Nursing 299 - (Nutrition and Development across the Lifespan) EXAM 1

How is health defined?

State of physical, mental, spiritual, and social functioning that realizes a person's potential and is experienced within a developmental context.

(ON TEST)

This relates to individual and societal responsibility.

Primary Level of prevention

Focus is to maintain and improve general, individual, family, and community health.

(example: education and vaccines

Before you have diabetes, etc etc)

Passive Prevention

When the person isn't personally involved. Includes clean water/sewer, watching a health commercial

(classified under primary prevention)

Active prevention

When the person is personally involved. Includes creating lifestyle changes.

(classified under primary prevention)

Health Promotion

Includes health education, marriage counseling, sex education, good standard of nutrition adjusted to developmental phases of life, and genetic screening.

(classified under primary prevention)

Specific Protection

Includes getting immunizations, attention to personal hygiene, and avoidance of allergen

(classified under primary prevention)

Tertiary level of protection

Restoration and rehabilitation

Includes treatment to return the person to a useful place in society. Treatment should help the patient prevent irreversible or permanent damage. Example: Teach lifestyle changes to prevent future strokes and to prevent complications of a stroke.

Secondary level of protection

Early diagnosis

Prompt treatment

Disability limitation (adequate treatment to arrest disease processes and prevent further complications and sequelae and prevent death.

Screenings (such as in scoliosis, mammograms) are examples of secondary prevention

Advocate

Helps individuals obtain what they are entitled to receive through the health care system.

Care Manager

Prevent duplication of services, maintain quality and safety and reduce costs.

Consultant

Provide knowledge about health promotion and disease prevention to individuals and groups

Deliverer of Services

Deliver direct services like vaccines and counseling in health promotion.

Educator

Teach effectively

Healer

Help individuals integrate and balance the various parts of their lives

Researcher

Evidence-based practice.

Clinical Model

Health is defined as absence of signs and symptoms of disease and illness is defined by the presence of signs and symptoms of disease.

Patients will seek medical attention only when they are really ill and may not seek preventive health services

Conventional model of medicine

Eudaimonistic Model

Health is more broadly defined and can encompass more individuals and more adverse life circumstances.

It emphasizes the interactions between physical, social, psychological, and spiritual aspects of life and the environment that contribute to goal attainment and create meaning.

What are the 4 overarching Healthy People 2020 goals?

Goal 1: Attain healthy, thriving lives and well-being free of preventable disease, disability, injury, and premature death.

Goal 2: Eliminate health disparities, achieve health equity, and attain health literacy to improve the health and well-being of all.

Goal 3: Create social, physical, and economic environments that promote attaining the full potential for health and well-being for all

Goal 4: Promote healthy development, healthy behaviors, and well-being across all life stages.

What was the 5th goal added for Healthy People, for 2030?

Goal 5: Engage leadership, key constituents, and the public across multiple sectors to take action and design policies that improve the health and well-being of all.

What does a culturally sensitive assessment process look like?

Assessing the patient and asking questions to get to know their culture to understand where they are coming from, which can help them form a successful plan with the patient.

Providing/applying culturally competent care

(seen in Chpt. 6 as well).

Cultural Competence Model

Cultural awareness

"Me-Centered" analysis

"Others-Centered" analysis

"What do YOU do?" "How do YOU handle that at home?

Cultural knowledge

Knowledge analysis-How are my values. beliefs, norms, customs, traditions, biases and stereotypes and behaviors the same or different from others? What additional cultural knowledge, awareness, and understanding do I need?

Cultural sensitivity

Sensitivity analysis

Cultural competence

Competence analysis - What adjustments do I need both in the way that I think and behave do I need to make in order to effectively operate in a different cultural context

Transcultural Nursing

Area of nursing that focuses on discovering and explaining cultural factors that influence the health, well-being, illness, or death of individuals or groups and seeks to provide and adapt culturally based appropriate care.

ex: Allowing a patient to use herbs, prayer, meditation, candles, etc to be used in conjunction with the care plan as long as it is safe with the patient and environment.

Impact of homelessness

The homeless population experience higher rates of substance abuse, HIV/AIDS. They have poor access to medical care and most of the time don't have health insurance.

Factors to homelessness

Lack of stable home, mental illness, substance abuse, poverty, basic survival issues, dental and vision problems.

*ON TEST - If somebody is newly homeless, many times it may be due to a shortage of affordable housing.

Homelessness is everyone's problem

Know health practices, health concerns, and culture for the different groups: Arab Americans

Culture: family centered, male-dominiated family, role of religion, present-oriented (view the future as uncertain), preference for a same-sex health provider, acculturation (lack of English skills)

Health concerns: Adult-onset diabetes mellitus, coronary artery disease, mental health, role of acculturation, teenage smoking, high levels of depression and anxiety

Health practice: They depend on their family and religion when they have a health concern.

