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Nursing 304 > Exam 2 > Flashcards

Exam 2 Flashcards

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1
Q

community

A

a specific group of people who share social relationships and common interests

are arranged in social structure, according to relationships

variety of settings, including workplaces, schools

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2
Q

healthy people 2030 highlights emphasis within

A

environmental and community context

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3
Q

what group of people will continue to frame trends for older population

A

baby boomers

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4
Q

what population will double from 52 mil (2019) to 95 million in 2060 and comprise 23% of total population

A

seniors

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5
Q

what will happen to the population

A

become more diverse

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6
Q

what social welfare programs will rise

A

social security and medicare epxenditures

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7
Q

what does community health nursing combine

A

nursing practice and public health

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8
Q

community health nursing promotes

A

promotion of health of populations but isn’t limited to a particular individual or group

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9
Q

what do nurses provide for at-risk communities

A

educational information to develop health-oriented skills, attitudes, and related behavioral changes

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10
Q

nurses develop essential relationships to promote

A

community health missions

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11
Q

what is a nurse’s role in influencing health policy

A

advocate for justice in health care delivery by participating in policy decisions making and political action as it affects health of community

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12
Q

lobbying

A

process of seeking to influence legislators’ views and votes

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13
Q

what does ANA advocate for

A

collaboration with constituent organizations, specialty and on-nursing organizations

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14
Q

what is causing a decrease in specialty organizations

A

high membership dues

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15
Q

nurse’s role in community health nursing process

A

independent, interdependent, dependent functions

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16
Q

nurses role in community health promotion (nursing process)

A

community participation, community assessment

targeted and measurable objectives, relevant interventions, evaluation

identify risk factors for health problems and disparities

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17
Q

methods of data collection

A

observation data
interview data

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18
Q

observation data

A

windshield survey
sight touch hearing smell taste
technological advances greatly assist this process

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19
Q

windshield survey

A

use of sense to determine community appearance

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20
Q

interview data - verbal statements

A

key informants: key community leaders
community residents can provide important info
health agency personnel

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21
Q

measurement data

A

population statistics, morbidity/mortality rates, US census statistics, epidemiological and environmental data

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22
Q

accessing data

A

internet, local community libraries, health dept., environmental protection agencies, police and fire departments, local health agencies, city or state planning

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23
Q

sources of community information

A

census information
community agencies and local planning commissions
communities and states’ databases available for public use

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24
Q

census information

A

located on-line in libraries and public agencies
most complete source for population information

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25
Q

what is an example of comunity agencies and local planning commisions

A

water safety concerns with local fracking

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26
Q

systems theory

A

interrelated, interacting parts (boundaries) that function via input and output

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27
Q

community structure

A

systems and subsystems (health care systems)
macrosystems - part of larger system (state)
exosystem- microsystem and the individual
demography- study of population

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28
Q

community function

A

process of dynamic change and adaptation
nurse functions as advocate - proactive planning
community liason - decision making, collaboration

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29
Q

clinical community integration model

A

displays the arrangment of the strong connections of family, individuals and health delivery in a community system

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30
Q

function of a community

A

refers to process of dynamic change
reflects adaptation in system’s parts
community systems and subsistence interact

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31
Q

interaction

A

process where systems exchange matter, energy and information to make decisions

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32
Q

where emerges from interactions

A

health-related patterns

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33
Q

nurses match resources to

A

needs

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34
Q

what is the focus of the community developmental perspective

A

particular age groups in the community

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35
Q

what is the developmental perspective used for within a community

A

used to plan health promotion for groups

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36
Q

example of developmental perspective for a community

A

adolescent, single mothers
children prone to childhood accidents

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37
Q

what guides health promotion activity

A

demographics

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38
Q

risk-factor theory

A

focus is on risks affecting community health and illness

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39
Q

what does the community risk factor perspective look at

A

population risk factors (ie age, gender, race, geographical location, poverty, availability of health services, education, environmental risks)

example: genomics and community assessment

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40
Q

genomics

A

target populations include (sickle cell, tay sachs, CF)
genetics services in community settings for high-risk persons

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41
Q

health perception-health management pattern community

A
  • community health status
  • health promotion and disease prevention practices
  • community member’s perception of health (substance abuse, unwanted pregnancies, STIs)

-key community members interviews
-mortality and morbidity stats
- other public health information

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42
Q

nutritional - metabolic pattern community

A

community consumption habits ( availability of food stores or food programs)

indicators: adequate food intake, presence/absence of kitchen facilities, adequate plumbing

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43
Q

how would someone observe the nutritional-metabolic pattern within a community

A

driving/walking through community
government programs
private soup kitchens
food donations at houses of worship

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44
Q

elimination pattern in community

A

environmental factors
physical- air quality, humidity, inaccessible health care, exposure to pollutants
biologic: bacteria, viruses

data sources
obsesrvation; interviews with key informants
EPA;CDCP

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45
Q

activity and exercise pattern in community

A

physical activites/recreational options within communities

data sources
observation
interviews

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46
Q

sleep-rest pattern of community

A

community rhythm of sleep, resting, relaxing
threats to sleep-rest pattern:
ongoing activity from open businesses, highways/trains/airplane noise

data sources:observations interviews

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47
Q

cognitive perceptual pattern in community

A

problem solving and decision making
provides clues about health priorities and values

assessment: interaction w/ environment, effectiveness of strategies to meet health concerns

