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Krystan: Semester One Nursing School > Nursing 2700 Fundamentals: Exam One > Flashcards

Nursing 2700 Fundamentals: Exam One Flashcards

1
Q

List some possible language barriers?

A

Not speaking the language well
Brain injury
Stroke
Developmental disorders

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2
Q

What are the three basic levels of communication?

A

Intrapersonal
Interpersonal
Group communication

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3
Q

What are the four levels of personal space?

A

Intimidate distances
Personal distances
Social distances
Public distances

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4
Q

What does SOLER pertain to and what does it stand for?

A

It pertains to therapeutic communication with a patient
Stands for:

Sit facing patient
Observe open posture
Lean in towards patient
Establish eye contact
Relax and show that you are comfortable
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5
Q

What are some barriers to therapeutic communication?

A 
Too many questions
Closed ended questions
Asking why
Abrupt subject change
Expressing approval or disapproval
False reassurance
Stereotyping
Patronizing
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6
Q

What are the four phases of the therapeutic relationship?

A

Pre-interaction
Orientation
Working phase
Termination

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7
Q

What happens in the pre-interaction phase of therapeutic communication?

A

The nurse gathers relevant information to prepare for interaction

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8
Q

What happens in the orientation phase of therapeutic communication?

A

Nurse and patient meet, rapport is established, relationship is defined

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9
Q

What happens in the working phase of therapeutic communication?

A

This is the active communication phase, in which the patient can freely and clearly express thoughts and concerns and the nurse can support, educate, provide care, and listen

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10
Q

What happens in the termination phase of therapeutic communication?

A

Ending of the nurse/patient relationship, either upon discharge, transfer, or shift change

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11
Q

What are some techniques that enhance therapeutic communication?

A 
Empathy
Respect 
Genuineness
Ability to be clear and be confronted
Eye contact
Open body language
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12
Q

Explain the defense mechanism of denial

A

A refusal to acknowledge anything that causes emotional pain, such as a hard diagnosis or the death of a loved one

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13
Q

Explain the defense mechanism of displacement

A

Anger directed at someone or something other than what the anger is stemming from (taking it out on whoever is present, not necessary whoever did the offending)

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14
Q

Explain the defense mechanism of regression

A

Acting out in behavior that is inappropriate for the developmental stage of that patient (acting like a child)

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15
Q

How is non-verbal communication especially important in therapeutic communication?

A

It often more clearly portrays what the sender is feeling

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16
Q

Therapeutic communication happens in the context of what kind of relationship?

A

A helping relationship, such as the nurse-patient relationship

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17
Q

Healthcare infection acquired in a hospital

A

Nosocomial infection

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18
Q

What are risk factors for healthcare-related infections?

A

Weakened immune systems of patients
Healthcare workers moving between lots of patients
Close patient quarters
Procedures making portals of entry
Poor nutrition status
Potentially contaminated medical equipment

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19
Q

What are some agencies that regulate standards and guidelines in healthcare?

A

CDC
Joint Commission
American Nurses Association

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20
Q

What are the six links in the chain of infection?

A 
Infectious agent
Reservoir
Portal of exit
Mode of transmission
Portal of entry
Susceptible host
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21
Q

What are some things pathogens need to survive and multiply?

A 
Nutrients
Moisture
Warm temps
Oxygen
Preferable pH of 5-8
Prefer low light
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22
Q

What is the most common reservoir for pathogens?

A

The human body

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23
Q

What is the most common portal of exit for pathogens?

A

Body fluids

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24
Q

What are some modes of pathogen transmission?

