Wellness

cheat sheet

developmental stages, concerns for health and safety, ages, and specific health concerns, risk factors are important

Freuds theory, erosions theory, Havighurst theory, Piaget's theory, Kohlbers theory, westerhoff's theory, Skinner's theory, bandora theory

Development from conception to birth:

fertilized ovum is a zygote. 3 weeks the zygote is known as an embryo. The rate of cells differentiation increase and organs begin to form. 8 weeks an embryo has the most rapid development. 2 month after conception it becomes a fetus and this lasts until delivery of the infant. Fetus grows and organs mature.

Newborn Period:

birth to 28 days. Primary developmental task is to adapt to external environment. Some health concerns: oxygenation, feeding difficulties, and safety issues.

Infant:

28 days to 1 year old:: physical development progress in a rapid sequential pattern. Physical growth progresses in cephalocaudal and proximodistal direction. 1 month: babies can life their had when placed in prone position. At 4 months: babies life the head and chest. Infants need only their mother's breast milk for nutrition the first 6 months. Iron supplementation is recommended between ages 4-6 months. Health concerns are SIDS, colic, and abuse

Toddler

1-3 years old. Physical growth slows but the child continues to develop rapidly in many ways. Visual acuity improves, binocular vision is developed. Most body systems have matured and heart and respiratory rate slow. Toddler can tolerate variety of foods. Child can ambulate after 12 months. Skills radually refined during 2-3 years of age. Toddlers often become picky eaters and it is important that mealtimes be enjoyable. Developing a sense of autonomy. They often say no when they mean yes. Understand that objects exist even though they cannot see them

Preschool age:

biologic growth slows. Average weight gain is 5 pounds per year. Physical appearance changes from that of the toddler to the more streamlined appearance of the child. Gross and fine motor skills develop. Nutriiton requirements stay the same. Calorie and fluid intake should increase slightly. Period of active learning. They have vivid imaginations. Egocentric thought processes. Objects are defined in terms of how the child uses them. Child maltreatment is a signficiant problem in childhood.

School Age:

6-12 years old: pace of physical growth is slower and child gains roughly 4-6 pounds per year. Physical appearance becomes slimmer and even more graceful. Boys and girls have similar physical growth characteristics in the early years. Body system is more mature. Beter able to fight infection and maintain a stable blood glucose pattern. Full bowel and bladder control have been achieved. Bullying can be in the form of verbal, physical or cyber. Still may have strong food preferences. Towards the end girls are often taller and heavier than boys. Develop the ability to classify objects

Adolescents

time of change both physically and socially. Puberty: homoronal changes that onset puberty trigger causes breat enlargement, increase height and weight, growth of pubic and axillary hair, enlargement of testicles, growth. Of pubic favial and body hair, rapid increase in height, nocturnal emisions. Body systems mature with increased size of heart and lungs. Deveopment of muscle mass and definition is apparent. Nutritional needs increase during adolescence owing to increased rates of growth in height, weight, and muscle mass with sexual maturation. Caloric and protein needs increase to one of the highest levels during life span. Healthy dietary habits should be discussed with adolescents and periodically reinforced during office visits, at school and at home. Time of physical and emotional upheavel.

Health:

a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.

Health Promotion

defined as the process of enabling people to increase control over, and to improve, their health. Includes a focus on individual behaviors as well as environmental and social factors. Optimal health implies a balance of physical, occupational, emotional, social, spiritual, intellectual, and environmental well-being. Health promotion activities are most effective when an individual is intrinsically motivated and committed to lifestyle changes and personal growth that support positive health behaviors

Healthy people goals

Attain high-quality, longer lives free of preventable disease, disability, injury, and premature death - Achieve health equity, eliminate disparities, and improve the health of all groups - Create social and physical environments that promote good health for all - Promote quality of life and healthy lifestyles

Primary prevention:

before the disease becomes established by removing the causes or increasing resistance. Intervention during this phase is to modify risk factors to avoid the onset of disease and prevent pathologic processes from occurring. strategies include interventions designed to prevent disease or disability.