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48
Q

self-perception - self-concept pattern in community

A

community self-worth and self-identity

indicators:
housing conditions, buildings, cleanliness
school systems, crime rates, accidents
degree of competence with social/political issues
amount of community spirit

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49
Q

roles-relationships within community

A

communication syles: formal or informal relationships
-identity roles/relationships which affect community health
- patterns of crime
-racial incidients
-social network

data sources:interviews, media

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50
Q

health programs success are dependent on

A

support from prominent community members

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51
Q

sexuality-reproductive pattern in community

A

reproductive data of communities: birth stats, mother’s age, ethnicity, marital status, prematurity, abortion rates

helps ID high-risk groups and mismatch between services and stats

data sources: meeting minutes, health records, stats, public documents

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52
Q

coping-stress tolerance pattern in community

A

community ability to cope or adapt
develop abilities to exchange good/services; foster goals, values, ideals; promote health

zoning, housing codes, industrial wastes

data: meeting minutes, public documents, health surveys and records, stats

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53
Q

values - belief pattern

A

family values, beliefs and goals
-ID of family values and beliefs
flexibility of rules
family view of spirituality; role of religion
cultural or ethnic practices; effect on illness/health
family practices
value conflicts within family
effect of values on health

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54
Q

analysis within community

A

identify community patterns
-subjective and objective data
-formulate hypothesis
-ID at risk-community groups
-establish probable causes/relationships

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55
Q

diagnosis within the community

A

apply theories, models, norms, standards
-broad knowledge needed
-databases: information to id health concerns/risks

id strengths and health concerns
-inferences made based on data interpretation
-determine status of problem and strategies indiciated

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56
Q

examples of community strengths

A

well child clinic available
feeding program for older adults
sex ed in schools
family planning services
fluoridated water system
open communication
interagency cooperation
adequate kitchen/plumbing
high interest health promotion

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57
Q

examples of community concerns

A

unavailable well child clinic
no feeding program for adults
no sex ed
no family planning services
non-fluoridated water system
dysfunctional communication
dysfunctional transactions
indequate kitchen and plumbing
lack of interst in health promotion

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58
Q

precontemplative

A

provide info and ID risk factors
raise doubts about current behaviors and future outcomes

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59
Q

contemplative

A

discuss risks of not changing, discuss benefits of changing

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60
Q

planning/preperation

A

help plan phases of change; help implement phases of change

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61
Q

action

A

help develop strategies to prevent relapse; offer encouragement

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62
Q

maintenance

A

highlight past success and future benefits

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63
Q

planning change with the community

A

prioritize problems, differntiate roles, ID goals and objectives, formalize plans

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64
Q

community nursing interventions

A

nurse-implemented behavior to achieve community health goals
consdier health belief models
communicate plans with other professionals
take steps to overcome resistance to change

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65
Q

evaluation with the community

A

actions: lead to desired outcomes-evaluate
directed at achievment of goals
results in continued cycle of nursing process

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66
Q

health people 2030 objective include

A

national and state partnerships that establish health objectives and sustain initiatives

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67
Q

preventative services are vital to

A

health promotion and disease prevention

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68
Q

who originally oversaw preventative services

A

CDC

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69
Q

screening

A

important tool to detect disease at early stage before it becomes both costly and threatens quality of life

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70
Q

what kind of prevention is screening

A

secondary

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71
Q

what is the primary objective of screening

A

detection of a disease in its early stages and treat disease and prevent progression

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72
Q

benefits of screening and early detection

A

reduce cost of disease management and avoid costly interventions required for later stages

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73
Q

some disease show a period called

A

latency where there are no symptoms

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74
Q

early detection of disease avoids

A

more intensive intervention and may allow for early isolation and mitigation

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75
Q

individual screening

A

one person tested; often chosen based on risk factors

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76
Q

group or mass screening

A

target population selected on basis of increased risk

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77
Q

one test disease specific screening

A

single test detects characteristic indicating high risk

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78
Q

multiple test screening

A

2 or more tests to detect one disease

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79
Q

advantages of screening

A

simple screening tests are cost-effective
can be applied to both individuals and larger populations
some screening is mandated by law
creates opportunity for health teaching
can be one test disease specific or multiple test

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80
Q

example of individual screening

A

BP check in primary care

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81
Q

example of population screening

A

community screening fairs

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82
Q

disadvantages of screening

A

uncertainty in scientific evidence- possibility of errors which can lead to:
false positives
false negatives

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83
Q

false positives can lead to

A

anxiety and unnecessary interventions

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84
Q

false negatives can lead to

A

disease being overlooked; missed opportunity for early intervention; false assurance

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85
Q

epidemiology

A

method used to find cause of disease and outcomes in populations

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86
Q

morbidity

A

disease state or disability from any cause
includes range or degree of illness

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87
Q

mortality

A

deaths in a given population as end outcome indices

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88
Q

incidence

A

rate of a new population problem and estimates risk of individual developing disease

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89
Q

prevalence

A

proportion of the poppulation with disease at any one point in time

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90
Q

quality of life is

A

subjective and difficult to assess

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91
Q

quality adjusted life year (QALY)

A

1 year of excellent health = 1 QALY
concern that it may be used to ration health care (not client focused, impersonal)

