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Health Promotion II > Primary- Secondary- Tertiary Prevention > Flashcards

Primary- Secondary- Tertiary Prevention Flashcards

1
Q

Generation 1 prevention/ Primary prevention includes aotf except:

a) education on nutrition
b) genetic screening
c) Use of specific immunizations
d) disease screening
e) Protection against accidents and hazards

A

d) disease screening, this is secondary prevention because the principle goal is to identify individuals in an early, detectable stage of the disease process.

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2
Q

Generation 2 prevention/ secondary prevention includes what?

A

Screening for disease
screening groups that have hereditary risk factors
screenings at health fairs ( BP, BS, and Cholesterol monitoring)
PAP smears, PSA, mammograms

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3
Q

Generation 3 prevention/ tertiary prevention

A

interventions are performed to prevent complications of an already diagnosed disease, including rehabilitation to maintain optimal functioning. The goal is to manage symptoms so that the patient has an improved quality of life.

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4
Q

What is the goal of secondary prevention interventions?

A

Goal is to prevent onset of diseases, but, also to diagnose and treat diseases early on.

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5
Q

Health defined by WHO

A

…a state of complete physical, mental and social well-being, not merely the absence of disease or infirmity.

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6
Q

Illness defined

A

where a person’s physical, emotional, intellectual, social, developmental or spiritual functioning is diminished or impaired compared with previous experience.

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7
Q

T or F: the health continuum evaluates health as being an absolute state that is the absence of disease.

A

False: the health continuum evaluates health as not being an absolute state and not just the absence of disease. The continuum ranges from death- to highest level of health. The continuum also evaluates health as optimally functioning within one’s environment. Health changes from day to day.

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8
Q

T or F: the health belief model is a paradigm used to predict and explain health behavior. Its focus is on an individual’s perceived risk of disease, along with modifying factors, and the likelihood of the person to take action.

A

True

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9
Q

The health promotion model emphasizes:

a) butt sex with multiple partners
b) butt sex with one partner
c) Individuals can achieve harmony by having healthy interactions with their environment
d) no butt sex with any partner

A

d

haha jking, C

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10
Q

Acute illness

A

illness that presents with severe symptoms that have rapid onset, with the outcome being the subsiding of symptoms or death.

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11
Q

Chronic illness

A

the irreversible presence, accumulation, or latency of disease states or impairments that involve the total human environment for supportive care and self care, maintenance of function and prevention of further disability.

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12
Q

Pain.– what’s the role of the nurse for patients with pain?

A

unpleasant sensory and emotional experience associated with actual or potential tissue damage with a decreased quality of life. A patient is his/her own authority of pain. Nurses advocate for patient to effectively manage pain.

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13
Q

How long does pain have to last in order for it to be considered chronic?

A

3 months or longer

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14
Q

Physiologic responses to pain include aotf except:

a) sympathetic nervous stimulation
b) crying, fear, anxiety
c) decreased cognitive function
d) increased BP and HR
e) confusion
f) increased need for oxygen
g) Nicole likes S&M so she will laugh/moan when experiencing pain
h) It may hurt to breath or cough, so secretions are retained.

A

G) Nicole may or may not like S&M but that is beyond the scope of the mandle or edelman textbook.

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15
Q

People that view their relationship with nature under the destiny model believe what?

A

They believe that what happens to them is controlled solely on fate or on the environment. Their behavior does not change this fate.

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16
Q

The harmony model for one’s relationship to nature is defined as….

A

the belief that one has control over their environment, and coexist with nature. People with this ideology are more likely to change behaviors after onset of disease in order to restore harmony

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17
Q

The ideology of mastery (with relationship to nature)

A

belief that one has total control and can overcome anything

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18
Q

Which group under time orientation is the least likey to use western medicine? (past, present or future)

A

past time, these people honor traditions and use folk medicine

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19
Q

T or F: the present time orientation group is NOT likely to prepare for death, pregancy, or discharge

A

True, they don’t plan for the future

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20
Q

Spirituality v. Religion

A

Spirituality defines beliefs that help find meaning/ purpose in life that doesnt always involve religion. Religion is a formal and organized system of beliefs that has symbols and/or supernatural powers

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21
Q

The universal rule for assessing intake and output of fluid with regards to hydration is that 1 liter of fluid= ?

A

1 kg of body weight (2.2 lbs)

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22
Q

What is the normal range for BUN and what is the significance of this value?