Know health practices, health concerns, and culture for the different groups: Asian Americans

Culture: Values of Collectivism vs Individualism, Family most important social institution; Respect elders, Cultural value of passivity to avoid conflict

Yin and Yang - forces which keep chi (innate energy) and Jing (sexual energy) in balance

Yin: feminine, negative, dark and cold

Yang: masculine, positive, light, and warm

Health concerns: Hesitancy to seek early diagnosis, higher rate of TB, Mental health problems due to adjustment issues (not to mention stigma to seeking help), lower rate of obesity, hypertension

Health practice: Taoism: foundation of Chinese medicine “achieving harmony”, folk medicine/alternative treatment modalities common, Chinese principles can be found through Asian countries.

Know health practices, health concerns, and culture for the different groups: Native Hawaiians/Pacific Islanders

Culture:

Health concerns: Higher rates of obesity, smoking and alcohol. Leading cause of death: cancer, heart disease, CVA, Diabetes, accidents. Prevalent diseases: HIV, hep B, TB. Strong knowledge of body is lacking.

Health practice: Holistic perspective, “Talk story” culture practice, Value for implementing health promotion strategy

Know health practices, health concerns, and culture for the different groups: Latino/Hispanic Americans

Culture: Family supersedes individual needs.

Religion plays a key role. Illness due to supernatural and psychological force ("evil eye"). Folk remedies in combination with professional care.

Highest rate uninsured

Largest ethnic group, and second fastest growing minority.

Health concerns: Health vulnerabilities- stomach cancer, diabetes mellitus, cardiovascular disease, obesity, HIV, complications from cigarette smoking

Health practice: Family supersedes individual needs, religions plays a key role, hot and cold concept of disease, Illness due to supernatural and psychological force, folk remedies in combo with professional care.

Know health practices, health concerns, and culture for the different groups: Black/African Americans

Culture: Family, Prayer/ Religion

Health concerns: Covid-19-Higher rate of death and complications, cancer death, HIV, hypertension, obesity, homicide

Health practice: centered on family and religion, family needs to be involved in care, churches importance in promoting health, traditional healing approaches.

Know health practices, health concerns, and culture for the different groups: Native Americans/Alaska Natives

Culture:

Health concerns: linked to social and economic conditions, smoking, substance abuse,

Death: unintentional injuries, liver disease cancer homicide, suicide pneumonia, diabetes, CVA.

High risk & poor outcomes with Covid-19 esp. Navajo nation

Health practice: present oriented; 1 day at a time. Value cooperation over competition, share resources, value families-form kinship system. Believe health exists when person is in harmony to nature. Traditional health practices important (Shaman).

Immigrants in the United States, population rates:

Immigrants include all foreign-born residents.

24.6% of LPRs (legal permanent residents) were from Mexico, followed by:

-5.3% from China

-4.4% from the Philippines

-4.4% from India.

Ethnic minorities:

Asian Americans/Pacific Islanders, Blacks/African Americans, Latinos/Hispanic Americans, Native Americans, Arab Americans

What is culture?

Languages, customs, beliefs, rules, arts, knowledge and developed by a social group to make life meaningful.

What is race?

A socially constructed category of people who share biologically transmitted traits that members of a society consider important

Historically associated with power and privilege disparities, social injustice, and prejudice.

What is ethnicity?

Commonalities of culture (language, history, customs, geographical origin, religion, or ancestry.)

Vulnerable populations include which groups?

-Ethnic minorities

-Homeless persons

-LGBT people

-Immigrants

-Refugees

What challenges are common for immigrants and refugees, including mental and physical health?

-Medical Insurance

-A home to live

-Job

-Fear of being deportation

-Increase risk of acute and chronic illness ex. PTSD

-Language and cultural barriers

Why is COVID-19 negatively impacting Black Americans at higher rates than other ethnic groups?

-Higher rates of risk factors/ comorbidities more susceptible to complications

-Infection rate 3x higher; death rate 5x higher

-Comorbidity Factors

-Less opportunity to work from home

-Less opportunity for high quality food delivery

Which ethnic group has the highest rate of COVID-19 infections?

Native Americans

How to build a positive nurse-person relationship? How to communicate with clients?

Establish open communication (MOST IMPORTANT)

Be nonjudgmental

Caregiver has to focus on needs of individual

Respect, confidence

Values -

What is it? How do you develop it?

What is it?

Core beliefs that hold great importance in identifying the inherent worth of an object, behavior, or idea that guide action. Evolve over time, depending on life events and social processes.

Guides our decision making.

Embedded in culture/family/social context.

How do you develop it?

With time influenced by a range of outside sources, most importantly culture.

*EVOLVES OVER TIME (stated needed to know this)

Reciprocity-

What is it? How do you apply it?

What is it?

The patterning of similar activities within the same interval by two people, can help the nurse communicate a listening stance in an effective way.

How do you apply it? When nurses match nuances of the individual's type and style of behavior, the chances that the person will interpret the nurse's behavior as an indication of active listening are increased, and the likelihood of misinterpretation is reduced.

ex: mirroring body language)

Reflection-

What is it? How do you apply it?

