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Social Behavioral Mindi > JuneBehavioral > Flashcards

JuneBehavioral Flashcards

1
Q

4 Modifiable Health Risks

A

lack of physical activity, poor nutrition, tobacco use, excessive alcohol

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1
Q

6 Chronic Diseases

A

CAD, Cancer, Respiratory from Smoking, Arthritis, Obesity

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1
Q

CCM

A

Care Coordination Model

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1
Q

Use of non-physician team members, onhancement of info systesm, planned encounters and care managemen for high risk patients are examples of which model?

A

CCM

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1
Q

Patient that is motivated, has the pertinent infomration and condfidence to make decisions about their health is called this.

A

Informed Activated Patient

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1
Q

A patient that is able to use and interpret health informatino , manage own illness, is attentive to preventative care, recognizes early sx and knows where to get help is called this

A

Health literate patient

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1
Q

A group that has patient info, decision that are backed up and resources are called this.

A

Prepared practive team

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1
Q

Describe productive interaction

A

Protocols mold management, collaborative goal setting, active follow-up

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1
Q

Cornerstone of self-management support

A

Emphasize patient role as most responsible

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1
Q

Changes to the delivery of healthcare system design include

A

Define roles/task, planned interactions (visits with agenda), case management for high risk pt., follow up, make sure pt. understand

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1
Q

A health visit that has an agenda is called this.

A

Planned interactions

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1
Q

Advantages of care coordination

A

Less delays or miscommunication, less waste, more rewarding

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1
Q

When is case management used

A

For high risk pt. Help PCP keep check on pt.

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1
Q

When evidence based guideline and specialist expertise are integrated int primary care it is called this.

A

Decision support

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1
Q

Identification of subpopulations that could beneift from proactive care is an example of this system.

A

Clinical Information Systems

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1
Q

Identification of subpopulatinos that could beneift from proactive care is an example of this system.

A

Clinical Information Systems

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1
Q

4 modifiable helath risks

A

lack of physical activity, poor nutrition, tobacco use, excessive alcohol

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2
Q

Describe quality care

A

Pt. centered, scientifically based, population outcome based, refined individualized, compationable with resources and policies

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2
Q

Organization philosophy empasizes Quality Improvement (QI)

A

Best practice

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2
Q

Determining what works in specific pt. population through outcome research

A

Evidence based Practice

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2
Q

% of participants who show improvement long term

A

Efficacy

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2
Q

Particiption times efficacy

A

Impact

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2
Q

Ability to make his/her own decision

A

autonomy

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2
Q

6 chronic diseases

A

CAD, Cancer, Respiratory from smoking, Arthritis, Obesity

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3
Q

do no harm

A

Benefience

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3
Q

CCM

A

Care Coordination Model

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4
Q

possibility that the best thing to do is nothing

A

non-maleficence

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4
Q

Use of non-physician team members, onhancement of info systesm, planned encounters and care managemen for high risk patients are examples of which model?

A

CCM

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5
Q

concept of moral rightness

A

justice

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5
Q

Patient that is motivated, has the pertinent infomration and candfidence to make decisions about their health is called this.

A

Informed Activated Patient

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6
Q

Describe situation of decreasing autonomy

A

Disability is increasing, competency in question

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6
Q

A patient that is able to use and interpret health informatino , manage own illness, is attentive to preventative care, recognizes early sx and knows where to get help is called this

A

Health literate patient

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7
Q

Surrogate needs to keep best in mind

A

susbstituted judgement

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7
Q

A group that has patient info, decision that are backed up and resources are called this.

A

Prepared practive team

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8
Q

Unintened effect of an action

A

double effect

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8
Q

Describe productive interaction

A

Protocols mold management, collaborative goal setting, active follow-up

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9
Q

Defines quality of life

A

personal values, beliefs, priorities

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9
Q

Cornerstone of Self-management support

A

Emphasize patient role as most responsible

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10
Q

Goal of palliative care

A

sx management and QOL

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10
Q

Changes to the delivery of healthcare system design include

A

Define roles/task, planned interactions (visits with agenda), case management for high risk pt., follow up, make sure pt. understand

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11
Q

POLST

A

Physician Ordered Life Saving Treatment

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11
Q

A helath visit that has an agenda is called this.

