NSG 411: Exam 3 Community

What is health promotion?

behavior motivated by desire to increase well-being and actualize health potential

What is disease prevention?

Primary and secondary preventive measures aimed at reducing the burden of disease and associated risk factors.

What is disease management?

Refers to an organized strategy of delivering care to a large group of individuals with chronic disease to improve outcomes and reduce costs

What is the vision for Healthy People 2030?

a society in which all people can achieve their full potential for health and well-being of all people

The healthy people 2030 objectives

address social determinants of health and health equity

What are the social determinants of health?

defined as the condition in which people are born, grow, live, work, and age

What are the 5 domains associated with SDOH?

-economic stability

-access to quality education

-access to quality healthcare

-neighborhood and built environment

-social and community context

What is the definition of change?

any planned or unplanned alteration of the status quo in an organism, situation, or process

T or F: Change may occur by design or default

T

What is evolutionary change?

gradual; adjustment on incremental basis

What is revolutionary change?

rapid, drastic, threatening type. Possible complete upset of balance of system

T or F: individuals often have similar motives or reasons for change?

False; people decide to change for many different reasons

Who were the stages of change described by?

Kurt Lewen

What are the three stages of change?

unfreeze, changing/moving, refreeze

What is unfreezing?

when desire for change develops

What is changing/moving?

when new ideas are accepted and tried out

What is refreezing?

when the change is integrated and stabilized in practice

Think of one example of the stages of change and work it through the stages

1. Unfreezing: The patient realizes smoking is harmful (e.g., shortness of breath, health risks, cost).

2. Moving (Changing) The patient takes action:

-Sets a quit date

-Uses nicotine patches or gum

-Avoids triggers (like smoking with friends)

-Attends a support group

3. Refreezing The patient maintains the new behavior:

-Remains smoke-free

-Finds new coping strategies (exercise, chewing gum)

-Continuous support systems to prevent relapse

What is the stages of change model?

This is a model that we use to assess a patient's readiness to make a change.

-precontemplation

-contemplation

-preparation

-action

-maintenance

-termination

What is precontemplation?

Not yet acknowledging there is a problem

What is contemplation?

acknowledging there is a problem but not ready or willing to make a change

What is preparation?

making small changes in preparation for a change in the next month

What is action?

Actively engaged in strategies to change behavior; lasts up to 6 months

What is maintenance?

maintaining the behavior changes

What is termination?

change is permanent; no desire to go back

T or F: Change is linear

F; change is not linear. Prepare for setbacks and readjusting

What are the principles for effecting positive change?

-participation

-resistance to change

-proper timing

-interdependence

-flexibility

-self-understanding

What are the three domains of learning?

-cognitive

-affective

-psychomotor

What are the six levels of the cognitive domain?

-remember

-understand

-apply

-analyze

-evaluate

-create

Which cognitive level involves recalling basic facts?

remember

What is an example of the 'Remember' level?

a school nurse asks adolescents in a weight loss group to list foods high in fat

What is the Understand level of the cognitive domain?

able to comprehend concepts when they are explained

What is an example of the Understand level?

a school nurse asks adolescents in wt loss group to identify ways to lose weight

What is the "apply" level of the cognitive domain?

transfer understanding into practice

What is an example of the apply level?

a school nurse asks adolescents in a wt loss group to keep a food and physical activity record for a week, draw up a diet, and share this plan with the group at the next meeting

What is the "analyze" level of the cognitive domain?

break down concepts into parts; establish the relationship among the parts

What is an example of the analyze level?

