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94 Cards in this Set

  • Front
  • Back
hhealthy people 2020: main focus

reach goals by year 2020

healthy people 2020: overarching goals

4 overarching goals:

1. attain high quality, longer lives free or preventable disease, disability, injury and premature death

2. achieve health equity, eliminate disparities, and improve health of all groups

3. create social and physical environment that promotes good healthy for all

4. promotes quality of life, healthy development, and healthy behaviors across all life stages

healthy people 2020: focus areas

42 focus areas: guide for healthy care research, practice, education, policy, and communication

primary care


true prevention that lowers the chances that a disease will develop


transtheoretical model


stage 1: pre contemplation

no thought to making changes, no action planned, not within the next 6 months

stage 2: contemplation

thought of making change, actions considered, within the next 6 months

stage 3: preparation

seriously thinking of making change, actions identified, within the next month

stage 4: action

involved in change, actively involved in changing behavior, involved in change for 6 months

stage 5: maintenance

processing effects of change, continuation of behavior, indefinite

stage 6: relapse

secondary care


focus on those who have early stages of a disease or are at risk to develop a disease

tertiary care


defect/ disability permanent or irreversible (stroke)

minimize effect to prevent complications/ deterioration

objective- return to useful place in society, maximize remaining capacity

no more treatment



Teaching can be formalor informal and will involve the patient, family, significant other, or othersupport systems. Teaching may range from chance remark based on perception ofpt behavior to formal planned teaching.



Providesknowledge about health promotion and disease prevention to individuals andgroups. Some nurses have specialized areas of expertise or advanced practicestanding which equips them to provide information



Nurses use researchfindings as the foundation to clinical practice and decision-making. Evidencebased practice is defined as the conscientious, explicit and judicious use of currentbest practice evidence.

care manager


Prevents duplication ofservices, reduces costs, and facilitate communication among involved parties.As a manager, you will collaborate with others to help your patients meet theirestablished outcomes and will evaluate the manner in which care isadministered.

what is ADPIE?

A- assessment

D- nursing diagnoses/ problem identification

P- planning the care

I- implementing the plan

E- evaluation effectiveness of the plan

A- assessment

A- assessment-collection and analysis of data

-Gordon’sfunctional health patterns

- hands on, nonverbal ques, objective and subjective data, (what are the complaints and whyare they here)

- putting this data into11 categories to find what to do next

D- nursing diagnoses

-problem,etiology, defining characteristics, contributing etiological factors,diagnostic variables

- takingcategorized data and looking at a list and coming up with nursing diagnoses tofind the problem

P- planning the care

-projectoutcomes (goals), prescribe interventions

-within theplanning phase we need to establish a goal, goals need to be measurable, have aprojected outcome


o how are yougoing to achieve the goal?

o Goal- loosing5lbs within a month

-intervention-exercise (walk30min 3x a week)

- food watching(1500 calories a day)

- eliminate 1 sugardrink per day

I- implementing the plan


E- evaluating effectiveness of the plan

did we achieve the goal?

Gordon health pattern: health perception- health management pattern

-patternsdescribes: clients perceived pattern of health and well-being and how health ismanaged

-examples: compliance with medication regimen, use of health-promotionactivities such as regular exercise, annual check-ups, current health/safetypractices, previous patterns of adherence, use of health care system, healthcare access

Gordons health pattern: nutritional - metabolic patten

-patterns described:patterns of food and fluid consumption relative to metabolic need and pattern;indicators of local nutrient supply

- examples: condition of skin, teeth, hair, nails, mucousmembranes; height and

weight;24 hour recall; frequency of “eating out”

Gordon health pattern: elimination pattern

-patterns describes:patterns of excretory function (bowel, bladder and skin) includes clientsperception of “normal” function

-examples: frequency ofbowel movements, voiding pattern, pain on urination, appearance of urine andstool

Gordon health pattern: activity - exercise pattern

-patternsdescribed: patterns of exercise, activity, leisure, and recreation

-examples: exercise, hobbies. May include cardiovascular and respiratory status,mobility, use of assistive devices, and actives of daily living

Gordon health pattern: sleep- rest pattern

-pattern describes:patterns of sleep, rest, and relaxation

-examples- clientsperception of quality and quantity of sleep and energy, sleep aids, routinesclient use

Gordon health pattern: roles- relationship pattern

-patterndescribes: clients pattern of role engagements and relationships

-examples: perception of current major roles and responsibilities; satisfactionwith family ,work, or social relationships

Gordons health pattern: sexuality- reproductive pattern

-patterndescribed: patterns of satisfaction and dissatisfaction with sexuality pattern;reproductive pattern