A

Planned interactions

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12
Q

Temporary reason for anorexia

A

recovering from surgery

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12
Q

Advantages of care coordination

A

Less delays or miscommunication, less waste, more rewarding

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13
Q

States where PAS is legal

A

OR, WA, MT, VT

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13
Q

When is case management used

A

For high risk pt. Help PCP keep check on pt.

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14
Q

Plan of care that focuses on quality of life rather than extending life by any means

A

Hospice

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14
Q

When evidence based guideline and specialis expertise are integrated int primary care it is called this

A

Decision support

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15
Q

Percent of Hospice patients with cancer

A

40%

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15
Q

Identification of subpopulatinos that could beneift from proactive care is an example of this system.

A

Clinical Information Systems

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16
Q

Common hospice chronic diseases

A

CAD, pulmonary disease, dementia, renal disease, stroke, ALS

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16
Q

Describe quality care

A

Pt. centered, scientifically based, population outcome based, refined individualized, compationable with resources and policies

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17
Q

Things to consider besides disease of hospice patient

A

prognosis, age, frailty

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17
Q

Organization philosophy empasizes Quality Improvement (QI)

A

Best practice

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18
Q

Reasons for early hospice referral

A

Allow relationship to form, better QOL, better chance of staying home

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18
Q

Determining what works in specific pt. population through outcome research

A

Evidence based Practice

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19
Q

Contraindications to hospice referral

A

Actively dying patints and patients who want aggressive care

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19
Q

% of participants who show improvement long term

A

Efficacy

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20
Q

1 symptoms of hospice patient

A

pain

20
Q

Particiption times efficacy

A

Impact

21
Q

Problem of prognosis given by Drs.

A

overly optimistic

21
Q

Ability to make his/her own decision

A

autonomy

22
Q

3 aspects of reserve irt to living with terminal illness

A

age, frailty, stress

22
Q

do no harm

A

Benefience

23
Q

Loss of ability to use nutritions cause this.

A

Loss of appetite

23
Q

possibility that the best thing to do is nothing

A

non-maleficence

24
Q

Anorexia/Cachexia syndrome

A

Loss of appetite and muscle wasting

24
Q

concept of moral rightness

A

justice

25
Q

Tipping point before dying, usually 1-2 weeks before

A

Transitioning

25
Q

Describe situation of decreasing autonomy

A

Disability is increasing, competency in question

26
Q

First area to be cut off while actively dying

A

lower extremities

26
Q

Surrogate needs to keep best in mind

A

susbstituted judgement

27
Q

inability to manage own secretions

A

death rattle

27
Q

Unintened effect of an action

A

double effect

28
Q

Breath pattern aftern stroke or active brain tumor

A

Cheyne-Stokes respirations

28
Q

Defines quality of life

A

personal values, beliefs, priorities

29
Q

Respiration pattern from cerebral ischemia

A

agonal respiration

29
Q

Goal of palliative care

A

sx management and QOL

30
Q

Area of brain affected in death first

A

Frontal center

30
Q

POLST

A

Physician Ordered Life Saving Treatment

31
Q

Brains shuts down in this area

A

Front to back

31
Q

Temporary reason for anorexia

A

recovering from surgery

32
Q

States where PAS is legal

A

OR, WA, MT, VT

33
Q

Plan of care that focuses on quality of life rather than extending life by any means

A

Hospice

34
Q

Percent of Hospice patients with cancer

A

40%

35
Q

Common hospice chronic diseases

A

CAD, pulmonary disease, dementia, renal disease, stroke, ALS

36
Q

Things to consider besides disease of hospice patient

A

prognosis, age, frailty

37
Q

Reasons for early hospice referral

A

Allow relationship to form, better QOL, better chance of staying home

38
Q

Contraindications to hospice referral

A

Actively dying patints and patients who want aggressive care

39
Q

1 symptoms of hospice patient

A

pain

40
Q

Problem of prognosis given by Drs.

