Health Promotion, Nursing Process & Care Plans

Question 1

What does healthy mean?

Answer 1

physical, mental, spiritual and social functioning that realizes a person’s potential and is experienced within a developmental context

Question 2

Epidemiology definition?

Answer 2

Study of health and disease in society

Question 3

5 dimensions of health?

Answer 3

PIESS

Physical

Intellectual

Emotional

Social

Spiritual

Question 4

Different concepts of health

Answer 4

Wellness, illness, disease, disability, and functioning

Question 5

2 paradigms of nursing health

Answer 5

• Wellness-Illness Continuum

Health ranges from high-level wellness at the positive end to a depletion of health at the negative end.

• Developmental Perspective of Health

Question 6

Wellness-Illness continuum

Answer 6

Wellness-Illness Continuum: Depicts the relationship between the opposing concepts of health and illness. In the wellness-illness paradigm, wellness involves an improved physical and mental health state. Whereas illness is a decrease in physical and mental health state.

Question 7

Developmental Perspective of Health is?

Answer 7

Depicts the relationship between the person and the environment throughout the lifespan. In this paradigm, both behavioral and social mechanisms are viewed as a part of the health experience.

Question 8

What are the 4 distinct models of health?

Answer 8

There are 4 distinct models of health.

• Clinical model
• Role performance model
• Adaptive model
• Eudamonistic model

Clinical Model: “Health is defined by the absence of illness”.

Role Performance Model: “Health is defined as the individuals ability to perform social roles.” “Illness is the failure to perform roles at the level of others in society.”

Adaptive Model: “Health is defined as the ability to adjust positively to social, mental, and physiological change.” “Illness is the failure to adapt.”

Eudaimonistic Model: “Health is defined as profound well-being in which there is a definite relationship between physical, social, psychological, spiritual, and the environment.” “Illness is a total lack of involvement in life; failure to thrive.”

Question 9

Clinical model

Answer 9

Clinical Model: “Health is defined by the absence of illness”

Question 10

Role performance model

Answer 10

Role Performance Model: “Health is defined as the individuals ability to perform social roles.” “Illness is the failure to perform roles at the level of others in society.”

Question 11

Adaptive model

Answer 11

Adaptive Model: “Health is defined as the ability to adjust positively to social, mental, and physiological change.” “Illness is the failure to adapt.”

Question 12

Eudamonistic model

Answer 12

Eudaimonistic Model: “Health is defined as profound well-being in which there is a definite relationship between physical, social, psychological, spiritual, and the environment.” “Illness is a total lack of involvement in life; failure to thrive.”

Question 13

Disease

Answer 13

Disease is the physical or structural disturbance of cell structure.

Question 14

Illness

Answer 14

Illness is the subjective experience and physical manifestation of the disease.

Question 15

4 goals of Healthier People 2020

Answer 15

These 4 goals include health promotion and disease prevention.

1. Attain high quality, longer lives free of preventable disease, disability, injury, and premature death.
2. Achieve health equity, eliminate disparities, and improve the health of all groups.
3. Create social and physical environments that promote good health for all.
4. Promote quality of life, healthy development, and healthy behaviors across the lifespan.

Question 16

Equality vs Equity

Answer 16

Equality is giving everyone the same thing

Equity is fairness in every situation

Question 17

3 Levels of prevention

Answer 17

Primary
Secondary
Tertiary

Question 18

Primary prevention

Answer 18

Primary prevention precedes the disease or illness.

Primary interventions include health promotion such as education and health protections like immunizations.

Primary prevention also involves advocating for healthy public policies and electing public officials who will enact legislations that protect the health of the public.

The purpose of primary prevention is to decrease the populations vulnerability to disease.

Question 19

Secondary prevention

Answer 19

Secondary prevention methods range from disease/illness screenings (mammograms, prostate exams, routine blood work, etc.) and treatment of early stages of disease to limiting disabilities by delaying disease advancement.