- examples: number andhistories of pregnancy and childbirths; difficulties with sexual functioning;satisfaction with sexual relationship

Gordon health pattern: coping- stress tolerance pattern

-pattern described:general coping pattern and effectiveness of the pattern in terms of stresstolerance

- examples: clients usual/past manner ofhandling stress, available support systems, perceived ability to control ormanage situations

Gordon health patterns: values- beliefs pattern

-pattern describes:patterns of values, beliefs(including spiritual) and goals that guide clientschoices or decisions

- examples: religiousaffiliation, what client perceives as important in life, value-belief conflictsrelated to health, special religious practices, perceptions of right and wrong

Gordon health patter: self- perception / self concept pattern

-patterndescribes: clients self concept pattern and perceptions of self

- examples: bodycomfort, body image, attitudes about self, sense of worth, perception ofabilities, objective data such as body posture, eye contact, voice tone andaffect

Gordon health pattern: cognitive perceptual patter

-pattern describes: sensory- perceptual andcognitive patterns

-examples: vision,hearing, taste, touch, smell, pain perception and management; cognitivefunctions such as language and vocabulary, memory, behavior, attention span,and decision making

learning plan: COGNITIVE


- teachingstrategies: lecture, one-on-one instruction, discussion, discovery, audiovisualor printed materials, computer-assisted instruction

- examples ofdesired outcomes: describes and/or explains relevant information

- want them toexplain it back to you so you know they understand

learning plan: AFFECTIVE


- teachingstrategies: role modeling, discussion, role playing, simulation gaming

- examples ofdesired outcomes: expresses positive feedback, attitudes, values

- feel goodabout something, excited about doing something, any kind of feelings

learning plan: PSYCHOMOTOR


-teachingstrategies: demonstration, practice, mental imaging

- examples ofdesired outcomes: demonstrates performance of skills

- demonstrates,describes, discuss



• federal program, paid through taxes

Finances formedical care for: people over 65, disabled, end stage renal failure, hospice

Only have to meet 1 of 4topics to get Medicare


• federal and state funds, benefits differ fromstate to state

State determinedeligibility (if you can get it and what you can get)

50% of statebudgets

available to: certainlow-income individuals, no age requirements, families with children- welfare towork- max of 5 years (can be broken up)


state children's health insurance program

affordable care act 2010

designed to address the issues of affordability and for more to be able to access it

patient self determination act

ensures that care and treatment match clients predetermined wishes

ethical principle: BENEFICENCE

doing or producing good, minimizing harm

ethical principle: NONMALEFICENCE

not harming others, stopping treatment if harm takes place

ethical principle: VERACITY

truthful and honest

ethical principle: JUSTICE

treating everyone equal, fair to everyone


factors: age, gender, low SES, stressful events, substance abuse, history of abuse as a child, pain / physical illness, mental illness

WHO definition

world health organization


"bad nourishment" inadequate or excess intake of protein, energy, and micronutrients

treatment for malnutrition

-The baby friendly hospital initiative- promotesbreastfeeding, wants mom tobe healthy to help baby be healthy

-The international micronutrient malnutrition preventionand control program

Goal is toeradicate vitamin and mineral deficiencies worldwide

homelessness goals and strategies

residential programs, supportive services for chronically ill, role of community health nurses, training, developing sense of community within homeless population, develop of public/ private partnerships


release of viruses, bacteria, or other agents to cause illness or death in people, animals, or plants

examples: anthrax, small pox, plague



sharing of customs, food, dress, language


based on physical properties and biological heredity

culture competency

may have impact on peoples: health, healing, wellness belief systems, perceived causes of illness and disease, behaviors of seeking health care, attitudes towards providers

Asian Americans / Pacific Islanders

Largest groups: Chinese, Koreans, Filipinos

Health concerns: hesitancy to seek earlydiagnosis/screening, higher rate of TB, mental health problems, lower rate ofobesity, hypertension

Barriers to care: poverty, stress, cultural norms thatprevent health care seeking, loss of social networks, poor access to services

Health realted cultural aspects: respect for elders,family importance, avoid conflict, Taoism- chinese medicine “achiving harmony”, folk medicine

Latino/ Hispanic Americans

Largest group: Mexican, Puerto Ricans, Cubans

Health concerns: stomach cancer, diabetes mellitus,cardiovascular disease, HIV

Barriers to care: highest uninsured rate of any US racialethnic group, use or receive less prevenative health care, lack of interpreterservices in health care, lack culturally appropriate health care services, folkmedicine

Health related aspects: family, spiritual strengthimportance, hot and cold concept, disease attributed to supernatural orpsychological causes, fold medicine used with western med