A school nurse asks adolescents in a wt loss group to distinguish the fat content in a variety of packaged foods

What is the "evaluate" level of the cognitive domain?

validate information

What is an example of the evaluate level?

a school nurse asks adolescents in a wt loss group to select a menu that is low in fat

What is the "create" level of the cognitive domain?

producing new or original work

What is an example of the create level?

a school nurse asks adolescents in a wt loss group to develop a menu that is low in fat

Affective learning domain deals with

-emotions, feelings, and affect

-deals with changes in interest, attitudes and beleifs

T or F: Since attitudes are learned, they are are hard to change

True

What is the psychomotor learning domain?

visible demonstartion of performance skills requiring some type of neuromuscular coordination

What are the three requirements for psychomotor learning to take place?

-learners must be capable of the skill

-learners must have a sensory image of how to perform the skill

-learners must practice the skill

What are the teaching-learning principles?

1. Client readiness (must start here, unfreezing)

2. client perceptions

3. educational environment

4. subject relevance

5. client satisfaction

6. client application

Give an example of client readiness.

A nurse waits until a patient recovering from surgery is alert and pain-free before teaching them how to use crutches.

Give an example of client perception.

A nurse asks a patient how they feel about starting a new diet before giving nutrition advice.

Give an example of an educational environment.

Teaching a patient about blood sugar monitoring in a quiet room rather than a busy hospital hallway.

Give an example of client particpation.

Ask the patient to practice administering their own insulin while the nurse observes.

Give an example of subject relevance.

Teaching a smoker about lung health rather than general nutrition (if quitting smoking is their priority).

Give an example of client satisfaction .

After learning exercises for back pain, the patient reports feeling more confident managing discomfort at home.

Give an example of client application.

A patient demonstrates proper handwashing technique after the nurse teaches it.

What is the cognitive learning theory?

-examines the learner thought process

-allows for understanding of mental processes

-used to encourage self reflection

What is the behavioral learning theory?

-Learning is influenced by external sources

-positive reinforcement makes a learned more likely to complete a task

What is the social learning theory?

-Learning happens by observing others

-depending on consquences, learner will imitate or avoid that behavior

-takes cognitive and environmental factors into consideration

what is the transformative learning theory?

-learners can change the way they think once they have new information

-learner reflects on previous experiences

-critical evaluation of pespective occurs

What is the experimental learning theory?

-learning comes from experience

-learners retain and recall information when they are hands-on

-involves participation in real-world experiences

What is the humanistic learning theory?

-Learning is a holistic process

-educator acts as a facilitator

-freedom for students to learn what they are interested in

-reteneton of knowledge is not used to evaluate learner

What are the four learning styles?

visual, auditory, reading/writing, kinesthetic

What is the visual learning style?

-needs to see the content

-photos, models, videos

What is the auditory learning style?

-needs to hear the content

-podcasts, recorded lectures

What is a tactile-kinesthetic learning style?

hands on experince

What are the steps of the teaching process?

1. interaction

2. assessment and diagnosis

3. setting goals and objectives (key step)

4. planning

5. teaching

6. evaluation

Interaction

establish basic communication patterns between patient and nurse

assessment and diagnosis

Determine client's present status and identify client's need for teaching through surveys, interviews, open forums, or task forces that include representative clients as members (keeping in mind that clients should determine their own needs).

Setting Goals and Objectives

Analyze needed changes, establish the goal (a broad statement of outcome), and prepare objectives that describe the desired learning outcomes. Objectives should be stated in measurable behavioral terms, using a grammatical structure that contains a subject, verb, condition/criterion, and time frame. That is, each objective should include a single idea that describes an outcome that can be measured within a certain time frame (see the example that follows these steps).

Planning

Design a plan for the learning experience that meets the mutually developed objectives; include content to be covered, sequence of topics, best conditions for learning (place, type of environment), methods, and materials (e.g., visual aids, exercises). A written plan is best; it may be part of the written nursing care plan.

Teaching

Implement the learning experience by carrying out the planned activities.

evaluation

Determine whether learning objectives were met, and if not, why not. Evaluation measures progress toward goals, effectiveness of chosen teaching methods, or future learning needs.

teaching methods

-can be planned or unplanned

-formal or informal

-lecture

-discussion

-demonstration

-role playing

What is a disaster?

any hazardous event that disrupts the functions of a community and causes hardships for community members

T or F: disasters can be natural or manmade

T

What is a manmade disaster?

a disaster caused by people, not nature.

