CONCEPTS IN THE CARE OF AT RISK AND SICK ADULT CLIENTS

Question 1

The global population now is ______ and it will increase by nearly ______ people a year to reach about ______ by the year 2025.By the year 2025 ______% of the global population will be living in rural areas and ______% in urban areas.

Answer 1

The global population now is 5.8 billion and it will increase by nearly 80 million people a year to reach about 8 billion by the year 2025.By the year 2025 41% of the global population will be living in rural areas and 59% in urban areas.

Question 2

Life expectancy

Answer 2

1955 - 48 years
1995 - 65 years
2025 73 years
today - 45 years (50 million people), 60 years (5 billion people in 120 countries)

Question 3

In the age structure of deaths what are the common diseases that causes death?

Answer 3

infectious and parasitic diseases, circulatory diseases, repiratory diseases, perinatal conditions

Question 4

what are the leading cause of death from infectious diseases?

Answer 4

acute lower respiratory infections, tuberculosis, diarrhea, HIV/AIDS, malaria

Question 5

what are the most deaths from circulatory diseases?

Answer 5

coronary heart disease and cerebrovascular disease

Question 6

what are the leading cause of death from cancers?

Answer 6

lung, stomach, colon and rectum, liver, and breast cancer

Question 7

As the economies of these countries grow, non-
communicable diseases will become more prevalent. This will be due largely to the adoption of “western” lifestyles and their accompanying risk factors:

Answer 7

smoking, high-fat diet, obesity, and lack of exercise

Question 8

TRUE OR FALSE: Heart disease and stroke have declined as causes of death in recent decades, while death rates from some cancers
have risen.

Answer 8

TRUE

Question 9

TRUE OR FALSE: “Diabetes” cases in adults will more than “double” globally from 143 million in 1997 to 300 million by 2025 largely because of “dietary and other lifestyle factors”

Answer 9

TRUE

Question 10

TRUE OR FALSE: Cancer will remain one of the leading causes of death worldwide. Only one-third of all cancers can NOT be cured by earlier detection combined with effective treatment.

Answer 10

FALSE

Question 11

Cases and deaths of lung cancer and colorectal cancer will “increase”, largely due to ___ and ___ respectively. Lung cancer deaths among women will “rise” in virtually all industrialized countries, but “stomach cancer” will become “less” common generally, mainly because of ___, ___ and ___.

Answer 11

Cases and deaths of lung cancer and colorectal cancer will increase, largely due to smoking and unhealthy diet
respectively. Lung cancer deaths among women will rise in virtually all industrialized countries, but stomach cancer
will become less common generally, mainly because of improved food conservation, dietary changes and declining
related infection.

Question 12

Cervical cancer is expected to “decrease” further in industrialized countries due to _____.

Answer 12

Cervical cancer is expected to decrease further in industrialized countries due to screening.

Question 13

Liver cancer will decrease because of the results of current and future immunization against the ____ virus in many countries.

Answer 13

Liver cancer will decrease because of the results of current and future immunization against the hepatitis B virus in
many countries.

Question 14

In general, more than 15 million adults aged ____ are dying every year. Most of these deaths are ___ and ___.

Answer 14

In general, more than 15 million adults aged 20-64 are dying every year. Most of these deaths are premature and
preventable.

Question 15

Cancer and heart disease are more related to the ___ age group than any other; people over 75 become more prone to impairments of ___, ____, ___ and ____.

Answer 15

Cancer and heart disease are more related to the 70-75 age group than any other; people over 75 become more prone to impairments of hearing, vision, mobility and mental function.

Question 16

Over 80% of circulatory disease deaths occur in people over ___

Answer 16

65

Question 17

what is the leading cause of death and disability in people over 65 years worldwide?

Answer 17

circulatory disease

Question 18

TRUE OR FALSE: breast cancer on average deprives women of at least 10 years of life
expectancy, while prostate cancer reduces male average life expectancy by only one year.

Answer 18

TRUE

Question 19

The risk of developing ____ rises steeply with age in people over ___ years. Women are more likely to suffer than men because of their greater longevity.

Answer 19

The risk of developing dementia rises steeply with age in people over 60 years. Women are more likely to suffer
than men because of their greater longevity.

Question 20

Philippine economy has been growing, but _____ and ____ remain as major challenges.

Answer 20

Philippine economy has been growing, but perennial poverty and income inequality remain as major challenges.