A

Direct or indirect contact
Droplet
Airborne
Vector

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25
What are some possible portals of entry for a pathogen?
Any normal or abnormal body opening
26
A contaminated object is also called a...
Fomite
27
What are the stages of the infectious process?
``` Incubation Prodromal Illness Decline Convalescence ```
28
What happens in the incubation period?
This is the stage from first pathogen entry to symptom exhibition
29
What happens in the prodromal stage?
Patient experiences the appearance of the first vague symptoms
30
What happens in the illness phase?
Patient shows signs and symptoms characteristic of the disease
31
What happens in the decline phase of illness?
Immune defenses and medical therapies reduce the number of pathogens present
32
What happens in the convalescence phase of illness?
Tissue repair, return to health, pathogen count approaches/reaches zero
33
What are the six primary defenses against infection
``` Skin Respiratory tree Eyes Mouth GI tract Genitourinary (GU) tract ```
34
What about skin protects against infection?
Tough intact barrier | Normal bacterial flora
35
What about the respiratory tree protects against infection?
Mucous membranes and cilia
36
What about the eyes protects against infection?
Lysozyme in tears
37
What about the mouth protects against infection?
Saliva contains lysozyme | Highly vascular, so lots of WBCs in mouth
38
What about the GI tract helps protect against infection?
Acidity | Normal bacterial flora
39
What about the genitourinary tract protects against infection?
High acidity (urine and vagina) Mucous membranes Lysozyme
40
How does tobacco use increase susceptibility to infection?
Paralyzes respiratory cilia, making it easy for bacteria to proliferate in respiratory tract
41
What about substance abuse increases infection susceptibility?
Drugs can cause skin lesions and changes mental orientation, energy levels, and normal body rhythms Alcohol is toxic to intestinal mucosa and decreases appetite (possible malnutrition)
42
What kind of medications can put a person at higher risk for infection?
Immunosuppressants for transplants | Anti-inflammatory medications
43
What are six wellness promotion factors to support defenses against infection?
``` Nutrition Hygiene Sleep Exercise Stress reduction Immunization ```
44
What is the most likely infectious agent in HAIs?
Staphylococcus aureus
45
What is medical asepsis?
Procedures that decrease potential for spread of infection
46
What are some examples of medical asepsis that can be used?
Hand washing Cleaning visible soil in rooms Disinfecting Sterilizing
47
What is an alternative modality?
Range of philosophies and practices not used in conventional healthcare settings
48
What is a complementary modality?
Non-conventional treatment that is used to supplement conventional medicine
49
What is integrative medicine/modality?
Coordination of safe and effective CAM therapies into allopathic healthcare
50
What does CAM stand for?
Complementary and alternative modalities
51
What is the focus of allopathic medicine?
Treatment of symptoms
52
What is the focus of holistic healthcare?
Making the patient feel better, taking into account the mental, emotional, and spiritual, not just the physical
53
What kind of medicine allows for everything in the human condition to be part of the growth process?
Holistic
54
What types of people are most likely to use holism?
Women Those in higher income bracket Those who are frequently hospitalized Those in pain
55
What are the five recognized categories of CAM?
``` Alternative medicine Mind-body interventions Biologically based therapies Manipulation/body-based methods Energy therapy ```
56
What are some commonly used CAM therapies?
``` Non-vitamin natural supplements Deep breathing Meditation Chiropractic Massage Yoga ```
57
What is the core focus of alternative medicine?
Restoring balance to the body
58
What alternative method involves giving medicine in very small doses?
Homeopathy
59
Which alternative practice seeks to balance the three forces of life?
Ayurveda
60
Which alternative practice seeks a single remedy to aid the body in healing itself?
Homeopathy
61
What alternative medicine system seeks to balance yin and yang and the 5 elemental forces?
Traditional Chinese medicine
62
What is acupressure?
Application of pressure to reflex zones in the body
63
What is the focus of chiropractic medicine?
Manipulation of spine and body structures to improve health and promote self-healing
64
What is the focus of tai chi?
Non-aggressive martial arts to decrease pain and improve strength and balance
65
What are some benefits of massage?
Decreased stress Decreased inflammation Improved circulation Sinus fluid drainage
66
What is the focus of simple touch therapies?
Decreasing stress and inflammation and promoting healing
67
What are some examples of mind-body interventions?
``` Meditation Yoga Art, dance, or music therapy Breath therapy Guided imagery Biofeedback ```
68
What are some examples of manipulative/body based methods?
Chiropractic Massage Tai chi Simple touch
69
What are some examples of alternative modalities?
Ayurveda Traditional Chinese medicine Homeopathy Acupuncture
70
What are biologically based therapies?
Diet therapies Herbs Aromatherapy Supplements
71
What are some examples of energy therapies?
Therapeutic touch Tai chi Magnet therapy
72
What is meant by “therapeutic use of self”?
Being present for one’s patient | Role modeling behaviors that one hopes to see in patient
73
Which nursing theorist advocated for optimal health by way of touch and environmental influences?
Florence Nightingale
74
Which nursing theorist said that disease is disequilibrium?
Margaret Newman
75
Which nursing theorist said that caring should be the focus of nursing?
Jean Watson
76
Hyperventilation
Breathing too quickly and deeply, causing low CO2 levels at first and increased CO2 after a long time
77
What can cause hyperventilation?
Medication Panic Fear Running at high altitude
78
What is the difference between hypoxia and hypoxemia?
Hypoxia is oxygen being too low for normal life functions Hypoxemia is low arterial oxygen levels (Not a ton of difference, some use interchangeably)
79
How can a nurse help a hyperventilating patient?
