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Theory 2 > Theory 2 Final Exam > Flashcards

Theory 2 Final Exam Flashcards

1
Q

What is medicare?

A

A key component of Canada’s social safety net for citizens is the provision of hospital & medical insurance, known as Medicare, which is funded by the general taxation.

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2
Q

What are the nursing shortage (most common causes)?

A
  • Aging workers
  • High retirement rate
  • Lack of full time positions
  • Constitute large % of health care budget
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3
Q

What are the 5 principals of health canada act?

A
  • Public Administration
  • Comprehensiveness
  • Universality
  • Portability
  • Accessibility
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4
Q

Principles of Canada Act - Describe Public Administration:

A

Public Administration- provincial insurance programs are publicly accountable for the funds they spend & the province determines the amount of coverage of insured services

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5
Q

Principles of Canada Act -Describe Comprehensiveness:

A

*Comprehensiveness-Provincial health insurance must cover all medically necessary services for the purpose of maintaining health, preventing disease, dx or tx an illness, injury or disability

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6
Q

Principles of Canada Act -Describe Universality:

A

Universality- provincial health programs must insure Canadians for all medically necessary hospital and physician (NPs also) care

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7
Q

Principles of Canada Act -Describe Portability:

A

Portability- People are covered by their provincial insurance during short absences from their province

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8
Q

Principles of Canada Act -Describe Accessibility

A

Accessibility-Canadians must have reasonable access to insured services without charge or paying user fees

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9
Q

What contributes to spending in healthcare?

A

Canadians pay directly, or indirectly, for every aspect of our healthcare system through a combination of taxes, payments to government, private insurance, and direct out-of-pocket fees of varying types and amounts
* Escalating costs are driving health care reform effects, challenging health care institutions to deliver quality care more efficiently.

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10
Q

Describe the key points to the Romanow Commission, 2002:

A
  • concluded that Medicare is sustainable and must be preserved
  • represents Canadian’s core values
  • recommended changes to Canada Health Act
  • did not make recommendations for cost
  • emphasized accountability for funding
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11
Q

Describe the key points to the Kirby Report, 2002:

A

Kirby Report, 2002

  • concluded that Medicare is not sustainable
  • advocated for private sector involvement
  • clarified the impact of spiraling health care costs
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12
Q

What is primary health care?

A

Primary health care (PHC) is a foundation of Canada’s Health care system, providing entry point of contact into the health care system, as well as the vehicle for continuity of care. The PHC is a philosophy and model for improving health that supports essential health care services (promotive, preventive, curative, rehabilitative, and supportive) with a strong emphasis on the principles of health promotion and disease prevention.

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13
Q

What are the settings for healthcare delivery?

A 
INSTITUTIONAL SECTOR
*Hospitals
*Long-Term Care Facilities
*Psychiatric Facilities
*Rehabilitation Centres
COMMUNITY SECTOR
*Public Health
*Physicians Offices
* Community Health Centres (CHCs) &  
   Clinics
*Assisted Living
*Home Care
*Adult Day Care Centres
*Community and Voluntary Agencies
* Occupational Health
*Hospice and Palliative Care
*Parish Nursing
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14
Q

What are the 5 levels of care?

A

5 Levels of Care

  • Level 1: Health Promotion
  • Level 2: Disease & Injury Prevention
  • Level 3: Diagnosis & Treatment
  • Level 4: Rehabilitation
  • Level 5: Supportive Care
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15
Q

What is primary care?

A

Primary care is the first contact of a client with the health care system that leads to a decision regarding a course of action to resolve any actual or potential health problems. PC providers include physicians and nurse practitioners.

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16
Q

What is secondary care?

A

Occurs usually in a hospital or home setting, involves provisions of a specialized medical service by a physician specialist or a hospital on referral from a PC practitioner.

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17
Q

What is tertiary care?

A

Tertiary care is specialized and highly technical care in diagnosing and treating complicated or unusual health problems. Clients have extensive, often complicated pathological conditions.

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18
Q

What are health care cost acclerators?

A
  1. technologies - e-health & nursing informatics
  2. demographics - aging population, increase in maternal age
  3. consumer involvement - demand higher quality care
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19
Q

What is the canadian patient safety institute

A

canadian patient safety institute is charged with providing leadership in building and advancing a safer health care system.