Secondly prevention:

undertaken in cases of latent disease. Although the pt may be asymptomatic, medical tests can detect a disease process. Goal for health intervention is early detection and diagnosis of health problems before pt exhibits symptoms of disease. focuses on early identification of an illness or plhenomenon to limit its impact or recurrence. Screenings like BP, blood sugar testing are examples.

Tertiary Prevention:

treatment or rehabilitation stage of preventive care, implemented when a condition or illness is permanent and irreversible. Intend to reduce suffering caused by poor helath and assist the pt in adjusting to chronic conditions. (interventions for those already experiencing symptoms of disease or disability. Focuses on maintenance or restoration of health and rehabilitation. Includes pt support groups, pain management counselling, and cardiac rehabilitation programs.)

Illness and factors effecting illness

Illness is abnormal process in which aspects of the social, physical, emotional, or intellectual condition and function of a person are diminished or impaired.

Acute Illness:

typically characterized by an abrupt onset and short durations.

Chronic illness:

characterized by a loss or abnormaliy of body function that last longer than 6 months an drequires on going long-term care.

Factors effecting illness:

social determinants of health are affected by resources distribution throughout the world. Conditions in which people live, work, play, and worship that shape health.

Effecting Illness (age)

chronologic age of an individual is a strong indicator of susceptibility to disease or disabling conditions. Older patients are at risk for oppportunisitic infections caused by harmless organisms that become pathogenetic and illness from the spread of community-acquired disease. Nurses need to educate the parents of newborns, infants, children, and adolescents about the importance of regular, age-appropriate checkups and screening examinations.

factors effecting illness: (gender)

gender-related risk factors for disease are assessed according to the characteristics of each disease. First health care providers to approach individuals about gender-specific health and wellness issues.

Factors effecting illness: (genetics)

involuntarily passed from biologic parents to their offspring. Controlling factors that place stress on physiologic function can reduce pathologic genetic expression and susceptibility to disease.

Factors effecting illness: (Lifestyle)

health and wellness risk factors are inherent in the choice to engage in and continue particular behaviors. Habitual lifestyle behaviors can produce health benefits or intensify the effects of pathologic risk factors. Nutrition and dietary intake have a direct link to modifiable lifestyle-related risk factors that predispose an individual to obesity, hyperlipidemia, atherosclerosis, heart disease, and cancer. Exercise is essential for the prevention of illness and promotion of wellness.

Factors effecting illness: (environment)

individuals live determines their access to food, water, shelter, and clean air. Indoor environments may harbor toxic household cleaning agents, chemicals, tabacoo smoke, and energy sources. Outdoor environments affect individual health in the areas of sanitation and waste disposal, water quality, and safety. Nurses assessment is critical in identifying and minimizing modifiable environmental risks that can affect status of community members

Factors effecting illnesses: (attitudes and emotions)

individuals respond differently to illness or the threat of illness. Attitudes, behaviors, and emotional reactions depend on the severity of the illness and is perceived impact on their health. A short-term, self-limited illness that is not life-threatening does not evoke emotions or actions that cause fundamental changes in daily lifestyle. Chronic, debilitating disease and severe illness can produce a broad range of emotional or behavioral responses in patients and their families. Shock may soon be replaced by anger, denial, anxiety, and withdrawal from others.

Factors effecting illnesses: (social concept)

refers to the way individuals perceive unchanging aspects of themselves, such as social character, cognitive abilities, physical appearance, and body image. Mental image of self in relation to others and the surrounding. Changed behaviors that may reflect altered self-concept when a person is faced with a severe or terminal illness range from minimally noticeable to extreme.

Factors effecting illnesses: (developmental level)

: intellect and behavior can be attributed to genetic traits and environmental stimuli. Individual's developmental level, as characterized by mastery of expected milestones and interactions with surroundings, reflects more than chronologic age and physical size. The concept of illness is different at each level of development. Fear and anxiety are common and appropriate traits for children and adults.