Coach them through deep and slow breathing Reduce environmental stressors and calm patient Administer oxygen
80
What are some effects of respiratory alkalosis on the body?
Tissue damage Low hemoglobin levels Cyanosis
81
What is hypoventilation?
Decreased and shallow breathing that might also lead to hypoxia
82
What is cyanosis?
Blue appearance of skin at late stages of hypoxia
83
Describe what happens in the lungs during inhalation?
Diaphragm contracts, moving down. Volume expands, pressure gets more negative so air goes in. Intercostals go up and out to help with expansion
84
Explain what happens in the chest cavity during exhalation?
Diaphragm relaxes, going up, volume decreases, creating pressure that pushed air out. No other muscles used unless exhalation is forced
85
How does hypoventilation increase the risk for hypoxemia/hypoxia?
Less air reaches the alveoli, so there is less gas exchange and less oxygen in the blood
86
What will hypoxia do to the brain?
Abnormal brain function/level of consciousness
87
What will hypoxia do to renal tissue?
Decrease urine output
88
What will hypoxia do to tissues of the limbs?
Cause muscle weakness and pain
89
What is a common oxygenation problem for vent patients?
High CO2 in the blood
90
What are some major risks to oxygenation in older adults?
``` Reduced lung expansion Decreased O2 demand Less alveolar elasticity Lots of medications Weaker cough reflex Cardiovascular changes ```
91
What are some environmental and lifestyle factors that influence ventilation that can be avoided/minimized?
``` Choking Smoking Lack of exercise Poor nutrition Obesity ```
92
What are some indirect things that affect tissue oxygenation?
Environment (altitude, air quality) Lifestyle (obesity, pregnancy, substance abuse) Medication
93
Hypocarbia
Low CO2 levels
94
Hypercarbia
High CO2 levels
95
What is the effect of high CO2 levels on the nervous system?
Anesthetic effect, can lead to coma and death
96
What is death caused by high CO2 called?
Carbon dioxide narcosis
97
What are the effects of low carbon dioxide on the nervous system?
Acts as a stimulant, so twitching and spasming will occur
98
Dsypnea
Difficulty breathing
99
Orthopnea
Difficulty breathing when lying down flat
100
Wheezing
High pitched and musical breathing sounds
101
What is different about patients with COPD?
Can survive with way lower oxygen sat (okay in 80s usually)
102
What are the four categories of conditions that can affect ventilation and oxygenation?
Pulmonary system abnormalities Pulmonary circulation abnormalities CNS disorders Neuromuscular abnormalities
103
Give some examples of pulmonary system abnormalities
Inflammation Infection Obstruction Structural changes to chest cavity
104
What are some examples of pulmonary circulation abnormalities?
``` Air embolus Pulmonary hypertension (leads to right sided heart failure) ```
105
What are some examples of CNS disorders that affect ventilation?
Trauma Stroke Effects of medications
106
What are some examples of neuromuscular abnormalities that affect ventilation/oxygenation?
Myasthenia Travis | Guillain-Barré syndrome
107
What are the different ways in which ventilation and oxygenation can be hindered (general)?
Gas exchange, gas transport, or ability to inhale can be affected
108
What types of injuries are most likely to cause oxygenation problems?
Spinal cord/CNS injuries Chest injuries Embolus formation
109
When doing a comprehensive assessment on a patient with oxygenation concerns, what areas should the nurse include?
Demographics History of health, respiration, cardiovascular function, environment Lifestyle
110
When is a cough considered significant?
When persistent, reoccurring, or productive
111
What are some signs that a patient is experiencing dyspnea?
``` Using accessory muscles to breathe Nasal flaring Grunting Body positioning to help breathing Wheezing ```
112
What kinds of questions need to be asked about a cough?
``` Type Duration Timing Appearance Sputum Alleviating factors Associated symptoms ```
113
What does a pulse oximetry reading tell you?
Arterial blood oxygen saturation
114
What is the difference between arterial PO2 and SaO2?
PO2 is the amount of oxygen available to combine with hemoglobin SaO2 is how much is actually bound to hemoglobin in the arterial blood
115
What are normal PO2 levels?
80-100 mmHg
116
What are normal SaO2 readings?
Between 95-100% saturated
117
What are normal PCO2 levels?
35-45 mmHg
118
How is PCO2 related to oxygenation?
It is inversely related, so as PCO2 goes up, PO2 is going down or vice versa
119
What are three nursing interventions to promote optimal respiratory function in a hospitalized patient?
Optimal patient positioning Flu/pneumonia vaccinations Incentive spirometry
120
What characterizes respiratory acidosis?
Increased levels of PCO2
121
What characterizes respiratory alkalosis?
Decreased levels of PCO2
122
What is a possible cause of respiratory acidosis?
Hypoventilation
123
What is a possible cause of respiratory alkalosis?
Hyperventilation
124
What would compensation for respiratory acidosis look like?
Renal compensation: Increased bicarbonate levels
125
What would compensation for respiratory alkalosis look like?
Renal compensation: decreased bicarbonate
126
What characterizes metabolic acidosis?
Low bicarbonate levels
127
What characterizes metabolic alkalosis?
Increased bicarbonate levels
128
What would compensation for metabolic acidosis look like?
Respiratory compensation: decreased CO2 levels (breathing faster)
129
What would compensation for metabolic alkalosis look like?
Respiratory compensation: increased CO2 (slow and shallow breathing to retain CO2)
130
Angel of Mercy nurse image
Serene and content Religious overtones Provide relief to suffering
131
Battle ax nurse image
Hardened/abusive authority figure
132
Nurse as Professional: image and origin
Came about from Florence Nightingale’s reforms to nursing profession Made nursing into a valid and respectable profession
133
Naughty nurse image
20th century idea, nurse is sexy/mindless/looking for rich doctor to marry
134
Military image of nursing
Nurses portrayed as warriors fighting diseases
135
Handmaiden image
views nurse as female assistant to male doctor or as emotional support to the patient. Limited scope of practice
136
What factors make it difficult to define nursing?
