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94 Cards in this Set
- Front
- Back
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hhealthy people 2020: main focus
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reach goals by year 2020 |
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healthy people 2020: overarching goals |
4 overarching goals: 1. attain high quality, longer lives free or preventable disease, disability, injury and premature death 2. achieve health equity, eliminate disparities, and improve health of all groups 3. create social and physical environment that promotes good healthy for all 4. promotes quality of life, healthy development, and healthy behaviors across all life stages |
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healthy people 2020: focus areas |
42 focus areas: guide for healthy care research, practice, education, policy, and communication |
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primary care |
GREEN IS THE BEST, NO SLOWING DOWN, GOOD TO GO true prevention that lowers the chances that a disease will develop TRANSTHEORETICAL MODEL |
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transtheoretical model PRIMARY CARE |
stage 1: pre contemplation no thought to making changes, no action planned, not within the next 6 months stage 2: contemplation thought of making change, actions considered, within the next 6 months stage 3: preparation seriously thinking of making change, actions identified, within the next month stage 4: action involved in change, actively involved in changing behavior, involved in change for 6 months stage 5: maintenance processing effects of change, continuation of behavior, indefinite stage 6: relapse |
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secondary care |
CAUTION, CATCH IT WHILE ITS EARLY, PREVENT PROGRESSION, PROVIDE EDUCATION focus on those who have early stages of a disease or are at risk to develop a disease |
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tertiary care |
THE WORST defect/ disability permanent or irreversible (stroke) minimize effect to prevent complications/ deterioration objective- return to useful place in society, maximize remaining capacity no more treatment |
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educator |
TEACHING, ALL EDUCATORS, GENERAL Teaching can be formalor informal and will involve the patient, family, significant other, or othersupport systems. Teaching may range from chance remark based on perception ofpt behavior to formal planned teaching. |
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consultant |
EXPERT ON SOMETHING, SPECIALIZED Providesknowledge about health promotion and disease prevention to individuals andgroups. Some nurses have specialized areas of expertise or advanced practicestanding which equips them to provide information |
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researcher |
EVIDENCE BASED PRACTICE, PUTTING INTO PRACTICE Nurses use researchfindings as the foundation to clinical practice and decision-making. Evidencebased practice is defined as the conscientious, explicit and judicious use of currentbest practice evidence. |
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care manager |
BEHIND THE SCENES Prevents duplication ofservices, reduces costs, and facilitate communication among involved parties.As a manager, you will collaborate with others to help your patients meet theirestablished outcomes and will evaluate the manner in which care isadministered. |
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what is ADPIE? |
A- assessment D- nursing diagnoses/ problem identification P- planning the care I- implementing the plan E- evaluation effectiveness of the plan |
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A- assessment |
A- assessment-collection and analysis of data
-Gordon’sfunctional health patterns - hands on, nonverbal ques, objective and subjective data, (what are the complaints and whyare they here) - putting this data into11 categories to find what to do next |
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D- nursing diagnoses |
-problem,etiology, defining characteristics, contributing etiological factors,diagnostic variables
- takingcategorized data and looking at a list and coming up with nursing diagnoses tofind the problem |
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P- planning the care |
-projectoutcomes (goals), prescribe interventions
-within theplanning phase we need to establish a goal, goals need to be measurable, have aprojected outcome -example: o how are yougoing to achieve the goal? o Goal- loosing5lbs within a month -intervention-exercise (walk30min 3x a week) - food watching(1500 calories a day) - eliminate 1 sugardrink per day |
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I- implementing the plan |
ACTION, DO STAGE |
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E- evaluating effectiveness of the plan |
did we achieve the goal? |
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Gordon health pattern: health perception- health management pattern |
-patternsdescribes: clients perceived pattern of health and well-being and how health ismanaged
-examples: compliance with medication regimen, use of health-promotionactivities such as regular exercise, annual check-ups, current health/safetypractices, previous patterns of adherence, use of health care system, healthcare access |