Ex of manmade disasters?

-industrial accidents (chemical spills, explosions, fire)

-transportation (plane crashes, shipwrecks, automobile crashes)

-structural failures (dam breaches, building collapses, bridge failures)

-environment (oil spills, greenhouse gases, plastic debris)

-terrorist attacks (9/11, London bombings, Paris attacks)

-urban fires (Great Fire of London, chicago fire, Grenfell Tower fire)

What is a natural disaster?

A natural hazard that has fatalities, damage, and economic effects

Ex of natural disasters?

-tornado

-drought

-eruption

-landslide

-forest fire

-earthquake

-storm

-tsunami

-avalance

What is a casualty?

Someone who was wounded or died in a disaster

What is a mass-casuality incident?

involving large number of deaths and injuries in a short period of time

T or F: a communitys disaster plan does not have to accomodate all of its members if they think they wil hold them back

F: A community's disaster plan should accommodate all its members, including those who are vulnerable.

-Infants and children

-Older adults

-People who are pregnant

-People who have chronic diseases or disabilities

-People living below the poverty line or who are without housing

-People who do not speak the dominant language of the region

-People who are incarcerated

Nursing roles with disaster preparedness?

-Developing personal, work, and family disaster plans

-Identifying community evacuation routes

-Identifying emergency shelter locations

-Developing a communication chain

-Performing regular drills

-Stockpiling food, water, medication, and first-aid supplies

-Making sure pet care is included

What is a displaced person?

A person forced to move from their home due to a disaster but who stays in their country of origin

Who is a refugee?

People forced to leave homeland due to war or persecution

What is the primary need of the indirect population?

Safety and basic survival needs (shelter, food, water, protection).

What agencies/organizations manage disasters?

-Civil Defense: originally to prepare/protect in a nuclear attack . Now connected with public health for disaster response and managment

-FEMA: created to coordinate emergency managment at the national level

-Red Cross: primary non-government agency

-DHS: includes FEMA, Customs/Immigration, Coast Guard, Secret Service

What is the role of an incident management system?

-Provides a standardized approach to managing disasters

-Coordinates resources, communication, and operations across agencies

-Ensures safety, accountability, and efficiency

What are the four phases of disaster managment?

1. preparation

2. prepardness

3. response

4. recovery

Ex for the preparation phase?

Activities to avoid or reduce the impact of a disaster

Example: Building levees, enforcing safety regulations, and vaccination programs

Ex for the preparedness phase?

Planning and training before a disaster

Example: Disaster drills, emergency kits, communication plans

Ex for response phase?

Immediate actions during and after a disaster

Example: Evacuation, triage, emergency medical care

ex for recovery phase

Long-term restoration of the community and individual health

Example: Rebuilding homes, mental health support, and rehabilitation services

What is triage?

the sorting of patients according to the urgency of their need for care

What type of apprach is used for triage during a disaster?

utilitarin

Disaster triage color codes

1. Red; immediate

2. Yellow: delayed

3. Green: minor

4. Black: deceased

Give an example of a patinet in each triage color code?

Four Categories (International Triage System):

Immediate/Red: Life-threatening, needs urgent care

Delayed/Yellow: Serious but not immediately life-threatening

Minor/Green: “Walking wounded,” can wait

Expectant/Black: Likely to die, focus on comfort

Who is the highest priority?

red/immediate patients

What is the goal of triage?

Do the greatest good for the greatest number

Types of treatment and support provided?

Provide first aid, medical care, emotional support

Long-term treatment and support:

Physical rehabilitation

Mental health counseling

Rebuilding community infrastructure

Self-care for responders:

Critical Incident Stress Debriefing (CISD): Helps responders process traumaW