Module 2 Flashcards
Nursing Process Steps
- Assessment
- Nursing Diagnosis
- Planning
- Implementation
- Evaluation
Community as Partner Process Steps
- Assessment
- Analysis
- Community Nursing Diagnosis
- Planning
- Intervention
- Evaluation
What is the major different step between community as partner and nursing process?
Analysis - in the community as partner process
Windshield Survey
Observations from driving through a community, collecting objective data (census, etc), interviewing social workers/mayor/health providers for subjective data
-This is for assessing the community aspect/ core of the assessment wheel
Assessment Components
- Core Demographics
- Physical Environment
- Education
- Safety and Transportation
- Politics and Government
- Health and Social Services
- Communication
- Economics
- Recreation
Stressors
threaten the community
ex: economic, disasters, weakness in a component of the community
Lines of Resistance
keeps the community strong
>also called Protective Factors
ex: attitudes, belief systems, strengths in the components
What do you do in the analysis step of community as partner?
- take the objective and subjective, verify with other statistics, identify strengths and weaknesses in the community, compare to other communities, and make conclusions to get a community diagnosis
Community Diagnosis
collaborate with other people to make a diagnosis and plan to get more community members to uphold and buy in to the plans/interventions
Plan
collaboration with community members makes MEASUREABLE GOALS that you can measure and see for carrying out interventions and comparing pre/post
Primary Prevention examples
- mostly education and safety policies
- ex: physical distancing and masks
Secondary Prevention examples
- Screenings, clinics, primary care access
ex: screening for COVID19 - remember the tests validity and reliability is important, there could be false positives and negatives
Tertiary Prevention examples
- hospitals, treatment, and chronic disease management programs
ex: treatments and cures - COVID is weak here, its mostly symptom management
Prevention focus for COVID19?
primary prevention focus (secondary and tertiary is shakier and harder right now since the tests are new and potentially unreliable and invalid, and theres no real cure/treatment)
Evaluation step of Community as Partner Process
Did you reach your goal? how do you know?
- Your outcomes become part of your ongoing assessments as you work at continuing improvements in the community
Prevention
the detection and intervention into the cause, risk factors, and precursors of disease
Level of prevention more important and why?
Primary prevention since preventing disease is less costly than treating disease
Primary Prevention
- Interventions that promote health and prevent disease
- it is aimed at individuals who are susceptible but have no discernible disease/pathology
Examples of Primary Prevention
- healthy eating
- exercise
- clean water
- immunizations
- adequate sleep
- bike helmet usage
- education programs
- safe sex practices
Secondary Prevention
-the goal is to detect disease in its early stages
- it involves activities detecting the disease in the early stages BEFORE clinical signs appear
- Reversing or reducing the severity of disease or providing a cure purpose
ex: screenings, immunoglobulin treatments
WE ARE LOOKING FOR DISEASE
Examples of Secondary Preventions
- Vision and hearing screenings
- blood pressure screenings
- pap smear
- test cholesterol
- immunoglobulins
- using antibiotics for an infectious disease
- surgery where complete recovery is expected
Tertiary Preventions
- The goal is to improve the course of the disease, reduce disability, or rehabilitate
- its aimed at people WITH clinically apparent disease
- expectation is that the individuals will not return to their pre illness level of functioning
Examples of Tertiary Preventions
- Physical Therapy
- Speech Therapy
- Insulin therapy for a diabetic
- end of life care
- support groups
Type of prevention when no one is sick but we want to prevent disease?
Primary
If the disease has occurred but symptoms have not, what prevention is used?
Secondary
Limiting the amount of disease or disability a person experiences involves which prevention type?
tertiary
2 of the Most Important Things for a Public health Nurse?
- Promotion
2. Prevention
The first step of the teaching/nursing process is?
Assessment
While assessing for the teaching process it is important to keep what in mind?
Developmental Level (physical, cognitive, psycho social, moral)
What to Keep in mind when Teaching and Working With Children?
