in women.
Serum triglycerides 150 mg/dl or above. HDL cholesterol 40mg/dl or lower in men and 50mg/dl or lower in women. Blood pressure of 130/85 or more. Fasting blood glucose of 110 mg/dl or above. (Some groups say 100mg/dl |
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Risks of Metabolic Syndrome
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Increases the risk of type 2 diabetes and heart disease.
Is associated with fat accumulation in the liver (fatty liver), resulting in inflammation and the potential for cirrhosis. Other problems include: sleep apnea, polycystic ovary syndrome , dementia, and cognitive decline. |
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Goals for Type 2 Diabetes
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A1C level (goal is <7%)
Blood pressure (goal is <130/80 mmHg) Total cholesterol level (goal is <200 mg/dL ) |
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Transtheoretical Model of Change
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Pre-contemplation
Contemplation Preparation Action Maintenance Relapse |
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Four Main Components of the Health Belief Model:
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Perceived susceptibility—perception of personal vulnerability to a condition
Perceived severity—evaluation of medical/clinical consequences (death, disability, pain) and social consequences (work, family life, social relations) Perceived benefits of action—perception of feasibility and efficacy of action Perceived barriers—perceptions of action as expensive, dangerous, unpleasant, inconvenient, time-consuming |
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Motivational Interviewing
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Involves careful listening and strategic
questioning rather than teaching in order to help patients resolve their ambivalence about change. Non-judgmental Patient centered: clients encouraged to make their own decisions regarding their health |
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Behaviorism
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Positive Reinforcement
Imitation/Modeling Teaching Provide practice time/repeat testing and redemonstration Provide opportunity to solve problems by trial and error Teaching strategies – avoid distracting information and evoke the desired response Praise & Positive feedback Role Model |
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Cognitivism Bloom
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Bloom – 3 Learning Domains
Cognitive – Thinking Knowing, comprehending, applying, analysis, synthesis, evaluation. Affective – Feeling Feelings, emotions, interests, attitudes and appreciations Psychomotor – Skill Motor skills |
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Theories- Cognitivism
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Social, emotional and physical environment
Positive teacher-learner relationship Multisensory teaching strategies Recognize personal characteristics Teaching styles appropriate to learning styles Teaching strategies appropriate for developmental levels Teaching has behavioral objectives that include 3 domains of learning |
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Humanism
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Convey empathy
Encourage the learner to set the goals/self directed learning Nurse serves as a facilitator, mentor or resource Active learning strategies Expose to new information/Ask questions so learner seeks answers. |
