Week 2 -- ati 2, 9, 16, 17, 35, & hw Flashcards
assessing the cognitive domain
lecture
question & answer
discussion
***thinking domain
assessing the affective domain
Role Play
Discussion
**emotions & feelings
5 steps of affective domain
- Receiving
- Responding
- Valuing
- Organization
- Characterization
assessing the psychomotor domain
demonstration
games
**learning based on action
7 Steps of Psychomotor Domain
- Perception
- Set
- Guided Response
- Mechanism
- Complex of overt response
- Adaptation
- Origination
Knowles 6 Fundamental Principles of Learning
- Relevance
- Self-Directed
- Life Experience
- Readiness
- Task Centered
- Motivations
S.M.A.R.T
S–Smart
M–Measurable
A– Achievable
R–Relevant
T–Timed
question that assesses client health literacy
” How confident are you about filling out medical forms by yourself ? “
fine motor skills
use of small muscles
gross motor skills
use of large muscle groups to perform whole body movements
7 principles of self-care
- Knowledge & health literacy
- Mental wellbeing & self-awareness
- Physical Activity
- Healthy eating
- Risk Avoidance
- Good Hygiene
- Reason
goal of Healthy People initiative
public to select their objective to use to improve overall health
Primary Prevention
behaviors & vaccinations
**act of intervening before negative health effects occur
Secondary Prevention
early screenings to detect disease
Tertiary Prevention
Therapy / Rehab
Support groups
***controlling chronic effects of ongoing disease
Quartanary Prevention
protects client from excessive use of medical interventions that cause more harm than good.
A nurse is caring for a client on the med-surg unit. Which client care needs should the nurse initiate a referral for a social worker?
- A client who has terminal cancer requests hospice care in the home
*A client asks about community resources available for older adults
*A client requests an electric wheelchair for use after discharge
a goal for a client who has difficulty with self-feeding due to rheumatoid arthritis is to use adaptive devices. Referral to which interprofessional team ?
Occupational Therapist
Which interprofessional care team can assist the client in understanding medication?
Provider
RN
Pharmacist
A client who had a cerebrovascular accident has problems with dysphagia. Referral to where?
Speech-Language Pathologist
Tasks CNA’s can perform
Bathing
Ambulating
Toileting
Measuring vital signs
client with low albumin levels & unexplained weight loss should be referred to?
Registered Dietician
Occupational Therapist
assesses & plans for clients regain ADL skills–motor &
UPPER extremities
**using utensils w/ dominant hand following stroke
Physical Therapist
assesses & plans for clients to increase musculoskeletal function – LOWER extremities to maintain memory
Social Worker
works w/ clients & family by coordinating inpatient & community resources to meet needs
terminal client can’t perform ADL’s–partner needs equipment. Refer to who?
Social worker
Baseline Data includes
vital signs
height
weight
allergy status
Psychosocial Assessment includes asking about..
alcohol, drug, & caffeine use
history of mental illness
history of abuse
history of homelessness
home- situation
a nurse is performing an admission assessment for an older adult client. After gathering the assessment data & performing the review of systems, which of the following actions is priority for the nurse?
Orient the client to their room
a nurse is admitting a client who has acute cholecystitis to a med-surg unit. Which of the following actions are essential steps of the admission procedure?
*Explain the roles of other care delivery staff
*Begin discharge planning
*Document the client’s wishes about organ donation
*Introduce the client to their roommate
A nurse is caring for a client who had a stoke & is scheduled for transfer to a rehab center. Which of the following tasks are the responsibility of the nurse at the transferring facility?
*Ensure that the client has possession of their valuables
*Confirm that the rehab center has a room available at the time of transfer
*Give a verbal transfer report via telephone
*Complete a transfer form for the receiving facility
A nurse is preparing the discharge summary for a client who has had knee arthroplasty & is going home. Which of the following info about the client should the nurse include in the discharge summary?
