Study Guide 2 - Nursing 101
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- 1. What are the three levels of Health Care Services?
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Primary Care
Secondary Care
Tertiary Prevention
- What is the focus of each of the three levels of Health Care Services?
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PRIMARY CARE --
Health Promotion and Illness Prevention
SECONDARY CARE --
Diagnosis and Treatment
TERTIARY PREVENTION--Rehabilitation, Health Restoration, and Pallative Care
- Name the Health Care Settings in which Primary Care takes place.
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Schools
Occupational Health Services
Physician's Offices
Clinics
Nursing centers
Parish Nursing
- Name the Health Care setting in which Secondary Care takes place.
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Emergency Departments
Hospitals
Free Standing Diagnosis Centers
Surigicare Centers
Medical Units
Intensive Care
Walk In Screening Clinics
Psychiartic Facilities
Rural Hospitals
Rehabilitation Centwers
- Name the settings in which Tertiary Care takes place.
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Agencies on Aging
Nursing Facilities
Assisted Living
Adult Day Care Centers
Hospice
Home Health Care
Rehabilitation Centers
Extended Care Facilities
- What is Pallative Care?
- Providing comfort and treatment of symptoms for End of Life; done in many settings such as home, hospital, Hospice, etc.
- Which patients benefit from Pallative Care?
- The terminally ill.
- What is rehabilitation?
- Care that emphasizes the importance of assisting clients to function adequately in the physical, mental, social, economical, and vocational areas of their lives.
- What level of Health Care do Pallative Care and Rehabilitation fall under?
- Tertiary Care
- What is "continuity of care"?
- The coordination of health care services by health care providers for clients moving from one health care setting to another and between and among health care professions. It insures uninterrupted and consistnet services for the client from one level of care to another.
- What is "seamless care"?
- Seamless care is an integrated health care system when services on all three levels are available through on organization, often called a health care organzation or an integrated health care system.
- When does discharge planning for the patient begin?
- Upon admission.
- What is collaboration?
- A working relationship with another health care provider in the provision of (to supply) patient care.
- What are the key elements of collaboration?
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Communication
Mutual Respect and Trust
Decision Making - What is a community?
- A collection of people who share some attritbute of their lives and interact with each other in some way.
- What is a population?
- A population is composed of people who share some common characteristics but who do not necessarily interact with each other.
- Identify if a group is a community or a population based on the definations of each.
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Community - interaction
Population - not necessarily interaction. - What is HIPAA?
- The Health Insurance Portability and Accountability Act. This insures that patient information is secure and only accessable to those who have a right or a need to access such information.
- What are nursing responsibilities in regard to HIPAA?
- Nurses must safe guard all client information (written, spoken, and electronic) form being given to anyone who is not in a direct need to know such information. It also can not be given to anyone other than the person or persons that the client has designated to receive such information.
- What is caregiver role strain?
- Caregiver role strain is when a caregiver may have physical, emotional, social, and financial burdens that can seriously jeopardize their own health and well-being.
- What are the signs that a person is suffering from caregiver role strain?
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- Difficulty performing routine tasks for the client
- Reports of declining physical energy and insufficient time for caregiving
- concern that caregiving responsibilities interfere with other roles such as those of parent, spouse, worker, friend
- Anxiety about ability to meet furtue care needs of client
- Feelings of anger and depression
- Dramatic change in the home environment's appearance - What is the difference between the home health nurse setting and the acute care setting?
- Home care nurses must work independently in an unfamiliar setting where the control and power belong to the family. In the acute setting , the nurse would be more in control of the area he or she works in and also have other health care providers for back up support if needed. Certain areas of care would be provided more quickly with resources at hand than they could be provided in the home where arrangements would have to be made to provide those services to the client.
- What is the Health Promotion Model?
- A competence or approach-oriented model in which the motivational source for behavior change is based on the individual's subjective value of the change(How the client perceives the benefits of changing the given health behavior).
- What are the stages of Health Behavior Change?
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Precontemplation Stage
Contemplation Stage
Preparation Stage
Action Stage
Maintenance Stage
Termination Stage - Define health.