Nursing roles and healthcare systems are constantly changing | Many different cultural views on what a nurse is an done
137
Why is it important to define nursing?
Public understanding To differentiate nursing and medical roles To help students know what is expected of them as a nurse
138
How long is the diploma program path to licensure?
3 years
139
What is the value of an advanced practice nursing degree?
To be able to teach and function more independently
140
What can a DNP do and not do?
A DNP gets clinical expertise but cannot do research. Only PhDs can do nursing research
141
Give examples of health promotion activities?
Eating healthy Drinking water Getting adequate sleep
142
Give examples of illness prevention strategies?
Sequestering sick people Hand washing Keeping immunocompromised people away from sick people
143
What are some health restoration activities?
Sleep Increased fluids Adhering to prescribed medicines
144
How does private healthcare insurance work?
Purchased directly by a person or for a person by a third party Premiums paid directly to insurance company Employee portion deducted directly fro paycheck
145
How does government-funded health insurance work?
Funded by tax collection | Federal (medicare) or federal/state collaboration (Medicaid)
146
How does being uninsured affect health status?
Illness or injury is likely to last longer and spiral into other issues because of hesitation to seek medical care
147
What is the role of a Nurse Practitioner?
Can work autonomously or with physician Treat across lifespan APRNs can prescribe medications
148
What can the clinical nurse specialist (CNS) do?
Able to advice as a clinical expert and resource in the practice area Has a lot of knowledge in specialized area
149
What can the certified registered nurse anesthetist do?
Administer anesthesia for surgery/diagnostic practices
150
What is a SWOT analysis?
``` A system for analyzing professional development that takes into account Strengths Weaknesses Opportunities Threats ```
151
What are some good attributes for a mentor?
``` Listening skills Communication Sensitive to needs Encourages excellence Good decision making Trustworthy ```
152
What are some good traits for a mentee?
``` Eagerness to learn Participation Seeks feedback Flexible Open Moves towards independence Evaluates choices and outcomes ```
153
What are three common leadership styles in the behavioral theories of leadership?
Authoritarian Democratic Laissez-faire
154
What is transformative leadership?
``` Participative Bottom up Future oriented Directed towards sense of vision/mission Promotes accountability All about inspiring and motivating followers ```
155
How does Frederick Taylors scientific theory of management work?
People should be paid by the item or task done, rather than the hours worked
156
What are the four sources of power available to nurses and managers?
Authority Reward Expert Coercion
157
What are the steps of conflict resolution?
``` Identify the problem or issue Generate possible solutions Evaluate suggested solutions Choose the best solutions Implement chosen solutions Evaluate outcomes ```
158
What is included in full spectrum nursing?
Thinking skills Problem solving Clinical judgement
159
What allows nursing to be defined as an occupation?
It is what one does on a regular/daily basis and has set tasks
160
What allows nursing to be defined as a discipline?
It is a domain of knowledge with theoretical and practical boundaries and requires continued and current knowledge
161
What allows nursing to be defined as a profession?
It has technical and scientific knowledge requirements Has a code of ethics Involves service
162
What makes it hard to define nursing as a profession?
Professions are the most autonomous domains, and the lack of autonomy in registered nursing makes labeling it as a profession challenging
163
Describe Benner’s scale of Nursing
1. Novice: student 2. Advanced beginner: new grad nurse 3. Competence: 2-3 years in same area 4. Proficient: able to see big picture 5. Expert: sees what needs to be done and knows how to do it
164
What is leadership?
The ability to influence others and set goals
165
According to trait theories, what makes a good leader?
``` Intelligence Initiative Interpersonal skills Self esteem Willingness to take risks ```
166
What is the difference between task and relationship theories of leadership?
Task focuses on what needs to be accomplished, often to the detriment of interpersonal relationships. Relationship theory focuses on interpersonal relationships, often at the detriment of tasks needing accomplished
167
How does situational leadership work?
Leader recognizes factors that are at play in a group and a particular environment and is able to adjust/adapt to meet those needs
168
What is the operating premise of transactional leadership?
People are motivated by reward and punishment. Employees are closely monitored and there are strict disciplinary guidelines in place
169
What are the two major schools of thought as pertains to management?
Scientific management and human-relations approach
170
What are the essential qualities for an effective manager?
Leadership Clinical expertise Business sense
171
What does SOAR stand for in strategic career planning?
strengths Opportunities Aspirations Results
172
How is followership defined?
Willingness to work with others to accomplish the group goal
173
How is power defined?
Ability to influence others in spite of resistance from them
174
What is empowerment?
Feeling of competence, control, and entitlement that a person experiences In nursing: self determination, caring about work, confidence in abilities, and knowing you can make a difference
175
What are the three domains of a managers activities?
Organizational Interpersonal Informational
176
Which leadership responsibility reinforces constructive behavior and discourages undesirable behavior while providing recognition and developing employee skills?
Evaluative feedback
177
What are some things that have strongly influenced the recent changes in nursing?
``` Economy Technology An aging population Consumer involvement in healthcare Women’s movement Changes in nursing role ```
178
List a few professional nurse organizations
ANA NLN ICN NSNA
179
What are the QSEN quality and safety competencies for nurses?
