Health Wellness Illness Diagnostic Tests Study Guide PDF

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Health and Wellness, Diagnostic Test Study Guide with student answers and explainations...

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Health/Wellness/Illness/Diagnostic Tests Study Guide NUR100 Fall 2021 1. What is a theoretical model of health? They are approaches used to understand and promote health in medicine. 2. What is the purpose/usefulness of a theoretical model of health? The models of health are integrated into healthcare systems to identify, develop, and implement the best way to care for clients or the community. 3. Describe the following theoretical models of health and describe the benefits/uses of each: a. Health-Belief Model is a social health behavior model. It is used to describe how the people’s beliefs about health can effect health promotion. b. High Level Wellness explains that health promotion and health care is an on-going process. c. Health Continuum is the kind of health care that follows the client through various levels of health care. d. Holistic Health is care that promotes the physical, emotional, social, intellectual, and spiritual well-being of the client. The client’s overall well-being is made the center of the care. 4. What are some cultural concepts a nurse must know? It would be greatly beneficial for a nurse to know some basic cultural differences to best care for the client. A nurse should know what values the main cultures value or what aspects of the culture are most important. 5. What is a culturally competent nurse? A culturally competent nurse respects cultural aspects of the client’s health. The nurse should attempt to relate to the client and find ways to care for the client by respecting and using cultural aspects of care . 6. What traits/behaviors does a culturally competent nurse exhibit? RESPECT 7. Describe some common cultural characteristics for the following cultural populations: a. Asian: Use nonverbal cues to determine pain levels; the client values balance; the client may have beliefs in herb healing/usage; teach the client about a low sodium diet if necessary

b. Black (African American): Family is incredibly important so it may be beneficial to include family into care plan; may need a spiritual leader; consider spiritual, herbal, home remedies c. Hispanic: Family is main source of support; respect is highly valued; may need diet counseling; very difficult to convince of lifestyle changes or illness d. White (Caucasian): self-diagnose frequently so may have to consider OTC drug use; may want to assess normal dieting and work on dieting recommendations

8. Define health: A state of complete physical, mental, and social well-being; passive (a person can be healthy but not well and vice versa)

9. Define wellness: an active process in which an individual progresses towards the maximum possible potential, regardless of current health status

10. Define illness: the state of a disease causing symptoms; the state of being sick

11. Define disease: a state in which the body is not functioning normally due to abnormalities/viruses/vectors/parasitic invasion/etc

12. Why is it important for a nurse to understand the similarities and differences between these terms? The two terms are linked in terms of having a sick client to care for, but depending on what illness or disease a client has is what determines the type of care that is given to the client. 13. What are the life dimensions? • Sociocultural • Emotional • Spiritual • Economic • Intellectual • Physical 14. Define health disparity: a specific difference in social, economic, and environmental disadvantages

15. What are some examples of health disparities in your community? • African American communities of project living • Low-income homes lacking necessary health care 16. What role does the nurse play in overcoming/lessening these disparities? ADVOCATE FOR CLIENTS!!!! 17. Compare and contrast acute versus chronic illness. • Acute illness is rapidly occurring, but also allows the client to return to their former state of health. • Chronic illness is slow and on-going, but can sometimes have no cure or controlled treatment. 18. What are the three levels of health promotion/prevention? Give examples of each. • Primary: directed towards PROMOTING health and PREVENTING the development of disease processes or injury; example: immunization clinic, family planning services, accident prevention education • Secondary: focus on screening for early detection of disease with prompt diagnosis and treatment of any found (early detection) • Tertiary: begins after an illness is diagnosed and treated, with the goal of reducing disability and helping rehabilitate patients to a maximum level of functioning 19. Describe each of the following diagnostic tests and explain what role the registered nurse plays in relation to each one (include pre- and post-test nursing care and client education). a. Blood tests: lab analysis of blood sample • Pretest: phlebotomist or professional takes blood samples • Posttest: lab results • Client education: make sure all blood components are within range; detect abnormalities b. Urine: urinalysis (lab analysis of urine sample to detect certain disorders or abnormalities) • Pretest: cleaning the area prior to decrease contaminants, urinate into sample cup, notify lab of any medications that would effect results • Posttest: lab results • Client education: to eliminate or determine certain disorders or sediments; to determine drug usage; no fluid or food restrictions; test takes less than 5 minutes c. Sputum: lab analysis on mucus sample from lungs, bronchi, and trachea to determine or identify any pulmonary or respiratory diseases