Question 21

TRYE OR FALSE: Compared to neighboring countries, Philippines is “faring well” in improving health outcomes. However, regional disparities are still “evident”

Answer 21

true

Question 22

TRUE LR FALSE: In the past decade, non-communicable diseases have become the leading causes of mortality in the country.

Answer 22

true

Question 23

What are the drivers of the current health status of our country?

Answer 23

1. Only a third of all provinces meets the bed-to population ratio
2. not all hospitals have complete basic emergency
   equipment.
3. increase in the cost of medical care
4. Philhealth has no clear pattern of benefit utilization and coverage.
5. Persistent Inequities in Health Outcomes
6. Restrictive and Impoverishing Healthcare Costs
7. Poor quality and undignified care synonymous with public clinics and hospitals

Question 24

It is a Platform for health and development in the Philippines - driven by action within and outside the health sector.

Answer 24

Universal Health Coverage

Question 25

What are the goals or UNIVERSAL HEALTH COVERAGE?

Answer 25

Goals: ▪ Financial Protection — Filipinos especially the poor, marginalized, and vulnerable are protected from high cost of health care. ▪ Better Health Outcomes — Filipinos attain the best possible health outcomes with no disparity. ▪ Responsiveness — Filipinos feel respected, valued, and empowered in all of their interaction with the health system.

Question 26

a medical condition or health problem with associated symptoms or disabilities that require long-term management

Answer 26

Chronic Illness

Question 27

are diseases that are prolonged (6 months), do not resolve spontaneously, and are rarely cured completely.

Answer 27

chronic illness

Question 28

What are the characteristics of chronic illness?

Answer 28

✓ Permanent impairments or deviations from normal ✓ Irreversible pathologic changes ✓ Residual disability ✓ Special rehabilitation required ✓ Need for long-term medical and/or nursing management

Question 29

Impact of alzheimer’s disease

Answer 29

• Patient has to relinquish everyday life interests and activities, let go, and die peacefully. • Immediate weeks, days, hours preceding death.

Question 30

one of the most common chronic illnesses that affects 1 in 5 people

Answer 30

arthritis

Question 31

2nd leading cause of death

Answer 31

cancer

Question 32

3rd leading cause of death and affects many older adults

Answer 32

COPD

Question 33

Leading cause of death that affects 17 million adults

Answer 33

coronary artery disease

Question 34

7th leading cause of death

Answer 34

Diabetes

Question 35

most common reason older adults are hospitalized

Answer 35

heart failure

Question 36

major contributor to other health problems that affects >35% of adults

Answer 36

obesity

Question 37

4th leading cause of death

Answer 37

stroke

Question 38

What phase of chronic illness trajectory refers to an event of where Genetic factors or lifestyle behaviors that place a person or community at risk for chronic condition

Answer 38

pre trajectory

Question 39

what are the focus of nursing care during pre trajectory phase?

Answer 39

Refer for genetic testing and counseling if indicated Provide education about prevention of modifiable risk factors and behaviors

Question 40

what phase of CIT refers when there is an Appearance or onset of noticeable symptoms associated with a chronic disorder?

Answer 40

trajectory onset

Question 41

what phase of CIT Includes period of diagnostic workup and announcement of diagnosis

Answer 41

trajectory onset

Question 42

what phase of CIT May be accompanied by uncertainty as patients awaits a diagnosis and begins to discover and cope with implications of diagnosis

Answer 42

trajectory onset

Question 43

give the focus of nursing care during trajectory onset

Answer 43

Provide explanations of diagnostic tests and procedures • Reinforce information and explanations given by primary health care provider • Provide emotional support to patient and family

Question 44

what phase of CIT when the Illness course and symptoms are under control as symptoms, resulting disability and everyday life activities are being managed within limitations of illness

Answer 44

stable

Question 45

what phase of CIT when Illness management centered in the home and Person maintains everyday activities.

Answer 45

stable

Question 46

give the focus of nursing care during stable phase

Answer 46

• Reinforce positive behaviors and offer ongoing monitoring • Provide education about health promotion • Encourage participation in health promoting activities and health screening

Question 47

what phase of CIT is Characterized by an exacerbation of illness symptoms, development of complications

Answer 47

unstable

Question 48

what phase of CIT when Period of inability to keep symptoms under control or reactivation of illness; difficulty in carrying out everyday life activities

Answer 48

unstable

Question 49

what phase of CIT May require more diagnostic testing and trial of new treatment regimens or adjustment of current regimen, with care usually taking place at home

Answer 49

unstable

Question 50

what life of CIT when Life becomes disrupted while patient works to regain stability and Hospitalization not required.

