Exam 1 - Test Map (Unit A) Flashcards
What may indicate barriers to receiving HIV prevention messages and accessing or using intervention and tx services?
Socioeconomic characteristics of the population, such as poverty and unemployment
According to the CDC, National Health Interview Survey, which ethnic group has a lack of health insurance?
Persons of Mexican origin
Which ethnic group is 1/3 of the uninsured population?
Hispanic origin
Which ethnic group is 14% of the uninsured population?
non-Hispanic Black
What must low-income families, without health ins rely on?
A fragmented and difficult-to-use public system of health care
What is sometimes difficult to obtain and its availability may not be adequately understood by uninsured, low-income families?
Reg preventive care, including prenatal care, immunizations, and well-child care
Define evidence-based practice
Conscientious, explicit, and judicious use of current best evidence in making decisions about care of individual pts
How does ANA define evidence-based practice?
Integrating individual clinical expertise with the best available external clinical evidence from systematic research
Why do nurses need to use evidence-based practice?
Emphasis is shifting from acute, hospital-based care to preventive, community-based care, which is provided in nontraditional health care setting in the community
What are the 5 steps within the 3 levels of prevention?
Health promo & specific protection (primary); Early dx, prompt tx, & disability limitation (secondary); Restoration & rehabilitation (tertiary)
Define primary prevention.
Precedes disease or dysfunction
What is the purpose of primary prevention?
To decrease the vulnerability of the individual or population to disease or dysfunction
What do the interventions at the primary prevention level encourage individuals and groups to do?
Become more aware of the means of improving health and the things they can do at the primary preventative health level and the optimal health level
Primary prevention can also include what that protects the health of the public?
Advocating for policies that promote the health of the community and electing public officials who will enact legislation
What is the focus of primary prevention?
Prevention of the initial occurrence of disease or injury
List examples of nurse prevention activities at the primary level
Counseling, planning, education, classes, immunizations, assessments, disease surveillance (communicable), & advocating for the resolution of health issues (access to health care, healthy environment)
Define passive strategies of health promo
Involves individual as an inactive participant or recipient
Define active strategies of health promo
Individual personally involved in adopting a proposed program of health promo
Examples of passive strategies of health promo
Public health efforts to maintain clean water and sanitary sewage systems to decrease infectious diseases and introducing vit. D in milk when there’s little sunlight
Examples of active strategies of health promo
Lifestyle changes - daily exercise and stress-management
When are primary prevention interventions considered health protection?
When they emphasize shielding or defending the body (or the public) from specific causes of injury or disease
Define secondary prevention
Ranges from providing screening activities & tx early stages of disease to limiting disability by averting or delaying the consequences of advanced disease
Why is screening a secondary prevention?
To identify individuals in an early, detectable stage of the disease process
What is a vital role for nursing in the secondary prevention level?
Limiting disability since preventative measures are primarily therapeutic and are aimed at arresting the disease and preventing further complications
What is the focus of secondary prevention?
Early detection of disease and tx with the goal of limiting severity and adverse effects
Examples of secondary prevention
Screenings, tx of STDs, tx of Tb, and control of outbreaks of communicable diseases
Are interventions for secondary prevention level similar to primary preventions?
Yes, but applied to individuals/populations with disease
What does the tertiary prevention process involve?
Minimizing the effects of disease and disability by surveillance and maintenance activities aimed a preventing complications and deterioration
What is the objective of the tertiary prevention level?
To return the affected individual to a useful place in society maximize remaining capacities, or both
Nurse prevention activities in the tertiary prevention level
Nutrition counseling, exercise rehab, shelters, support groups, case mgmt (chronic illness or mental illness), and exercise for hypertensive clients (individual)
What are some roles nurses have in health promo and protection?
Advocate, care manager, consultant, deliverer of services, educator, healer, and researcher
What is considered a major portion of the nurse’s role when influencing health policies?
To advocate not only for the individual, but also for justice in health care delivery
Define lobbying
The process of trying to persuade legislators to vote for or against measures important to the interest group represented
Define a lobbyist
A registered representative of a special interest group
What organization employs nurse lobbyists?
ANA, located in Washington D.C.
What is a DRG?
Diagnosis-Related Group: A statistical system of classifying any inpatient stay into groups for the purposes of pymt
Who must be covered by state MCD programs?
All pregnant women and children up to 6yrs of age with family income <133% of the federal poverty level and encourages states to voluntarily expand coverage to women up to 185% of the poverty level
What is the most profound and pervasive determinant of health status in Blacks/African Americans (BAA)?
Poverty
What happens when poor people can’t afford health insurance?
Limits their access to health care services such as prenatal & maternal care, childhood immunizations, dental checkups, well-child care, & a wide range of other health promo preventive services
What does decreased resources for preventative care in people living in poverty mean?
May necessitate more expensive services, such as emergency room care and intensive care in times of severe illness
What 2 indices show the effects of poverty?
High rates of infant mortality and maternal mortality
What ethnic group has responded well to prevention and tx of infectious diseases, but have other health problems that are closely linked with poverty and harmful lifestyle practice?
