Health and wellness study exam 2 study guide PDF

Preview

Summary

notes for exam 2 and final...

Description

NR222 Health and Wellness Exam 2 Study Guide Ethical Principles:  Autonomy- freedom from external control. Respect for patient autonomy refers to the commitment to include patients in decisions about all aspects of care. Involving patients in decisions about their care is now standard practice.  Veracity- devotion to the truth; in giving people information about their health care needs facilitates autonomous choice and enhances personal decision-making. Health care professionals may be tempted to withhold certain details when this is seen as serving the person’s best interests or when family members demand it. It is sometimes difficult to determine how much and what types of information will best serve a person’s needs.  Fidelity - the agreement to keep promises  Nonmaleficence- the avoidance of harm or hurt; not only the will to do good but the equal commitment to do no harm.  Beneficence- taking positive actions to help others; implies that the best interests of the patient remain more important than self-interest. It implies that nurses practice primarily as a service to others, even in the details of daily work.  Justice- refers to fairness  Respect for People  Confidentiality- Act of keeping information private or secret; in health care the nurse only shares information about a patient with other nurses or health care providers who need to know private information about a patient to provide care for him or her; information can only be shared with the patient's consent. Levels of Health Prevention/Promotion- Preventive measures can be applied at any stage along the natural history of a disease, with the goal of preventing further progression of the condition.  Primary – BEFORE the condition occurs. Purpose to decrease the vulnerability of the pt to disease or dysfunction. True prevention (examples: Health education, immunization, nutritional programs, and physical fitness activities).  Secondary- EARLY DIAGNOSIS and prompt treatment. Pt with health problems and risk for developing complications or worsening conditions. (Screening techniques treating early stages of disease to limit disability and averting or delaying the consequences of advanced disease).  Tertiary- RESTORATIN AND REHABILITATION. Restoring health or rehabbing to the maximum level of functioning.  Nursing Process- The nursing process is a series of organized steps designed for nurses to provide excellent care. A legal document to ensure it is written correctly ADPIE A) Assessment: nurse collects comprehensive data pertinent to the pt's health and/or situation (subjective and objective). A physical examination of the patient. 1a. Subjective- That the pt, family member or witness informs you of pt condition. Example: "pt stated I have pain in leg" 1b. Objective- Your scenes (look, touch, smell, and hear), the pts chart (pt history) Example: "pt grimaced upon palpation of leg" D) Diagnosis: Apply clinical judgment to the client's human response to actual or potential health problems based on the assessment. nurse analyzes the assessment data to determine the diagnosis or issue. ~what is wrong with the patient? ~priorities that issues that pt has (acute, actual and risk/potential diagnosis). Types: Actual ProblemRisks for ProblemsWellness IssuesComponent /Parts - PES Statement Problem= diagnostic label or definition Etiology = cause and contributing factors (related to) Signs/ Symptoms = defining characteristics

P) Planning: Plan the steps to reach that goal. Nurse develops a plan that prescribes strategies and alternative to attain expected outcomes. Nurse identifies expected outcomes for a plan individualized to the pt or situation (what do I want to happen to my pt when I act on interventions based on diagnosis). 3a. Goals: 3b. Objective: SMART Specific- "what is to be done" Measurable-how will u know? Achievable- "can I do it" Realistic- "what will be the impact?" Time-Oriented- "when will it be done?" I) Implementation: Nurse implements the identified plan. 5a. Coordination of care: nurse coordinates care delivery. 5b. Health teaching and health promotion: nurse uses strategies to promote health and safe environment 5c. Conclusion: the graduate level-prepared specialty nurse or advanced. 5D. Prescriptive Authority and Treatment: nurse uses prescriptive authority, procedures, referrals, treatments, and therapies in accordance with state and federal laws and regulations E) Evaluation: nurse evaluates progress toward attainment of outcomes Going back to outcomes and plan... have I achieved the outcome for the pt? If you have not met go back to assessment.