``` Patient centered care Teamwork and collaboration Evidence based practice Quality improvement Safety Informatics ```
180
What are the five main nursing models of care?
``` Case method Functional nursing Team nursing Primary nursing Differentiated practice ```
181
How does the case method of nursing work?
One to one care, where nurse does all aspects of care for one patient over the course of a shift
182
How does functional nursing work?
Care is compartmentalized, with each task assigned to a staff member with the right knowledge and skills
183
How does team nursing work?
A licensed nurse and some nursing assistants team up to care for a group of patients
184
How does primary nursing work?
One nurse manages the care for a group of patients. Develops a plan of care and provides the care
185
How does differentiated practice work?
Variation on primary nursing. Each unit outlines the needed skills to work on that unit, and nurses must demonstrate competency to be able to care for patients.
186
The managing and processing of information necessary to make decisions
Informatics
187
In what ways is informatics applied to nursing?
In practice, education, and research
188
What are the four components of informatics?
Data Information Knowledge Wisdom
189
Why was wisdom added as a component of informatics?
Because its crucial to know how to use information appropriately
190
How is telehealth defined?
Using telecommunication to talk between patients and providers across multiple sites
191
What are the benefits of EHRs?
``` Efficiency Privacy Accessibility Error Reduction Research Planning Care made simpler ```
192
What does NANDA stand for?
North American Nursing Diagnosis Association
193
What does NANDA do?
Nursing diagnoses, definitions, and classifications | Emphasis is on independent practice
194
What does NIC stand for?
Nursing Interventions Classification
195
What is the focus of the NIC system?
Standardized Nursing Interrventions
196
What does NOC stand for?
Nursing outcomes classification
197
What is the focus of NOC?
Standardized outcomes in nursing
198
How does the Omaha taxonomy system work?
Research based standardized taxonomy that includes assessment, intervention, and evaluation
199
What are some reasons for why we need documentation in nursing?
``` Planning Evaluation Communication Legal document Quality improvement Reimbursement review Education research ```
200
What are the steps in the process of evidence based practice?
``` Ask an answerable question Review published evidence Evaluate quality of evidence Analyze data and prepare report Turn evidence into a guideline Integrate guidelines into patient care ```
201
What are background questions?
General knowledge questions that focus more on “what is?” Or “why do?” Questions.
202
What are foreground questions?
Questions that answer specific, pointed questions
203
What does the PICO method do?
Give a way to ask foreground questions for evidence based practice
204
What does PICO stand for?
Patient Problem (what is it?) Intervention Comparison (this vs that or this vs no action) Outcome
205
When it comes to evidence for nursing research, what is the very best kinds of evidence?
Meta-analysis
206
Systematic reviews of clinical topics to provide evidence for guidelines and quality measures
Evidence reports
207
Statements developed from review of evidence and benefits or harms to patients?
Clinical practice guidelines
208
What are some key factors of quantitative research?
``` Numerical data Hypothesis Controlled setting Objective Large test population ```
209
What are some key factors of qualitative research?
Non-numerical Small participant pool Subjective Natural setting
210
What are the four rights of informed consent?
Right to not be harmed Right to full disclosure Right to self-determination Rights of privacy and confidentiality
211
What are the responsibilities of institutional review boards?
Protect participants | Ensure quality research
212
What are some distinguishing factors of a research article?
Trustworthy source Peer reviewed Published in a medical journal
213
What are some possible causes of respiratory acidosis?
Hypoventilation (could be from COPD, obesity, drugs, sleep apnea)
214
What are some possible causes of respiratory alkalosis?
Hyperventilation (could be from fever, overventilation, hepatic failure, hysteria, fever)
215
What are some possible causes of metabolic acidosis?
Increase of acid in the body from lactic acid, diabetes, or acid ingestion
216
What are some possible causes of metabolic alkalosis?
Excess gastric drainages, vomiting, potassium depletion, diuretic therapy, burns
217
What sort of questions are good for getting specific information in a timely manner?
Close ended questions
218
What sort of information is gathered through a directive interview?
Age, gender, pain level, anything immediately pertinent
219
How does a non-directive interview work?
Patient controls the interaction | Nurse summarizes, listens, and clarifies
220
What does the FOLK acronym help with?
Active listening
221
What does FOLK stand for?
Face the patient Open, relaxed posture Lean towards patient Keep eye contact
222
What are the elements of a nursing health history?
``` Biographical data Patient’s perception of health Past health history Family health history Social history Medications Review of body systems ```
223
During a general health survey, the nurses main task is to...
Observe
224
What are the things a nurse will observe in a general health survey?
``` Appearance and behavior Body type and posture Speech Dress, grooming, hygiene Mental state ```
225
What specific things will a nurse assess for mental status?
Awake, alert, and oriented times three (person, place, and time)
226
What are activities of daily living?
``` Bathing Dressing Using restroom Continence Feeding oneself ```
227
What are instrumental activities of daily living?
``` Tasks needed to maintain immediate environment: Shopping Managing money Using phone Cooking Managing medications ```
228
What does a functional ability assessment look at?
ADLs and IADLs
229
What does Katz’s functional ability tool look at?
Independence in ADLs
230
What does Lawton’s functional ability tool look at
Ability to perform IADLs
231
What is the HSI?
The Home Safety Inventory for adults with dementia