Answer 50

unstable

Question 51

give the focus or nursing care during unstable phase

Answer 51

Provide guidance and support; reinforce previous teaching

Question 52

what phase of CIT when there is an Active illness with severe and unrelieved symptoms or complications.

Answer 52

acute

Question 53

what phase of CIT when The development of illness complications necessitating hospitalization, bed rest, or interruption of the person’s usual activities to bring illness course under control and Hospitalization may be required for management.

Answer 53

acute

Question 54

give the focus of nursing care during acute phase

Answer 54

Provide direct care and emotional support to the patient and family member

Question 55

what phase of CIT when there is Critical or life-threatening situation requiring emergency treatment or care and suspension of everyday life activities until the crisis had passed

Answer 55

crisis

Question 56

what phase of CIT when emergency services are necessary

Answer 56

crisis

Question 57

give the focus of nursing care during crisis phase

Answer 57

Provide direct care, collaborate with other health care team members

Question 58

what phase of CIT when there is Gradual recovery after an acute period and learning to live with or to overcome disabilities and return to an acceptable way of life within the limitations imposed by the chronic condition or disability

Answer 58

comeback

Question 59

what phase of CIT involves physical healing, limitations stretching through rehabilitative procedures, psychosocial coming-to- terms, and biographical reengagement with adjustments in everyday life

Answer 59

comeback

Question 60

give the focus of nursing care during comeback phase

Answer 60

Assist in coordination of care • Rehabilitative focus may require care from other health care providers • Provide positive reinforcement for goals identified and accomplished

Question 61

what phase of CIT when Illness course characterized by rapid or gradual worsening of a condition

Answer 61

downward

Question 62

what phase of CIT when physical decline accompanied by increasing disability or difficulty in controlling symptoms

Answer 62

downward

Question 63

what phase of CIT requires biographical adjustment and alterations in everyday life activities with each major downward step

Answer 63

downward

Question 64

what phase of CIT when there is Gradual and progressive deterioration in physical or mental status

Answer 64

downward

Question 65

what phase of CIT when it is Accompanied by increasing disability and symptoms and there is Continuous alterations in everyday life activities.

Answer 65

downward

Question 66

give the focus of nursing care during downward phase

Answer 66

Provide home care and other community-based care to help patient and family adjust to changes and come to terms with these changes • Assist patient and family to integrate new treatment and management strategies • Encourage identification of end-of-life preferences and planning

Question 67

what phase of CIT when Final days or weeks before death; characterized by gradual or rapid shutting down of body process, biographical disengagement and closure, and relinquishment of everyday life interests and activities

Answer 67

dying

Question 68

what phase of CIT when Patient has to relinquish everyday life interests and activities, let go, and die peacefully and refers to Immediate weeks, days, hours preceding death.

Answer 68

dying

Question 69

give the focus of nursing care during dying phase

Answer 69

Provide direct and supportive are to patients and their families through hospice programs

Question 70

what are the seven tasks of people with chronic illness

Answer 70

1. preventing and managing crisis 2. carrying out prescribed treatment regimen 3. controlling symptoms 4. reordering time 5. adjusting to changes in course of disease 6. preventing social isolation 7. attempting to normalize interactions with ithers

Question 71

what are the major task of px and caregiver when preventing and managing crisis?

Answer 71

1. Need to understand what the potential for the crisis is 2. Need to know ways to prevent or modify the threat

Question 72

what are the characteristics of treatment regimens

Answer 72

difficult time consuming painful or uncomfortable unsightly appearance slow rate of effectiveness

Question 73

what are the prevention of chronic illness

Answer 73

Prevention of Chronic Illness • Primary prevention – proper diet, proper exercise, and immunizations • Secondary prevention – actions aimed at early detection of disease that can lead to interventions to prevent disease progression • Tertiary prevention – refers to activities that limit disease progression, such as rehabilitation.

Question 74

what are the steps when Applying the Nursing Process Using the Phases of the Chronic Illness System?

Answer 74

Step 1: Identifying Specific Problems and the Trajectory Phase Step 2: Establishing and Prioritizing Goals Step 3: Defining the Plan of Action to Achieve Desired Outcomes Step 4: Implementing the Plan and Interventions Step 5: Following Up and Evaluating Outcomes

Question 75

purpose of assessment during Step 1: Identifying Specific Problems and the Trajectory Phase

Answer 75

to identify the specific medical, social, and psychological problems likely to be encountered

Question 76

what will you include in your assessment during Step 1: Identifying Specific Problems and the Trajectory Phase?

