Fund Exam #1 Study

Social Determinants of Health

1. Economic Stability (employment, income)

2. Neighborhood and Physical Environment (housing, transportation, parks)

3. Education (literacy, higher education)

4. Food (hunger, access to healthy options)

5. Community and Social Context (support systems, discrimination)

6. Health Care System (health coverage)

Katz Index of Independence in Activities of Daily Living

1. Bathing

2. Dressing

3. Toileting

4. Transferring

5. Continence

6. Feeding

Instrumental Activities of Daily Living

1. Cooking

2. Cleaning

3. Transportation

4. Laundry

5. Managing Finances

Institute for Healthcare Improvement Age-Friendly Health Systems

4 M’s

1. what Matters - align care with each person’s specific goals and preferences

2. Medication - review if medication is necessary and then consider #1

3. Mind - prevent, identify, manage, and treat delirium/dementia/depression

4. Mobility - ensure that they move safely and #1

Steps of the Nursing Process

1. A ssessment - gather data, consider pt’s baseline, age-related variations (physical exam, health history, lab results)

2. D iagnosis - create nursing diagnosis based on assessment

3. P lanning - make care plan with measurable/realistic goals, based on the individual & their preferences

4. I mplementation - use nursing interventions (medication administration, wound care, mobilization assistance, pt education)

5. E valutation - assess how affective the interventions have been and adjust accordingly

Stages of Assessment

1. Collect and verify data from pt, family members

2. Analysis of data to complete the picture

Types of Assessment

1. Subjective

• Verbal statements from pt or caregiver (write in quotation marks)

• Primary - from the pt themselves

• Secondary - from family members, chart, or other sources

2. Objective

• Anything that can be observed with your own senses while assessing the pt

• Vital signs, height, weight, intake, output, physical exam findings, lab results

Sources/Methods of Assessment

• Interview/History taking

• Physical Exam

• Labs/other test results

Examples of Health History

• Biographical info

• Pt expectations

• Reason for seeking care

• Present illness / Health concerns

• Health history

• Family history

• Psychosocial history

• Spiritual health

• Review of systems

Nursing vs Medical vs Collaboration Diagnoses

Nursing - pt problems nurses can treat independently

Medical - pt problems that providers direct the treatment

Collaboration - Using provider prescribed methods and nursing prescribed interventions

Priority of Diagnoses

1. Maslow’s Hierarchy of Needs - basic safety

2. ABC’s - Airway, Breathing, Circulation

3. Actual vs Potential - sometimes treat potential problem first

4. Acute vs Chronic - treat acute first

5. Least invasive first - this order can lead to less health risks

6. Patient safety - always consider their safety first

What to consider when creating a plan

S pecific

M easurable

A ttainable

R ealistic

T imed

• Long term goals can be a goal for discharge

• Short term goals can be attained in a specific time period

Implementation Types