Test 2 Functional Ability Flashcards
What are risk factors for impaired functional ability?
Risk recognition is a major domain of functional ability
- Developmental Abnormalities
- Physical or psychological trauma or disease
- Social and Cultural factors
- Age
- Cognitive function
- Level of Depression
- Beliefs & perceptions of health and physical environment
What are the Antecedents of Functional Ability?
Big picture= normal growth and development
-Developmental Milestones, learning and acquiring skills,
Integration of -Neural/Endocrine/Musculoskeletal Capacity
-Metabolic Manifestations to Provide Energy (Krebs Cycle)
What are the Attributes of functional Ability?
Big Pic= ability and willingness to perform unassisted under normal circumstances and at a normal level/ pace
Interrelated Concepts for Functional Ability
- immobility
- coping
- sensory perception
- mobility
- human development
- Cognition
- Gas Exchange
- Nutrition
What are negative outcomes for Functional Ability?
- Further Disability
- Increased Dependence
- Increased Use of Health Services
- Depression
- Stress **
What are positive outcomes for Functional Ability?
- Goal Achievement
- Quality of Life/Well Being
- Learning Effective Coping
- Adaptation to work, environment, and health status
- Hope
What are the four domains of Functional Ability
- Physical Domain
- Psychological Domain
- Cognitive Domain
- Social Domain
Two main/basic categories of Functional Ability
- BADLs (ADLs) =personal care and mobility
- IADLs = ability to function in community
What are the 12 activities of daily living in Roper-Logan-Tierney model of Nursing?
- Maintaining Safe Environment
- Communication
- Eating & Drinking
- Personal Cleansing & Dressing
- Maintaining Body Temperature
- Expressing Sexuality
- Breathing
- Mobilizing
- Elimination
- Sleeping
- Work & Playing
- Dying +++
What is the different between primary and secondary problems related to Functional Ability?
Primary problems are when a particular function never developed and secondary represents a loss of functional ability.
What are the changes across the lifespan that are related to Functional Ability?
- Developmental Stage
- Physical Health
- Psychosocial Health
- Cognitive Ability
- Social and Cultural Factors
Definition of Functional Ability
The physical, psychological, cognitive & social ability to carry on normal activities
What are the Functional Assessment Components
is a multidimensional and often interdisciplinary diagnostic process. should be routinely screened in older adults
- Vision
- Hearing
- Mobility
- Falls
- Social Participation/support
- Nutrition
- Cognition
- Affect
- Home Environment
- Continence
- BADLs
- IADLs
Define Healthy
State of complete physical, mental and social well-being, not merely the absence of disease or infirmity
Name the 4 goals of Healthy People 2020
to attain high-quality, longer lives free of preventable disease, disability, injury, and premature death
What is the key factor in quality of life, and therefore in health
an individuals ability to function
True or False. Functional ability may differ from functional performance, which refers to the actual daily activities carried out by an individual
true
What are some of the causes for change in functional abilities?
Developmental and biological factors, including current state of health, as well as by psychological, sociocultural, environmental, and politicoeconomic factors. Changes in functional level may be temporary such as recovering from an illness or injury or long term
An individual with full functional ability means what?
The individual can independently meet all necessary life activities without any sort of assistance or use of assistive devices
Dependence
Measurement tool- level of assisted needed (from person or tool) to function. options are : no assistance, partial assistance, total assistance
What are instrumental activities of daily living (IADLs)?
More complex skills that are essential to living in the community. Examples: managing money, grocery shopping, cooking, house cleaning, doing laundry, taking medication, using the telephone, and accessing transportation
What 4 complex concepts represent functional activity?
- Physical domain
- Psychological domain
- Cognitive domain
- Social Domain
overlapping
primary vs secondary problem with functional ability
Primary- never developed ability
secondary- lost the ability
*Functional Status Scale (FSS)
used for Hospitalized children who severely impaired. used for a small number of activity limitations (motor function and eating) and is designed for use by trained professionals
- (FASE)
Functional Assessment Screening in the Elderly adults: functional disability, can be used on a time schedule to id progression of deterioration
Minimum Data Set (MDS) for Nursing Facility Resident Assessment and Care Screening
Nursing home residents
(MMSE)
Folstein Mini-Mental Status Examination Older adults- cognitive function
*NGAGED
NGAGED (Now, Growth & Development, Activities of Daily Living, General Health, Environment, and Documentation)Children ages 2-12 with physical disabilities: assesses engagement in life activities: personal, family, social, and school parameters
*Dartmouth COOP Functional Health Assessment Charts
Dartmouth COOP Functional Health Assessment Charts - Adults & Adolescent: comprehensive functional and social health test for making a brief, practical and valid method to assess the functional status of adults and adolescents. the system was developed by Dartmouth co-op project.