What is it?

The restatement of what the individual has said in the same or different words.

How do you apply it?

By paraphrasing or summarizing the person's main point to indicate interest and to focus the discussion.

Self-awareness-

What is it? How do you apply it?

Who is it that you aspire to be?

What kind of person are you?

Start with your identity before look at other people

Steps in Self-Awareness: (IMPORTANT TO KNOW FOR THE EXAM)

Listening to oneself:

Attention to emotions, thoughts, memories, reactions. Self-reflection is important as it controls and accommodates responses to behavior

Listening to and learning from others:

Giving feedback.

Integration of feedback can alter ineffective behavior

Self-disclosure:

Appropriate sharing of self-enhances self-knowledge

Promotes reciprocal interaction (patterning of similar activities within the same interval by two people); mutual exchange (my mom had cancer too)

Practical reflection: Enhances understanding events and corrective action

Feedback-

What is it? How do you apply it?

What is it?

New information exchange is triggered by a response Controls and accommodates responses to behavior. It is like a reflection, if somebody behaves a certain way and then you can provide that feedback, or if somebody acts out, how you respond to that

How do you apply it?

When a person or group controls the internal and external responses to behavior (output) accommodates responses appropriately.

What is Erickson's 7th Stage of Development?

(Middle adulthood; 40-65)

Generativity vs. stagnation

What is Erickson's 8th Stage of Development?

Maturity (65 years onward)

Ego integrity vs. despair

What is functional focus when assessing a person?

1. Collection and analysis of data

Biographical data & purpose for visit

2. Problem identification/nursing diagnosis (NANDA)

Problem, etiology, defining characteristics, contributing etiological factors, diagnostic variables

3. Planning the care

Project outcomes, prescribe interventions. Work with the client for a plan.

4. Implementing the plan

Actions necessary to fulfill the goals for optimal health

5. Evaluating effectiveness of plan

Analyze changes experienced by the individual

Examine relationship between nursing actions and the individual’s goal achievements

Healthy People objectives provide a framework for______________

health promotion and disease prevention

Stages of change model

A.) Precontemplative - Not considering a behavior change within the next 6 months

B.) Contemplative - The person is seriously considering a change within the next 6 months.

C.) Planning or preparation: The person who has made a behavior change is seriously thinking about

making a change within the next month (or making small or sporadic changes)

D.) Action - the person has actively engaged in the behavior change, and it has persisted for 6 months.

E). Maintenance - continued long term commitment to behavior

F.) Relapse

How to evaluate if a health education plan was met?

-An asthmatic person or someone with diabetes has less ER visits (takes medication regularly or modifies behavior)

-A teen drives within the speed limit

Teaching plan (assessment, development based on expected learning outcomes, implementation with designing learning strategies, and evaluating the teaching-learning process).

Remember to consider what factors may influence an individual's decision-making:

Assessment: Determine learner characteristics and learning needs:

-age

-developmental stage

-level of education

-health beliefs

-motivation

-readiness to learn

-health risks

-current knowledge and skills

-barriers and facilitators to learning

What is the health belief model?

How would it influence someone's decision to take action with a health consideration?

Health belief model says people are going to do it if they perceived it is a threat enough. (IMPORTANT, ON TEST)

A person is willing to make a decision based on a perceived threat.

How is education defined?

Any combination of planned learning experiences based on sound theories that provide individuals, groups, and communities the opportunity to acquire the information and skills needed to make quality health decisions.

Empowerment-what is it?

How do you apply it with patients?

Belief one can make a difference in one's health

What is social justice in the context of health promotion?

A social justice lens can identify the structural cause of targeted health disparities

What are the 6 dimensions of health?

Physical health

Emotional health

Spiritual Wellness

Social Wellness

Intellectual

Environmental

Causes of hypoglycemia and signs and symptoms

Cause:

Missing meals, low blood sugar

Symptoms:

Anxiety, confusion, difficult to control emotions

The difference and examples between community health promotion and individual health promotion:

Individual health promotion

You are working with the individual one on one

Community level

Such as creating a vaccine campaign for the entire community or labeling the proper way to store foods at the community level so that when people bring it home, they can store it properly so that they don’t get ill because it is not cold enough. (WORD BY WORD FROM HER LECTURE)

The body needs sufficient amounts of all _____for efficient functioning and maintenance.

nutrients

What is the purpose of Myplate, The Dietary Guidelines for Americans, and nutrition priorities and goals for American adults found in Healthy People?

Health Literacy

The ability to understand basic health concepts and apply them to one’s own health decisions.

Primordial Prevention

-Newest level of prevention; policy level.

-Original three levels developed in 1945s to 1950s

-Aimed at affecting health before at-risk lifestyle behaviors are adopted

-Occurs at national, state, community levels

-Examples: healthy eating school-based programs, reduction of sodium in food supply, creating bike/walking paths