Factors effecting illnesses: (influence of peers and family)

value that friends and family place on health status can positively or negatively influence the health of an individual. Typically the developmental level of the pt determines whether peers or family have more influence. Children and adults: family & adolescents: friends. Family is the principal collective framework for health promotion an disease prevention. Peers and generational norms influence the health behaviors and risk-taking attitudes of adolescent pts.

Factors effecting illnesses: (traditions, beliefs, and values)

grealty influence illness behaviors and therapeutic practices. Some people have ethnic practices or beliefs that nurses must consider before treatment or diagnostic procedures are performed. Sometimes can be contrary to medical treatment to the point that life and death issues become secondary to beliefs.

Factors effecting illnesses: (healthcare access and availability)

gaining access to any type of health care can be an intimidating task for healthy and sick individuals. Socioeconomic factors can compound the need for care if it is not affordable. The circumstances affecting access to care may confound nurses' attempts to assist pts to adhere to therapy. Determine whether they are wiling to seek preventative care or screening examinations. Diminished availability of care has a major impact on the health and wellness of the people residing in rural areas.

Primary Prevention:

strategies include interventions designed to prevent disease or disability.

Social determinants

are health are the conditions in which people are born, grow, work, live, and age and the wider set of forces and systems shaping the conditions of daily life. These factors must be assessed and analyzed by public health nurses to determine their potential impact on the health of the population the nurses serve. They can cause a population to be healthy or vulnerable to disease and disability.

Agents of disease and etiologic factors:

host factors or intrinsic factors: individual variables that affect a person's health like genetics, age, gender, ethnic group, immunicaiton status, and human behavior. Environmental factors or extrinsic factors: immediate physical environment, the biologic environment and socioeconomic influences, such as workplace conditions or residence in an urban versus rural setting.

Epidemiology:

study of disease incidence and prevalence. Determine and influence the frequency and distribution of disease, injury, and other health-related events and their causes in a defined human population. Descriptive epidemiology: consists of studies that are conducted once a disease is evident. Analytic epidemiology: generates a hypothesis as to why the disease might be occurring in the community and then tests the hypothesis.

Targeted populations:

children, adults, teens, elderly people, those experiencing homelessness, economically disadvantaged, single and expectant parents, people who experience abuse, and those with substance use disorders.

Intrinsic

age, gender, ethnic group, immunization status, and the human behaviors that will determine or affect health

Extrinsic (environmental factors)

physical environment, food sources, vectors of disease such as animals or insects, community settings, workplace setting, socioeconomic influences.

Health literacy:

: the ability to obtain, process, and understand basic information and services needed to make appropriate health decisions and follow instructions for treatment

Role in nursing: (Literacy)

read and identify credible health information, understand numbers in the context of the patient's health care, make appointemnts, fill out forms, gather health records, and ask appropriate questions of physicians, advocate for appropriate care, navigate complex insurance programs, medicare/Medicaid, and other financial assistance programs, and use technology to access information and services

Factors effecting learning:

life span, pt education provided for children should be age specific, assess adults' reading level, learning styles, and readiness, culture and religion, language, beliefs, and values inhibit understanding, different cultural and religious practices, beliefs, and values may interfere with certain medical treatments, diability, and pts with physical impairments, learning disabilities, visual loss, or hearing loss may require learning alternatives

Cognitive domain:

learning comprises knowledge and material that is memorized

Psychomotor domain:

incorporates physical movement and the use of motor skills in learning. Nurse demonstrates skill and then pt demonstrates skill

Affective Domain:

learning recognizes the emotional component of integrating new knowledge. Takes into account the pt's feelings, values, motivations, and attitudes

Learning Styles:

written, verbal, pictures. VARK: verbal, aural, read/write, and kinesthetic assessment. Evaluated to educate pt on the basis on their learning preference.

Assessment

(how the patient learns and observe pt behavior during interactions), nursing diagnosis: relevant to the education needs of the pt, planning: develop the pt education care plan. Nurse should allow pts to identify what is most important to them. Implementation and evaluation: nurses often advocate for pts when other members of the interprofessional health care team have provided information that needs clarifaction.