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92
Q

disability adjusted life year (DALY)

A

reflects a year spent in less than healthy life
gages burden of disease
little difference from QALY

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93
Q

detection

A

are there well documented diagnostic criteria
resources treatment available to support screening

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94
Q

diagnostic criteria

A

disease should have early asymptomatic state
who should be screened

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95
Q

screening measures

A

must be safe, cost-effective and accurate

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96
Q

reliability

A

reproducability of test results

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97
Q

interobserver

A

same results when 2 persons do test

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98
Q

intraobserver

A

same person able to reproduce results (if low, test may be faulty)

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99
Q

validity

A

accuracy, distinguish those with/without

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100
Q

new avenues for screening

A

23 and me
prenatal screening

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101
Q

development of community health program

A

lead agency: oversees development
partnerships with community stakeholders
community assessment - systematic data collection
target population resources, health needs, program strategies identified
program constraints (financial, accessibility, follow up services)

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102
Q

screening guidelines

A

US Preventative Services Task Force puts forth guidelines

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103
Q

how have mammography guidelines changed

A

kept getting false positives

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104
Q

controversies of screening results

A

false positives, false negatives; duty to inform?
cutoff points
borderline cases

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105
Q

costs of health screening

A

social and political forces becoming more cost conscious vs past practice
do costs result in improved health are benefits of screening worth the expenditures required

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106
Q

what are the three approaches to evaluate economic costs and ethics

A

cost benefit ratio
cost effectiveness
cost efficiency analysis

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107
Q

cost benefit ratio

A

allow comparison of various outcomes in monetary forms
cost screening vs cost of HPV vaccine for cervical cancer
chronic disease cost calculator - published by CDC is useful

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108
Q

cost effectiveness

A

detemines optimal use of resources to reach desired health outcome
if there are limited resources, must choose among various screening options

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109
Q

cost efficiency

A

budget limited funds toward optimizing goal

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110
Q

selection of a screenable population

A

descision based on incidence and prevalence
goal: minimize costs, maximize benefits

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111
Q

healthy people 2020 and 2030

A

establishes benchmarks and monitor progress
includes screening objectives

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112
Q

recommend screenings of US preventative services task force

A

part of agency for healthcare research and quality
ids specific population recommendations

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113
Q

US affordable care act and prevention

A

mandates coverage for preventative services
medicare advantage programs: enhanced coverage

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114
Q

affordable care act

A

passed in 2010 focuses on prevention and health promotion to allow preventative services to be covered without copay or coinsurance including medicare and private insurance

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115
Q

national prevention strategy

A

released in june 2011 still being implemented
addresses clean air and water, healthy foods, violence free environment, healthy homes
empower people in making health choices
eliminate health disparities

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116
Q

strategic direction recommendations

A
  1. improve cardiovascular health
  2. incorporate screening
  3. reimbursement to encourage preventative services
  4. reduce access barriers to preventative services
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117
Q

nurse’s role

A

development and implementation of screening programs
decision maker
planner
education and counseling
follow-up
collaborate with other health care providers
focus and primary and secondary prevention

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118
Q

racial and ethnic considerations

A

CDC REACH
-breast and cervical CA prevention
-cardiovascular health
-diabetes management

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119
Q

stress

A

an expected or emotional reaction change that can cause or exacerbate health problems like heart disease, DM, and mental health issues

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120
Q

stress management

A

effective intervention for health promotion

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121
Q

management strategies

A

relaxation and imagery, self monitoring
goal setting, cognitive restructuring
mindfullness and problem solving

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122
Q

what is the goal of stress management

A

improve quality of life
coping reduces unhealthy consequences

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123
Q

stressor

A

any psychological ,environmental or physiological stimulus that disrupts homeostasis therby necessitating change or adaptation

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124
Q

homeodynamics

A

stress not necessarily bad or unhealthy - essential component of being alive
stress triggers adaptive response: positive or negative
describes continuously changing nature and interaction of life

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125
Q

stress threatens homeodynamics which triggers efforts to restore stability

A

physiological responses
behavioral responses
social responses

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126
Q

extrinsic factors

A

stressors over which individuals do not have control over
death of spouse, weather

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127
Q

modifiable facotrs

A

stressors which individual can modify through change environment, interactions, behavior

128
Q

intrinsic factors

A

stressors created or exacerbated by individual response to stress
negative thinking, procrastination

129
Q

general adaptation syndrome

A

Hans Selye in 1954
stress can be both useful and harmful
stress increases productivity to a point

130
Q

eustress

A

challenging and useful stress; not destructive

131
Q

distress

A

chronic or excessive stress; body unable to adapt; threatens homeostasis

132
Q

sociophysiology

A

integrates social and biological models to see how social processes affect physiology of organism and how does altered physiology affect future social behavior

133
Q

consequences of stress

A

physical, psychological, socio-behavioral, spiritual
homeodynamic interplay of factors has widespread effects

134
Q

physiological effects of stress

A

neuroendocrine activation/behavior change
-fight or flight stress response
-hypothalamus signals sympathetic nervous system: epinephrine and norepinephrine
-increased metabolism, pulse, blood pressure, respiration, muscle tension, increased glucose
Maladaptive: cause/exacrebate disease or symptoms of disease