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20
Q

hospital infections

A

Preventable adverse events occur annually in Canadian hospitals, one per nine clients contract an infection while in the hospital, and the same number experiences a medical-related error.

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21
Q

Define population:

A

Is a collection of individuals who have in common one or more personal or environmental characteristics. Examples- high-risk infants, older adults, or a cultural group such as aboriginals.

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22
Q

Define community:

A

Is a group of people who share a geographic (locational) dimension and a social (relational) dimension.

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23
Q

What are the healthy characteristics of healthy community?

A

The key characteristics of a healthy community include a collective capacity to solve problems; adequate living conditions; a safe environment; and sustainable resources such as employment, health care, and educational facilities.

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24
Q

What does community health nursing involve?

A

Community health nursing includes public health nursing, home health (community-based) nursing, and community mental health nursing, as well as a variety of other specialities such as street health, telehealth, and parish nursing.

COMMUNITY NURSING
•Delivery of health care where people live, work & learn
•Essential for improving health for the general public

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25
Q

4 GOALS OF COMMUNITY NURSING

A
  1. Keep people healthy
  2. Encourage client participation & choice in care
  3. Promote health-enhancing social environments
  4. Provide in-home care for ill or disabled
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26
Q

What are vulnerable populations?

A

Vulnerable populations of clients are those who are likely to develop health problems as a result of excessive risk, who experience barriers when trying to access health care services, or who are dependent on others for care.

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27
Q

cultural competency & sensitivities

A

???

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28
Q

Steps in assessing vulnerable populations:

A

1)SETTING THE STAG
2)NURSING HISTORY OF AN INDIVIDUAL OR A FAMILY
3) PHYSICAL EXAMINATION OR HOME ASSESSMENT
see pg. 47 box 4-4 for more detail

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29
Q

What are the 7 Roles of Community Health Nurses?

A

7 Roles of Community Health Nurses:

  1. Understand roles agencies, regulations & laws
  2. coordinate services to address needs of community
  3. Set up screening programs
  4. Educate local health providers
  5. Work to improve condition of housing
  6. Educate the public
  7. Assessment & referral
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30
Q

Describe risk behaviours:

A

Potentially stigmatizing risk behaviours include substance abuse and unsafe sexual practices.

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31
Q

What would a community assessment involve?

A

As a community health nurse, you must assess the community- the environment in which people live and work. The community can be seen as having three components: the locale or structure, the social systems, and the people.

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32
Q

What is harm reduction nursing?

A

Harm reduction nursing exemplifies community nursing practice guided by primary health care, health promotion, empowerment, and ethical principles. An example would be a needle exchange program.

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33
Q

List the 5 types of loss:

A
  1. necessary loss
  2. actual loss
  3. perceived loss
  4. maturational loss
  5. situational loss
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34
Q

TYPE OF LOSS?

integral part of each person’s life
eg. death of loved one, divorce, loss of independence

A

NECESSARY

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35
Q

TYPE OF LOSS?

  • loss of person or object that can no longer be felt, heard, known or experienced
  • loss of a body part, child, relationship or role at work
A

ACTUAL

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36
Q

TYPE OF LOSS?

  • any loss that is defined uniquely by the grieving client
  • eg. loss of confidence or prestige
A

PERCEIVED

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37
Q

TYPE OF LOSS?

  • includes any change in the developmental process that is normally expected during a lifetime
  • eg. parents feeling loss as a child goes to school for the first time
A

MATURATIONAL

38
Q

TYPE OF LOSS?

  • includes any sudden, unpredictable external event
  • often includes multiple losses rather than single loss
  • eg. car accident
A

SITUATIONAL

39
Q

____________ IS THE ULTIMATE LOSS

A

DEATH

40
Q

Kubler-Ross’s 5 stages of dying

A
  1. Denial
  2. Anger
  3. Bargaining
  4. Depression
  5. Acceptance
41
Q

Bowlby’s 4 phases of mourning

A
  1. Numbing
  2. Yearning and searching
  3. Disorganization and despair
  4. Reorganization
42
Q

4 Types of Grief:

A
  1. normal grief
  2. anticipatory grief
  3. complicated grief
  4. disenfranchised grief
43
Q

WHICH TYPE OF GRIEF?