- know their stage of development
- choose relevant goals and realistic objectives
- develop teaching strategies that are age appropriate
- Determine methods and materials based on physical and cognitive level
Health promoting behaviors are acquired more readily in ____, when routines and habits are being formed
childhood
____or ___ developed in childhood and adolescence are more likely to persist as a lifestyle than when learned in adult years.
habits or behaviors
Erikson developed a theory of ____ development
Psychosocial
Piaget developed a theory of ___ development
Cognitive
Kohlber developed a theory of ___ development
Moral
Erikson’s Stages of Psychosocial Development
- Trust v Mistrust (0-1.5)
- Autonomy v Shame (1.5-3)
- Initiative v Guilt(3-5)
- Industry v Inferiority(5-12)
- Identity v Role Confusion(12-18)
- Intimacy v Isolation(18-40)
- Generativity v Stagnation(40-65)
- Ego Integrity v Despair(65+)
Piaget’s Stages of Cognitive Development
- Sensorimotor (Birth-2)
- Pre Operational (2-7)
- Concrete Operational (7-11)
- Formal Operational (11+)
Kohlberg’s Levels of Moral Development
Level 1 - Pre-Conventional Morality (up to age 9)
Level 2 - Conventional Morality (Adolescents and Adults)
Level 3 - Post Conventional Morality (10% of adults)
*each has 2 stages
Kohlberg’s Stages of Moral Development
Level 1 1. Obedience and Punishment Orientation 2.Individualism and Exchange -------------------------------------------------------------- Level 2 3. Good interpersonal Relationships 4. Maintaining the Social Order ---------------------------------------------------------------- Level 3 5. Social contract and Individual Rights 6. Universal Principles
Obedience and Punishment Orientation Morality
Child is good to avoid punishment. If punished, they must have done wrong
Individualism and Exchange Morality
Children recognize there is not just one right view that is handed down by authorities. Different individuals have different viewpoints
Good Interpersonal Relationships Morality
child/individual is good in order to be seen as being a good person by others. Therefore, answers relate to others approval
Maintaining the Social Order morality
child/individual becomes aware of the wider rules of society, so judgments concern obeying the rules in order to uphold the law and to avoid guilt
Social Contract and Individual Rights Morality
Individual becomes aware that rules/laws might exist for the good of the greatest number, but there are times they will work against the interest of particular individuals. Issues are not always clear
Universal Principles Morality
people at this stage have developed their own set of moral guidelines which may or may not fit the law. These principles then apply to everyone
It is important to keep in mind what about the stages of development?
the ages are not rigid guidelines, people develop at their own rate
Infancy Age Range
0-12 Months
Physical Development of Infancy
- Cephalocaudal Development
- innate reflexes
Cephalocaudal Development
- head to toe
ex: infants can first eat, then neck control. then hold head up, etc ,etc - proximal to distal development and more fine control over time
Erikson’s Stage of Development for Infants
- Trust v Mistrust (0-18 mo)
- A sense of hope develops if the infant receives consistent and predictable care
Piaget Stage of Development for Infants
- Sensorimotor Stage (0-24 mo)
- the world is learned through physical interaction and experience
- object permanence, memory, and causality begin to develop at month 7
- possible separation anxiety
Kohlberg’s Stage of Development for Infants
no stage for morality in infants
Top 5 Leading Causes of Death in Infants
- Birth Defects
- Pre-term birth/low birth weight
- SIDS
- Maternal pregnancy complications
- Injuries
Top 5 Leading Causes of Non Fatal Unintentional Injuries in Infants
- Falls
- Struck by or against
- Animal Bite or Insect Sting
- Foreign Body, non-fatal suffocation
- Fire, burns
How to promote health in infancy?
- proper care is its learning need
- teach the caregiver to promote health
- develop trust
Toddler Age Group
1-3 years
Physical Development in Toddlers
- physical coordination, starting to walk and talk
- can undress, build a tower of four blocks, scribbling
- can run, walk up and down stairs, pushes and pulls toys
Erikson’s Stage of Development for Toddlers
-Autonomy vs Shame and Doubt
- Children want growing independence and should become more confident and secure with own survival ability if encouraged
- failure leads to sense of shame in abilities and low self esteem
this can lead to the Terrible 2
Kohlberg’s Stage of Development for Toddlers
- Preconventional
- if an action is wrong, one gets punished for it
Piaget’s Stage of Development for Toddlers
- Preoperational (2-7 years)
- imagery and symbolic thinking
- symbolic play
- egocentrism
- animism
- artificialism
- transductive reasoning
Symbolic play
- preoperational
- imaginary friends or social play with roles assigned
Egocentrism
- preoperational
- unaware that other viewpoints exist
Animism
- preoperational
- inanimate objects are capable of actions and have lifelike qualities
Artificialism
- preoperational
- the belief that environmental characteristics are attributed to human actions or interventions
ex: thunder is angels bowling
Transductive Reasoning
- Preoperational
- Does not understand cause and effect
- will draw relationships between unrelated things
Top Leading Causes of Death in Infants
1 cause of death is Injury (motor vehicle accident, suffocation, poison, fire burn, fall, poison)
- Birth Defects
- Homicide
The US has the ___ highest injury death rate for 0-14 year olds
3rd
How to promote health in Toddlers?