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Gordons health pattern: nutritional - metabolic patten |
-patterns described:patterns of food and fluid consumption relative to metabolic need and pattern;indicators of local nutrient supply
- examples: condition of skin, teeth, hair, nails, mucousmembranes; height and weight;24 hour recall; frequency of “eating out” |
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Gordon health pattern: elimination pattern |
-patterns describes:patterns of excretory function (bowel, bladder and skin) includes clientsperception of “normal” function
-examples: frequency ofbowel movements, voiding pattern, pain on urination, appearance of urine andstool |
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Gordon health pattern: activity - exercise pattern |
-patternsdescribed: patterns of exercise, activity, leisure, and recreation
-examples: exercise, hobbies. May include cardiovascular and respiratory status,mobility, use of assistive devices, and actives of daily living |
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Gordon health pattern: sleep- rest pattern |
-pattern describes:patterns of sleep, rest, and relaxation
-examples- clientsperception of quality and quantity of sleep and energy, sleep aids, routinesclient use |
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Gordon health pattern: roles- relationship pattern |
-patterndescribes: clients pattern of role engagements and relationships
-examples: perception of current major roles and responsibilities; satisfactionwith family ,work, or social relationships |
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Gordons health pattern: sexuality- reproductive pattern |
-patterndescribed: patterns of satisfaction and dissatisfaction with sexuality pattern;reproductive pattern
- examples: number andhistories of pregnancy and childbirths; difficulties with sexual functioning;satisfaction with sexual relationship |
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Gordon health pattern: coping- stress tolerance pattern |
-pattern described:general coping pattern and effectiveness of the pattern in terms of stresstolerance
- examples: clients usual/past manner ofhandling stress, available support systems, perceived ability to control ormanage situations |
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Gordon health patterns: values- beliefs pattern |
-pattern describes:patterns of values, beliefs(including spiritual) and goals that guide clientschoices or decisions
- examples: religiousaffiliation, what client perceives as important in life, value-belief conflictsrelated to health, special religious practices, perceptions of right and wrong |
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Gordon health patter: self- perception / self concept pattern |
-patterndescribes: clients self concept pattern and perceptions of self
- examples: bodycomfort, body image, attitudes about self, sense of worth, perception ofabilities, objective data such as body posture, eye contact, voice tone andaffect |
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Gordon health pattern: cognitive perceptual patter |
-pattern describes: sensory- perceptual andcognitive patterns
-examples: vision,hearing, taste, touch, smell, pain perception and management; cognitivefunctions such as language and vocabulary, memory, behavior, attention span,and decision making |
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learning plan: COGNITIVE |
THINKING - teachingstrategies: lecture, one-on-one instruction, discussion, discovery, audiovisualor printed materials, computer-assisted instruction - examples ofdesired outcomes: describes and/or explains relevant information - want them toexplain it back to you so you know they understand |
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learning plan: AFFECTIVE |
FEELING - teachingstrategies: role modeling, discussion, role playing, simulation gaming - examples ofdesired outcomes: expresses positive feedback, attitudes, values - feel goodabout something, excited about doing something, any kind of feelings |
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learning plan: PSYCHOMOTOR |
ACTING -teachingstrategies: demonstration, practice, mental imaging - examples ofdesired outcomes: demonstrates performance of skills - demonstrates,describes, discuss |
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LEARNING PLAN |
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medicare |
• federal program, paid through taxes
Finances formedical care for: people over 65, disabled, end stage renal failure, hospice Only have to meet 1 of 4topics to get Medicare |
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medicaid |
• federal and state funds, benefits differ fromstate to state
State determinedeligibility (if you can get it and what you can get) 50% of statebudgets available to: certainlow-income individuals, no age requirements, families with children- welfare towork- max of 5 years (can be broken up) |
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SCHIP |
state children's health insurance program |
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affordable care act 2010 |
designed to address the issues of affordability and for more to be able to access it |
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patient self determination act |