Blacks/ African Americans

Higher cancer deaths, HIV, hypertension, obesity, mentalhealth concerns

Barriers to care: poverty, lack of insurance, unsafeenvironments

Health-related cultural aspects: centered onfamily and religion, family needs to be involved in care, churches important inpromoting care, traditional healing approaches

communication techniques: clarification

a method for discovering ones values and the importance of those values


valuing process




valuing process: choosing

-Choosing freely

-Choosingfrom alternatives Choosingafter careful consideration of potential outcomes of each alternative


valuing process: prizing

-cherishing and being happy with personal beliefsand actions

-affirmingthe choice in public, when appropriate


Valuing process: acting

-acting out the scene

-repeatedlyacting in some type of pattern


meta communication

understanding the hidden meaning of a message, reading between the lines

Adolescent: health perception/ health management pattern

Lessacute illness than younger children Less chronic illness thanadults

Negative health choices/outcomes . sense ofinvincibility


risk takingbehaviors

partnering approach in care

support autonomy

focus on strengths

Adolescent: cognitive perceptual pattern

adolescentbehaviors and characteristics . introspection andegocentrism . intolerance of“status quo”

erikson’s theory : identityvs. role confusion language

-increased cognitiveskills and understanding language

-receptive andexpressive vocab increase . -slang,electronic communication

Adolescent: self perception/ self concept pattern

selfperception and body image . influenced byexpectations . individual,peer, societal goal: develop healthy selfperception/healthy body image

assessment,anticipatory guidance, edu . cation, counseling

Adolescent: roles - relationship pattern

changingroles- stressful family time . increasingindependence for adolescent . parents try to learnto “let go”

positive stratigies

willingness tolisten, ongoing affection for . and acceptance of teen, negotiation of lim . -its

peer groups

moving from child infamily to member of . group

strong influence onadolescent

Young Adult: health perception/ health management pattern

Behavioralhealth history

Risk factors forunintentional injuries Preventive care

Maximize healthstatus, detect problems . . early

Age 18: full healthappraisal . Repeat history/physical every 2 years . Screenings: breastexam & PAP smear; tes . ticular exam

Over age 25: focus oncoronary risk factors . Cholesterol,diabetes, smoking, hyperten . sion, metabolic syndrome

Decision making and risktaking . Risk taking behaviordecreases from adoles . cence

Leading causes ofdeath: unintentional in . . juries, homicide, suicide

Communicable disease

Threats: changestravel, social, sexual be . . . haviors

Drug resistance; newstrains emerging . Disease examples:immunizations: rubella, . HPV (women), HEP B . TB,HIV, lyme disease

Young Adult: coping stressing tolerance


Assess forstress related complaints . Assess forsigns of achievement stress . Listen,offer support, referrals as needed Suicide anddepression

Suicide:leading cause of death

Cause: unable to cope with stressful circum . . stancesor events

More womenattempt; more men succeed . Assess fordepression and suicidal ideation

Young Adult: cognitive perceptual pattern

Piaget:formal operations

Analysis of allcombinations of possibilities . . and constructs hypotheses;more percep . . tive/ insightful

Intellectual growth

Recall performanceand memory. Peaks in . . 20s

Erikson: intimacy vs.isolation

Increased sence ofcompetency/ self esteem . Learns to developreciprocal intimate rela . . tioships (requires mutual trust) Kohlberg: postconventionalmoral reasoning . Definerights and morality in terms of self- . . chosen principles

Young Adult: self perception/ self concept pattern

Westernculture: adulthood

Financial andresidential independence . Explore andexperiment vs. firm commit . . . ments

Employment issues (can lead topoor self image) . Pay differentials bygender . . Variance in benefits,occupational hazards . Stress of employment

Childbearing choices,childcare issues . Increased job burdenwith decreased job se . . curity

Young Adult: roles / relationship pattern

Maturingrealtionships and roles . Development ofenduring friendships . Formation of intimaterelationships . Decisions bout life/career directions . Formation of familyunits . Multipledecisions related to child bear . . ing, finances, roles/ relationships . Self andfamily development Separation/ divorce

Affects children,families of couple . Re-evaluation ofbasic values, strengths, per. . sonality

Depression common-supportive counseling/ . services


80% of violence idindividual acts (homicide, . suicide)

homicide: 2ndleading casue of death in 15 . to 24 year olds

associated:guns, alcohol, drug abuse, . . crimes

intimate partnerviolence . crosses alldemographic boundaries . underreported;women report higher . . lifetime violence

appropriateassessment, detection, . . treatment needed

Young Adult: occupation stress

youngadults work in hazardous jobs vocational training needed toavoid hazards periodic assessment,counseling for risks