- A dynamic state of bing in which the developmental and behavioral potential of an individual is realized to the fullest extent possible.
- Define wellness.
- A state of well-being whic includes self-responsibility, an ultimate goal, a dynamic growing process, daily dedision making in the areas of mutrition, stress management, physical fitness, preventive health care, and emotional health. (the whole being)
- Define well-being.
- A subjective perception of vitality and feeling well which can further be described objectively, experienced, and measured and can be plotted on a contimuum.
- Describe illness.
- A highly personal state in which the person's physical, emotional, intellectual, social, developmental, or spiritual functioning is thought to be diminished. It is not synomymous with disease.
- Define disease.
- An alteration in body functions resultilng in a reduction of capabilities or a shortening of the normal life span.
- What are the dimensions (componennts) of wellness?
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- Physical
- Emotional
- Social
- Intellectual
- Spiritual
- Occupational
- Environmental - What is adherence?
- The extent to which a patient follows medical or health advise. (examples: sticking to a diet, taking prescribed medications as directed, makeing lifestyle changes).
- What factors affect health care adherence?
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- Client motivation to become well
- Degree of lifestyle change necessary
- Perceived severity of the health care problem
- Value placed on reducing the threat of illmess
- Degree of inconvenience of the illmess itself or of the regimens
- Beliefs that the prescribed therapy or regimen will or will not help
- Complexity, side effects, and duration of the proposed therapy
- Cultural heritage, beliefs, or practices that support or conflict with the regimen
- Degree of satisfaction and quality and type of relationship with the health care providers
- Overall cost of therapy - Describe the function of the family.
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- Protecting the physical health of the family members
- Provides an environment conducive to physical growth and health
- Influences the cognitive and psychosocial growth of its members
- Has values and beliefs that are unique that shape the family's structure, methods of interaction, health care practices, and coping mechanisms. - List the types of families.
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- Traditional families
- Two-Career Families
- Single Parent Families
- Adolescent Families
- Foster Families
- Blended Families
- Intragenerational Families
- Cohabiting Families
- Gay and Lesbian Families
- Single Adults Living Alone -
Describe each type of family.
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Traditional family - an independant unit with both parents residing in the home and one is the nuturer and the other is the income provider.
Two- Career Families - Both parents are employed and child care is provided by an an outside source or other family member.
Single-Parent Family - A one parent family due to divorce, death, or seperation, birht of a child to an unwed mother, or adoption by a single person.
Adolescent Family - A family headed by a teenager due to the increase in teenage birthrates.
Foster Family - A family that brings in children who can no longer remain with their birth parents due to a variey of reasons. These families usually changd dynamics often as the foster children get moved through the system.
Blended Families - When two people who had children from previous relationships marry and bring the children to the new family.
Intragenerational Families - Families where more than two generations live in the same household.
Cohabiting Families - Families who live under the same roof without a legal bound between the parties.
Gay or Lesbian Families - Families where the parents are homosexual.
Single Adults Living Alone - Families where the adult is independant and lives in a home by themselves due to a variety of reasons. - What is the purpose of the family assessment?
- To determine the level of family functioning, clarify family interaction patterns, dientify family strengths and weaknesses, and describe the health status of the family and its individual members. It helps to provide family living patterns, communication, child rearing,coping strategies, and health practices.
- Identify topics assessed in each section of the Family Assessment.
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Health Beliefs - Health knowledge and/or misconceptions about health; provide educational updates to patients who have not been able to keep up with the changes in technology
Family Communication Patterns - Who makes the decisions for the family regarding health care; why does this person make the decisions, where do they get their information from, what signs do they provide as misunderstanding or acknowledging the information provided, who communicates the return messages and can they repeat back the message correctly.
Coping Mechanisms - How do family members and the client deal with stressful or aggrevating issues; how are problems solved; who or whom determines a problem is resolved; are any hostilities observed; any nonverbal signs of distress
Risk of Health Problems - which family members are still living and which ones have passed on; what illnesses or diseases did they pass from and at what age; has the client ever had any serious health issues and what are they; do surviving family members have any serious health issues; who provides the income for the family; does the family receive assistance if the income is low or non-existant
- What are the nurse's roles with families experiencing illness or death of a family member?