  • normal feelings, behaviours, and reactions to loss
  • resentment, sorrow, anger, crying, loneliness, temporary withdrawal from activities
A

NORMAL

44
Q

WHICH TYPE OF GRIEF?

  • process of disengaging or “letting go” before an actual loss or death has occurred
  • beginning the process of saying goodbye and settling life affairs after a terminal diagnosis is received
  • family members may withdraw emotionally too soon, leaving client with no emotional support as death approaches
A

ANTICIPATORY

45
Q

WHICH TYPE OF GRIEF?

  • when a person has difficulty progressing through normal stages of grieving
  • includes 4 types: chronic, delayed, exaggerated, masked
A

COMPLICATED

46
Q

WHICH TYPE OF GRIEF?

  • grief experienced when a loss cannot be openly acknowledged, socially sanctioned, or publicly shared
  • eg. loss of partner to AIDS, stillborn
A

DISENFRANCHISED

47
Q

TYPE OF GRIEF?

- people verbalize an inability to “get past” the grief

A

COMPLICATED - CHRONIC

48
Q

TYPE OF GRIEF?

- active grieving is held back, only to resurfaces later, usually in response to a trivial loss or upset

A

COMPLICATED - DELAYED

49
Q

TYPE OF GRIEF?

  • grief overwhelms some people to the point where they cannot function
  • may be reflected in the form of severe phobias or self-destructive behaviour: addiction or suicide
A

COMPLICATED - EXAGGERATED

50
Q

TYPE OF GRIEF?

  • lack of awareness by survivors that behaviours that interfere with normal functioning are a result of loss
  • eg. altered sleeping or eating patterns
A

COMPLICATED - MASKED

51
Q

7 factors that influence loss and grief

A
  1. Human development
  2. Psychosocial perspectives of loss and grief
  3. Socioeconomic status
  4. Personal relationships
  5. Nature of the loss
  6. Culture & ethnicity
  7. Spiritual beliefs
52
Q

2 GRIEF-RELATED ROLES OF THE NURSE

A
  1. Facilitating grief process effectively

2. Assist clients to peaceful dignified death

53
Q

TRUE OR FALSE?

Nurses must develop an understanding of own feelings towards death

A

TRUE

54
Q

5 Potential Nursing Diagnoses related to grief

A
  1. HOPELESSNESS related to failing physical condition
  2. INEFFECTIVE INDIVIDUAL COPING related to low mood, and inability to manage loss
  3. POWERLESSNESS related to perceived poor outcomes
  4. SELF-CARE DEFICIT related to inability to perform activities of daily living
  5. SOCIAL ISOLATION related to inability to cope with loss
55
Q

THE FOCUS OF CARE PLANNING IN DEATH & DYING:

A
  • support the client physically, emotionally, developmentally, and spiritually in the expression of grief
56
Q

When caring for the dying client, it is important to devise a plan that helps the client die with ______________ and offers family members the ________________ that their loved one is cared for ______________.

A

dignity, assurance, compassionately

57
Q

The care planning process is highly _____________ to the client and family. Both must be included as active participants in planning, goal setting, and development of realistic _______________ & ______________.

A

individual
interventions
timelines

58
Q

What is the aim of palliative care?

A
  • relieve suffering, and improve the quality of living and dying
59
Q

When can someone receive palliative care?

A

for any age, any diagnosis, at any time, and not just during the last few months of life

60
Q

7 treatments provided with palliative care:

A
  1. RELIEF from pain and other distressing symptoms
  2. AFFIRM life and REGARD dying as normal process
  3. neither HASTEN nor POSTPONE death
  4. INTEGRATE psychological and spiritual aspects of client care
  5. HELP CLIENTS LIVE as actively as possible
  6. HELP FAMILIES COPE
  7. ENHANCE quality of life
61
Q

MASSIVE VAGUE QUESTION ABOUT pg. 465 box 29.8……

  • nursing care planning with dying patients
  • dealing with and treating the symptoms
  • from a symptoms perspective
A

NO IDEA.