232
What does the Hendreich II model look at?
Fall risk
233
What is the SPICES tool?
An overall assessment tool for older adults that helps flag areas for further assessment
234
What does SPICES stand for?
``` Sleep Disorders Problems with eating or feeding Incontinence Confusion Evidence of falls Skin breakdown ```
235
What is meant by the wellness-illness continuum?
A portrayal of health and illness that ranges from high-level wellness to complete depletion of health
236
What is high-level wellness?
A sense of well-being, life satisfaction, and quality of life
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What kind of interactions can exist between health and wellness?
They can exist together or change independently. For example, someone can have high health but low wellness, or vice versa. They don’t have to progress together
238
Definition: the idea of health being an outcome of ongoing patterns of person and environment interactions
Developmental perspective of health
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How does the ecological approach to health work?
It is comprehensive and multidimensional, and takes into account all the environmental factors that play a role in health. Also looks at what the options are for people in that environment
240
Which approach to health is useful for promoting health at many levels, such as individual, family, community, and society?
Ecological approach to health
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What are the four models of health most commonly used?
Clinical model Role performance model Adaptive model Eudaemonistic model
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How does the clinical model of health define health and illness?
Health is the absence of signs and symptoms of disease | Illness is the presence of S/S of disease
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What is the problem with the clinical model of health?
Lack of preventative care
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How does the role performance model define health and illness?
Health is an individual’s ability to perform social roles. | Illness is failure to perform roles at the same level as others in society
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What are some areas that use the role performance model as their basis for examination?
Occupational health exams | School physicals
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How does the adaptive model of health define health and illness?
Health is ability to adjust positively to social, mental, or physiological change Illness is failure to adapt or becoming maladaptive
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What is an example of the adaptive model of health?
Using spirituality to adapt to changes
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What is the emphasis of the eudaemonistic model of health?
The interaction of spiritual, physical, social, and psychological aspects of life as pertains to achieving goals and attaining meaning for the individual
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How would illness be defined in the eudaemonistic model of health?
Languishing and a lack of involvement in life
250
How could an ill patient still be considered healthy under the eudaemonistic model?
If the ill person could still find meaning in life, they would be considered healthy by this model
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What is the meaning of functional health?
Ability to function in one’s environment
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What might be included in environmental functioning?
Being present or absent High or low level wellness Societal influence
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What are the different realms or levels of function?
Physical Mental Social
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Loss of function would warrant what nursing intervention from an ecological perspective?
Assessment of environmental aspects that could be causing loss of function
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What four components comprise the metaparadigm for nursing?
Person Health Environment Nursing
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What is the difference between disease and illness?
Disease is the failure of adaptive mechanisms in the body | Illness is the subjective experience of the individual and the physical manifestation of the disease
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What are the three components of illness?
Psychological Spiritual Social
258
What are some benefits of physical activity?
Maintain and improve mobility Positive mental health (stress reduction) Lowered risk of cardiovascular disease
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What are some barriers to participation in physical activity?
Current physical condition No access to a doctor to okay exercise Pre-existing beliefs or attitudes towards exercise
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How do health disparities impact the development of disease?
People of minority groups or lower SES exercise less/eat more unhealthily than their wealthier white counterparts, increasing the number of people who develop diseases. This leads to more diseases and a culture where disease is normal, perpetuating the cycle
261
What is one requirement of the Patient Protection and Affordable Care Act?
PCP’s must provide free wellness services to older adults to promote wellness
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How can community partnerships better serve the needs of the community?
Partnerships can provide screenings, referral, and education to underserved populations without the need to incentivize doctors and hospitals to provide that care
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What is primordial prevention?
Prevention that occurs before a risk factor develops
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What is an example of primordial prevention?
Reduction of sodium in food supply
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What are the two general aspects of primary prevention?
Education | Specific prevention
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What is the purpose of primary prevention?