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Pretest: collect mucus sample; no fluid or dietary restrictions Posttest: lab results; perform dental hygiene; assess and monitor vital signs and respiratory status; monitor oxygen via pulse oximeter Client education: make sure that flora is normal and detect any abnormal mucus components; samples are taken in the morning before breakfast

d. X-ray: a painless, non-invasive test uses electromagnetic waves to produce visual images of the heart, lungs, bones, and blood vessels of the chest. • Pretest: make sure client is not pregnant; remove all jewelry (metals); pain medication due to having to stay in uncomfortable positions; assess the client’s ability to hold breath • Posttest: provide comfort while awaiting results • Client education: explain procedure; may have to be very still or hold breath for extended periods of time; noninvasive e. Ultrasound: sound waves used to detect organs • Pretest: food and drink restrictions, • Posttest: • Client education: noninvasive; sound waves are used to see organs; lay still for about 20 minutes; may have sticky gel; no pain should be present f. CT Scan: To evaluate soft tissue and organs of the abdomen, pelvis, and retroperitoneal space To evaluate inflammatory disease To aid staging of neoplasms To evaluate trauma To detect tumors, cysts, abscesses, fluid collection, hemorrhage, or edema To evaluate response to chemotherapy or radiation To guide biopsies or other procedures To plan for and/or assess results of surgery such as transplants •

Pretest: o Have the patient wear a radiologic examining gown and remove all metal objects and jewelry, hearing aids, and piercings. o An informed consent may be necessary based on facility protocol. o Assess medication history and medical history for renal impairments. o Check the patient's history for hypersensitivity reactions to iodine, shellfish, or contrast media. Note them in the chart and notify the practitioner, who may order prophylactic medications or choose not to use contrast enhancement. o If IV contrast is being used, ensure that a recent creatinine level test has been done and that the results are within normal limits.

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o CT scanning of the abdomen and pelvis usually isn't recommended during pregnancy because of potential risk to the fetus. o There are dietary restrictions if a contrast medium is to be used. Posttest: none Client education: o Have the patient wear a radiologic examining gown and remove all metal objects and jewelry, hearing aids, and piercings. o An informed consent may be necessary based on facility protocol. o Assess medication history and medical history for renal impairments. o Check the patient's history for hypersensitivity reactions to iodine, shellfish, or contrast media. Note them in the chart and notify the practitioner, who may order prophylactic medications or choose not to use contrast enhancement. o If IV contrast is being used, ensure that a recent creatinine level test has been done and that the results are within normal limits. o CT scanning of the abdomen and pelvis usually isn't recommended during pregnancy because of potential risk to the fetus. o There are dietary restrictions if a contrast medium is to be used.

MRI: To obtain images of internal organs, bones, and soft tissues not readily visible on standard X-rays •

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Pretest: o Contact MRI staff in advance of the test for patients requiring life support equipment, including ventilators, because special preparation will be required to ensure that all necessary equipment is ready and situated outside of the room. o Verify that informed consent has been obtained. o Make sure that the scanner can accommodate the patient's weight and abdominal girth. o Perform a complete medical history before the test and assess for any contraindications (see “Precautions” below). o Screen for surgically implanted joints, pins, clips, valves, pumps, or pacemakers or stimulators containing metal; some implants cannot be safely scanned, so be sure that the practitioner and MRI technician are aware of all nonremovable implants. o Note and report allergies. o No dietary restrictions are required. o A claustrophobic patient may require sedation or an open MRI to reduce anxiety. (See Open MRI.) o Make sure that the patient has removed any metal objects on the body Posttest: monitor vital signs; be vigilant of orthostatic hypotension Client education: o Explain who will perform the test and where it'll be done.

