Patient Centered Care: Exam 1 (found) Flashcards

1
Q

Health Promotion: Primary Prevention

A

things we do to prevent disease & promote health

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2
Q

Health Promotion: Secondary Prevention

A

screening tests for disease

  • Sensitivity: picks up a disease when disease is present (without too many false positives)
  • Specificity: correctly identifies when disease is not present
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3
Q

Health Promotion: Tertiary Prevention

A

taking medicine/ disease management

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4
Q

Health Disparities

A

differences in the quality of care received by minorities and non-minorities who have equal access to care.
Based on conscious or unconscious thought process

ex. treating 2 patients with similar conditions differently based on types of insurance they have

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5
Q

Six Aims for Improvement of the Healthcare System (IOM):

A
  1. Safe: avoiding accidental injuries
  2. Effective: providing services based on scientific knowledge (evidence-based)
  3. Patient-Centered: providing care that is responsive to individual patient preferences, needs and values
  4. Timely: reducing waits and harmful delays
  5. Efficient: avoiding waste
  6. Equitable: care does not vary in quality because of personal characteristics
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6
Q

Attributes of Patient-Centered Care

A

Empathy: treating patients how you want to be treated
Communication: encouraging active communication between the healthcare team & patient

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7
Q

Holistic Care:

A

treating a patient based on complete physical, mental, and social well being, not merely absence of disease or infirmity

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8
Q

Steps of the Nursing Process

A

ADPIE

  1. Assessment: gathering patient care data through observation, interviews, and physical assessment
  2. Diagnosis: Analyze, validate, and cluster patient data to identify patient problems
  3. Planning: Prioritize the nursing diagnosis and identify short/long term goals that are realistic, measurable, and patient focused
  4. Implementation: Initiate specific nursing interventions and treatments designed to help the patient achieve established goals and outcomes
  5. Evaluation: Determine whether the patients goals are met, examine effectiveness, and decide whether the plan of care should be discontinued or revised
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9
Q

Assessment

A

Data collection:
Primary Data: patient interview
Secondary Data:
-Subjective Data: verbal communication, signs/symptoms told by patient
-Objective Data: signs observed/ measured/ tested

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10
Q

Nursing Diagnosis

A

Looks at patient problems, clusters to find a common problem

  • Actual Nursing Diagnosis: a problem already exists, trying to prove the problem. Identified by signs/ symptoms
  • Risk Nursing Diagnosis: a potential problem. Assessment findings suggest the patient is at risk
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11
Q

Actual Nursing Diagnosis

A

A problem already exists. Trying to prove the problem by identifying signs/ symptoms

3 parts: problem, etiology, symptoms
formula: PROBLEM related to PATHOPHYSIOLOGY as evidenced by SIGNS/ SYMPTOMS

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12
Q

Risk Nursing Diagnosis

A

a potential problem, identified by signs/ symptoms

2 parts: problem, risk factors
formula: PROBLEM due to RISK FACTORS

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13
Q

Planning

A
  • prioritizes a patients various diagnosis
  • create short & long term goals
  • chooses outcome indicators & identifies interventions to address patient goals

Goals= things the patient will do to improve

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14
Q

Goals must be SMART

A
Specific
Measurable
Appropriate to patient
Realistic
Timeframe (have a timeframe specified)
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15
Q

Implementation

A

initiation of interventions to meet patient needs.

Clinical Pathways: multidisciplinary resources to guide patient care
Protocols: standard procedures
Standing Orders: to be carried out when certain criteria is met

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16
Q

Evaluation

A

Patients response to nursing interventions and goal or outcome attainment

  • care plan evaluation
  • continue or discontinue treatment
  • revise/adapt treatment
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17
Q

Development

A

sequence of physical, psychosocial, and cognitive changes that take place over the human lifespan

  • physical growth: measured in numerical changes
  • differentiation: growth @ cellular level
  • developmental tasks
  • maturation
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18
Q

Order of Developmental Stages

A
Infant
Toddler
Preschool
School Age
Adolescent
Young Adult
Middle Adult
Older Adult
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19
Q

Developmental Milestones

A

Specific skills most individuals achieve at a certain age

Used to identify developmental delay or regression

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20
Q

Principles of Intervention

A
#1 Early identification and early intervention are critical
#2 Specific interventions are dependent on category, age & type of developmental delay
#3 Management requires interdisciplinary collaboration
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21
Q

Sigmund Freud: Psychoanalytic/Psychosexual Development

A

Personality grows, develops, & changes during lifespan

ID: Unconscious, present @ birth, generates impulses that seed immediate satisfaction
EGO: view of self/ what one wants others to see
SUPEREGO: 3-5 yrs. delays immediate gratification for socially appropriate reasons, recognition of good and bad, moral guide/ conscience

*5 stages of psychosexual development

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22
Q

5 Stages of Psychosexual Development (Freud)

A
  1. Oral (0-1): Mouth/sucking
  2. Anal (Toddler): Self-control of bowels/ potty training
  3. Phallic (Preschool): self-centered, masturbation, identifies with parent of opposite sex
  4. Latency (School Age): focuses on industry, achievement & skills
  5. Genital (Puberty): seeks mutual pleasure with a partner, sexual urges
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23
Q