*Follow up care
*Instructions for diet & medications
*Contact info for the home health care agency
As part of the admission process a nurse at a long-term care facility is gathering a nutrition history for a client who has dementia. Which of the following components of the nutrition evaluation is the priority for the nurse to determine from the client’s family?
Any difficulty swallowing
Admission Procedure
- introduce yourself
2.explain roles of team - introduce roomate
- Position client & apply ID
- Provide info & include advanced directive
- Document client advanced directive status
Procedure for transferring a client
- confirm availability & time
- complete documentation
- give verbal transfer report (person or phone)
- confirm mode of transport
Procedure for receiving a transfer client
- have equipment ready
- inform team & roommate
- meet & assess
scheduling routine physicals
age 20-40
**1-3 yrs female
**every 5 yrs male
scheduling dental
vs
scheduling TB
dental = every 6 mo
TB = 2 yrs (annually if health care worker)
Schedule for Blood Glucose
vs Blood Cholesterol
Glucose = start age 45–minimum every 3 yrs
Cholesterol = start age 20 – minimum every 5 yrs
Assessing vision vs BP
vision
*under 40 every 3-5 yrs
*40-64 every 2 yrs
*65+ annually
BP = every 2yrs unless elevated then annually
skin assessment occurs
ages 20-40 = every 3 yrs
40+ annually
Colorectal screening
annually age 50-75
items periodically assessed a routine physicals
BMI
hearing
digital rectal
Tests specific for women
- Cervical Cancer Screening
-age 21-65 every 3 yrs
-age 30 every 5 yrs + HPV test
-age 65 no test
*Breast Cancer
-age 20-29 every 3 yrs
-age 40-54 annual
-age 55+ every 1-2 yrs
Tests specific for men
**Clinical Testicular exam —routine since puberty
**Prostate Specific Antigen Test—age 50
**digital rectal exam–age 50
primary prevention
promotes health & prevents disease
*health education
*immunizations
secondary prevention
identifies illness, provides treatment, & prevents worsening
*disease screening
* early detection
tertiary prevention
begins after illness/injury, & prevents consequences of illness
**optimal functioning
**rehab/support groups
a nurse is caring for a young adult at a college health clinic. which of the following actions should the nurse take first?
Determine the client’s health risks
A nurse in a health clinic is planning health promotion & disease prevention strategies for a client who has multiple risk factors for cardiovascular disease. Which of the following interventions should the nurse include?
*Help the client see the benefits of their actions
**Identify the client’s support systems
**Suggest & recommend community resources
**Teach stress management strategies
A nurse in a health clinic is caring for a 21yr old client who tells the nurse that their last physical was in high school. Which of the following health screenings should the nurse expect the provider to perform?
Testicular examination
Which of the following activities should the nurse include as part of primary prevention?
Teaching about a healthy diet
A nurse at a provider’s office is talking about routine screenings w/ a 45yr old female client w/ no specific family history of cancer or diabetes.which of the following client statements indicate an understanding of how to proceed?
“For now, I should continue to have a mammogram each year”
A nurse in a provider’s office is collecting data from the caregiver of a 12 mo old infant who asks if the child is old enough for toilet training. Following an educational session w/ the nurse, the client agrees to postpone toilet training until the child is older. Learning has occurred in which of the following domains?
Affective
A nurse is providing pre-op education for a client who will undergo a mastectomy. Which of the following statements should the nurse identify as an indication that the client is ready to learn?
“Can you tell me about how long the surgery will take?”
A nurse is preparing an instructional session for a client about managing stress incontinence. Which of the following actions should the nurse take first when meeting with the client?