ensures that care and treatment match clients predetermined wishes |
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ethical principle: BENEFICENCE |
doing or producing good, minimizing harm |
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ethical principle: NONMALEFICENCE |
not harming others, stopping treatment if harm takes place |
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ethical principle: VERACITY |
truthful and honest |
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ethical principle: JUSTICE |
treating everyone equal, fair to everyone |
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violence |
factors: age, gender, low SES, stressful events, substance abuse, history of abuse as a child, pain / physical illness, mental illness |
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WHO definition |
world health organization |
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malnutrition |
"bad nourishment" inadequate or excess intake of protein, energy, and micronutrients |
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treatment for malnutrition |
-The baby friendly hospital initiative- promotesbreastfeeding, wants mom tobe healthy to help baby be healthy
-The international micronutrient malnutrition preventionand control program Goal is toeradicate vitamin and mineral deficiencies worldwide |
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homelessness goals and strategies |
residential programs, supportive services for chronically ill, role of community health nurses, training, developing sense of community within homeless population, develop of public/ private partnerships |
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Bioterrorism |
release of viruses, bacteria, or other agents to cause illness or death in people, animals, or plants examples: anthrax, small pox, plague |
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ethnicity |
distinctiveness sharing of customs, food, dress, language |
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race |
based on physical properties and biological heredity |
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culture competency |
may have impact on peoples: health, healing, wellness belief systems, perceived causes of illness and disease, behaviors of seeking health care, attitudes towards providers |
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Asian Americans / Pacific Islanders |
Largest groups: Chinese, Koreans, Filipinos
Health concerns: hesitancy to seek earlydiagnosis/screening, higher rate of TB, mental health problems, lower rate ofobesity, hypertension Barriers to care: poverty, stress, cultural norms thatprevent health care seeking, loss of social networks, poor access to services Health realted cultural aspects: respect for elders,family importance, avoid conflict, Taoism- chinese medicine “achiving harmony”, folk medicine |
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Latino/ Hispanic Americans |
Largest group: Mexican, Puerto Ricans, Cubans
Health concerns: stomach cancer, diabetes mellitus,cardiovascular disease, HIV Barriers to care: highest uninsured rate of any US racialethnic group, use or receive less prevenative health care, lack of interpreterservices in health care, lack culturally appropriate health care services, folkmedicine Health related aspects: family, spiritual strengthimportance, hot and cold concept, disease attributed to supernatural orpsychological causes, fold medicine used with western med |
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Blacks/ African Americans |
Higher cancer deaths, HIV, hypertension, obesity, mentalhealth concerns
Barriers to care: poverty, lack of insurance, unsafeenvironments Health-related cultural aspects: centered onfamily and religion, family needs to be involved in care, churches important inpromoting care, traditional healing approaches |
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communication techniques: clarification |
a method for discovering ones values and the importance of those values VALUING PROCESS |
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valuing process |
choosing prizing acting |
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valuing process: choosing |
-Choosing freely
-Choosingfrom alternatives Choosingafter careful consideration of potential outcomes of each alternative COGNITIVE PROCESS |
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valuing process: prizing |
-cherishing and being happy with personal beliefsand actions
-affirmingthe choice in public, when appropriate AFFECTIVE / EMOTIONAL PROCESS |
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Valuing process: acting |
-acting out the scene
-repeatedlyacting in some type of pattern BEHAVIOR |
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meta communication |
understanding the hidden meaning of a message, reading between the lines |
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Adolescent: health perception/ health management pattern |
Lessacute illness than younger children Less chronic illness thanadults
Negative health choices/outcomes . sense ofinvincibility adolescentexperimentation risk takingbehaviors partnering approach in care support autonomy focus on strengths |
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Adolescent: cognitive perceptual pattern |
adolescentbehaviors and characteristics . introspection andegocentrism . intolerance of“status quo”