Quality

depends on nurses understanding the connections or family dynamics

Roles

family members assume assigned roles and roles change over time.

Complexity:

the more numerous the family members, the more complex the interactions. Complexity of caregiver activities, fatigue, gastrointestinal upset, weight change

Beneficence

Doing good or causing good to be done; kindly action. Nurses demonstrate by acting on behalf of others and placing a priority on the needs of others rather than on personal thoughts and feelings

Nonmaleficence

do no harm. Requires only the avoidance of harm. Fundamental ethical mandate of all health care professionals.

Respect for autonomy

refers to respecting patients' rights to make decisions about their own healthcare. the freedom to make decisions supported by knowledge and selfconfidence. Considered a basic health care right in US.

Justice:

fairness; rightfulness. the obligation to act fairly and equitably to everyone regardless of income or power. Although justice may seem easy to achieve, the concept is often challenging to apply in health care.

Veracity

truthfulness. the obligation to always be truthful. Honesty promotes unrestricted communication among individuals, demonstrates respect for others, and builds trust.

Accountability

ability to answer for one's own actions. the willingness to accept responsibility for one's actions. Requried to provide safe pt care and address potential problems.

Advocacy

taking action to influence others to address a health-related concern or to support a health-related belief. supporting or promoting the interests of others or of a cause greater than oneself. Nurses are ethicaly required to advocate for the rights of all pts.

Confidentiality

Respecting the privacy of both parties and keeping details secret. the ethical concept that limites sharing private pt information. Disclosure is limited to authorized individuals and agencies.

Fidelity

keeping promises or agreements made with others. Is essential for building trusting relationships with pts and their fams.

Responsibility:

Being responsible for one's actions. the concept of being dependable and reliable. Who is responsible adheres to professional standards of care, complies with institutional policies meets requirements of continuing education and follows the orders of physicians and nurse practitioners.

Deontology:

ethical theory focused on the rightness or wrongness of individual behaviors, duties, and obligations without concern for the actual consequences of those actions. Immanuel Kant developed this theory. He believed ethical rules were consistent and could be understood by all rational individuals

Utiliarianism

The idea that the goal of society should be "the greatest happiness for the greatest number". focuses soley on the consequences and maintains that behaviors are determined to be right or wrong based on their outcomes. The utilitarian concept of greatest happiness maintains that the right action is one that brings the greatest happiness to most people.

Right-based:

focuses on the rights of the individual and does not always take into consideration the effects on society as a whole.

Rights-based ethics

belief that individual rights provide the vital protection of life, liberty, expression, and property. emphasizes the ethical principle of justice, stating that no individual person should have any advantage over another. Underlying tenet of organ transplantation lists; having money or power does not give any one person an advantage over others on the lists.

Virtue-based ethics

ethical theory that emphasizes the agents who perform actions and make choices; character and virtue form the framework of this ethical theory. focuses on personal traits of individuals rather than societal norms. This theory is often exemplified by people with certain characteristics choosing to enter the profession of nursing as their calling rather than entering a profession with greater income potential.

codes of ethics

formalized rules and standards that describe what a company expects of its employees

Historical Background

foundation of ethical codes of professional conduct for nurses is the original Nightingale Pledge. The first official nursing code of ethics was adopted in 1950 by the American Nurses Association.

codes of ethics for nurses:

a succinct statement of the ethical values, obligations, duties, and professional ideals of nurses individually and collectively. Nine basic provisions under which nursing practice takes place.

Constitutional law:

Laws relating to the interpretation of the Constitution. derived from a formal, written constitution that defines the powers of government and the responsibilities of its elected or appointed officials.

Statutory Law

Law passed by the U.S. Congress or state legislatures. created by legislative bodies like US congress and state legislatures. Often referred to as statues. States should be consistent with all federal laws. NPA (nurse practice act) defines the scope of nursing practice in the state.