Screenings provide early detection and staging of diseases.

Nurses play a vital role in limiting disability since preventive measures are aimed at stopping the disease and preventing further complications.

Question 20

Tertiary prevention

Answer 20

Tertiary prevention occurs when an illness or disease is permanent and irreversible.

Tertiary prevention focuses on minimizing the effects of the disease through rehabilitation and treatments.

Nurses play a vital role in ensuring that people have access to all available services that will allow them to live at the most optimal level.

Question 21

The Nurses Role in Health Promotion & Disease Prevention

Answer 21

Nurses play an active role in disease prevention and health promotion. “More than ever nurses are accountable morally, ethically, and legally for their professional behavior.”

Nurses assume a variety of roles in order to provide optimal care.

Advocate

Care Manager

Consultant

Deliverer of Services

Educator

Researcher

Question 22

The Nursing Process

Answer 22

It is a systematic method that directs the nurse and patient in planning patient care, and enables you to organize and deliver nursing care

It is patient centered and outcome oriented

The steps are interrelated and dependent on the accuracy of each of the preceding steps

It is used to identify, diagnose, and treat human responses to health and illness

Together, the nurse and the patient:

Assess the patient to determine need for nursing care

Diagnose actual and/or potential health problems

Plan care and identify expected outcomes

Implement care

Evaluate the results

Question 23

5 Steps of the Nursing Process

Answer 23

ADPIE

Assessment – collection of patient data

Diagnosis – identifies patients strengths and potential problems

Planning – develop the specific holistic desired goals and nursing interventions to assist the patient

Implementation – carry out the plan of care

Evaluation – determine the effectiveness of the plan of care

Question 24

Assessment

Answer 24

The purpose of the assessment is to;

Establish a baseline

Determine presence or absences of dysfunction

Provide data for diagnostic phase

Nursing assessments focus on the patient’s responses to health problems or potential health problems.

We complete our assessment by;

Collecting Subjective & Objective data

Interviews and health histories

Performing physical examinations such as vital signs, system assessments, analyzing lab values and diagnostic imaging

Approaches to Collecting Assessment Data

Gordon’s 11 Functional Health Patterns: This framework allows nurses to combine assessment skills with subjective and objective data to construct patterns that reflect patient lifestyles.

“Functional health patterns view the individual as a whole being, using interrelated behavioral areas” (Edelman, Kudzma, & Mandle, 2014, pg. 130).

“As a framework for assessment, functional health patterns provide an effective means for nurses to perceive and record complex interactions of individuals’ biophysical state, psychological makeup, and environmental relationships” (Edelman, Kudzma, & Mandle, 2014, pg. 130).

Gordon’s framework allows us to view the patient as a whole.

Gordon’s to be discussed in full following nursing process review.

Problem-Focused Assessment: Focuses on the patient’s problem and aids in the development of the plan of care around an individual problem.

Data collection includes biographical data such as age, gender, and the purpose of the visit.

Types of Data to Collect:

Subjective: The patient’s verbal description of the problem. (Ex: Nausea, anxiety, fear, cold)

Objective: Measurable and observable problems. (VS, GCS, weight, appearance of a wound).

Data is obtained via interview, examination, observation, research & literature, history & patient’s health records, prior knowledge.

Sources of data include the patient, family, friends, other members of the interdisciplinary team, health records, and/or legal guardian.

Question 25

Diagnosis

Answer 25

NURSING DIAGNOSIS CANNOT BE A MEDICAL DIAGNOSIS

A nursing diagnosis is a clinical judgment about an individual, family, or communities response to actual and potential health problems or life processes.

The goal of a nursing diagnosis is to identify actual and potential responses.