135
Q

psychological effects of stress

A

contributory role in negative mood states (anxiety, depression, hostility, anger)
elevated cortisol levels; immune system response
affects health outcomes in key populations
-quality of life
-depressive symptoms
-degree of suffering

136
Q

sociobehavioral effects of stress

A

stress response
-overeating
-excessive use alcohol/drugs
-smoking
-social isolation
unhealthy behaviors associated with increased morbidity/mortality

137
Q

stress response

A

individual reliance on less health behaviors

138
Q

what are healthy adaptations of sociobehavioral effects of stress

A

exercise
healthy diet
quit smoking
weight loss
social interactions

139
Q

spiritual effects of stress

A

spirituality: feelings thoughts experiences and behaviors that arise from a search for meaning

stress response often feel disconnected from life’s meaning/purpose
spirituality assists with coping with stress
promoting connection with life meaning and purpose: health benefits

140
Q

assessment of stress

A

primary appraisal: descriptions of percieved actual/potential positive and negative outcomes
-negative outcomes (harm/injury,disease,death)
-positive outcomes (challenges which can be managed, promotion/graduation)
secondary appraisal : individuals identification of choices to cope with stress
-internal or external resources and responses

141
Q

measuring of stress

A

standardized instruments are available

142
Q

burnout

A

emotional exhaustion, depersonalization and sense of reduced accomplishment
- personal or work related

143
Q

stress management interventions

A

self awareness one of the most effective tools
recognize signs (muscle tension resulting in backache, headache)
attend to cues to reduce negative mood states (anxiety symptoms) or symptoms (stretching for backache)

144
Q

nursing role in stress-management interventions

A

assist people to identify stress signals, change response (breathe/relaxation), break stress cycle

145
Q

physical symptoms of stress

A

headaches
indigestion
stomachaches
sweaty palms
sleep difficulties
dizziness
back pain
tight neck and shoulders
racing heart
restlessness
tiredness
ringing in ears

146
Q

behavioral symptoms of stress

A

excess smoking
bossiness
compulsive gum chewing
attitude critical of others
grinding of teeth at night
overuse of alcohol
compulsive eating
inability to get things done

147
Q

emotional symptoms of stress

A

crying
nervoussness and anxiety
boredom
edginess
feeling powerless
overwhelming sense of pressure
anger
lonliness
unhappiness for no reason
easily upset

148
Q

cognitive symptoms of stress

A

trouble thinking clearly
lack of creativity
memory loss
forgetfullness
inability to make decisions
throughts of running away
constant worry
loss of sense of humor

149
Q

spiritual symptoms of stress

A

emptiness
loss of meaning
doubt
unforgiving
martydom
looking for magic
loss of direction
cynicism
apathy
\needing to prove self

150
Q

relational symptoms

A

isolation
intolerance
resentment
lonliness
lashing out
hiding
claming uo
lowered sex drive
nagging
distrust
lack of intamcy
using people

151
Q

monitoring stress

A

negative stress cycles can be difficult to break
anxiety sensitivity: tendency to misinterpret physical anxiety cues
-anxiety related symptoms believed to be due to serious physical danger
relaxation response: measures to reduce stress

152
Q

relaxation response technique

A

technique to help develop awareness/counter-negative effects of stress
reduces sympathetic arousal

153
Q

what are the two components of the relaxation response technique

A

repition of word/thought/activity
passive disregard for everyday thought

154
Q

mini relaxations

A

can be used throughout the day
keep initial stress symptoms form intensifying

155
Q

relaxation techniques

A

yoga
deep breathing
mindfullness
conscious diaphragmatic breaths
quiet sitting
visualizations

156
Q

alternative complementary therapies

A

acupuncture
hypnosis
reiki
reflexology
chiropractic
herbal

157
Q

cognitive behavioral restructuring

A

modifies negative or exaggerated thinking to reduce stress
evaluates challenges thoughts; replaces with more rational responses
teaches patient to recognize negative thinking and replace with reframing or cognitive reappraisal

158
Q

affirmations

A

positive thought (short phrase or saying) that has meaning for person
repeat affirmation through day- enhances self-esteem and reduces stress

159
Q

social support

A

network of close family friends coworkers and professionals
number of supporters and quality of relationships important

160
Q

steps of cognitive restructuring

A

stop
breath deep
reflect
what are my thoughts
choose more helpful thinking

161
Q

empathy

A

consider another person’s perspective and communicate understanding back to person

162
Q

active listening

A

conscious empathetic nonjudemental awareness

163
Q

additional modalities

A

clarifying values and beliefs
setting realistic goals
humor
engaing in pleasurable activies

164
Q

health benefits of managing stress

A

stress managment is key to disease managment and better health outcomes
social support system protective vs stress related symptoms and disease
caregiver stress/burden is a major concern

165
Q

effective coping

A

the art of finding a balance between acceptance and action between letting go and taking control

166
Q

CAM therapies

A

date back 5000 years

167
Q

national center for complementary and integrative health is one of NIH institutes

A

describes CAM as health practices other than those used in mainstream healthcare
addresses an ever increasing array of modalities
distinguishes complementary therapy alternative therapy and integrative therapy

168
Q

complemntary therapy

A

non-mainstream practice that uses CAM in conjunction with allopathic traditional medicine

