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Medsurg Review > CONCEPTS IN THE CARE OF AT RISK AND SICK ADULT CLIENTS > Flashcards

CONCEPTS IN THE CARE OF AT RISK AND SICK ADULT CLIENTS Flashcards

1
Q

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.

A

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.

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2
Q

Life expectancy

A

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

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3
Q

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

A

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

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4
Q

what are the leading cause of death from infectious diseases?

A

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

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5
Q

what are the most deaths from circulatory diseases?

A

coronary heart disease and cerebrovascular disease

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6
Q

what are the leading cause of death from cancers?

A

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

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7
Q

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:

A

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

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8
Q

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

A

TRUE

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9
Q

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”

A

TRUE

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10
Q

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.

A

FALSE

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11
Q

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 ___.

A

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.

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12
Q

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

A

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

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13
Q

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

A

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

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14
Q

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

A

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

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15
Q

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

A

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.

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16
Q

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

A

65

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17
Q

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

A

circulatory disease

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18
Q

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.

A

TRUE

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19
Q

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.

A

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.

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20
Q

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

A

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

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21
Q

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

A

true

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22
Q

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

A

true

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23
Q

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

A
  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
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24
Q

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

A

Universal Health Coverage

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25
Q

What are the goals or UNIVERSAL HEALTH COVERAGE?

A

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.

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26
Q

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

A

Chronic Illness

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27
Q

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

A

chronic illness

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28
Q

What are the characteristics of chronic illness?

A

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

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29
Q

Impact of alzheimer’s disease

A

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

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30
Q

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

A

arthritis

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31
Q

2nd leading cause of death

A

cancer

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32
Q

3rd leading cause of death and affects many older adults

A

COPD

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33
Q

Leading cause of death that affects 17 million adults

A

coronary artery disease

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34
Q

7th leading cause of death

A

Diabetes

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35
Q

most common reason older adults are hospitalized

A

heart failure

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36
Q

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

A

obesity

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37
Q

4th leading cause of death

A

stroke

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38
Q

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

A

pre trajectory

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39
Q

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

A

Refer for genetic testing and counseling if indicated

Provide education about
prevention of modifiable
risk factors and behaviors

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40
Q

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

A

trajectory onset

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41
Q

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

A

trajectory onset

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42
Q

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

A

trajectory onset

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43
Q

give the focus of nursing care during trajectory onset

A

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

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44
Q

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

A

stable

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45
Q

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

A

stable

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46
Q

give the focus of nursing care during stable phase

A

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

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47
Q

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

A

unstable

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48
Q

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

A

unstable

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49
Q

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

A

unstable

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50
Q

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

A

unstable

51
Q

give the focus or nursing care during unstable phase

A

Provide guidance and
support; reinforce previous
teaching

52
Q

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

A

acute

53
Q

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.

A

acute

54
Q

give the focus of nursing care during acute phase

A

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

55
Q

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

A

crisis

56
Q

what phase of CIT when emergency services are necessary

A

crisis

57
Q

give the focus of nursing care during crisis phase

A

Provide direct care,
collaborate with other
health care team members

58
Q

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

A

comeback

59
Q

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

A

comeback

60
Q

give the focus of nursing care during comeback phase

A

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

61
Q

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

A

downward

62
Q

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

A

downward

63
Q

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

A

downward

64
Q

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

A

downward

65
Q

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

A

downward

66
Q

give the focus of nursing care during downward phase

A

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

67
Q

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

A

dying

68
Q

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.

A

dying

69
Q

give the focus of nursing care during dying phase

A

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

70
Q

what are the seven tasks of people with chronic illness

A
  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
71
Q

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

A
  1. Need to understand what the potential for the crisis is
  2. Need to know ways to prevent or modify the threat
72
Q

what are the characteristics of treatment regimens

A

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

73
Q

what are the prevention of chronic illness

A

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.

74
Q

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

A

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

75
Q

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

A

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

76
Q

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

A

health status
Perception of relative health or illness

77
Q

possible nursing interventions include:

A

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

78
Q

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

A

(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.

79
Q

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

A

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.

80
Q

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

A

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

81
Q

what are the cultural factors affecting health and health care

A

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

82
Q

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.

A

Amish

83
Q

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

A

Catholicism

84
Q

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.

A

catholicism

85
Q

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).

A

catholicism

86
Q

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.

A

mormons

87
Q

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

A

mormons

88
Q

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).

A

mormons

89
Q

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

A

mormons

90
Q

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

A

hinduism

91
Q

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

A

hinduism

92
Q

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

A

islam

93
Q

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

A

islam

94
Q

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

A

Islam

95
Q

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.

A

Jehovah’s witness

96
Q

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

A

Jehovah’s Witness

97
Q

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

A

Jehovah’s Witness

98
Q

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.

A

Judaism/Jews

99
Q

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

A

Judaism

100
Q

This religious group believes that all animals must be ritually slaughtered

A

Judaism

101
Q

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.

A

Judaism

102
Q

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

A

mormons and judaism

103
Q

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.

A

Judaism

104
Q

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

A

judaism

105
Q

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).

A

Seventh-Day Adventism

106
Q

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

A

Seventh-Day Adventism / Adventist

107
Q

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.

A

Seventh-Day Adventism

108
Q

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

A

buddhism

109
Q

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

A

buddhism

110
Q

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

A
  1. Nurse’s self-assessment
  2. Patient assessment
  3. Cultural assessment
  4. Nursing Implementation
111
Q

Ability to understand patient’s unique cultural needs.

A

cultural awareness

112
Q

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

A

cultural knowledge

113
Q

Patients as the best source of information about their culture

A

Cultural knowledge

114
Q

Ability to collect relevant cultural data

A

Cultural skill

115
Q

Performance of a cultural assessment

A

cultural skill

116
Q

Direct cross-cultural interactions between people from culturally diverse backgrounds

A

Cultural encounter

117
Q

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

A

Cultural encounter

118
Q

What are the role of nurse in cultural awareness?

A

• 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.

119
Q

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

A

• 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.

120
Q

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

A

• 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.

121
Q

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

A

• 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.

122
Q

A cultural assessment should include the following:

A

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

123
Q

Nursing Interventions to Reduce Health Disparities:

A

✓ 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.

124
Q

Guidelines for Communicating When No Interpreter is Available

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

Medsurg Review (3 decks)

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