Nursing Theories:  Orem’s Self-Care Theory - Dorothy Orem's Self Care Theory- Self-care deficit theory- Nursing becomes necessary when client is unable to fulfill biological, psychological, developmental, or social needs  Watson’s Human Caring Theory Nursing Theories - Jean Watson's Human Caring (science) Theory- Relationship between pt and nurse. Role of the nurse is defining the pt as a unique human being to be valued, respected, nurtured, understood and assisted. Important connections between the nurse and pt.  Transcultural Theory - Madeleine M. Leininger's Trans-cultural Nursing and Human Care TheoryMajor area in nursing focused on the comparative study and analysis of diverse cultures and subcultures in the world with respect to their caring values, expressions, health-illness benefits and patterns of behavior. Models of healthcare: Health Promotion (Pender's)- The model focuses on the following three areas: (1) individual characteristics and experiences; (2) behavior-specific knowledge and affect; and (3) behavioral outcomes, in which the patient commits to or changes a behavior The HPM notes that each person has unique personal characteristics and experiences that affect subsequent actions. The set of variables for behavioral-specific knowledge and affect have important motivational significance. Active Health Promotion- Individual becomes involved (ie: lifestyle changes - eating, physical activity, etc) Passive Health Promotion- promote public health with low participation from individual, with greatest effect to society. Examples: government regulation (FDA, air cleanliness, sanitation) Transtheoretical- individual feels confident that there are no risks for relaps Pre-contemplative- Not considering change Contemplative- Aware of but not considering change soon Preparation - Planning to act soon Action- Has begun to make behavioral change (recent)

Maintenance- Continued commitment to behavior (long-term) Relapse- Reverted to old behavior Health Belief- relationship between a person's beliefs and behaviors & factors influencing patients' perceptions, beliefs, and behavior to plan care that will most effectively assist patients in maintaining or restoring health and preventing illness Basic Human Needs Model- Maslow’s Hierarchy of Needs/Basic Human Needs Model- Basic human needs are elements that are necessary for human survival and health (e.g., food, water, safety, and love). Although each person has unique needs, all people share the basic human needs, and the extent to which people meet their basic needs is a major factor in determining their level of health. (level 1) Physiological Needs (level 2) Safety and Security (level 3) Relationships, Love and Affection (level 4) Self Esteem (level 5) Self Actualization Holistic Health Model- considering emotional and spiritual well-being and other dimensions of an individual to be important aspects of physical wellness. Assesses the whole person because it views the mind, body, and spirit as interdependent and functioning as a whole within the environment. Health depends on all these factors working together Self-Determination- This law was designed to increase individual involvement in decisions about lifesustaining treatment, ensuring that advance directives for health care are available to physicians at the time that medical decisions are being made and ensuring that individuals who have not prepared such documents are aware of their legal rights Advance Directives - based on values of informed consent, patient autonomy over end-of-life decisions, truth telling, and control over the dying process.  Institutional- – written document; can be very specific or tailored to order or may be a form document that can be downloaded from the internet. Types:  Living will- represent written documents that direct treatment in accordance with a patient's wishes in the event of a terminal illness or condition.  Terminal Care document  Health care proxy – allows a competent person to designate a decision maker in the event of incapacity.  Durable Power of Attorney- is a legal document that designates a person or people of one's choosing to make health care decisions when a patient is no longer able to make decisions on his or her own behalf. This agent makes health care treatment decisions on the basis of the patient's wishes Best advance directive – combination of proxy and written directions. Leading Healthy Indicators 2020: 12 Topics: Access to Health Services Persons with medical insurance Persons with a usual primary care provider Clinical Preventive Services Adults who receive a colorectal cancer screening based on the most recent guidelines Adults with hypertension whose blood pressure is under control Persons with diagnosed diabetes whose A1c value is >9 percent Children aged 19 to 35 months who receive the recommended doses of DTaP, polio, MMR, Hib, hepatitis B, varicella, and PCV vaccines Environmental Quality Air Quality Index (AQI) exceeding 100 Children exposed to secondhand smoke