169
Q

alternatie therapy

A

non-mainstream practice that uses CAM to substitue for standard medicine

170
Q

integrative therapy

A

total approach that combines standard with CAM

171
Q

allopathy

A

conventional biomedicine

172
Q

holistic health

A

preventative care which considers whole individual

173
Q

holism

A

focus on proactive healthy living

174
Q

how is health defined

A

as the absence of disease

175
Q

goals of holistic practice

A

support a person’s natural healing systems
consider the whole person
consider the environment surrounding person

176
Q

health policy for CAM

A

NCCIH has clinical practice guidelines for CAM
healthy people 2020 and 2030 support each others goals
Affordable Care Act mandates insurers not discriminate against liscensed provides including alt medicine providers
National Prevention Strategy tied to ACA
support prevntion
seeks to eliminate health disparities

177
Q

holistic nursing

A

AHNA defines holistic nursing as a practice that heals the whole person

178
Q

types of CAM interventions

A

whole medical system
biologically based practice
manipulatie body based practices
energy therapies
mind and body techniques and practices
ancient medical systems

179
Q

ayrvedic medicine (india)

A

herbs, massage, doet, drugs
goal is mind-body harmony

180
Q

traditional chinese medicine (china)

A

herbs, CAM treatments, accupuncture
balance yin and yang life forces
describes organs via fire, earth, metal, H2O, wood

181
Q

naturopathy

A

combination of traditional and 19th century European modalities on healing power of nature
no prescriptions injections xrays or surgery
health lifestyle, cleansing regiments, diets, manipulation, and exersice

182
Q

homeopathy

A

Hahnemann
administers small amounts of dilute pathogenic substances ot stimulate body’s healing abilities

183
Q

current biologically based practices

A

nutritional counseling
herbs, vitamins, minerals
probiotics
aromatherapy
hydrotherapy

184
Q

manipulative and body based modalities

A

spinal or bone manipulation
cranial and carnio-sacral therapy
physcial therapy
massage
reflexology

185
Q

spinal or bone manipulation

A

application of controlled force on bone or joint
chiropracters, physical therapists, and osteopathic physicans
spinal alignment

186
Q

cranial and carniosacral therapy

A

focus on skull and flow of CSF
gentle pressure cranium spine and sacrum
goal to restore free movement of CSF

187
Q

physical therapy

A

manipulation, massage, heat or cold, movement, electrical impulse
treat pain and restore function and ROM

188
Q

massage

A

manipulation of msucle and soft tissue
reduce stress and enhance relaxation

189
Q

reflexology

A

manipulation and energy fields
pressure to hands and feet
pressure points correspond to body organs

190
Q

mind body medicine

A

visual guided imagery
meditation
hypnotherapy
biofeedback
neruolinquistic programming

191
Q

visual guided imagery

A

focuses on calming thoguhts or experiences
promotes well being and relaxation

192
Q

meditation

A

focused attention and mindfullness
quiets mind and reduces stress
breath, chosen word, walking

193
Q

hyponotherapy

A

focused attention of unconscious mind
recall of suppressed events

194
Q

biofeedback

A

relaxation technique
focus on vital function HR BP breathing rate
visualization to bring about change

195
Q

neurolinquistic programming (NLP)

A

changes behavior via change in thinking and speaking

196
Q

movement therapy

A

qigong (chinese)
tai chi (chinese martial art)
yoga (hindu)
dance therapy

197
Q

qigong

A

chinese
relaxed movement with meditation
controlled breathing to move qi energy and increase vital energy

198
Q

tai chi

A

chinese martial art
combined physical movement, breath control meditation
sequences of poses flows in unbroken rhythm to balance energy flow
moment to moment state of body
meditative state

199
Q

yoga

A

involves positions and breath control

200
Q

energy therapy

A

energy flows through body and nourishes organs/promotes optimal functioning
goal: energy work relases blockages to energy flow, rebalances life energy
chinese: chi or qi
japanese: ki
east indian: prana

201
Q

acupunture

A

manipulates chi or qi on channels where chi travels
stimulation via needles, electrostimulation, laser, light, burning herbs (moxibustion)

202
Q

acupressure

A

stimulation of meridian points by hand pressure

203
Q

reflexology

A

deeply applied pressure to mapped points on feet and hands
applied with thumbs
pressure points correspond to organs of the body that will be stiulated by pressure

204
Q

touch therapies

A

practioners use their hands to direct energy from environment to individual
goal is to restore balance and harmony
examples: theraputic touch, reiki, attunement, jin shin jyutsu, polarity therapy, healing touch

205
Q

therapeutic tocuh

A

human energy fields interact with environmental energy fields
three elements:
centering of prationer
assesssment
treatment

206
Q

energy therapy modalities

A

healing touch
qigong
pranic
riki
polarity therapy
jin shin jyutsu

207
Q

prayer

A

different meanings to different people
commong belief aids in recovery
research mixed on therapuetic benefit

208
Q

distant healing

A

prayer for others
method: praying circle
sharing energy and sending of energy to person in need

209
Q

nursing presence

A

nurses presence can contribute to healing
attention focused vs attentive
touch caring vs task oriented
listen vs hearing

210
Q

safety and effectiveness of CAM

A

lack strong scientific evidence based as many have not been studied with rigourous trials
some CAM providers are not credentialed
safety issues fr some CAM