A

BUN measures the amount of urea nitrogen present in the blood. Urea nitrogen is a waste product of protein metabolism that is normally excreted by the kidneys, thus this lab test indicates kidney function. normal range= 10-20 mg/dl of blood.

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23
Q

T or F: BUN is the primary indicator nutrition

A

False, BUN is the primary indicator for hydration, because if water intake decreases, then BUN value increases. The primary indicator for nutrition is Albumin

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24
Q

T or F: Creatinine levels depend on oral fluid intake

A

False, BUN levels depend on oral fluid intake, whereas, Creatinine levels are NOT affected by liquid/solid intake.

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25
Q

Creatinine– normal range and it’s significance

A

normally 0.5-1.5 mg/dl
Creatinine is a product of muscle breakdown. The lab value is a more sensitive indicator of kidney function than BUN values.

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26
Q

Normal serum sodium values

A

135-145 mEq/L

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27
Q

Normal serum potassium values

A

3.5- 5.0 mEq/L

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28
Q

T or F: Heart function is impaired if potassium levels increase to 5.7-5.8 mEq/L or greater.

A

True

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29
Q

Fluid volume deficit– What are causes?

A

also called hypovolemia, defined as loss of total body water. Causes of hypovolemia include inadequate intake of fluids, diarrhea, vomitting, hemorrhaging, excess drainage from wounds, burns, shock, diuretics.

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30
Q

Signs of fluid volume deficit include: (multiple- multiple)

a) tachycardia
b) hypotension
c) polyuria
d) confusion
e) cold, clammy skin
f) constipation

A

a) tachycardia
b) hypotension
d) confusion
e) cold, clammy skin

31
Q

Mrs fukurhuzbend comes into the hospital and shows signs of fluid volume deficit. She is taking diuretics. Which otf lab values would we not expect to see?

a) BUN of 27 mg/dl
b) Na 150 mEq/L
c) K 5.7 mEq/L

A

c) K 5.7 mEq/L, Fluid volume deficit causes BUN and Na levels to rise because blood is more concentrated with urea and sodium is retained. The patient is on diuretics which causes more potassium to be excreted so she would have K

32
Q

What are the causes of fluid volume excess, or hypervolemia?

A

CHF, liver disease, renal failure, ascites, excess intake.

33
Q

The most common symptom of hypervolemia is seizures. T or F?

A

False, the most common symptoms include peripheral edema, sudden increases in weight, hypertension, and fatigue. Seizures and coma are severe/extreme symptoms.

34
Q

Mr. Rokyobod comes into the clinic complaining of fatigue and swollen lower extremeties. His eMR indicates he has been previously diagnosed with CHF and liver disease and he is taking K sparing diuretics. Objective assessment findings include edema 2+ pitting to LEs and crackles upon auscultating the lungs. Given this data, what would you expect his lab values to be?

a) low BUN, high Na, low K
b) high BUN, low Na, high K
c) low BUN, low Na, high K

A

C) low BUN, low Na, high K, hypervolemia results in dilution of molecules, including urea, in the blood. It also will cause increased excretion of sodium to attempt to lower the excess water. Potassium is spared and is retained in the blood so values are high.

35
Q

T or F: The elderly are commonly diagnosed with dehydration because of decreased thirst sensation

A

True

36
Q

What are nursing interventions for preventing S&S of fluid volume excess?

A

Monitoring and restricting intake of fluids
Having the patient avoid caffeinated beverages b/c this will ultimately cause fluid retention.
Minimize potassium levels in food intake b/c this will help increase Na levels.
Recognize changes in patients body weight.

37
Q

Normal adult urine output per day = ?

A

1200-1500 ml/day

38
Q

Nurses become concerned when patients void less than…..

A

30ml/ hr for 2 consecutive hours

39
Q

Mr BBC is a white, middle aged adult that has been gaining weight. You find that his waist circumference is greater than 45cm. Given this, you would explain to him that his risk for what has increased?

A

his risk for diseases like HTN, hypercholesteremia, hyperlipidemia, heart disease, and arteriosclerosis is increased.

40
Q

Mrs A for asshole comes in with an apple shaped body. What is she at a higher risk for when compared to those pear shaped black women?

A

She has a higher risk of developing heart disease and hypertension. However, the pear shaped/ donk ass women may develop resistance to insulin and eventually acquire diabetes.