Decreasing vulnerability of person or population to disease or dysfunction
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How does primary prevention go beyond the individual?
Because health promoting policies for institutions and public health can be primary prevention things
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What is the difference between active and passive health promotion?
Passive: individual participates inactively (things like clean water or sanitary sewage movements) Active: individual actively chooses, like exercise and healthy eating
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What is the key factor to remember with the Transtheoretical Model of Change (TTM)?
People often need repeated opportunities to change before they can succeed at the desired change
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What are the six stages of change according to the Transtheoretical Model of Change?
1. Not considering change 2. Aware but not considering it soon 3. Planning to act soon 4. Has recently begun to make changes 5. Continued commitment to long-term change 6. Reverted to old behavior
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How do the TTM stages of change provide opportunities for the nurse?
The nurse can provide information, support, and encouragement at each stage
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What is meant by late secondary prevention?
Delayed recognition of a disease
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What are the main goals of tertiary prevention?
Minimize effects of disease | Maximize remaining capacity
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What are the responsibilities of the nurse in tertiary prevention?
Making sure the patient has services and resources to live and work to the fullest extent possible
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What are some of the functions of a nurse in the role of advocate?
Help patient get what they are entitled to in healthcare system Works to make system more responsive to patient needs Teach people to advocate for themselves Making sure all people receive high-quality, appropriate, cost-effective care
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In what ways does the nurse act as a care manager?
Maintain quality and safety Reduce costs Prevent duplication of services Facilitate communication between different parties
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How might a nurse act as a consultant?
By providing specialized knowledge about something like health promotion or disease prevention
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What might it look like for a nurse to act as a deliverer of services?
Delivering things like flu shots, health education, and counseling in health promotion
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What does it mean for a nurse to act as a healer?
Nurse helps to realize what is important to the patient and implement a care strategy to maximize patient’s ability for healing
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How does the nurse function as a researcher?
Must use evidence based findings in clinical decision making, so they must be good researchers
281
How is the ethnic landscape supposed to change in the US by 2050?
Those of white European descent will no longer be the majority
282
In what two ways is age distribution changing in the US?
Considerable increase in those over 65 in the next decade | Lower birth rate (but offset by immigration)
283
What are some current environmental threats to health?
Environmental pollution Psychological conditions due to fast paced/stressful society Ingestion of unhealthy foods Drug abuse/alcoholism
284
What is detrimental about treating disease through the application of complex technology?
It is very costly | It does little to improve health because it focuses on effects, not causes
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What are the major causes of death in the US today?
Chronic diseases Heart disease Stroke Cancer
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What are the two major directions that can be the focus of health solutions?
Individual involvement | Government involvement
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What are two examples of government mandates that are primary prevention strategies?
Increased physical activity time in schools | Mandating seatbelt use
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How is asset planning defined?
A planning approach that looks at the reality of the current situation and gives realistic building blocks for the future
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What is the focus of asset planning?
How to use the assets of the individual, the family, and the community
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What is a person able to do well when they have a high quality interaction between their inner and outer worlds?
Respond to the demands and stressors of the biological, psychological, and environmental systems internally and externally
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What are some reasons why patient education is becoming more important?
Patients are participating more in their own care Hospital stays are usually very brief, and patients need to know what to do upon discharge Education helps decrease readmittance and reduce overall cost
292
Definition: an interactive process that involves planning and implementing instruction to meet outcomes or provide information
Teaching
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Definition: a change in behavior, skills, or attitude that occurs because of planned or unplanned education
Learning
294
What are the five rights of learning?
``` Right time Right context Right goal Right content Right method ```
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What is cognitive learning?
Storing and recalling information in the brain
296
What are some strategies and tools that can help support cognitive content?
``` Lectures Reading materials Discussions AV materials Problem based learning Visual aids ```
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What is psychomotor learning?