- The nurse interacts with the family and the client, provides support and information, educates family members, evaluates the families readiness and ability to provide continued care and supervision when needed at home. Nurses also work with the family to identify available resources if needed. Understanding the effects of death on a family allows the nurse to help the family get past the greif and move on with life.
- What if family centered nursing care?
- A nursing concept that considers the health of the family as well as the health of the individual.
- How is anticipatory guidance helpful?
- Anticipatory guidance is helpful because the nurse has educated or informed the individual and the family members of what to expect and it allows the family time to prepare for the changes that may take place. They can make decisions based on knowledge rather than emotions.
- What are the four types of knowledge that are a part of nursing practice?
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- Emperical Knowledge / The Science of Nursing
- Personal Knowledge / Ther Therapeutic Use of Self
- Ethical Knowledge / The Moral Component
- Aesthetic Knowledge / The Art of Nursing - What are the four parts of the communication process?
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Sender
Message
Receiver
Response / Feedback - What are the modes of communication?
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Verbal
Non-Verbal
Electronic - What are the four personal space zones?
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INTIMATE: Touching to 1 and 1/2 feet
PERSONAL: 1 and 1/2 feet to 4 feet
SOCIAL: 4 feet to 12 feet
PUBLIC: 12 feet to 15 feet - Know theraputic and non-theraputic communication techniques on tables 26-2 and 26-3.
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26-2 Theraputic
26-3 Barriers (Non-Theraputic) - How are the communication techniques utilized in the nursing process?
- Communication techniques allow the nurse to affirm or question the individual's and families knowledge, skills, willingness, values, and understanding of the health issue.
- What is the purpose of the client admission asessment and the chart as a whole
- It is used for communication, client care planning, auditing by health agencies, research, education, reimbursement, legal documentation, and health care analysis.
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What are the guideilines for charting?
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Date and Time
Timing
Legibility
Permanence
Accepted Terminology
Correct Spelling
Signature
Accuracy
Sequence
Appropriateness
Completeness
Conciseness
Legal Prudence - What is subjective data?
- Any data provided that has not been verified.
- What is objective data?
- Data that has been verifide.
- What are the guidelines for writing an incident report or quality report?
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Identify the client by name , initials, and hospital or identification number
Give the date, time, and place of the incident.
Describe the facts of the incident
Incorporate the client's account of the incident
Identify all witnesses
Identify any equipment by number and any medication by name and dosage -
What are the legal implications involved with nursing documentation?
- Accurate and complete documentation should give legal protection to the nurse as it provides quality of care. If an activity is not documented, then it did not occur.
- What is andragogy? (term and theory)
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The art of teaching adults
- People move from dependant to independant as the mature.
- An adult's previous experience can be used as a resource for learning.
- Learning is related to an immediate need, problem, or deficit
- An adult is more oriented to learning when the material is useful immediately, not something in the future.
- Learning is reinforced by application and prompt feedback. - What is pedagogy?
- The art of helping children learn.
- What is geragogy?
- The process used in helping older adults learn.
- Define Behaviorism.
- Behaviorism is a learning theory that believes subjects learn by responding to a traceable stimulus. To change a behavior, this school of thought believes you either must alter the stimulus or change what happens after a response occurs.
- Define Cognitivism.
- Cognitive learning theory states that learning is the process of sorting information based on experience and the developmental level of the learner.
- Define Humanisn.
- Humanisn learning theory focuses on both the cognitive and the affective qualities of the learner and encompasses the biological, psychological, social, cultural, and spiritual factors.
- What are the three domains of learning?
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Cognitive Domain
Affective Domain
Psychomotor Domain - What factors affect learning positive and negatively?
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Age and Development
Motivation
Rediness
Relevance
Feedback
Nonjudgemental Support
Simple to Complex
Repetition
Timimg
Environment
Emotions
Physiological Events
Cultural Aspects
Psychomotor Ability
- What is the nursing process related to education/teaching?
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ASSESSING - Deals with obtaining the nursing history factors (age, understanding of health problem, health beleifs and practices, cultural factors, economic factors, learning style, and the support system for the client) as well as the physical exam, the client's readiness to learn, their motivation, the understanding of health terms by the client.