Older Adult: stress/coping

older adult at higher risk,medical conditions, losses, physical changes

suicide- highest in elderly-serious illness, social isolation, alchol abuse

physician assisted suicide

Older Adult: nutritional- metabolic

malnutrition factors: access to food, decline in GI absorption, deterioration of senses, living environment, anorexia from disease, medications

food stamps

Older Adult: activity - exercise

increasingly important to reduce, stop, or reverse physical decline

popular activities: walking or aquatic

Older Adult: Osteoporosis risk factors

brittle bones

small thin frame, caucasian, family history, inactivity, low calcium intake



- adolescent-13 to 18- identity vs. role confu . . sion

achieving identityrole confusion- don’t know . whothey are- confused- weak sense of self

- young adult-18 to 35- intimacy vs. isolation

intimacy-able to establish longlasting rela . . tionships- marriage- set job

isolation- lonely

middle adult- 35 to 65- generactivity vs. stagna . . tion

generactivity- producing/ nurturing/ creat . . ing.. Somethinggood, leaving a lasting Im . pression

stagnation- not going anywhere..unfulfilled

older adult-65 and older- ego integrity vs. de . .. . . spair

ego integrity- im proud of myselfand what . I have accomplished

despair- didn’t do enough, couldhave . . . . done more


encompasses birth to 15 years old

4 stages

about our thoughts and how we think about things

scheme- pattern of action or thoughts

schemes are used to assimilate ( take in) or accommodate (modify) new experiences


BEHAVIORAL- goal is justice

Preconventional- avoid punishment, gain reward(school age)

Conventional- gain approval, avoid disapproval (adolescent)

Postconventional- agreeing upon rights, personalmoral standards (young adult)


Preconventional•Whatis practical to others and best for self/ realizing connection to others

Conventional•Sacrificeswants and needs to fulfill others’ wants and needs

Postconventional•Moreequal of self and others

•Researched with Kohlberg: Noted womenscored lower than men on Kohlberg’s tool

•Suggests a different process of moraldevelopment exists in women: Relationship-basedvs.cognitive development

Dietary supplements and herbal medicines:

general, pregnancy, elderly

general: include vitamins, minerals, herbs, botanicals/ plant- derived substances, amino acids, metabolites, constituents, and extracts

pregnancy: folic acid & iron

elderly: calcium & vitamin D


BMI: used to screen for risk health/ nutritional disorders

Healthy: <25 (18.5- 24.9)

Overweight: 25-30

Obese: <30

benefits of exercise

increase metabolic rate, increase lean body mass, increase density of bones, reduce fat

FITT prescription

F- frequency :how often, (3 days a week)

I-intensity: how intense, stranious,measurable,how hard it is, (2 laps)

T- type: type of activity, (aquatictherapy)

T- time: how long for, (30 minutes )

exercise type

resistance training, weight bearing, aerobic


challenging and useful stress; not destructive

(good, normal)


chronic or excessive stress; body unable to adapt; threatens homeostasis (BAD)

assessment of stress: primary appraisal

descriptions of perceived actual/ potential positive and negative outcomes

primary appraisal: negative outcome

harm (physical injury, diseases, death)

primary appraisal: postive outcome

challenges individual perceives can be overcome

(graduation, promotion)

assessment of stress: secondary appraisal

individuals identification of choices to cope with stress

choices: internal or external resources/ responses


stress responce: individual reliance on less healthy behaviors ( not good things to do)

over eating, excessive use of drugs or alcohol, smoking, social isolation


negative mood states: anxiety, depression, hostility, anger

affects key populations: elderly, terminally ill, caregivers

stress management interventions

Self awareness: monitoring stress warning signs

Whatstresses me out?

Relaxation: helps develop awareness of nega . . tive effects of stress

Repetitionof word/ thought/ activity . . Minirelaxations

Lessenthe stress and keep it from getting worse

Acupuncture: (Chinese) needles placed on points ofbody to reduce pain

Hypnosis: ( Greek for sleep) narrow consciousness

Reiki: (Japanese) uses life force energy fields to affect health

Expressive Writing: telling a story about lifeevents, used to process emotions

Healthy Diet: positive influence on health,physical performance, state of mind

Physical activity: enhances well being whiledecreasing stress

Sleep hygiene: improve quality of life, helpssleep deprivation, depression and fatigue

Cognitive behavioral restructuring: stop andbreathe, think about response

Affirmations: positive thought that has meaning toyou, repeat phrase or saying throughout day and it will enhance self esteem andreduce stress

holistic nursing

nursing practice that heals the whole person

nursing role in holistic nursing

support a persons natural healing systems, consider the whole person, consider the environment surrounding person

subjective vs. objective

subjective- client tells you

objective- measurable.. blood pressure, vitals