A

overly optimistic

41
Q

3 aspects of reserve irt to living with terminal illness

A

age, frailty, stress

42
Q

Loss of ability to use nutritions cause this.

A

Loss of appetite

43
Q

Anorexia/Cachexia syndrome

A

Loss of appetite and muscle wasting

44
Q

Tipping point before dying, usually 1-2 weeks before

A

Transitioning

45
Q

First area to be cut off while actively dying

A

lower extremities

46
Q

inability to manage own secretions

A

death rattle

47
Q

Breath pattern aftern stroke or active brain tumor

A

Cheyne-Stokes respirations

48
Q

Respiration pattern from cerebral ischemia

A

agonal respiration

49
Q

Area of brain affected in death first

A

Frontal center

50
Q

Brains shuts down in this area

A

Front to back

51
Q

Pain Evaluation - LOCATES

A

Location, Other sx, Chraacter of pain, Aggravating factor, Timing, Enviroment where pain occurs, Severity of pain

52
Q

Four componets of total pain

A

PAIN - Physical pain, Anxiety, Interpersonal Interactions, Nonacceptance

53
Q

No baseline pain treatment?

A

Short acting tx

54
Q

Baseline pain tx

A

Long acting tx

55
Q

Baseline pain + breakthrough pain

A

long acting + short acting pain

56
Q

Tramadol pro drug of?

A

Morphine

57
Q

Oxyocodone prodrug of?

A

Dilaudid

58
Q

Dosing equivalent to enteral

A

oral, buccal, sublingual, rectal

59
Q

parentral equivalent

A

IV, subcutanous, transdermal, intramuscular

60
Q

Enteral opiates peak time

A

1 hour

61
Q

Parental Iv peak

A

8 minutes

62
Q

Parental subcutanous peak

A

30 minutes

63
Q

Methadone

A

start low, go slow - very long half life

64
Q

Things to consider with opiate dosing by estimate

A

age, disease, tolerance

65
Q

Morphine Iv dose –> Morphine oral

A

3 times

66
Q

Duladid(hydromorphone) IV –> Duladid Oral

A

4 times

67
Q

Duladid Oral –> Morphine Oral

A

5 times

68
Q

Concern Methadone

A

Long QT syndrome (above 30 mg/day)

69
Q

Methadone half life

A

4 days

70
Q

Biggest side effect of Opiates

A

Constipation

71
Q

Most important skill to becoming good Dr

A

Active listening

72
Q

Location of neurons that cause emesis

A

medulla

73
Q

Input that disrupt cortex and causes vomiting

A

ICP/anxiety

74
Q

Input that disrupts vestibular

A

motion or vestibular disease

75
Q

input that bothers chemoreceptor trigger zone

A

NT as no BBB

76
Q

Input that triggers nausea in peripheral pathway

A

Gi tract and vagus nerve

77
Q

Drug for chemo nausea

A

Zofran - 5 HT3 antagonist

78
Q

Drug for opiod nausea

A

Reglan, compazin, haldol - D2 antagonist

79
Q

Drug for vestibular nausea

A

scopolamine - muscarinci Ach

80
Q

5 classes of treatment for constipation

A

stool softener, bulk foriming agents, osmoitic agents, lubricant, stimulant laxative

81
Q

stool softener

A

docustae

82
Q

bulk forming agents

A

absorb water - methylcellulose

83
Q

osmotic agents

A

miralax (sorbitol)

84
Q

lubrincant

A

mineral oil

85
Q

stimulant laxative

A

senns

86
Q

Drugs that cause dyspnea

A

opiods, benzodiazepines, bronchodilators, duretic

87
Q

delerium differs from dementia

A

more acute, more flucuating,

88
Q

Reason for increased pain in delerium

A

loss of disinhibition

89
Q

Dyspnea treatment medication

A

Haldol

90
Q

Dyspnea treatments

A

antibiotics, O2, Meds, Fluids

91
Q

Anticipating, preventing and treating suffering

A

Def. of palliative care

92
Q

Reason for palliative sedation

A

sedate so they are not aware of pain/suffering

93
Q

Palliative sedation restrictions

A

less than 2 weeks to live

94
Q

Defintion of intolerable

A

opinion of patient

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