Injury and Violence Fatal injuries Homicides Maternal, Infant, and Child Health All Infant deaths Total preterm live births Mental Health Suicides Adolescents who experience major depressive episodes (MDE) Nutrition, Physical Activity, and Obesity Adults who meet current Federal physical activity guidelines for aerobic physical activity and musclestrengthening activity Adults who are obese Obesity among children and adolescents Total vegetable intake for persons aged 2 years and older Oral Health Children, adolescents, and adults who visited the dentist in the past year Reproductive and Sexual Health Sexually active females aged 15 to 44 years who received reproductive health services in the past 12 months Knowledge of serostatus among HIV-positive persons Social Determinants Students who graduate with a regular diploma 4 years after starting 9th grade Substance Abuse Adolescents using alcohol or any illicit drugs during the past 30 days Adults engaging in binge drinking during the past 30 days Tobacco Adults who are current cigarette smokers Adolescents who smoked cigarettes in the past 30 days Complementary and Alternative Medicine (CAM) Complementary Therapies- Therapies used in addition to or together with conventional treatment recommended by a person's health care provider. As the name implies, complementary therapies complement conventional treatments. Many of them such as therapeutic touch contains diagnostic and therapeutic methods that require special training. Others such as guided imagery and breath work are easily learned and applied. Complementary therapies also include relaxation; exercise; massage; reflexology; prayer; biofeedback; hypnotherapy; creative therapies, including art, music, or dance therapy; meditation; chiropractic therapy; and herbs/supplements Alternative Therapies- include the same interventions as complementary therapies; but they become the primary treatment Integrative Therapies (Table 33-1, p. 689) o Biologically Based Therapies- Natural Products * Dietary Supplement - Defined by the Dietary Supplement Health and Education Act of 1994 and used to supplement dietary/nutritional intake by mouth; contain one or more dietary ingredients, including vitamins, minerals, herbs, or other botanical products * Herbal Medicines - Plant-based therapies used in whole systems of medicine or as individual preparations by allopathic providers and consumers for specific symptoms or issues o Energy Therapies - Use or Manipulation of Energy Field

* Healing touch - Plant-based therapies used in whole systems of medicine or as individual preparations by allopathic providers and consumers for specific symptoms or issues * Therapeutic touch - Biofield therapy involving direction of a practitioner's balanced energies in an intentional manner toward those of a patient; practitioner's hands lay on or close to a patient's body o Manipulative and Body-Based Methods - Involve Movement of Body with Focus on Body Structures and Systems * Acupressure - Applying digital pressure in a specified way on designated points on the body to relieve pain, produce analgesia, or regulate a body function * Massage Therapy - Manipulating soft tissue through stroking, rubbing, or kneading to increase circulation, improve muscle tone, and provide relaxation o Mind-Body Interventions - Honor Connections Between Thoughts and Physiological Functioning Using Emotion to Influence Health and Well-Being * Biofeedback - Process providing a person with visual or auditory information about autonomic physiological functions of the body such as muscle tension, skin temperature, and brain wave activity through the use of instruments * Breathwork- Using a variety of breathing patterns to relax, invigorate, or open emotional channels * Guided Imagery - Concentrating on an image or series of images to treat pathological conditions * Meditation-Self-directed practice for relaxing the body and calming the mind with focused rhythmic breathing * Music Therapy - Using music to address physical, psychological, cognitive, and social needs of individuals with disabilities and illnesses; improves physical movement and/or communication, develops emotional expression, evokes memories, and distracts people who are in pain. * Tai Chi - Incorporating breath, movement, and meditation to cleanse, strengthen, and circulate vital life energy and blood; stimulate the immune system; and maintain external and internal balance o Movement Therapies - Eastern or Western Approaches to Promote Well-Being * Dance Therapies - Intimate and powerful medium because it is a direct expression of the mind and body; treats people with social, emotional, cognitive, or physical problems * Pilates o Whole Medical Systems- Method of body movement used to strengthen, lengthen, and improve the voluntary control of muscles and muscle groups, especially those used for posture and core strengthening o Whole Medical Systems- Complete Systems of Theory and Practice That Have Evolved Independently from or Parallel to Allopathic [Conventional] Medicine * Homeopathic medicine - Developed in Germany and practiced in the United States since the mid-1800s. It is a system of medical treatments based on the theory that certain diseases can be cured by giving small, highly diluted doses of substances made from naturally occurring plant, animal, or mineral substances that stimulate the vital force of the body so it can heal itself. * Native American Traditional Healing- Tribal traditions are individualistic, but similarities across traditions include the use of sweating and purging, herbal remedies, and ceremonies in which a shaman (a spiritual healer) makes contact with spirits to ask their direction in bringing healing to people to promote wholeness and healing. Integrative nursing is defined as “a way of being-knowing-doing that advances the health and well-being of people, families, and communities through caring-healing relationships. Integrative nurses use evidence to inform traditional and emerging interventions that support “whole person/whole systems healing”