erikson’s theory : identityvs. role confusion language -increased cognitiveskills and understanding language -receptive andexpressive vocab increase . -slang,electronic communication |
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Adolescent: self perception/ self concept pattern |
selfperception and body image . influenced byexpectations . individual,peer, societal goal: develop healthy selfperception/healthy body image
assessment,anticipatory guidance, edu . cation, counseling |
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Adolescent: roles - relationship pattern |
changingroles- stressful family time . increasingindependence for adolescent . parents try to learnto “let go”
positive stratigies willingness tolisten, ongoing affection for . and acceptance of teen, negotiation of lim . -its peer groups moving from child infamily to member of . group strong influence onadolescent |
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Young Adult: health perception/ health management pattern |
Behavioralhealth history
Risk factors forunintentional injuries Preventive care Maximize healthstatus, detect problems . . early Age 18: full healthappraisal . Repeat history/physical every 2 years . Screenings: breastexam & PAP smear; tes . ticular exam Over age 25: focus oncoronary risk factors . Cholesterol,diabetes, smoking, hyperten . sion, metabolic syndrome Decision making and risktaking . Risk taking behaviordecreases from adoles . cence Leading causes ofdeath: unintentional in . . juries, homicide, suicide Communicable disease Threats: changestravel, social, sexual be . . . haviors Drug resistance; newstrains emerging . Disease examples:immunizations: rubella, . HPV (women), HEP B . TB,HIV, lyme disease |
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Young Adult: coping stressing tolerance |
Stress
Assess forstress related complaints . Assess forsigns of achievement stress . Listen,offer support, referrals as needed Suicide anddepression Suicide:leading cause of death Cause: unable to cope with stressful circum . . stancesor events More womenattempt; more men succeed . Assess fordepression and suicidal ideation |
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Young Adult: cognitive perceptual pattern |
Piaget:formal operations
Analysis of allcombinations of possibilities . . and constructs hypotheses;more percep . . tive/ insightful Intellectual growth Recall performanceand memory. Peaks in . . 20s Erikson: intimacy vs.isolation Increased sence ofcompetency/ self esteem . Learns to developreciprocal intimate rela . . tioships (requires mutual trust) Kohlberg: postconventionalmoral reasoning . Definerights and morality in terms of self- . . chosen principles |
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Young Adult: self perception/ self concept pattern |
Westernculture: adulthood
Financial andresidential independence . Explore andexperiment vs. firm commit . . . ments Employment issues (can lead topoor self image) . Pay differentials bygender . . Variance in benefits,occupational hazards . Stress of employment Childbearing choices,childcare issues . Increased job burdenwith decreased job se . . curity |
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Young Adult: roles / relationship pattern |
Maturingrealtionships and roles . Development ofenduring friendships . Formation of intimaterelationships . Decisions bout life/career directions . Formation of familyunits . Multipledecisions related to child bear . . ing, finances, roles/ relationships . Self andfamily development Separation/ divorce
Affects children,families of couple . Re-evaluation ofbasic values, strengths, per. . sonality Depression common-supportive counseling/ . services Violence 80% of violence idindividual acts (homicide, . suicide) homicide: 2ndleading casue of death in 15 . to 24 year olds associated:guns, alcohol, drug abuse, . . crimes intimate partnerviolence . crosses alldemographic boundaries . underreported;women report higher . . lifetime violence appropriateassessment, detection, . . treatment needed |
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Young Adult: occupation stress |
youngadults work in hazardous jobs vocational training needed toavoid hazards periodic assessment,counseling for risks
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Older Adult: stress/coping |
older adult at higher risk,medical conditions, losses, physical changes
suicide- highest in elderly-serious illness, social isolation, alchol abuse physician assisted suicide
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Older Adult: nutritional- metabolic |
malnutrition factors: access to food, decline in GI absorption, deterioration of senses, living environment, anorexia from disease, medications food stamps |
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Older Adult: activity - exercise |
increasingly important to reduce, stop, or reverse physical decline popular activities: walking or aquatic |
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Older Adult: Osteoporosis risk factors |
brittle bones small thin frame, caucasian, family history, inactivity, low calcium intake |
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Erickson |