Concepts representing major influencing factors and hence determinants of functional ability are
Development, Cognition, and Culture
The nurse is participating at a health fair at the local mall giving influenza vaccines to senior citizens. What level of prevention is the nurse practicing? A. Primary prevention B. Secondary prevention C. Tertiary prevention D. Quaternary prevention
Primary prevention is aimed at health promotion and includes health-education programs, immunizations, and physical and nutritional fitness activities. It can be provided to an individual and includes activities that focus on maintaining or improving the general health of individuals, families, and communities. It also includes specific protection such as immunization for influenza
A patient experienced a myocardial infarction 4 weeks ago and is currently participating in the daily cardiac rehabilitation sessions at the local fitness center. In what level of prevention is the patient participating? A. Primary prevention B. Secondary prevention C. Tertiary prevention D. Quaternary prevention
Tertiary prevention involves minimizing the effects of long-term disease or disability by interventions directed at preventing complications and deterioration following the myocardial infarction. Tertiary-prevention activities are directed at rehabilitation rather than diagnosis and treatment. Care at this level aims to help patients achieve as high a level of functioning as possible, despite the limitations caused by illness or impairment. This level of care is called preventive care because it involves preventing further disability or reduced functioning
Which activity represents secondary prevention?
A. A home health care nurse visits a patient’s home to change a wound dressing.
B. A 50-year-old woman with no history of disease attends the local health fair and has her blood pressure checked.
C. The school health nurse provides a program to the first-year students on healthy eating.
D. The patient attends cardiac rehabilitation sessions weekly.
Secondary prevention focuses on individuals who are experiencing health problems or illnesses and who are at risk for developing complications or worsening conditions. The home health nurse changing the wound dressing is an activity that is focused on preventing complications. Much of the nursing care related to secondary prevention is delivered in homes, hospitals, or skilled nursing facilities.
Self-report tools
Provide information about the client’s perception of functional ability
performance-based tools
Actual observation of a standardized task, completion of which is judged by objective criteria.
preferred tool because they avoid potential for inaccurate measurement inherent in self-report.
Which factors are associated with maintenance of high-level functional ability?
Well-balanced nutrition, physical activity, routine health checkups, stress management, regular participation in meaningful activity, and avoidance of tobacco and other substances associated with abuse
Comprehensive assessment of functional ability in older adults is indicated when the individual has demonstrated what actions?
A loss of functional ability; has experienced a change in mental status; has multiple health conditions; or is a frail elderly person living in the community
What are the two basic types of assessment tools?
Self-report and performance-based
In long-term care services, functional impairment are defined as?
Needing assistance with a minimum of two or three ADLs
What are the 3 major dimensions a nurse is concerned relative to an individual’s functional ability?
- risk recognition
- functional assessment
- care delivery- planning and delivery of individualized care appropriate to level of functional ability.
Key issues that affect function?
IMPACT: Impairment ,Memory, Physical, Access, Clarity, Time
*KATZ index of Independence in activities of daily living
instrument to assess functional status as a measurement of the client’s ability to perform activities of daily living independently. clinicians use to detect problems and plan care- ranks ability to bath, dress, toilet, transfer, continence and feeding- usually for older adults
First thing to asses- self care deficit/functional ability
teeth- closest thing to your brain, eating, hygiene, weapons, then nails- weapons/ safety
CVA (stroke)
Assess with FAST: face (can smile?).Arms (can lift to sides?), Speech, Time is of the essence. brain attack when blood to brain is cut off. abilities performed by part of brain died is lost
hemorrhagic stroke
a brain aneurism burst or weakened blood vessel leak (hemorrhagic) is one of 2 types of stroke. less common more deadly
ischemic stroke
blood vessel carrying blood to brain is blocked by a clot (ischemic)
downs
trisomy 21, associated with physical growth delay, facial features and mild to moderate mental disability
Multiple Sclerosis
progressive immune related demyelination disease of the CNS. process: destruction of the fatty and protein material that surrounds nerve fibers in the brain and spinal cord. results in impaired nerve transmission. is unpredictable, often disabling disease of the CNS that disrupts the flow of info within the brain and btwn brain and body
Parkinson’s Disease (PD)
is a neurodegenerative brain disorder that progresses slowly in most people. most people’s symptoms take yrs to develop, and they live for yrs with the disease. brain slowly stops sinement (med for) producing a neurotransmitter called dopamine with less and less ability to regulate their movements, body and emotions.
social domain
encompasses the attitudes, orientations, or behaviors which take the interests, intentions or needs of others into account. one personalizes and customizes the interactions within one’s social area
psychosocial domain
happens from psychosocial development which changes is in one’s emotions, personality and social relationships. therefore this domain relates to the person’s mental development.
Mild Alzheimers
loss of recent memory, disorientation to date and time, flat affect, lack of spontaneity, impaired abstraction, cognition and judgment
moderate alzheimers
agitation, impaired ability to recognize close family and friends, loss of remote memory, confusion, apraxia, agnosia, alexia (inability to do simple tasks)mobility rigid and slow
severe alzheimers
inability to do self care, incontinence, immobility, limb rigidity, flexor posturing
what is important to assess regularly in an Alzheimers patient
cognition- mini mental state examination (MME)
functional capacity- physical self maintenance scale PSMS
warning signs of a stroke
sudden numbness, weakness, paralysis of the face, arm, or leg especially on one side of the body. sudden confusion, trouble speaking or understanding. slurred speech. sudden trouble seeing in one or both eyes. sudden trouble walking, dizziness, loss of balance or coordination. sudden, severe headache with no known cause(hemorrhagic)
adaptive utensils
devices for eating and feeding that have been modified to accommodate some type of disability.