211
Q

growth and development is a framework for

A

health assessment and health promotion
addresses concepts and milestones normally achieved through various stages of life
includes both physical and psychosocial stages

212
Q

life stages

A

infant: birth to 12 months
toddler: 12 months to 3 years
preschool child: 3-5 years
schoolaged child: 5-12 years
asolescent: 12-18 years
young adult: 18-35 years
middle-aged adult: 35-65 years
older adult: >65 years

213
Q

growth

A

quantifiable change in structure
change increases number and size of cells
occurs throughout life
many facotrs impact and influence growth like gender, age, genetics, emotional health, environment, cultural practices

214
Q

growth patterns

A

exist for all people
varying rates of growth throughout life
example: rapid in infancy, adolescent growth spurts

215
Q

growth patterns in early life and in newborns

A

head is fastest growing section then trunk followed by arms and legs

newborn head is 1/4 overall body length vs 1/9 for adults

216
Q

CDC recommends using 2006 WHO growth charts for age _____ months then use revised 2000 CDC charts for age ____

A

0-24 months, 2-20 years

217
Q

CDC and WHO charts accounts for

A

weight, length, and BMI all for a given age including percentiles

218
Q

development

A

refers to change and expansion of ability
advancement of skill
qualitative changes- not easily measured
process which follows certain sequencing patterns
rate of development will vary with individual

219
Q

developmental patterns

A

cephalocaudal
proximodistal
differentiation

220
Q

cephalocaudal

A

head to toe

221
Q

proximodistal

A

midline to periphery

222
Q

differentiation

A

simple to complex

223
Q

learning and maturation

A

learning- process of gaining knowledge/skills from exposure, education, experience
maturation- increased competence
learning requires sufficient maturity to understand/control behavior

224
Q

theories of development

A

erikson
piaget
vygotsy
kohlberg and gilligan

225
Q

erikson’s theory of psychosocial development

A

individual needs to develop sense of trust and personal worth
each stage requires a resolution of conflict between two opposing forces
a conflict once resolved may re-emerge

226
Q

infancy

A

trust vs mistrust - faith and hope

227
Q

toddler

A

autonomy vs shame and doubt - self-control, willpower

228
Q

preschool

A

initiative vs guilt - direction and purpose

229
Q

school age

A

industry vs inferiority - method and competence

230
Q

adolesence

A

identity vs role confusion - devotion and fidelity

231
Q

young adult

A

intamcy vs isolation - affiliation and love

232
Q

middle adult

A

generativity vs stagnation - production and care

233
Q

older adult

A

ego integrity vs despair - renunciation and wisdom

234
Q

piaget’s theory of cognitive development

A

uses term scheme to describe a pattern of action or tought
individuals strive to maintain balance between assimilation and accommodation
criticism - underestimated children’s capabilities; does not address effect of culture

235
Q

piagets stages of cognitive development

A

birth to 15 years
sensorimotor - birth to 2 years
preoperational - 2-7 years
concrete operations - 7-11 years
formal operations -11-15 years

236
Q

sensorimotor (birth to 2 years)

A

reflexes decrease, voluntary acts develop
imitation predominates
though dominated by physical manipulation of objects
develops object permancence - forms mental images

237
Q

preoperational (2-7 years)

A

no cause and effect reasoning, advanced use language
thought dominated by sense
egotistical, animistic, magical thinking
uses representational thought to learn

238
Q

concrete operations (7-11 years)

A

can consider other points of view, collecting facts
assume logical approaches to problem solving including cause and efect
collecting and master facts; language perfected
thought influenced by social contacts

239
Q

formal operations (11-15 years)

A

true logical thought and manipulation of abstract concepts emerge mortality established

240
Q

vygotsky’s theory

A

proposed that learning preceded devleopment vs piaget who proposed development must be reached before learning
learning pulls development
-individual process of making meaning or sense of experiences
-can learn by observation

241
Q

kohlberg theory of moral development

A

based on piaget’s theory of cognitive development
emphasizes an ethic of justice
stges of moral development proceed during school age adolescent and young adult years

242
Q

preconventional (kohlberg)

A

avoiding punishment/gaining reward

243
Q

conventional (kohlberg)

A

gaining approval/avoiding disapproval

244
Q

postconventional

A

agreeing upon right
establishing personal moral standards
achieving justice

245
Q

gilligan feminist theory of moral development

A

noted women scored lower vs men with kohlbergs tool
suggest a diffferent process of moral development exists in women
women are relationships based vs cognitive development- social relationships are key
women think and act based on caring and relationships
emphasis on individual moral situations

246
Q

preconventional (gilligan)

A

what is practical to others and best for self
goal is individual survival

247
Q

conventional (gilligan)

A

sacrifices wants and needs to fulfill others needs
goal: self-sacrifice is goodness

248
Q

postconventional (gilligan)

A

moral equal of self and others
goal: principle of non-violence; do not hurt self or others

249
Q

behavioral-biological development

A

nature vs nurtue
evidence suggests that environmental experiences can change gene functioning
brain plasticity theory: brain cell development can modify learning and environmental experience

250
Q

infant refers to the time period of

A

birth to 12 months

251
Q

determinants of health for an infant

A

socioeconomic status
physical and social environment
genetics and biological influences
access to health care