Psychosocial - adolescent-13 to 18- identity vs. role confu . . sion achieving identityrole confusion- don’t know . whothey are- confused- weak sense of self - young adult-18 to 35- intimacy vs. isolation intimacy-able to establish longlasting rela . . tionships- marriage- set job isolation- lonely middle adult- 35 to 65- generactivity vs. stagna . . tion generactivity- producing/ nurturing/ creat . . ing.. Somethinggood, leaving a lasting Im . pression stagnation- not going anywhere..unfulfilled older adult-65 and older- ego integrity vs. de . .. . . spair ego integrity- im proud of myselfand what . I have accomplished despair- didn’t do enough, couldhave . . . . done more |
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Piaget |
encompasses birth to 15 years old 4 stages about our thoughts and how we think about things scheme- pattern of action or thoughts schemes are used to assimilate ( take in) or accommodate (modify) new experiences |
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Kohlberg |
BEHAVIORAL- goal is justice Preconventional- avoid punishment, gain reward(school age) Conventional- gain approval, avoid disapproval (adolescent) Postconventional- agreeing upon rights, personalmoral standards (young adult) |
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Gilligan |
–Conventional•Sacrificeswants and needs to fulfill others’ wants and needs –Postconventional•Moreequal of self and others •Researched with Kohlberg: Noted womenscored lower than men on Kohlberg’s tool •Suggests a different process of moraldevelopment exists in women: Relationship-basedvs.cognitive development |
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Dietary supplements and herbal medicines: general, pregnancy, elderly |
general: include vitamins, minerals, herbs, botanicals/ plant- derived substances, amino acids, metabolites, constituents, and extracts pregnancy: folic acid & iron elderly: calcium & vitamin D |
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BMI |
BMI: used to screen for risk health/ nutritional disorders Healthy: <25 (18.5- 24.9) Overweight: 25-30 Obese: <30 |
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benefits of exercise |
increase metabolic rate, increase lean body mass, increase density of bones, reduce fat |
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FITT prescription |
F- frequency :how often, (3 days a week) I-intensity: how intense, stranious,measurable,how hard it is, (2 laps) T- type: type of activity, (aquatictherapy) T- time: how long for, (30 minutes ) |
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exercise type |
resistance training, weight bearing, aerobic |
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eustress |
challenging and useful stress; not destructive (good, normal) |
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distress |
chronic or excessive stress; body unable to adapt; threatens homeostasis (BAD) |
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assessment of stress: primary appraisal |
descriptions of perceived actual/ potential positive and negative outcomes |
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primary appraisal: negative outcome |
harm (physical injury, diseases, death) |
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primary appraisal: postive outcome |
challenges individual perceives can be overcome (graduation, promotion) |
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assessment of stress: secondary appraisal |
individuals identification of choices to cope with stress choices: internal or external resources/ responses |
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sociobehavioral |
stress responce: individual reliance on less healthy behaviors ( not good things to do) over eating, excessive use of drugs or alcohol, smoking, social isolation |
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psychological |
negative mood states: anxiety, depression, hostility, anger affects key populations: elderly, terminally ill, caregivers |
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stress management interventions |
Self awareness: monitoring stress warning signs
Whatstresses me out? Relaxation: helps develop awareness of nega . . tive effects of stress Repetitionof word/ thought/ activity . . Minirelaxations Lessenthe stress and keep it from getting worse Acupuncture: (Chinese) needles placed on points ofbody to reduce pain Hypnosis: ( Greek for sleep) narrow consciousness Reiki: (Japanese) uses life force energy fields to affect health Expressive Writing: telling a story about lifeevents, used to process emotions Healthy Diet: positive influence on health,physical performance, state of mind Physical activity: enhances well being whiledecreasing stress Sleep hygiene: improve quality of life, helpssleep deprivation, depression and fatigue Cognitive behavioral restructuring: stop andbreathe, think about response Affirmations: positive thought that has meaning toyou, repeat phrase or saying throughout day and it will enhance self esteem andreduce stress |
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holistic nursing |
nursing practice that heals the whole person |
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nursing role in holistic nursing |
support a persons natural healing systems, consider the whole person, consider the environment surrounding person |
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subjective vs. objective |
subjective- client tells you objective- measurable.. blood pressure, vitals |