The purpose of the nursing diagnosis is;

1. Identify how an individual, group or community responds to an actual or potential health and life processes
2. Identify factors that contribute to or cause health problems (etiology).
3. Identify resources or strengths the individual, group or community can utilize to prevent or resolve problems

Nursing Diagnosis vs Medical Diagnosis

Nursing diagnosis deals with human response to bio-psycho-social stressors and/or health problems that a nurse is licensed and competent to treat

Medical diagnosis deals with disease or medical condition or pathology (treating or curing)

Examples:

Medical Diagnosis

Myocardial infarction, pneumonia, Cerebral Vascular Accident

Nursing Diagnosis (NANDA)

Fear, knowledge deficit, falls, pain, etc.

We are focusing on 2 types of Nursing Diagnoses; Actual & Potential

Actual Diagnosis is a 3 part statement which includes the nursing diagnosis approved by the North American Nursing Diagnosis Association (NANDA) followed by the related to statement and then the as evidenced by statement.

Potential Diagnosis is a 2 part statement which includes a RISK for nursing diagnosis approved by the Northern American Nursing Diagnosis Association (NANDA) followed by the related to statement. There is NO as evidenced by statement as the problem is only a potential problem that could arise.

The related to statements includes;

Factors that contribute to or cause the problem

Can not be a medical diagnosis

Must be modifiable by nursing interventions

The evidenced-by statement includes;

Signs and symptoms noted through subjective and/or objective data.

Prioritizing is done in collaboration with the client if possible.

Abraham Maslow’s Hierarchy of Needs

Client Preference

Resources Available

Health Beliefs & Values

Question 26

Maslow’s hierarchy of needs

Answer 26

Self actualization

Esteem

Love/belonging

Safety

Psychological

Question 27

Planning

Answer 27

The Planning process includes

Formulating client-centered goals & nursing interventions

Goals: Goal will begin with a ‘patient will’ statement, identify an expected outcome and state an appropriate timeline.

SMART

Address the nursing diagnosis

Identify an expected outcome

Observable and measurable terms

Made in collaboration with the client

Nursing Interventions:

Actions taken by the nurse to achieve the goals/expected outcome

Focuses on eliminating/reducing/modifying the etiology of the nursing diagnosis

Question 28

Implementation

Answer 28

The phase in which the nurse carries out or delegates the planned interventions.

Determine assistance required to carry out the intervention

Implement the intervention

Supervise delegated care

Document

Question 29

Evaluation

Answer 29

Assessing the client’s response to nursing interventions and determining whether the goal has been attained.

Comparing the response to predetermined standards or outcome criteria.

Four possible judgments:

The goal was completely met.

The goal was partially met.

The goal was completely unmet.

New problems or nursing diagnoses have developed.

Must state how you know it was met/unmet

Question 30

Gordon’s 11 functional health patterns

Answer 30

“Nurses promote health by encouraging the use of processes in patterns that lead towards wellness. Holistic nursing acts as a central unifying theme to connect pattern recognition to the examination of person-environment relationships throughout the life span” (Edelman, Kudzma, & Mandle, 2014, pg. 128).

Gordon’s Framework provides the foundation for the construction of the NANDA-I nursing diagnosis nomenclature. This framework is used to demonstrate assessment approaches with the individual, family, and community (Edelman et al., 2014).

“Effective health assessment considers not only the physiological parameters, but also how the human being interacts with the whole environment. Behaviour patterns, beliefs, perceptions, and values form the essential components of health assessment when maximal health potential of the individual is considered by nurses” (Edelman et al., 2014, pg. 129).

“Gordon’s 11 functional health patterns interact to depict an individual’s lifestyle. Using the framework, nurses combine assessment skills with subjective and objective data to construct patterns reflective of lifestyles” (Edelman et al., 2014, pg. 129).

Question 31

Gordon’s 11

Answer 31

Health perception/health management
Nutritional/metabolic
Elimination
Activity/exercise
Cognitive/perception
Sleep/rest
Self perception/self concept
Role/relationship
Sexuality/reproductive
Coping/stress tolerance
Value/beliefs