Determine what the client knows about stress incontinence
a nurse is evaluating how well a client learned the info. presented in an instructional session about following a heart healthy diet. which of the following actions should the nurse take to evaluate the client’s learning?
ask the client to explain how to select or prepare meals
when are one’s values developed
unconsciously during childhood
5 factors contributing to culture
- Knowledge
- Values
- Beliefs
- Morals & Law
5 Customs & habits
cultural imposition
cultural blindness
Intrapersonal vs Interpersonal vs transpersonal
Intra = within oneself
Inter = with others
Trans = w/ unseen higher power
transcendence
the belief in a force outside the person & material world that is superior
Buddhism Practices
- good health thru good deeds
- illness is a result of nonhuman spirits
- medications seen as harmful – chemicals
- no euthanasia or bovine derived medications
- same gender health care worker
Buddhism Diet & Death
- some vegetarians –avoid alcohol & tobacco
*fast on holy days - death is a stage of life–preferred at home
- avoid touching body (head ok) — body prepared by male
- brain death not requirement for death
Christianity Rituals
*lay hands while praying
*anoint a client ill/near death
*fast during lent
*Holy Communions & clergy visits
**hydration & nutrition as long as possible
Sikhism rituals
*removing undergarments is distressing
*females w/ females
*not cutting/shaving hair
Navajo Rituals
*holistic health –wellness intervention more than disease prevention
*blessingway practice, songs rituals, & prayer correct health
*focus on humanity & place of humans in universe
Hinduism Ritual & diet
- illness = sins
*decisions are made by community/senior family
*females defer to spouse/family
*life prolonging discouraged
*decline porcine medications
DIET = ahisma (nonviolence to food) = vegetarian
Hinduism Death rituals
*dying client on floor w/ hear north
*cremations purifies
*body prepared by same gender
Islam Beliefs
*pain is cleansing
*death is predetermined (avoid talking about it)
*spirituality is connected to health (5x a day prayer & strength in group prayer)
*avoid organ transplant & euthanasia
*permit withdrawl of life support but not nutrition/hydration
Islam DIet
*decline porcine meds
*avoid alcohol & pork
*fast during Ramadan
Islam Death
*no autopsy burial preferred
*face turned toward Mecca
*body washed & wrapped in cloth (same gender or mosque person)
Jehovah witness beliefs
no blood transfusion
no food w/ blood
Judaism beliefs
*obligation to visit ill
*balance of God & medicine
*refuse treatment on Sabbath
*no euthanasia or life support
*males circumcised 8th day after birth
*kocher diet
Judaism death
*burial within 24hrs & someone always w/ body
*no autopsy, cremation, or embalming
*Orthodox prefer Jewish Burial Society
Mormonism beliefs & death
*avoid alcohol, caffeine, & tobacco
*temple clothing during death
*children baptized by age 8
*clients might recite confessional (Shema near death)
*body not left alone
*burial preferred
*visit from spiritual leaders (local elders) for blessing
4 C’s cultural assessment
- Call – what do you call the problem
- Cope –how do you cope
- Concerns
- Cause
FICA spiritual assessment
F –Faith/beliefs
I –Implications, Importance, Influence
C– community
A –address
LEARN assessment tool
Listen
Explain
Acknowledge
Recommend
Negotiate
A nurse is using an interpreter to communicate w/ a client. Which actions should the nurse use when communicating w/ a client & family members?
*determine the client understanding several times during the conversation
*Use lay terms if possible
*Do not interrupt the interpreter & the family as they talk
A nurse is caring for 2 clients who report following the same religion. which info should the nurse consider when planning care for these clients?
the same religious beliefs can influence individuals differently
a nurse enters the room of a client who is crying while reading from a religious book & asks to be left alone. Which action should the nurse take?
ensure no visitors or staff enter the room for a short time period
a nurse is discussing the plan of care for a client who reports following islamic practices. which statement by the nurse indicates culturally responsive care to the client?
” I will ask the client if they want to schedule some times to pray during the day.”
A nurse is caring for a client who tell the nurse that based on religious values & mandates, a blood transfusion is not an acceptable treatment option. Which response should the nurse make?
“Let’s discuss the necessity for a blood transfusion with your religious and spiritual leaders and come to a reasonable solution”