41
Q

Mrs. dignified elderly female comes to the clinic complaining of pain. Her medical record indicates that she has osteoporosis and you notice her cervical spine is protruding anteriorly. You would identify this as ______ and would inform her she has an increased risk of _______ and _________.

A

Dowager’s hump, increased risk of falling and fracturing femur/hip.

42
Q

Educating women regarding osteoporosis includes aotf except:

a) chances of acquiring it increase after menopause
b) diets should include 1200mg calcium/day, 600mg magnesium/day and 800mg vit D/day.
c) Walking/ weight bearing exercises helps reabsorb calcuim back into bone
d) Caffeine, excess fiber, and preserved foods have no effect on calcium levels.

A

D) Caffeine, excess fiber, and preserved foods have no effect on calcium levels.

These all cause increased excretion of calcium.

43
Q

What are the causes of malnutrition?

A

malabsorption problems, psychological stress, diarrhea, hemorrhaging, intentional starvation due to depression or chronic life altering conditions, and decreased taste buds (elderly)

44
Q

Nurses would include aotf except _____ when discussing the consequences of malnutrition:

a) elevated wbc count
b) anemia
c) hypotenstion
d) osteoporosis
e) impaired cognition

A

a) elevated wbc count,

The immune system is suppressed with malnutrition.

45
Q

Types of tube feeds provide different amounts of kilocalories/ml of fluid, How many kilocalories/ml of fluid does the following types of tube feeds provide?

a) polymeric
b) elemental
c) molecular

A

a) polymeric= 1-2 kcals/ml
b) elemental= 1-3 kcals/ml
c) molecular= 3.8- 4 kcals/ml

46
Q

What conditions necessitate the need for enteral nutrition?

A

Those without teeth (endentulous diet) and those who have had a stroke.

47
Q

Albumin- normal level, best assessment for ?

A

3.5-5 g/dL, it the best lab test to assess nutrition

48
Q

For what conditions do you particularly want to analyze albumin levels

A

Patients with tube feeds, chronic illnesses, dehydration or malnutrition, trauma, and the elderly

49
Q

T or F: the primary cause of MORBIDITY for those greater than 65 years of age is osteoporosis

A

False, falls are the primary cause of morbidtity, resulting in roughly half of nursing home admissions.

50
Q

Safety measures to include for patients at risk for falling include aotf except:

a) non skid mats, rubber back rugs
b) alarms
c) low bed
d) night lights, clean environments
e) sedatives, including ativan

A

e) sedatives, including ativan

51
Q

T or F: the elderly are at a greater risk for adverse reactions to drugs because of decreased GI function and increased absorption.

A

False, absorption is decreased in the elderly

52
Q

With distribution, medications move to where?

A

to their target organ or appropriate receptor site. distribution is altered in the elderly due to decreased lean body mass and total body water.

53
Q

T or F: A common reason that older adults have adverse side effects to medications is that there is inadequate albumin proteins to bind to medications.

A

True, medications that are free flowing in the CV system exert side effects

54
Q

Mr. assasmacker is a diabetic with altered kidney function. You would notice that kidney function is decreased when ______ and ______ lab values are _______. You also remember that this causes decreased excretion of medications leading to an increased risk for ________.

A

Creatinine and BUN lab values are increased.

Decreased excretion causes increased risk for side effects.

55
Q

T or F: Age related changes include aotf:

  • Decreased total body water, and lean body mass
  • increased fat deposition
  • increased serum albumin
  • decreased liver and kidney function
A

False: albumin levels are decreased with aging.

56
Q

What are psychotropic medications used to treat?

A

psychotropic medications are used to treat depression, anxiety, and psychosis, however, their use alters the chemistry of the brain which changes the patient’s behavior/affect.

57
Q

T or F: side effects are extreme/severe effects that warrant immediate withdrawal of said medication. They include N&V, constipation, depression, cancer and nervous system changes.

A

False: Adverse effects are the severe responses that warrant withdrawal from medication. They are unintentional, undesirable, and unpredictable, and can occur either immediately or take weeks to develop.

58
Q

Side effects

A

predictable but often unavoidable, secondary effects to medications that are either harmless or injurious. Examples include dry mouth, headache, and drowsiness.

59
Q

The pneumococcal vaccine, which prevents pneumonia, is recommended for what ages? (middle-older adults)

A

Single/ one-time dose is recommended for patients who are 50 years old that have chronic conditions. Otherwise, it is recommended for ages 65+

60
Q

What is important to remember about pneumonia in elderly patients?