Answer 76

health status Perception of relative health or illness

Question 77

possible nursing interventions include:

Answer 77

o providing direct care o serving as an advocate for the patient o educating o counseling o making referrals o case management

Question 78

The nurse works with each patient and family to identify the best ways to integrate treatment regimens into their ADLs to accomplish two tasks:

Answer 78

(1) adhering to regimens to control symptoms and keep the illness stable, and (2) dealing with the psychosocial issues that can hinder illness management and affect quality of life.

Question 79

what is the “primary goal” of Applying the Nursing Process Using the Phases of the Chronic Illness System?

Answer 79

Maintaining the stability of the chronic condition while preserving the patient’s control over his or her life and the patient’s sense of identity and accomplishment.

Question 80

____ it is a way of life for a group of people. It includes the ____, ____, ____, ____, and ____ that the group accepts, generally without thinking about them

Answer 80

Culture is a way of life for a group of people. It includes the behaviors, beliefs, values, traditions, and symbols that the group accepts, generally without thinking about them

Question 81

what are the cultural factors affecting health and health care

Answer 81

time orientation language and communication economic factirs health care system beliefs and practices

Question 82

What religious group believes that Alcoholic beverages and drugs are prohibited unless prescribed by health care professional. Abortion, artificial insemination, and stem cell use are prohibited.

Answer 82

Amish

Question 83

What religious group believes Many fast and abstain from meat and meat products on Ash Wednesday and the Fridays of Lent.

Answer 83

Catholicism

Question 84

What religious group believes in Artificial contraception and direct abortion are prohibited. Indirect abortion (e.g., treatment of uterine cancer in a pregnant woman) may be morally justified.

Answer 84

catholicism

Question 85

What religious group believes in Sacrament of the Sick includes anointing of sick with oil, blessing by a priest, and communion (unleavened wafer made of flour and water).

Answer 85

catholicism

Question 86

What religious group believes in Strict dietary code called Word of Wisdom prohibits all alcoholic beverages, hot drinks (nonherbal teas and coffee), tobacco, and illegal or recreational drugs.

Answer 86

mormons

Question 87

what religious group practices the Fasting for 24-hour period occurs monthly on “Fast Sunday.”

Answer 87

mormons

Question 88

what religious group practices During hospitalization or serious illness, an elder anoints the ill person with oil while a second elder seals the anointing with a prayer and blessing (laying on of hands).

Answer 88

mormons

Question 89

what religious group believes that Abortion is prohibited except when the mother’s life is in danger.

Answer 89

mormons

Question 90

what religious group practices Eating meat is prohibited because it involves harming a living creature.

Answer 90

hinduism

Question 91

Cremation is most common form of body disposal, but fetuses or newborns are sometimes buried in this religious grouo.

Answer 91

hinduism

Question 92

what religious group practices Fasting during daytime hours occurs during a month-long period called Ramadan.

Answer 92

islam

Question 93

In this religious group, Eating pork or taking medicines with pork derivatives is prohibited.

Answer 93

islam

Question 94

In this religious group, Drinking alcoholic beverages is prohibited. Artificial insemination is permissible only if from the husband to his own wife.

Answer 94

Islam

Question 95

In this religious group, Transfusions of blood in any form or agents in which blood is an ingredient are not acceptable. Blood volume expanders are acceptable if they are not derivatives of blood. Transplants that involve bodily mutilation are prohibited.

Answer 95

Jehovah’s witness

Question 96

In this religious group, Therapeutic and on-demand abortions are prohibited.

Answer 96

Jehovah’s Witness

Question 97

In this religious group, Artificial insemination is prohibited for both donors and recipients.

Answer 97

Jehovah’s Witness

Question 98

They never eat pork, shellfish, or predatory fowl and never mix milk dishes and meat dishes in preparing foods. Fish with fins and scales are permissible.

Answer 98

Judaism/Jews

Question 99

What religious group beleives in Certain foods and drink are designated as “kosher”, which means “proper.”

Answer 99

Judaism

Question 100

This religious group believes that all animals must be ritually slaughtered

Answer 100

Judaism

Question 101

this religious group believes that On the eighth day after birth, boys are circumcised in a ritual called Brit Milah, and girls are given a dedication ceremony involving prayers and blessings.

Answer 101

Judaism

Question 102

This religious group believes that Abortion is morally unacceptable except when the mother’s life is in danger.