252
Q

infants are

A

completly dependent on caregiversd

253
Q

developmental landmarks

A

guide parents, nurse must know what behaviors to expect at certain age levels
physical growth landmarks
developmental tasks

254
Q

physiological equilibrium

A

task of survival; basic physiological functions
oral stage of development

255
Q

stimulation and environmental interaction

A

essential for infant development
progressive connection of dendrites
increase vascularization of brain structures
increases myelation of brain/nerves

256
Q

infant should have what kind of stimuli

A

auditory and visual stimuli like radios spoken voice mobiles - touch is important

257
Q

concepts of infant development

A

erikson: trust vs mistrust (psychosocial development)
trust influences future relationships
infant needs maximum gratification/minimum frustration

piaget: cognitive development
sensorimotor period
mastering simple coordination acitvities through senses and motor activity

reflexes
responses following stimulation
rooting and sucking reflex: assits survival

258
Q

infant developmental theory

A

assessment tool that screens from birth to 18 months
monthly developmental milestones

259
Q

Gender and Race

A

XY=male
XX= female
male: larger, more muscle mass, more motor activity
female: smaller but more physically mature at birth

race- universal norms do not exist

260
Q

birth defect

A

abnormality structure, function or metabolism due to genetic or environment issue
maternal age: down syndrome > 35 years old
ethnic background
eastern european jews: tay sachs disease
blacks: sickle cell anemia
family history
- huntingtons chorea, hemophilia, mentardation

261
Q

reproductive history

A

spontaneous abortions
stillbirths
previous children with genetic conditions

262
Q

maternal disease

A

diabetes mellitus seizure disorder PKU

263
Q

nurses role in genetics

A

case findings, referral, family education during genetic counseling process

264
Q

health perception and helath management pattern for infant

A

health promotion through parents
promote competence in parent’s ability to act to enhance infant’s health
ID problems
help parents recognize infant susceptibility
teach characteristics that influence health

265
Q

essential infant nurtients (nutritional metabolic pattern)

A

water: supplied by breast milk or formula
protein: high quality not over 20%
CHO 37% of calories in breast milk
fat: 40-50% of calories
vitamins and minerals (vitamin D, iron, vitamin C, flouride is not recommended for 6 months)
solid food not needed for first 6 months
avoid food additives
under and over nutrition

266
Q

how is baby food cooked

A

home prepared is encomomical option: cook without salt or sugar then blenderized
commerical food is safe, nutritious and high quality

267
Q

breastfeeding

A

optimum source of nutrition
preferred method first 6 monthhs
health people 2030 adress brest feed
AFA requires accomadations and coverage

268
Q

solid foods for infant

A

cereals, particullarly rice, nonallergenic
fruits: peaches pears applesauce
vegetables: yellow veggies before green vegetables
strained meats, non allergenic lamb, veal

269
Q

4-6 month food

A

iron-fortified rice ceral

270
Q

5-7 months food

A

strained veggies fruits and juices

271
Q

6-8 months

A

protein foods; cheese, meat, fish, yogurt

272
Q

9 months

A

finely chopped meat, toast, crackers

273
Q

10-12 months

A

whole egg, whole milk

274
Q

weaning

A

gradual process of introducing infant to cup around 5-6 months

275
Q

baby bottle syndrome

A

tooth decay

276
Q

what is at risk when you prop baby bottles

A

aspiration danger

277
Q

why can’t infants have honey before 2 years old

A

risk botulism

278
Q

elimination pattern

A

develops second week of life
breastfed stool - softer consistency, clean smell
- initial several stools daily; progress to once daily

bottlefed stool - harder consistency, smellier
-similar to infant on solid food
defecation involuntary- avoid toilet training till 18 months

279
Q

urinary elimination

A

6-12 times/day first few months
irregularly after first few months
voiding involuntary

280
Q

when does bladder sensation develop

A

2nd year

281
Q

anticipatory guidance

A

teach parents regarding inability to control bladder so parental expectations are realistic

282
Q

activity-exercise pattern in infants

A

activity through play
-exercise of sense
-solitary and repititious
-promoting play is important

activity through stimulation
-parental stimulation important to development
-singing, music, rocking
-mirrors, face-to-face interaction

283
Q

sleep-rest pattern of infants

A

sleep needs correlate to rate of growth
-80% at birth - will sleep less over time
-12 hrs daily at 12 months
promote infants sleep patterns
-sensitivity to sleep cycles, develop rituals
-not firm schedule
sleep problems are highly prevalent
-bedtime routine helps
-brief arousals at night are normal for infants
-quiet room separate from parents is recommended

284
Q

SIDS

A

sudden unexplained death of infant <1 year that mostly occurs before 6 months
risk factors: prone sleeping, exposure to tobacco smoke, soft sleeping surfaces, hyperthermia, bed sharing, lack of breast feeding, SIDS sibling, preterm
recommendations:
avoid risk factors
supine sleep position (place on back)

285
Q

safe to sleep campaign

A

placing child on back vs prone for sleep
avoids one of risk factors for sids
has significantly reduced incidence of SIDS
increased incidence of occipital flattening