Oral Stage of Development

A

0-1 yr

focuses on mouth & need to suck

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24
Q

Anal Stage of Development

A

Toddler

learning self control of bowels

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25
Phallic Stage of Development
Preschool self-centered, masturbation, child identifies with parent of opposite sex
26
Latency Stage of Development
School Age surprises sexual urges, focuses on achievement & skills
27
Genital Stage of Development
Puberty sexual urges involving opposite sex, seeks mutual pleasure with partner
28
Defense Mechanisms for Coping
- Rationalization: excuse for behavior - Repression: Forced forgetfulness - Projection: onto another person - Agression/Regression: going backward in developmental stages
29
Jean Piaget: Cognitive Theory of Development
4 stages of development related to learning to understand and relate logically to the world cognitive milestones involving sensory & motor interactions with the world
30
Sensorimotor Stage of Cognitive Development
Piaget's 1st stage: 0-2: object permanence, cause & effect, time of day
31
Preoperational Stage of Cognitive Development
Piaget's 2nd stage: 2-7: pretend play, self-centered, language explosion
32
Concrete Operations Stage of Cognitive Development
Piaget's 3rd stage: 7-11: understands more than 1 piece of info, realistic understanding, present focused
33
Formal Operations Stage of Cognitive Development
Piaget's 4th stage: Adolescent: abstract & logical thinking, future oriented, social & moral rules
34
4 Stages of Cognitive Development (Piaget)
1. Sensorimotor (0-2): object permanence, cause/effect, time awareness 2. Preoperational (2-7): pretend play, self-centered, language explosion, logic development 3. Concrete Operations (7-11): Realistic, present oriented, processes more than 1 idea 4. Formal Operations (12+): abstract thinking, future oriented, scientific understanding, social & moral rules
35
Erik Erikson: Psychosocial Theories of Development
``` personal development dependent upon social environment & interactions. each stage involves a social crisis that must be positively resolved to successfully pass on to the next stage Trust v. Mistrust Autonomy v. Shame & Doubt Initiative v. Guilt Industry v. Inferiority Identity v. Role Confusion Intimacy v. Isolation Generativity v. Self Absorption Integrity v. Despair ```
36
Trust vs. Mistrust
Eriksons 1st stage: Infant: 0-1 develops trust to meet personal needs, begins to trust himself/herself
37
Autonomy vs. Shame and Doubt
Eriksons 2nd stage: Toddler: 1-3 independent, potty training, trusting oneself to be good
38
Initiative vs. Guilt
Eriksons 3rd stage: Preschool: 3-6 imitates role models, follows rules, self control in social interactions
39
Industry vs. Inferiority
Eriksons 4th stage: School age: ability to make friends, individually achieve school tasks
40
Identity vs. Role Confusion
Eriksons 5th stage: Adolescent: learns to know oneself & what one believes (career goal)
41
Intimacy vs. Isolation
Eriksons 6th stage: Young Adult: ability to share all aspects of life with others (intimate relationships)
42
Generativity vs. Self Absorption
Eriksons 7th Stage: Middle Adult: contributes to society in a meaningful way
43
Integrity vs. Despair
Eriksons 8th stage: Older adult: geriatric reflecting on life, sense of life achievement
44
Maslow's Hierarchy of Needs
Basic needs must be met in order to move toward self-fulfillment
45
Kohlberg's 3 Stages of Moral Development
a set of social rules that enables a person to differentiate between right and wrong Preconventional (toddler, early childhood): obeys rules to avoid punishment Conventional (school age): conforms to rules to gain recognition/ reward Postconventional (adolescent, adult): follows rules leading others to believe they are "good", sense of responsibility (older adult): develops own sense of principles, independent
46
The period of infancy
4 weeks to 1 year
47
toddler age period
1-2 years
48
preschool age period
2-6 years
49
school age period
6-12 years
50
adolescent age period
12 plus years
51
separation anxiety begins at this age
6 months
52
pincer action
grasp small objects with the thumb and forefinger around 9 months of age
53
weight of a child of 1 year
triple the birth weight
54
tasks to be mastered during early childhood
walking, bowel control, visual maturity
55
toddler-age child in which of Erikson's stages?
autonomy vs. shame and doubt
56
preschool-age child is in which of Erikson's stages?
initiative vs. guilt
57
between 12 and 24 months of age, child's speech includes
three to four word sentences
58
best disciplinary technique
rewarding good behavior
59
middle childhood includes children between the ages of
6 and 12 years
60
a major developmental task of middle childhood
developing positive self esteem and a positive self image
61
middle childhood play activities
competitive games
62
middle childhood includes Erikson's stage of
industry
63
length & weight of typical newborn
20 inches long | 7.5 lbs
64
length at 1 year old
birth length increases 50%
65
infant's weight at 6 months
double birth weight
66
infant's weight at 1 year
triple birth weight
67
emotional development of infant
mimic facial expressions
68
stranger anxiety
begins at 9 months; doesn't feel comfortable with strangers
69
Language development of infant
receptive before expressive, nonverbal, few words by 1 year
70
sleep patterns of infants
self-regulating skills to return to sleep without prompting
71
Infant nutrition
``` breast milk/ formula for 1 year feed every 2-3 hours no solid food before 6 months high fat cows milk at 1 year introduce 1 food at a time (allergies) vegetables 1st, fruits 2nd meat & eggs at 11 months can move to normal eating schedule at 1 year ```
72
Infant: Teeth
primary teeth begin at 5-7 months #months-6= #teeth teething/chewing/fussy/ drooling
73
Early Childhood: Walking
begins 12-15 months
74
Early Childhood: Nutrition
solid foods | plate= fruits, veggies, grains and protein
75
Toddler: Language
receptive before expressive 1st clear word responds to simple commands
76
Preschooler: Language
occurs rapidly | 5 years= more than 2000 words
77
Middle Childhood: Physiological
grows 1-2 inches/year on average bones growing starts to lose teeth mature GI tract & sensory organs
78
Three phases of moral behavior
1. Knowledge- knowing what is right 2. Emotion- feeling good/bad about what you did 3. Action- behaving according to the rule of what is right
79
Parallel Play
1-3 years | playing side by side without interaction
80
Cooperative Play
3-5 years | playing together