o Tell the patient that fasting isn't required unless an abdominal or pelvic MRI will be performed. o Instruct the patient to remove any metal objects, such as jewelry, hairpins, or a wristwatch. o Explain that the patient will be asked to remain still during the procedure. o Warn the patient that the machine makes loud clacking sounds o Tell the patient that the test takes 30 to 90 minutes. h. Endoscopy: shows the lining of hollow organs • Pretest: o Confirm that informed consent has been obtained and that the signed consent form is in the patient's medical record. o Review all medications (prescriptive, over-the-counter, herbal preparations) taken by the patient. o Inform the health care practitioner if the patient is taking nonsteroidal antiinflammatory drugs (NSAIDs), anticoagulants, antihypertensives, diabetic medication, or dietary supplements. o Note and report all allergies. o If a contrast medium is to be used, inform the health care practitioner if the patient has hypersensitivity to iodine, seafood, or iodinated contrast media. o Start an IV, and administer an IV sedative if ordered to help the patient relax before the endoscope insertion. o For the patient taking an anticoagulant or antidiabetic agent, it may be necessary to adjust these drug dosage. o Remove dentures before the procedure. o Make sure that the patient had nothing to eat or drink for 6 to 8 hours before the procedure, per facility protocol. o Conduct a preprocedure verification to make sure that all relevant documentation, related information, and equipment are available and correctly linked with the patient's identifiers. o Perform a complete preoperative assessment, and obtain vital signs. • Posttest: o Withhold food and fluids until the gag reflex returns. o Provide soothing lozenges and warm saline gargles for sore throat. o Monitor the patient's vital signs. o Monitor the patient's respiratory and neurologic status. o Monitor the patient's cardiac rhythm. o Monitor for any bleeding if a biopsy or other invasive procedure has been done. o Monitor the patient for complications. • Client education: o Explain the purpose of the test and how it's done. o Tell the patient who will perform the test and where it will be done.

o Advise the patient not to eat or drink for 6 to 8 hours before the test (or per facility protocol) and of medication restrictions as ordered. o Inform the patient that the test takes about 1 hour. o Advise the patient that there must be a driver to take the patient home after the procedure. o Explain that the patient may have a sore throat for 3 to 4 days after i.

Angiography: Rapid-sequence blue-colored flash photographs of fundus taken with a special camera after IV injection of a vegetable-based dye, sodium fluorescein; Enhances visibility of microvascular structures of the retina and choroids from fluorescein dye and sophisticated photographic equipment; Permits evaluation of the entire retinal vascular bed, including retinal circulation • Pretest: check the client’s history for glaucoma; ask for allergies • Posttest: encourage the client to increase fluid intake to expel the testing dye • Client education: o Explain the purpose of the test and how it's done. o Tell the patient who will perform the test and where it will be done. o Tell the patient that no dietary restrictions are required. o Warn that the patient may experience a strobe-light effect during the test. o Explain that the study is fairly painless and that adverse effects are uncommon but may include nausea and mild urticaria. o Inform the patient that skin and urine may appear yellow for 24 to 48 hours. o Inform the patient that the test takes about 30 minutes. o Caution the patient that near-vision will be blurred for up to 12 hours after the test due to dilation of the pupils. o Instruct the patient not to drive and to avoid direct sunlight during the period of blurred vision.

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EKG: Graphically records the electrical current generated by the heart and measured by electrodes connected to an amplifier and strip chart recorder. It is used to detect cardiac abnormalities. • • •

Pretest: none Posttest: none Client education: o Explain the purpose of the procedure and how it's done. o Tell the patient who will perform the test and where it will be done. o Tell the patient that no dietary or activity restrictions are required. o Instruct the patient to lie still, relax, and breathe normally during the procedure. o Inform the patient that the test is painless and takes 5 to 10 minutes.

20. What are the normal values for the following diagnostic tests? a. Urine characteristics (color, odor, turbidity, specific gravity):

-urine color is straw to dark yellow -odor is slightly aromatic -specimen appears clear -pH 4.5-8 -specific gravity is 1.005-1.025 b. Complete blood count (hemoglobin, hematocrit, red blood cells, white blood cells, platelets): WBC 5,000-10,000 CELLS/MM3 RBC 4.2 -5.9 MILLION CELLS/MM3 HEMOGLOBIN 12-17 G/DL HEMATOCRIT 35%-52% PLATELET COUNT 150,000-400,000*10^3/MM3 c. Blood urea nitrogen and creatinine: Creatinine levels of women: 88-128 mL/min Men: 97-137 mL/min BUN levels: 7-22mg/dL...