Studied by 174 people
Chapters 1, 5, 10, 11, 21, 22, and 25
patient/client centered care
cultural traditions
personal preferences → consider literacy skills and how the client prefers to learn
values → what is important to the client?
families
lifestyles
health information technology (HIT)
comprehensive management of health information and its exchange between consumers, providers, government, and insurers in a secure manner
telehealth
use of electronic information and telecommunications technologies to support long-distance clinical healthcare, patient and professional health-related education, public health, and health administration
personal responsibility for health
active participation in one’s own health through education and lifestyle changes
social determinants of care
social conditions in which people live, their income, their social status, their education, their literacy level, their home and work environment, their support networks, their gender, their culture, and the availability of health services
principles of public health nursing
client or unit of care is the population
primary obligation = greatest good for the greatest number of people
collaborate with the client as an equal partner
primary prevention
focusing on strategies that create healthy conditions in which populations may thrive
actively identify and reach out to all who might benefit from a specific service
optimal use of available resources and creation of new evidence-based strategies
collaboration with other professions, populations, organizations, and stakeholder groups
equity
providing equal care without discriminating against gender, race, sexual orientation, socioeconomic status
primary prevention
maximizing health and wellness through strategies that are set in place BEFORE illness or injury is present
secondary prevention
maximizing health and wellness through strategies that are set in place at the early and active chronic stages of the pathogenesis of illness and injury
tertiary prevention
maximizing health and wellness through strategies that are set in place at the palliation and end stage of disease and injury trajectories
culture
knowledge, values, practices, customs, and beliefs of a group
properties of culture
dynamic
shared
learned
cultural competence
a skill the nurse develops in learning to respect individual dignity and preferences, as well as acknowledging cultural differences
an attitude of openness to, respect for, and curiosity about different cultural values and traditions, and ideally includes a broader critical analysis of power relations affecting health disparities
cross-cultural / transcultural nursing
any nursing encounter in which the client and nurse are from different cultures
For community and public health agencies to be culturally competent, they must…
have a defined set of values and principles
demonstrate behaviors, attitudes, policies, and structures that enable them to work effectively cross-culturally
have the capacity to
value diversity
conduct self-assessment
manage the dynamics of difference
acquire institutionalize cultural knowledge
adapt to diversity and the cultural contexts of the communities they serve
cultural humility
an acknowledgment that…
everyone’s views are culturally influenced,
that our own are NOT inherently better than those of our clients, and
that our clients can teach us
ethnocentrism
an assumption that everyone shares your cultural values or an opinion that your culture is superior to others
What is the first step to being culturally competent?
to be competent in one’s own cultural heritage
Aspects of culture DIRECTLY affecting health and health care are…
attribution of illness
diet
verbal communication
nonverbal communication
eye contact
personal space
style of communication
time orientation
roles
religion
folk medicine
A cultural assessment provides…
information to the healthcare provider about the effect of culture on communication, space and physical contact, time, social organization, and environmental control factors
Why should the nurse perform a self-assessment PRIOR to collecting information about a client’s culture?
to prevent personal bias
Question Examples
Am I aware of my culture and views about other cultures?
Am I able to perform a culturally sensitive assessment?
Do I have the knowledge necessary to develop culturally appropriate nursing interventions?
What is my goal in learning about diverse populations?
cultural sensitivity
awareness and appreciation of the values, norms, and beliefs characteristic of a cultural, ethnic, racial, or other group that is NOT one’s own, accompanied by a willingness to adapt one’s behavior
Conveying Cultural Sensitivity
Address clients by their last names, unless the client gives the nurse permission to use other names.
Introduce yourself by name and explain your position.
Be authentic and honest about what is known or not known about a client’s culture.
Use culturally sensitive language.
Find out what clients know about their health problems and treatments, and determine the client’s intent to adhere to the prescribed treatment plan.
Incorporate clients’ preferences and practices into care when possible.
Do not make assumptions about clients.
Encourage clients to ask about anything that they might not understand.
Respect clients’ values, beliefs, and practices.
Show respect for clients’ support systems.
Provide health teaching materials in the client’s primary language and at the recommended readability level.
Using an Interpreter
The nurse should use an interpreter when it is difficult for a nurse or client to understand the other’s language.
Interpreters should have knowledge of health-related terminology.
The use of family members as interpreters is not advisable because clients might need privacy in discussing sensitive matters. Family members can lack objectivity when relaying information to or from the client, and the family member can have difficulty understanding medical terminology.
The nurse should consider client preferences when selecting the age and gender of an interpreter.
A community assessment includes…
examination of biological, psychological, and sociocultural influences of the environment that surrounds a specific group of people.
Windshield Survey
observation of a community while driving a car or riding public transit to collect data for a community assessment
Community Assessment Asset-Based Approach
identifies community resources and strengths along with community needs
Collaborative Model
an assessment by an interdisciplinary team and members of the community
Risk Factors for Suicide (SAD PERSONS scale)
Sex
females have more attempts
males are more lethal
Age
increases with age
adolescents and the elderly are the highest-risk groups
Depression
Previous attempts
Excessive alcohol and/or drug use
Rational thinking loss
Social support lacking
Organized plan
NO spouse
Sickness
chronic or debilitating
Symptoms of Bipolar Disorder
Depression Symptoms
LOW self-esteem and energy
slow movement and speech
suicidal ideation
poor hygiene
anergia
anhedonia
Mania Symptoms
HIGH self-esteem and energy
euphoric
delusions of grandeur
rapid speech
risk for violence
risky behavior
outlandish clothing
Autism Interventions
early identification and treatment
screening tools mostly used in toddlers
screening for prodromal symptoms in infancy
some of the more debilitating features of the disorder might be mitigated with early intervention and treatment
Long-term outcomes of children with autism are improved with…
early identification and treatment.
3 main symptoms of attention-deficit/hyperactivity disorders (ADHD)
inattention
hyperactivity
impulsivity
What is the diagnostic criteria for ADHD?
symptoms occur in 2 settings (e.g., home and school for children or home and work for adults
What medications are given to children with ADHD?
psychostimulants
methylphenidate (Ritalin)
methylphenidate hydrochloride extended-release tablet (Concerta)
Nursing Considerations for ADHD Medication (children)
DO NOT administer after 6 PM
may cause insomnia
affects growth and development
keep a growth chart
monitor BP
obtain bloodwork
Role of the School Nurse
health assessment
individual
population-based
health promotion
school health needs
health educator
emergency preparedness
School nursing encompasses many roles:
case manager
community outreach
consultant
counselor
direct caregiver
health educator
researcher
Common Health Concerns (school nursing)
drugs and alcohol
smoking
sexual behavior and teenage pregnancy
sexually transmitted infections
nutrition
violence
The school nurse as a child advocate…
provides education and communication necessary to ensure that the student’s health and educational needs are met
implements strategies to reduce disruptions in the student’s school activities
communicates with families and healthcare providers as authorized
ensures the student receives prescribed medications and treatments and that staff who interact with the student on a regular basis are knowledgeable about these needs
provides a safe and healthy school environment to promote learning
site walk-through
a part of a workplace assessment focused on the following:
observation of work processes and materials
job requirements
actual and potential hazards
employee work practices (hygiene, water disposal, housekeeping)
incidence/prevalence of work-related illness/injuries
control strategies to eliminate exposures
Note 
Flashcard (91)