Regulatory Law:

reflects decisions made by administrative bodies. outlines how the requirements of statutory law will be met. Nursing roles and regulations are categorized as this This gives state boards of nursing authority.

Case Law:

the rules of law announced in court decisions. judicial decisions from individual court cases. Historically referred to as common law bc it originally determined by customs or social mores that were common at the time.

Intentional tors:

wrongs committed by individuals who deliberately seek to injure or hurt another person

Assault:

a threat of bodily harm or violence caused by a demonstration of force by the perpetrator

Battery:

actual physical harm caused to another person

defamation of character

when a public statement is made of force by the perpetrator

False Imprisonment

restraining an individual or restricting an individual's freedom

Invasion of privacy:

public disclosure of private information, use of a person's name or likeness without permission, intrusion into a person's place of solitude, and meddling into another's personal affairs

Unintentional torts:

omissions or acts by individuals that cause unintended harm

Negligence

careless neglect, often resulting in injury. creating a risk of harm to others by failing to do something that reasonable person would ordinarily do or doing something that a reasonable person would ordinarily not do

Malpractice

Failure by a health professional to meet accepted standards. negligence committed by a person functioning in a professional role. Can occur when a professional acts unethically demonstrates deficient skills or fails to meet standards of care required for safe practice.

Professional practice conduct:

building and maintaining trusting relationships with pts and colleagues requires professionals communication and competent practice. Focusing on the needs of pts and their families help nurses avoid crossing professional boundaries that breach pt's rights. Examples: social networking, competent practice, workplace bullying, substance use disorder.

Adherence to principles of delegation:

appropriate delegation by RN seeks to ensure pt safety and meet nursing standards of care

Accurate and timely documentation:

nurses are required to document pt information in written or electronic format. Documentation must be accurate to provide a realistic view of pt's condition. Nurses need to record assessment findings and concerns as soon after their discovery as possible.

Informed consent

An ethical principle requiring that research participants be told enough to enable them to choose whether they wish to participate.

Patient's Bill of Rights

summary of a patient's rights regarding fair treatment and appropriate information. including special privileges that they should be aware of

ORGAN DONATION

individuals must make it their desire to donate organs known to family members before their death to ensure their wishes are fulfilled.

advance directives

A legal document designed to indicate a person's wishes regarding care in case of a terminal illness or during the dying process

DNR

do not resuscitate

Licensure

seeks to ensure professional competence

standards of care:

the minimum requirements for providing safe nursing care. The ANA identifies standards of safe practice and regularly releases policy statements and current practice information to guide and update the standards of care for nurses

Health Insurance Portability and Accountability Act (HIPAA)

contains 4 sets of standards each with rules that must be implemented by all health care facilities. Prohibits sharing of any pt info with anyone who doesn't need to know

Good Samaritan act:

offering protection for physicians and other health care professionals who provide emergency care if its in professional scope of knowledge and standards of care and no fee is received or charged for services

Uniform Determination of Death Act

A proposal that established uniform guidelines for determining when death has occurred.

medical aid in dying and euthanasia

Medical aid in dying: when a person who ins mentally competent with a prognosis of 6 months or less to live causes their own death by self-administering prescribed medication

Euthanasia: occurs when a person who willingly requests to die is injected with a lethal drug dosage by another individual

Natural death acts

permit competent patients to make health care decisions that may result in their deaths

American with Disabilities Act

Law that prohibits employers from discriminating against people with physical disabilities

physical restraint

any manual method or physical or mechanical device, material, or equipment attached to or near the person's body that he or she cannot remove easily and that restricts freedom of movement or normal access to one's body. nurses are responsible for providing safe pt care, which includes preventing pt injury from physical restraint and unrestrained, falls.

additional acts introduced in congress

- registered nurse safe staffing act

- nurse and health care worker protection act

- safe patient handling and movement

various versions of RN safe staffing act, the nurse and health care worker protection act have been introduced to US congress for several years in effort to increase patient safety an prevent the loss of RNs from the workforce bc of physical injury