A

Pneumonia may initially cause confusion in the older adult, which is often misdiagnosed as dementia. It is the 5th leading cause of death in elderly.

61
Q

The influenza vaccine should be given annually beginning at age _____.

A

50

62
Q

The immune theory of aging is the theory that increased mortality and morbidity are direct results of diminished thymus gland and immune system functioning. T or F?

A

True, also with diminished immune system, the nurse should remember that vaccines’ efficacy is diminished too.

63
Q

Multiple Multiple: Which of the following are true regarding the stages of pressure ulcers?

a) Stage I includes non-intact skin with erythema
b) Stage IV extends to tendons, muscle and bone
c) Stage III is a full thickness PU that affects subcutaneous tissue
d) Stage II is full thickness skin loss
e) Stage II include the epidermis and dermis, and presents with a blister, crater, or abrasion.
f) Necrotic ulcers are unstageable, and often present with leathery brown eschar.

A

b) Stage IV extends to tendons, muscle and bone
c) Stage III is a full thickness PU that affects subcutaneous tissue
e) Stage II include the epidermis and dermis, and presents with a blister, crater, or abrasion.
f) Necrotic ulcers are unstageable, and often present with leathery brown eschar.

64
Q

Definition of Pressure ulcers

A

tissue damage due to compressed skin betweeen bony prominences and external structures. These develop from physical forces like friction and shear.

65
Q

A stage I pressure ulcer is present if the redness doesn’t subside with relieve of pressure to area after how long?

A

30 minutes

66
Q

NRS interventions for PU’s include aotf except:

a) dry, wrinkle free linens
b) Using low pressure mattresses
c) Debriding necrotic or slough tissue
d) Maintaining nutrition at 25 kcal/kg/day
e) applying creams and dressings

A

d) Maintaining nutrition at 25 kcal/kg/day

Patients with PU’s need 35 kcal/kg/day

67
Q

T or F: stress incontinence is stress from having physical deformities or musculoskeletal problems that prevent the adult from making it to the bathroom on time.

A

False, Functional incontinence is due to musculoskeletal/locomotion impairments or EVEN restraints, that prevent toileting.

68
Q

The mnemonic for causes of incontinence is DRIP.

What are the the causes for this mnemonic?

A 
D= delirium, depression, dementia, dehydration, and diet changes
R= restricted mobility and retention of fluid
I= infection, inflammation, impaction of stool
P= Polyuria (often nocturnal) and Pharmaceuticals (like sedatives that cause drowsiness)
69
Q

Ms. dingleberry is an 85 year old women who comes to the clinic complaining of incontinence. The nurse, recognizing her age, would recognize that kegal exercises….?

A

would not help the client return to a continent status

70
Q

Clinical manifestations of dementia include aotf except:

a) going bat shit crazy
b) aphasia
c) apraxia (loss of fine motor movements)
d) Agnosia (inability to recognize objects, people, etc…)
e) disturbances in executive function, can no longer plan or organize

A

a) going bat shit crazy.

But they still do that regularly

71
Q

Type 1 diabetes insipidus

A

type of diabetes in which the pancreas does not produce insulin, and treatment includes the regular injection of insulin, thus, this type is insulin dependent.

72
Q

Type II diabetes mellitus

A

type of diabetes in which the production and secretion of insulin from the pancreas is normal, however, there is an impaired ability of the cells to absorb and metabolize the secreted insulin. This type is non-insulin dependent

73
Q 
T or F: microvascular changes with diabetes include:
Neuropathy 
Retinopathy
Nephropathy
Neuropathic pain
A

True
neuropathy presents as peripheral nerve dysfunction with tingling or numbness
Retinopathy causes vision impairments and blindness
Nephropathy is renal pain
Neuropathic pain is constant, and includes tingling/numbing

74
Q

Mr. Sam Berstein comes to the clinic to verify his lab results regarding his glycosated Hgb assay (HgB A1C). This is his first lab result, as he was diagnosed with diabetes 120 days ago, and he wants to know what the test indicates. The results show that his Hgb A1C is 20%. You would tell the client that the test indicates __________ and you would do what?

A

The test indicates how well the patient has adhered to their medication/diet regimen for diabetes. The value gives a range up to a 4 month period and normal values are less than 7%. Thus, you would slap the shit out of Mr. Berstein cause he wasn’t being compliant.

Health Promotion II (5 decks)

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