Learning something that requires mental and physical activity: DOING something
298
What are some good strategies and tools for psychomotor skills?
Demonstration and return demonstration Simulation Printed/AV materials
299
What is affective learning?
A change in feelings, beliefs, attitudes, or values
300
What are some good ways to help and support affective learning?
``` Positive reinforcement Role modeling Mentoring Counseling Discussion ```
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How is motivation to learn created?
A desire within a person that stems from an idea, a need, an emotion, or a belief
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What are some principles for motivating learners?
Show interest in them and the learning process Create a warm and friendly environment Establish rapport and respect Help them identify a need Incentivize learner Make sure they believe that health is important
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What is readiness to learn?
Demonstration that behaviors that shows the learner is ready and able to learn at the specific time
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What physical factors might impact readiness to learn?
Pain Energy level Impaired cognition, vision, or hearing
305
What emotional factors can impact readiness to learn?
Anxiety Stress Emotional pain
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IF POSSIBLE, LET PATIENT WORK THROUGH EMOTIONS BEFORE TEACHING
..
307
Explain a key concept for how teaching and timing are related
People learn better when they will have a chance to use their knowledge in the near future
308
How much of what people do vs read do they retain?
They retain 90% of what they do and speak, but only 10% of what they read
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What is an example of active involvement by a patient?
Having a patient do a return demonstration
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When is positive feedback especially important?
When trying to learn something that involves a behavior change
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How should a nurse go about pointing out errors made by a patient?
Be positive and encouraging | Try to not seem judgmental
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REPETITION IS IMPORTANT TO PATIENT TEACHING
..
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What are some factors in a positive learning environment?
``` Good lighting Comfortable seating Good teaching materials Quiet space/no distractions Good temperature ```
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What should scheduling look like for teaching sessions?
Shorter sessions, especially with higher pain levels or complex material
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What should be taken into consideration when teaching complex subject matter?
Reduce medical jargon Shorter sessions Be comfortable with content Repeat exposure
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What are some general barriers to communication/teaching?
``` Pain Anxiety Fatigue Illness Hunger Relationship stress Language/culture differences Distractions ```
317
What special needs might need other considerations when planning a teaching session?
Learning disabilities Mental illness Brain injury Communication disorders
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Who should be present when teaching a patient with special needs?
Family member, caregiver, or other significant person
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What are Piagets stages of cognitive development?
Preoperational stage Stage of concrete operations Formal operational stage
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When planning to teach older adults, what considerations should be made?
``` Pain Vision/hearing issues Medication effects Chaotic environment Need for extra time ```
321
What are some good strategies for teaching children?
Gain trust Reduce anxiety Promote cooperation Enhance emotional readiness to learn
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What is health literacy?
Capacity to obtain, process, and understand basic health information to be able to make good healthcare decisions
323
Who are some groups that may have limited health literacy?
Limited English proficiency Medically underserved population Minority populations Older adults
324
What are some barriers to the teacher for good education?
Time factors | Lack of space/privacy
325
What are some barriers to learning for a learner?
Physical condition | Language barriers
326
What are the steps of the teaching process?
``` Assessment Nursing diagnosis Planning outcomes Teaching plans Implementation Evaluation ```
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What is important for planning outcomes?
Always have the objectives in mind
328
What is meant by a contractual agreement
Statement of understanding between teacher and learner about how to achieve a goal. Both parties agree on it
329
What is a teaching goal?
Broad goal that outlines the expected final outcome
330
What is a learning objective?
A short term, measurable, specific behavior change that must be accomplished to meet the goal
331
What are three things that might be included in teaching content?
Facts Skills Emotions
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What are some guidelines regarding scheduling and sequencing of content?
Simple topics before complex topics Non-threatening topics before controversial ones Schedule in advance if it will take a while
333
Why is it essential to evaluate the effectiveness of teaching?
There is no way to know how it worked or how to improve it if we do not evaluate it
334
Who is the best source for providing feedback on teaching effectiveness?
The client
335
What are some methods to evaluate client learning?
Questions/interviews Direct observation of client performance Reports/records Tests
336
What are two reasons to document teaching and learning?
Legal evidence | Communication to other healthcare professionals
337
What should be included when documenting teaching and learning?
What was taught Skills and behaviors demonstrating learning Nursing notes on informal teaching

Krystan: Semester One Nursing School (6 decks)

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