Native Americans
When does tertiary prevention occur?
Occurs when a defect or disability is permanent and irreversible
What are the 6 dimensions of health promotion?
Individual, family, community, socioeconomic, cultural, and environment
What is Health Promotion?
A process that enables individuals, groups, families, & communities to exhibit control over determinants of their behavior & to take action; Biological, Ecological-social, Psychological, & Moral Dimensions of a person
What is health promotion behavior motivated by?
By the desire to increase well-being and actualize human health potential
What is disease prevention (or health protection) behavior motivated by?
By the desire to avoid illness, detect early, or maintain functioning within constraints of illness
How is life span studied?
Physically, emotionally, cognitively, spiritually, and socially
What is seen as the last developmental phase?
Dying - the final attempt to come to terms with self, others, and life in general
What’s included in the development of a person?
Physiologic/Emotional, Cognitive, Cultural, Social, Moral, Spiritual
List the 4 models of health
Clinical, Role-performance, adaptive, & eudaimonistic dimensions
Define the models of health
The realization of human potential thru goal-directed behavior, competent self-care, & satisfying relationships w/others, while adapting to maintain structural integrity & harmony w/the social & physical environment
What is the health extreme in the clinical dimension?
Absence of s/s of disease or disability
What is the illness extreme in the clinical dimension?
Presence of s/s or obvious disability
Who uses the clinical model of health?
People who use this model may not seek preventive health services or they may wait until they are very ill to seek care
What is the health extreme in the role-performance model of health?
Performance of social roles w/max expected output
What is the illness extreme in the role-performance model of health?
Failure to perform one’s social roles
What does the role performance model of health include?
Work, family, & social roles, with performance based on societal expectations
What model is the basis for occupational health evals, school physical exams, & physician excused absences?
Role performance model of health
What is a vital component of the role performance model?
The idea of the “sick role,” which excuses people from performing their social fxns
What is the health extreme in the adaptive model of health?
Flexible adaptation to the environment
What is the illness extreme in the adaptive model of health?
Alienation of the person from environment
What is the measure of health in the adaptive model of health?
People’s ability to adjust positively to social, mental, & physiological change
What occurs when the person fails to adapt or becomes maladaptive to changes?
Illness
How is life span studied?
Physically, emotionally, cognitively, spiritually, & socially
What is seen as the last developmental phase in a life span?
Dying: the final attempt to come to terms with self, others, & life in general
What is the health extreme of the eudaimonistic model of health?
Exuberant well-being
What is the illness extreme of the eudaimonistic model of health?
Devitalized, increasing debility
What does the eudaimonistic model of health emphasize?
The interactions btwn physical, social, psychological, & spiritual aspects of life & the environment that contribute to goal attainment & create meaning
How is illness reflected in the eudaimonistic model of health?
By a denervation or languishing, a lack of involvement with life
What is an indicator of need for nursing intervention in functional health?
Loss
How are the levels reflected in functional health?
In terms of performance/social expectations
How is functional health characterized?
As being present or absent, high level or low level, and influenced by neighborhood and society
How does society view healthy people?
If they can meet role obligations (work, parenting, etc.)
How does W.H.O. define health?
A state of physical functioning & also the total functioning of the person (physically, socially, psychologically & spiritually)
Define physical health concepts?
Change and adapt
Define social health concepts?
Interact and form relationships
Define psychological health concepts?
Problem solve, manage stress & crises, & respond appropriately to situations
Define spiritual health concepts?
Belief in higher power, ethical standards, moral character & values
What does the total positive functioning within the health domains equal?
Healthy state, fulfilling life, and homeostasis
Define “disease”
The failure of a person’s adaptive mechanisms to counteract stimuli and stresses adequately, resulting in functional or structural disturbances
Define “illness”
Made up of the subjective experience of the individual and the physical manifestation of disease
What are the 7 determinants of health according to Healthy People 2020?
1) Physical activity 2) Obesity 3) Tobacco use 4) Responsible sexual behavior 5) Mental health 6) Environmental equality 7) Access to health care
What does the National guidelines to promote health define?
National emphasis for health promotion and disease prevention efforts
What are the 4 overarching goals of Healthy People 2020?
Attain high-quality, longer lives free of preventable disease, disability, injury, & premature death; Achieve health equity, eliminate disparities, & improve the health of all groups; Create social & physical environment that promotes good health for all; Promote quality of life, healthy development, & healthy behaviors across all life stages
What are the 4 foundational health measures that serve as an indicator of progress towards the goals of Healthy People 2020?
General health status; Health related quality of life & well being; Determinants of health; Disparities
What is the Health, United States report?
A published document reporting the health status of the nation by tracking a variety of specific, measurable health indicators
Who prepares the Health, United States report?
Dept of Health & Human Resources
What is the main goal of Health, United States report?
Inform policy makers, the President, & Congress of the trends of the nation’s health to guide the development of sound health policy & allocate resources to maintain & improve the health of the nation’s citizens
What is the goal of Healthy People 2020?