DIAGNOSING - here the nurse determines if the client and family have sufficient knowledge to make health decisions or if they need education and to what level of health education is needed.
PLANNING - The nurse must determine what teachings take priority over others, set learning outcomes, choose the learning content, select teaching strategies, and organize the learning experiences.
IMPLEMENTING - the nurse now uses the appropriate learning stragegies to help the client and family learn the needed information.
EVALUATION - during this phase the nurse can observe, ask questions, view written measurements, or self reports to verify the learning outcome. If the behavior has not changed then the process needs re-thought and re-planned.
DOCUMENTING - Documentation of the learning process is necessary for both the client and other health professionals; it verifies that the teaching process either changed a behavior or that additional teaching is needed.
- Define culturally sensitivity.
- Cultural Sensitivity means someone has the basic knowledge of the culture; what you know about the culture that can benefit you in dealing with people of that culture.
- Define Culturally Appropriate.
- Applying the knowledge you have about the culture in a repectful manner.
- Define Culturally Competent.
- Looking at the whole person and applying the knowledge of their culture as part of the health care process.
- Define ethnicity.
- The relationship between individulals who believe that they have distinctive characteristics that make them a group.
- Define ethnocentrism.
- The concept of thinking one's own way is best or superior, assuming everyone is alike, and expecting others to acquire our values.
- Define race.
- Race is our genetics of which humans are 99.9% alike.
- Define culture shock.
- The feelings and emotions people experience when they enter a new culture.
- Define stereotyping.
- The concept of assuming that all people in a group act, respond, or behave in a particular way.
- Give examples of ethnocentric behavior byh a health care professional.
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- Direct eye contact
- Ask direct questions
- "We do it this way here ..."
- "He's a minority."
- "You people are so ..."
- Label people ... "He's noncompliant" or "They are so lazy."
- Wear white
- Expect individual decisions - What is a health beleif? Give examples.
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What an individual believes to be true regarding health issues.
Examples:
- Headache produced as a result of a spell and only a spell will releive the headache.
- - What are the three health beliefs/practice systems?
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MAGICO-RELIGIOUS - illness is the result of being bad or it is God's will that someone is ill. If medicine helps it is because wanted the client healed/well.
SCIENTIFIC or BIOMEDICAL HEATLH BELIEF - Belief that life is controlled by physical and biochemical processess that can be manipulated by humans, such as pills, treatment, or surgery. -
What are the three health beliefs/practice systems?
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MAGICO-RELIGIOUS - illness is the result of being bad or it is God's will that someone is ill. If medicine helps it is because wanted the client healed/well.
SCIENTIFIC or BIOMEDICAL HEATLH BELIEF - Belief that life is controlled by physical and biochemical processess that can be manipulated by humans, such as pills, treatment, or surgery.
HOLISTIC HEALTH BELIEF - the forces of nature must be in balance or harmony with the rest of nature. Any unbalance causes illness. - What if folk medicine and why is it so commonly used?
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Those beliefs and practices relating to illness prevention and healing that derive from cultural traditions rather than from modern nedicine's scientific base.
It is commonly used because it is thought to be more humanistic than biomedical health care. - What are the guidelines that you use when using verbal communications with someone with limited English language skills?
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- Avoid slang words, medical terminology, and abbreviations.
- Augment spoken conversations with congruent gestures or pictures to increrase the client's understanding
- Speak slowly, in a respectful manner, and at a normal volume
- Frequently validate the client's understandingof what is being communicated. - How do you use the aid of an interpeter?
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- Avoid asking a member of the client's family, expecially a child or spouse, to act as an interpeter.
- Be aware of gender and age differences, preferably use an interpeter of the same sex
- Choose an interpeter who is politically or socially compatible with the client
- Address the questions to the client, mot to the interpeter
- Ask the interpeter tointerpret as closely as possible the workds used by the nurse
- Speak slowly and distinctly
- Observe the facial expressions and body language that the client assumes when listening to the interpeter
- Become aware of the individual expressions and colloquial words used in specific regions and acknowledge them when using interpreting services.