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37 Cards in this Set

  • Front
  • Back

19-26 years
HPV (females)
Influenza (annually)
Pneumococcal, Hep. A & B, Meningococcal if risk factors present

27- 49 years
Influenza (annually)
Pneumococcal, Hep. A & B, Meningococcal if risk factors present

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
Young Adult
Intimacy vs. Isolation
Healthy People 2010
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.
5 A’s
Health Promotion and Intervention

Weight loss
Unexplained upset stomach
Redness in face or cheeks
Numbness or tingling of hands or feet


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
Intimate Partner Violence (IVP)
Signs and Symptoms (IVP)
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Flat affect or withdrawn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
Screening (IVP)
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?”
Positive (IVP)
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
Physical- Young Adult
At peak for strength, energy, and endurance
19-30 yrs
Maintain longer with diet, exercise, & moderation
Early 40’s- decreased bone mass and density
Prevent with diet and exercise
P – 72 B/P – 100-120/60-80
Smoking Cessation
Smokers advised to quit and receiving cessation counseling are 50% more likely to attempt quitting than those with no counseling.
Benefits of Smoking Cessation
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
Work – Important Role in life
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
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
Emotional Intelligence
Young Adult
Understand and regulate personal feelings
Respond empathetically and effectively to feelings of others
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
Leading Causes of Death in Middle Age
Age 45 - 54
Cancer (lung, colorectal, breast/prostate)
Heart Disease
Unintentional Injury
Liver Disease
Cerebrovascular Disease
Diabetes Mellitus
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
Five Grades used by the USPSTF
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].
Prostate Screening
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.
Lung Cancer
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
Lung Cancer Screening
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
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
61% of adults are overweight and 30% of adults are obese. This causes an increased risk of:
High Cholesterol
Type 2 diabetes
Heart Disease
Gallbladder disease
Sleep apnea see p. 592
Colon Cancer
Metabolic Syndrome
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.
Definition of Metabolic Syndrome
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
Risks of Metabolic Syndrome
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.
Goals for Type 2 Diabetes
A1C level (goal is <7%)
Blood pressure (goal is <130/80 mmHg)
Total cholesterol level (goal is <200 mg/dL )
Transtheoretical Model of Change


Four Main Components of the Health Belief Model:
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
Motivational Interviewing
Involves careful listening and strategic
questioning rather than teaching in order to
help patients resolve their ambivalence about
Patient centered: clients encouraged to make their own decisions regarding their health
Positive Reinforcement
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
Cognitivism Bloom
Bloom – 3 Learning Domains
Cognitive – Thinking
Knowing, comprehending, applying, analysis, synthesis, evaluation.
Affective – Feeling
Feelings, emotions, interests, attitudes and appreciations
Psychomotor – Skill
Motor skills
Theories- Cognitivism
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
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.