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Community Health > Chapter 27, 28, 41 > Flashcards

Chapter 27, 28, 41 Flashcards

1
Q

Family definition

A

Is broadening as the numbers of nontraditional families increase

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2
Q

What has happened to the number of households since 1940

A

Trippled

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3
Q

single person households

A

more people living alone, higher life expectancy= more single person households

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4
Q

impact of single person households on healthcare

A

single indiv may delay seeking care, transportation may be a problem, isolation from other family members

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5
Q

Marriage

A

higher age for first marriage, divorce rate for people 50 years or older doubled between 1990-2010

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6
Q

Increased occurance of cohabitation

A

potential for negative child well-being, parental separation 5 times more likely than for married couple, increase in unstable living conditions, higher rate of poverty in cohabitating families

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7
Q

avg age of mothers birth

A

25.4

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8
Q

immigration

A

in 2010, 20% of all US births were to mothers born outside the country

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9
Q

family caregivers

A

30% of american adults. most provide care for someone 50 or older. most caregivers are over 50 themselves. *children are becoming caregivers; this affects their school permance and health

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10
Q

four approaches to family nursing

A

family as context, family as client, family as system, family as component of society

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11
Q

family as context

A

individual first, family second, family as influence, family as helpers

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12
Q

family as client

A

family primary, individual secondary, family=sum of its members, response of the family as a whole

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13
Q

family as a system

A

family as international client, whole is more than the sum of its parts, interactions among family members become the focus, all are effected

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14
Q

family as component of society

A

one of many institutions, primary unit of society (where do they get community support?)

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15
Q

family systems theory

A

families are social systems; thus, nurses can learn much from a systems approach (how does the indiv participate in functions of entire family)

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16
Q

family development and life cycle theory

A

focuses on predicted stresses of families as they change and transition over time (what stressors are most probable to occur)

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17
Q

health of the nation leading cause of death

A

shift from infectious disease to chronic disease as leading cause of death. link between lifestyle and health; link between heredity and lifestyle/environment

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18
Q

neuman systems model

A

physiological, psychological, sociocultural, developmental, spiritual

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19
Q

health risk: inherited biological risk

A

age-related risks, social and physical environment risks

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20
Q

health risk: environmental risks

A

social aspects, physical aspects

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21
Q

health risk appraisal

A

assessing for factors associated w/an increased likelihood of an unhealthy event (does this family wear seat belts?)

22
Q

health risk reduction

A

based on the assumption that decreased risk (in number or magnitude) lowers probability of an undesired event

23
Q

family crisis

A

family lacks or loses the ability to cope w/a specific event or multiple event and becomes disorganized or dysfunctional (demands of the situation exceed the resources of the family)

24
Q

continuous stress has negative effects on…

A

physical and mental health, family communication, positive growth-tendency to get “stuck”, potential for abuse, child development and education

25
Q

home health care focus

A

focus is on the three levels of prevention

26
Q

home health nursing focus

A

focus is on empowerment for highest possible levels of function and health

27
Q

hospice and palliative care focus

A

focus is on optimizing quality of life for those experiencing life-limiting, progressive illness

28
Q

cleveland clinic 1987

A

first comprehensive, integrated palliative care program

29
Q

medicare and medicaid

A

recognized importance of home health nursing right away, but didnt reimburse for hospice nursing until 1980s

30
Q

population focused home care

A

public health services make home-visits thatre usually related to primary prevention. (tuberculosis directly observed therapy)

31
Q

transitional care

A

ensures coordination and continuity of health care as patients transfer between different locations and different levels of care in the same location (hospital to home. prevents further complications of going back into hospital)

32
Q

home based primary care

A

(provider goes to pt) offers patients an alternative to receiving services in primary care clinic, community center, or physicians office. serves patients with functional or other health problems that make the trip from their homes to other care sites very difficult

33
Q

examples of home based primary care

A

veterans health administration hospital-based home care program, medical home (centralized and accessible)

34
Q

home health

A
  • provided care at home- focused mostly on tertiary prevention, helps pts and families achieve improved health and independence in a safe environment.
  • medi-care certified
  • recipients have diverse needs (most common dx is circulatory disease, then neoplasms and endocrine diseases (esp diabetes)
  • skilled nursing services
  • national and state regulations in place
35
Q

hospice and palliative care: 4 types of care

A

routine home care w/intermittent visits, continuous home care when condition is acute and death is near, general inpatient/hospital care for symptom relief, respite care in nursing home of no more then 5 days at a time to relieve family members

36
Q

four categories of hospice providors

A

home health agencies, hospital-based facilities, skilled nursing facilities, freestanding facilities

37
Q

four foci of hospice

A
  1. attention to body, mind, and spirit
  2. death is not a taboo topic
  3. health care technology used with discretion
  4. clients have a right to truthful discussion and participation in treatment decisions

*support family that will be left behind too

38
Q

problems with communication

A

incomplete or missing documentation from rushed assessments, low health literacy levels, failure to use current evp

39
Q

consequences of poor communication

A

higher risk of readmission, poorer outcomes

40
Q

involving family in clients care

A

improves self-management of care, results in fewer medication errors, improves health outcomes

41
Q

goals of ACA

A

provide patient protection, ensure availability of affordable health care, decrease overall cost of health care

42
Q

the remaining uninsured

A

undocumented immigrants, citizens who choose not to enroll in medicaid, residents of states that opt out of medicaid expansion provision (voluntary program)

43
Q

five skills for effective home visits

A

observing, listening, questioning, probing, prompting

44
Q

before you go: home visit

A

clarify referral- do you have all the info you need, actual or potential problem identified, possible resources (family, physician, school nurse, caseworker), pre-encounter data (referral source, family, previous needs)

45
Q

assessment tool qualities

A

uncomplicated language (fifth-grade level), take 10-15 min to complete, relatively easy and quick to score, renders valid data for decision making, diversity sensitive

46
Q

genogram

A

assessment instrument. can be as involved or as simple as you want them to be.

47
Q

ecomap

A

family unit in relation to other units or subsystems in the community. close look at family interaction with various groups in the community. (what support systems are available? faith based resources)

48
Q

interviewing someone in their home

A

general to specific; save sensitive topics such as religion, sexual partners or similar topics topics until at least the middle of the interview; fill out assessment tool in car so patient more comfortable; ask family what they think of their current situation, and they would identify as their most pressing problems. *write little, listen more. know what information you need before you go in, write down what you will most likely forget and when done w/the visit fill in the blanks

49
Q

contacting with families

A

working agreement that is continuously non negotiable and may or may not be written. goals can change over time and be used as building blocks

50
Q

evaluation of the plan

A

determine whether- the plan is working, the plan is working fast enough to address the problem, the plan is addressing only part of the problem, the plan needs to be revised based on changes

*if the plan is not working, identify barriers

51
Q

nurse related barriers to effective goal setting

A

paternalism, negative labeling, overlooking family strengths, neglecting culture, poor assessment and goal setting at the onset

52
Q

barriers to effective goal setting family related

A

poor decision making skills, too many problems-hard to focus

Community Health (6 decks)

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