62
Q

symptoms displayed in the terminal stages

A
  • discomfort
  • fatigue
  • nausea
  • constipation
  • diarrhea
  • urinary incontinence
  • inadequate nutrition
  • dehydration
  • INEFFECTIVE BREATHING PATTERNS
    (air hunger, shortness of breath)
  • confusion
63
Q

management of air hunger:

A
  • oxygen therapy

- morphine and antianxiolytics

64
Q

treatment for TERMINAL STAGE discomfort:

A
  • skin care
  • special mattress
  • oral care
  • artificial tears to reduce corneal drying
65
Q

treatment for TERMINAL STAGE fatigue

A
  • help client identify priority tasks
  • help client conserve energy for those tasks
  • time and pace care activities
  • encourage use of energy-saving devices
66
Q

treatment for TERMINAL STAGE nausea

A
  • nutritional supplements

- clear liquid diet

67
Q

treatment for TERMINAL STAGE constipation

A
  • increase fluid & fiber intake

- laxatives

68
Q

treatment for TERMINAL STAGE diarrhea

A
  • medication

- low-residue diet

69
Q

treatment for TERMINAL STAGE urinary incontinence

A
  • protect skin

- catheter or brief

70
Q

treatment for TERMINAL STAGE dehydration

A
  • mouth care

- ice chips

71
Q

treatment for TERMINAL STAGE ineffective breathing patterns

A
  • oxygen therapy
  • medications
  • semi-fowlers position
  • comfort and reassurance
72
Q

treatment for TERMINAL STAGE confusion

A
  • ensure safe environment
  • monitor client frequently
  • reorient client as needed
73
Q

PREPARING THE DYING CLIENT’S FAMILY objectives

A

improve family’s ability to provide:

  • appropriate physical care
  • appropriate psychological support
74
Q

PREPARING THE DYING CLIENT’S FAMILY teaching strategies

A

demonstrate:

  • feeding technique
  • bathing, mouth care
  • safe transfer techniques

instruct family on need to take rest breaks

teach family to recognize signs & symptoms of worsening conditions

answer questions & provide info as needed

75
Q

TRUE OR FALSE?

Cultural beliefs are not important in post-mortem care

A

False

76
Q

Maintaining the integrity of rituals and mourning practices helps families ____________ the client’s death and achieve inner ____________

A

accept

peace

77
Q

WHO?

* Premier of Saskatchewan

A

TOMMY DOUGLAS

78
Q

WHO?

* 1961 - Introduced first hospital insurance plan in Saskatchewan

A

TOMMY DOUGLAS

79
Q

WHO?

* Well-known founder of both Medicare & Canada’s social democratic movement

A

TOMMY DOUGLAS

80
Q

WHO?

* One of nation’s most eloquent orators

A

TOMMY DOUGLAS

81
Q

differences in care between volunteer & professional person

A
  • volunteers can offer emotional support

- professionals can provide hands-on care

82
Q

3 major environmental threats

A
  1. Indoor air pollution
  2. Outdoor air pollution
  3. Unsafe water, sanitation, and hygiene
83
Q

Environmental agents that trigger changes, or mutations, in the genetic material (DNA) of living cells are called ______________

A

mutagens

84
Q

______________: mutagen that causes cancer

A

Carcinogen

85
Q

8 Community Environmental Concerns:

A
  1. Pollution
  2. Water
  3. Food
  4. Pesticides
  5. Chemical weapons
  6. Cosmetic chemical
  7. Radiation
  8. Noise pollution
86
Q

____________ ______________ can cause floods, heat waves, changes in patterns of infectious diseases, water supplies, and food availability

A

Climate change

87
Q

This is known as any long term significant change in the “average weather” that a region experiences

A

Climate change

88
Q

____________ ____________: small amounts of solar radiation pass through the Earth’s atmosphere so heat is generated – rest of the solar radiation bounces back into space

A

greenhouse effect

89
Q

6 greenhouse gases

A
  1. water vapor,
  2. carbon dioxide,
  3. nitrous oxide,
  4. methane,
  5. chlorofluorocarbons1,
  6. ozone
90
Q

____________ ____________ an agreement among the industrialized nations of the world to reduce emissions of six greenhouse gases over a certain period of time

A

kyoto protocol

Theory 2 (2 decks)

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