286
Q

cognitive perceptual pattern

A

vision: eye muscle weak
-initially vision is unfocused without meaning
-eye movements coordinate by 3 months
-eye movements mature by 6 months

hearing-acute ability
-sound discrimination is important developmental task

smell-fully developed
-can differentiate odor of mothers milk from other at 2 weeks

taste-present at birth; salvation at 3 months of age

touch and motion
-tactile sensation well developed
-touch relieves infant tensions and speeds neuromuscular development

language development
-sensory stimulation important

287
Q

language development in infants

A

cooing by 2 months
babbling at 6 months
single words by 12 months
expressive jargon 15-18 months

288
Q

self perception - self concept pattern

A

separating me from non me
developed through feedback
-effect of crying/smiling on others
-ability to use body to influence others
-messages infant recieves from body

differentiates self in mirror images at 4 months
develops body image as he or she experiences the environment through senses

289
Q

roles-relationship patterns in infants

A

attachment and bonding
theories of attachment: freudian psychoanalytic theory and social learning theory
difficulties with attachment: increased risk of child abuse, failure to thrive, behavior problems, poor growth
paternal attachemnet/bonding: engrossment

290
Q

child abuse

A

active or passive abuse at hands of parents or caregivers
most common under age 2
response to inadequate parental coping - often socially isolated

intergenerational cycle of behavior
long term effect on child

291
Q

prevention of child abuse

A

id of abuse when it occurs
protection of abuse/at-risk children

292
Q

scope of child abuse

A

1 in 7 children or infants are victims of abuse
1700 children die from abuse or neglect
abused children commonly become abusing parents

293
Q

sexuality-reproductive pattern of infants

A

sexual identity begins at birth
caretakers behavior secondary to gender
infants sexuality gives direction to own responses through life

infants characteristics
-oral sensivity
-enjoy skin to skin contact
-explores own body for pleasure in infancy

294
Q

coping-stress tolerance in infants

A

developmental crisis
situational crisis- not anticipated as part of normal growth/development
-seperation from significant other
infants have little coping capability but they learn over time

295
Q

protest

A

infant cries loudly; screams for mother

296
Q

despair

A

stops crying withdrawn apathetic

297
Q

withdrawl

A

ignores mother on her return

298
Q

values-belief pattern of infants

A

parents’ values and beliefs influence care and development of infant

nurse interventions
-works with parental framework
-serving as a consultant (listener)
-expressive values/attitudes
-remaining open to other approaches

299
Q

physical agents

A

leading cause of death
falls
burns
swallowing and choking on foreign objects

300
Q

biological agents

A

common indoor bacterial pathogens
-food, cribs, air, parents, siblings, pets
-bacteria and viruses
-immunizations helpful

common indoor pollutants
-kerosene oil, gas, tobacco, damp carpets, household cleaners, central air

301
Q

HIV and AIDS

A

acquired immunodeficiency syndrome
transmission: pregnancy, delievery, breastfeeding
symptoms usually during first year: infections, developmental delays, failure to thrive
WHO and UNAIDS recommend circumcision

302
Q

nursing role in HIV and AIDS

A

education of disease and transmission
prevention of AIDS transmission

303
Q

immunization

A

ICDC and AAP recommended schedule
1,2,4,6,12 months

304
Q

active immunization

A

live killed or attenuated organism that stimulates immune system to build immunity

tetanus, inactivated polio, measles, mumps, rubella

305
Q

passive immunization

A

transient antibodies (mother)
naturally occurs in newborns from maternal antibodies

306
Q

chemical agents

A

drugs
-asprin, acetaminophen, vitamins
-childproof packaging
prevention - safety measures enacted into law

poison prevention- children naturally explore
-plants can be poisonous
-cleaners, household supplies

toxins
pesticide
lead- slows mental development
asthma
indoor air pollutants
water pollution

307
Q

car seats

A

infant on lap can project and is distracting
rear-facing safety seat for as long as possible
foward facnig care with harness as long as possible
belt positioned booster with 3pt restraint for 8-12 years
all children < 13 to ride in back seat

308
Q

heat stroke

A

-if left unattended in motor vehicle
dangerous temps occur in 15-30 min
ambient temp 86 - internal temp 120-140
look before you leave routine

309
Q

radiation exposure

A

natrual background radiation: cosmic rays, soil, water, air
human made radiation: microwaves, electronic devices, xrays, radiation emergencies
can cause rapid cell growth in infants
exposure to UV radiation alters development of immune system

310
Q

day care

A

ideal for mother and child to be together for 4-6 months before day care
nurses role: help parents understand seperation and expected behaviors

311
Q

culture and ethnicity influences from conception

A

power structure
breastfeeding decisions
traditional and folk beliefs

312
Q

religion

A

impacts health
decisions on treatment
evaluation of health services

313
Q

legistlation

A

health people 2020 and 2030 include initiatives to improve infant health
-family planning services
-pregnancy and infant services
-educational efforts on prenatal care
-immunization efforts

nursing’s role
participate in development of health care policy
coordination of community resources

314
Q

poverty for infants

A

infant mortality rates higher
higher disease
delayed language development
parents overwhelmed

315
Q

nursing interventions for poverty

A

ID community resources; family advocate
participate in legislative process
well child visits promote and maintain health

316
Q

nursing application for infants

A

primary role- provide the family with education
infancy is critical development period

additional:
focus on nutritional needs in first 18 months
anticipitory guidance to parents
routine well visits and immunizations
health promotion
support evidence based models of care

Nursing 304 (2 decks)

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