Answer 102

mormons and judaism

Question 103

What religious group practices Organized support system for the sick includes a visit from the rabbi. The rabbi may pray with the sick person alone or in a minyan, a group of 10 adults over age 13.

Answer 103

Judaism

Question 104

what religious group practices that If an autopsy is performed, all body parts must be returned for burial.

Answer 104

judaism

Question 105

what religious group when Vegetarian diet is encouraged? Nonvegetarian members refrain from eating foods derived from any animal having a cloven hoof that chews its cud (e.g., pigs, goats).

Answer 105

Seventh-Day Adventism

Question 106

What religious group believes that Eating fish with fins and scales is acceptable, but consuming shellfish is prohibited.

Answer 106

Seventh-Day Adventism / Adventist

Question 107

What religious group believes that Consumption of alcoholic beverages is prohibited. Fasting is practiced and involves abstaining from food or liquids by healthy members of the church.

Answer 107

Seventh-Day Adventism

Question 108

What religious group believes that Consumption of alcoholic beverages and illicit drugs is prohibited. Moderation in diet and avoidance of extremes are practiced.

Answer 108

buddhism

Question 109

what religious group believes that Central tenets are maintaining right views, intentions, speech, actions, livelihood, effort, mindfulness, and concentration.

Answer 109

buddhism

Question 110

What are the Nursing Management in Reducing Health Disparities and Increasing Cultural Competency?

Answer 110

1. Nurse’s self-assessment 2. Patient assessment 3. Cultural assessment 4. Nursing Implementation

Question 111

Ability to understand patient’s unique cultural needs.

Answer 111

cultural awareness

Question 112

Process of learning key aspects of a group’s culture, especially as it relates to health and health care practices

Answer 112

cultural knowledge

Question 113

Patients as the best source of information about their culture

Answer 113

Cultural knowledge

Question 114

Ability to collect relevant cultural data

Answer 114

Cultural skill

Question 115

Performance of a cultural assessment

Answer 115

cultural skill

Question 116

Direct cross-cultural interactions between people from culturally diverse backgrounds

Answer 116

Cultural encounter

Question 117

Extended contact with a cultural group to enhance understanding of its values and beliefs

Answer 117

Cultural encounter

Question 118

What are the role of nurse in cultural awareness?

Answer 118

• Identify your own cultural background, values, and beliefs, especially as related to health and health care. • Examine your own cultural biases toward people whose cultures differ from your own culture.

Question 119

What are the role of nurse when she has cultural knowledge?

Answer 119

• Learn basic general information about predominant cultural groups in your geographic area. Cultural pocket guides can be a good resource. • Assess patients for presence or absence of cultural traits based on an understanding of generalizations about a cultural group. • Do not make assumptions based on cultural background because the degree of acculturation varies among individuals. • Read research studies that describe cultural differences. • Read ethnic newspaper articles and books. • View documentaries about cultural groups.

Question 120

What are the role of nurse when she has cultural skill?

Answer 120

• Be alert for unexpected responses with patients, especially as related to cultural issues. • Become aware of cultural differences in predominant ethnic groups. • Develop assessment skills to do a competent cultural assessment for any patient. • Learn assessment skills for different cultural groups, including cultural beliefs and practices.

Question 121

What are the role of nurse when she has cultural encounter?

Answer 121

• Create opportunities to interact with predominant cultural groups. • Attend cultural events, such as religious ceremonies, significant life passage rituals, social events, and demonstrations of cultural practices. • Visit markets and restaurants in ethnic neighborhoods. • Explore ethnic neighborhoods, listen to different types of ethnic music, and learn games of various ethnic groups. • Visit or volunteer at health fairs in local ethnic neighborhoods. • Learn about prominent cultural beliefs and practices, and incorporate this knowledge into planning nursing care.

Question 122

A cultural assessment should include the following:

Answer 122

o Brief history of the cultural group with which person identifies o Values orientation o Cultural sanctions and restrictions o Communication o Health-related beliefs and practices o Nutrition o Socioeconomic considerations o Organizations providing cultural support o Educational background o Religious affiliation o Spiritual considerations

Question 123

Nursing Interventions to Reduce Health Disparities:

Answer 123

✓ Treat all patients equally. Inform patients about health care services available for their specific cultural/ethnic group. ✓ Ensure availability of culturally appropriate patient educational resources.

Question 124

Guidelines for Communicating When No Interpreter is Available

Answer 124

1. Be polite and formal. 2. Pronounce name correctly. 3. Proceed in an unhurried manner.