Lecture Material Week 4 Flashcards
Name some factors to consider about patient variation that will impact what they allow:
Age Education Religion Health literacy & beliefs Beliefs and Norms Language Family Offense in language and gestures Values
Can you think of examples in which cultural adjustments would need to be made?
Communication Issues
Translator & Body language
Offensive gestures
Handshakes with Islamic women etc
Name some questions to consider when evaluating pts health beliefs:
Pts perception about:
What caused it?
How has it impacted you?
Have you seen anyone?
What remedies have you tried?
Will you accept my treatment?What can be said about the idea of family to a patient?
Traditional family model doesn’t always apply
Ask about definition to pts, roles, family values, who has decision making
If unsure about a pts beliefs, religion, practices, what should you do?
Ask, pts generally responsive and willing to educate.
Avoid making assumptions
What do assumptions lead to?
Bias
Why would asking about nutrition be important?
Deficiencies
Food borne illnesses
Chronic disease (osteoporosis)
Evaluate rituals, foods, avoidance, allergies, preparation practices
What nutritional def might a vegan commonly have?
zinc, B12, D, Calcium, amino acids
What is pellagra?
A deficiency of niacin
Manifests often as 4 Ds,
photosensitive dermatitis, diarrhea, dementia, and death
What does vitamin C def lead to commonly?
Scurvy
Ricketts
What are important life events to consider with your pts?
Prenatal Care Death Afterlife beliefs Acceptance of blood products Acceptance of organs or tissues
What are topics to discuss concerning religion?
Religion Participation Prayer Relationship between religion and healthcare Taboos affecting healthcare
If a patient fills out a form prior to their well visit, what is your responsibility concerning it?
Document that it was reviewed with pt
Well visits count for what fraction of ambulatory care?
1/5 of ambulatory care
What is health maintenance?
holistic approach to minimize illness and death
What is a screening?
Any test used to detect disease in those at risk
Levels of Prevention:
Primary: complete prevention of illness
vaccines, hand washing, safer sex
Secondary: Aim to detect in earliest asymptomatic stages
Mammography, HIV screen, PSA
Tertiary: Aim at elimination of consequences
Most health care measures
Diabetic managing to prevent neuropathy
Complete documentation of adult preventative care includes:
ID of risk factors Age/gender screenings Lab testing Counseling and Education Immunization status and administration
What is a risk factor?
Any life variable known to have linkage to increased risk of illness, death, and disability
Why bother to identify risk factors?
While some are un-modifiable (genetic)
Many factors are modifiable
risky behaviors
smoking
diet
Take care to avoid biases!
Name at least five modifiable risk factors
Exercise Diet/Nutrition BMI Tobacco Use EtOH/ Drug use Sexual practices Partner violence Safety measures Occupational history Oral health Blood product transfusions
What does syncope during exercise indicate?
Heart problem
Factors to discuss about exercise:
Type, Duration, Frequency
Any induced symptoms?
Recommended : 30min/ 5xweek
combined cardio and wt
Screen for related conditions:
Anorexia
Over exertional syndromes
Dehydration
Early onset osteoporosis
Factors to discuss about diet and BMI
Frequency and type of food Proportion of caloric intake Screen for nutritional deficiencies Caffeine and vitamin use BMI
What is BMI?
Body Mass Index
wt. controlled for height
(Wt in lbs/ (ht in inches X height in inches)) X 703
BMI numbers and classes:
Normal up to 24.9
Overweight 25-30
Obese >30
Morbidly obese >35
What fraction of Americans use tobacco products?
1/5
Smoking contributes to what percentage of deaths?
20%
What length of education on smoking has been shown to improve outcomes?
2 minutes