- teach health habits like sleep routine and immunizations
- teach caregivers play, repetition and imitation, a need to stimulate the child’s senses, demonstration and return demonstration, role play
Preschoolers age group?
3-5 years
Physical Development of Pre-Schoolers
- can manage tools, like scissors, and utilization of things to promote health like a toothbrush
- prone to fears
- learns through play
- highly curious
Erikson’s Stage of Development for Pre-Schoolers
- Initiative v Guilt
- child interacts with other children and play is pivotal now
- Sense of initiative and feeling secure in ability to lead others and make decisions is based on this play
- they need control (just not ultimate control) - need consistency and knowing the rules/what to expect
Piaget’s Stage of Development for Pre-Schoolers
Preoperational (still)
Kohlber’s Stage of Development for Pre-Schoolers
- Pre-conventional Stage
- avoids punishment, has self interest orientation (self centered)
- Decisions based on pleasing others and avoiding punishment
Leading Causes of Death in Pre-Schoolers
1 Injury (vehicle accident, suffocation, poison, fall, burns)
- Birth Defects
- Homicide
How to promote health in pre-schoolers?
- needs to learn routines, control. and choices, as well as school and heatlh routine readiness
- teach the child through reinforcement, play, stimulation, simple instructions, and on a child by child basis
School-Age Age Group
6-12 years
Physical Development of School Age Children
- fine motor skills continue to improve
- plays card and board games and more complex games
Eriksons Stage of Development for School Age Children
- Industry v Inferiority
- success leads to sense of competence by expanding relationships outside the nuclear family - peer groups are important
- gain awareness of their uniqueness
Piaget’s Stage of Development for School Age Children
- Concrete Operational Stage
- ability to understand conservation
- intelligence shown through logical and systematic manipulation of symbols related to concrete objects
- less egocentric and more operational (mental actions reversible)
Kohlberg’s Stage of Development for School Age Children
- Pre Conventional (avoid punishment and self centered) AND Conventional (approval or disapproval from social norms, rules, and expectations)
- Developing a conscience
5 Leading causes of Death in School Age Children
- Unintentional injury
- Homicide
- Suicide
- Malignant Neoplasms
- Heart Disease
5 Leading Causes of non Fatal Injuries
- Falls
- Struck by or against an object
- Cut or piercing (ages 5-9)
- Overexertion (ages 6-14)
- Bite or Sting
- Bike Accident
Promoting Health in School Age Children
- has learning needs to make decisions and take responsibility and cause/effect
- teaching strategies involve assessing individual learning styles, needs concrete step by step information, needs to be allowed questions and non verbal feedback
- can use models/diagrams/drawings
Adolescence Age Group
12-18 years
Physical Development of Adolescence
Puberty, new sport attempts, driving motor vehicle
Erikson’s Stage of Development in Adolescence
- Identity v Role Confusion
- learn roles to adopt as an adult, self identity forms, body image very important
Piaget’s Stage of Development in Adolescence
- Formal Operational Stage
- intelligence is demonstrated through logical use of symbols related to abstract thought and concepts
- very ego-centric thought in early adolescence due to increased independent thinking
Kohlberg’s Stage of Development in Adolescence
- Conventional Stage
- behavior guided by approval or disapproval from social norms, rules, and expectations
- recognizes the importance of obeying laws and social conventions and violating them is seen as morally wrong
Top 5 Leading Causes of Death in Adolescents
- unintentional injury
- homicide
- suicide
- malignant neoplasms
- heart disease
Top 5 Leading Causes of Non-Fatal Injuries in Adolescents
- Struck by or against an object
- Fall
- Overexertion
- Motor Vehicle Accident
- Bike Accident
How to promote health in adolescents?
- needs to be able to make decisions and take responsibility while keeping mental health and physical health well
- teach via one on one and case by case basis and provide rationales behind things
Pedagogy
refers to the art of science of helping children learn
Sensorimotor
Piaget - learning through interaction with surroundings
Preoperational
Piaget - begin to learn to manipulate symbols and do symbolic play
Concrete Operations vs Formal Operations
Formal has the ability to think abstractly and use deductive reasoning in comparison to concrete