To increase quality & yrs of healthy life & eliminate health disparities
What statistics does the W.H.O. provide?
Morbidity data & compares U.S. with other countries
What are the standard measures used to compare the health status of the population of one nation with another?
Death indicators (infant mortality rates)
Who is responsible for interventions for Healthy People 2020?
Individuals, health care providers, and community partnerships
What responsibilities does an individual have for interventions r/t Healthy People 2020?
Lifestyle and behaviors
What responsibilities does health care providers have for interventions r/t Healthy People 2020?
Offer preventative services and monitoring behaviors
What responsibilities does the community partnerships have for interventions r/t Healthy People 2020?
To promote health (e.g., work sites, faith communities)
Define prevention in a narrow sense
Averting the development of disease in the future
Define prevention in a broad sense
Prevention consists of all measures, including definitive therapies, that limit disease progression
What are the levels of prevention related to?
The natural hx of disease. They can also be used to prevent disease & provide nurses with starting points in making effective, positive changes in the health status of their clients
Can people be in 2 different periods of the life cycle at the same time?
Yes
What is the prenatal period in the life cycle?
Conception to birth
What is the infancy period in the life cycle?
birth to 1 yr
What is the preschooler period in the life cycle?
3 to 6 yrs
What is the school-age period in the life cycle?
6 to 12 yrs
What is the adolescence period in the life cycle?
12 to 20-25 yrs
What is the young adult period in the life cycle?
20 or 25 to 45 or 50 yrs
What is the middle age period in the life cycle?
45 or 50 to 65-70 yrs
What is the older adult period in the life cycle?
65 or 70 yrs and olders
Generality about people
All persons are similar and have the same basic needs, but they are unique in following and expressing their own developmental patterns
Growth patterns
Growth rate not steady (infancy vs. school age); Different body parts grow at different rates
Growth charts
CDC; Chart linear, wt, & head circumference (infants), BMI for age; Serial measurements best reflection of growth
Can early patterns of behavior persist throughout life?
Yes
How is development lifelong?
Follows definable, predictable & sequential pattern, and occurs throughout adulthood
Why is childhood the foundation period of life?
Attitudes, habits, patterns of behavior and thinking, personality traits, and health status are established
How is growth and development continuity evidenced?
Cumulative change
How is growth and development discontinuity evidenced?
Distinct stages, abrupt occurrence, or even regression
Growth is accompanied by a change in what?
Behavior
Does human behavior have a purpose?
Yes, it is goal directed and involves both gain and loss
What are the critical periods in growth and development?
When there are tremendous demands on the person - the susceptibility to adverse environmental factors increases
What are the 3 critical periods during growth and development?
Prenatal (1st trimester), Middle age, and Old-age
What happens if the appropriate stimuli and resources aren’t available during critical periods or when the person is ready to receive and use particular stimuli for the development of a specific pyschomotor skill?
The skill may be more difficult to learn later in the developmental sequence
What is the basis for the next developmental era?
Mastering developmental tasks of one period
Progressive differentation of the self from the environment results from what?
Increases self-knowledge and autonomy
What does development involve for growth, improvement, maintenance, recovery, or dealing with loss?
Changing allocation of resources (time, energy, talent, social skills, or money)
How does the development period birth thru adolescence allocate their resources?
Uses energy towards growth
How does the development period old age allocate their resources?
Towards loss
Development is multidimensional by acquiring what 4 major competencies?
Physical, cognitive, emotional, social
Explain the physical competencies of development
Motor and neurologic capacities to attain mobility and manipulation and to care for self
Explain the cognitive competencies of development
Learn how to perceive, think, solve problems, and communicate thoughts and feelings
Explain the emotional competencies of development
Develop an awareness and acceptance of self, respond to other people and factors in environment, cope with inner and outer stresses, and become responsible for personal behavior
Explain the social competencies of development
Learn how to affiliate securely with the family (1st then with other people in various situations
What is essential for learning to occur during development?
Readiness and motivation
How is development relative?
Many factors contribute to the formation of permanent characteristics and traits (genetic inheritance, prenatal environment factors, family & society, nutrition/physical/emotional environment, & deg of intellectual stimulation in the environment)
How is development modifiable?
Using skills stimulates and related abilities are improved whereas; not using certain skills or abilities causes neuronal loss and consequent decrease or loss of fxn
What is the primary determinant of normal growth governed by?
The Central Nervous System
What does the ability to perform a physical task depend on?
Maturation of neurologic structures in the brain and maturation of the muscular & skeletal systems
Principle of Differentation: How does development proceed?
Simple to complex; Homogeneous to heterogeneous; General to specific
What are the 3 directional growth patterns?
Cephalocaudal, proximodistal, & bilateral (symmetric)
Can the growth of parts of the body increase at different rates?
Yes (e.g., the head becomes smaller in relation to the rest of the body from infancy to adulthood)
What is the principle of Asynchronous Growth?
Developmental shifts at successive periods in development