Nursing Accessible Therapies (p. 691)

o Relaxation Therapy - Relaxation helps individuals develop cognitive skills to reduce the negative ways in which they respond to situations within their environment. Cognitive skills include the following: • Focusing (the ability to identify, differentiate, maintain attention on, and return attention to simple stimuli for an extended period) • Passivity (the ability to stop unnecessary goal-directed and analytic activity) • Receptivity (the ability to tolerate and accept experiences that are uncertain, unfamiliar, or paradoxical). The long-term goal of relaxation therapy is for people to continually monitor themselves for indicators of tension and consciously let go and release the tension contained in various body parts. o Meditation and Breathing- any activity that limits stimulus input by directing attention to a single unchanging or repetitive stimulus so the person is able to become more aware of self o Imagery- or visualization is a mind-body therapy that uses the conscious mind to create mental images to stimulate physical changes in the body, improve perceived well-being, and/or enhance self-awareness. Training-Specific Therapies - CAM treatments that nurses administer only after completing a specific course of study and training. o Biofeedback- a mind-body technique that uses instruments to teach self-regulation and voluntary self-control over specific physiological responses. This feedback is given in physical, physiological, auditory, and/or visual feedback signals that increase a person's awareness of internal processes that are linked to illness and distress. Biofeedback therapies can change thinking, emotions, and behaviors, which in turn support beneficial physiological changes, resulting in improved health and well-being. o Acupuncture - Acupuncture regulates or realigns the vital energy (qi), which flows like a river through the body in channels that form a system of 20 pathways called meridians. An obstruction in these channels blocks energy flow in other parts of the body. Acupuncturists insert needles into the skin in specific areas along the channels called acupoints, through which the qi can be influenced and flow reestablished. o Therapeutic Touch- It affects the energy fields that surround and penetrate the human body with the conscious intent to help or heal. TT consists of placing a practitioner's open palms either on or close to the body of a person It occurs in five phases:     

Centering- centers physically and psychologically, becoming fully present in the moment and quieting outside distractions. Assessing- scans the body of the patient with the palms from head to toe. Unruffling- While assessing the patient's energetic biofield, the practitioner focuses on the quality of the qi and areas of energy obstructions, redirecting the energy to harmonize and move Treating- Using long, downward strokes over the energy fields of the body, the practitioner touches the body or maintains the hands in a position a few inches away from the body Evaluating- evaluating the patient, ensuring that energy is flowing freely, and determining additional outcomes and responses to the treatment.

 Cultural AwarenessCulture- norms, values, and traditions passed down through generations. It also has been perceived to be the same as ethnicity, race, nationality, and language.  Intersectionality- Gender, sexuality, race, ethnicity, and class must not be studied in isolation, because they have intermingled effect on our identity, knowledge, and outcomes.  Oppression- a formal and informal system of advantages and disadvantages tied to our membership in social groups, such as those at work, at school, and in families. It impacts an individual's access to resources such as health care, housing, education, employment, and legal services. the state of being subject to unjust treatment or control

Ethnicity- Identity with a group of people that share distinct physical and mental traits as a product of common heredity and cultural traditions. Dynamic set of historically derived and institutionalized ideas and practices that allows people to identify or to be identified with groupings of people on the basis of presumed (and usually claimed) commonalities including language, history, nation or region of origin, customs, ways of being, religion, names, physical appearance, and/or genealogy or ancestry; can be a source of meaning, action, and identity; and confers a sense of belonging, pride, and motivation"

Health Disparities- are differences among p...