Funds #4 ( Week 14,15,16)

what is malnutrition?

occurs when there is an imbalance between nutrient intake and the body's needs, leading to undernutrition (insufficient nutrients) or overnutrition (excess nutrients).

what is food security?

means all household members have access to sufficient, safe, and nutritious food to maintain a healthy lifestyle on a consistent basis.

what is food insecurity?

is the inability of a household to provide enough food for every person to live an active, healthy life.

what are factors influencing nutritional status?

- Patients’ values, beliefs, and attitudes about food
- Environmental factors and lifestyle choices
- Developmental needs
- Cultural and religious influences
- Disease or health conditions

what is obesity?

A prevalent health issue in the U.S. associated with excess caloric intake and limited physical activity.

what is dysphagia?

Difficulty swallowing, which can lead to complications such as aspiration pneumonia, dehydration, weight loss, and decreased nutritional status. Silent aspiration can occur without overt signs.

what is NPO?

Patients who are NPO for extended periods (>5-7 days) and receive only IV fluids are at risk for nutritional deficits.

what are subjective assessment for nutrition?

- Risk factors: Age (very young/old), disease, immobility, cognitive impairment, increased metabolism

- Screening tools: 24-hour recall, food diary, food frequency questionnaires

what are objective assessment for nutrition?

- Anthropometry: Waist-to-hip ratio, height, weight, BMI

- Laboratory values: Hemoglobin, hematocrit, cholesterol, triglycerides, serum protein, albumin

- Physical Assessment: Clinical signs of malnutrition—changes in skin, hair, nails, oral mucosa, eye conjunctivae, neuro-muscular function

what are Nursing Diagnoses for Nutritional Problems?

- Imbalanced nutrition (less/more than body requirements) related to:
- Lack of appetite or interest in food
- Recent significant weight loss or gain
- Risk for imbalanced nutrition related to:
- Impaired swallowing
- Feeding self-care deficit

what are Nursing Interventions to Help Clients Achieve Nutritional Goals?

- Stimulating appetite:
- Optimize the environment and social activity
- Maintain oral hygiene
- Offer small frequent meals
- Consider medications like Megace, Marinol, Periactin
- Assisting with eating:
- Ensure patient safety, independence, and dignity
- Assess risk for aspiration (decreased alertness, impaired reflexes, difficulty managing saliva)
- Provide a 30-minute rest period before eating
- Position patient upright (90 degrees) and slightly flex chin-down
- Adapt utensils for patients with impairments

what is diet progression?

Patients progress based on tolerance from NPO → ice chips → clear liquid → full liquid → pureed → mechanical soft → soft/low residue → regular diet.

what is therapeutic diets?

- Clear liquid

- Full liquid

- Pureed

- Mechanical soft

- Soft/low residue

- High fiber

- Low cholesterol

- Low sodium

- Diabetic

- Dysphagia diets with modified consistencies

what are Nursing Evaluation for Clients Achieving Nutritional Goals?

- Monitor individualized care plans and interprofessional collaboration.
- Evaluate patient weight, labs, and intake.
- If goals are unmet, ask open-ended questions to reassess needs.

Identify how personal attitudes, beliefs, and biases impact nursing care

- A nurse’s attitudes, prejudices, actions, speech, level of knowledge, and avoidance behaviors can either promote or inhibit discussions about sexuality.

- Nurses must maintain a non-judgmental and open-minded approach to create a respectful and safe environment for patients.

- Recognizing and exploring personal feelings about topics such as homosexuality, contraception, abstinence, and sexual health helps nurses provide unbiased care.

what is sexuality?

Encompasses all aspects of being sexual, including sexual identity, thoughts, and feelings about the body. Healthy sexuality allows individuals to develop and maintain their fullest potential.

what is sexual health?

A state of physical, emotional, mental, and social well-being related to sexuality. It involves positive and respectful sexual relationships free from coercion, discrimination, and violence.

what is biologic sex?

denotes chromosomal sexual development (XX or XY), external/internal genitalia, secondary sex characteristics, and hormones.

what is gender identity?

The inner sense a person has of being male or female, which may differ from their biologic sex.

what is Sexual Development Through the Lifespan for Infancy & Early Childhood?

• Development of sexuality and gender identity

• Identification of gender

• Exploration

what is Sexual Development Through the Lifespan for School-Age years?

•Same sex friends

• Asking questions

• Beginning secondary sex characteristics

• Anticipatory guidance about puberty and body changes

what is Sexual Development Through the Lifespan for Puberty/Adolescence?

• Body image

• Peer groups

• Sexual exploration

• Anticipatory guidance; STI, pregnancy, relationships, contraception

what is Sexual Development Through the Lifespan for Young Adult?

• Sexual relationships

• Intimacy

• Safety and support

what is Sexual Development Through the Lifespan for Middle- Age adult?

• Females: hormones and dyspareunia

• Males: delayed ejaculation, increase of postejaculatory refractory period

• Anticipatory guidance

• Illness, meds, pain, health concerns

what is Sexual Development Through the Lifespan for Older Adults?

• Increased HIV and STI

• Longer to reach orgasm

• Reduced hormones

• Physically disabling conditions

• Medications, hormones, health concerns, positions

• Safety with partners

what are factors that affect an individual’s sexuality?

- Physical Factors: Chronic pain, mobility issues, spinal cord injuries, diabetes, hypertension, myocardial infarction.

- Psychological Factors: Mental illness, self-concept, body image.

- Social and Relationship Factors: Cultural beliefs, past experiences, interpersonal relationships.

- Lifestyle Factors: Stress, medication side effects, environmental influences.

what are Altered Sexual Function & Factors Affecting Sexual Function?

- Male: Erectile dysfunction, premature ejaculation, retarded ejaculation.
- Female: Inhibited sexual desire, dyspareunia, vaginismus.
- Both: Impact from chronic conditions, surgery, spinal cord injuries, medication side effects, mental health conditions.

What are key considerations during the assessment phase of sexuality?

Maintain privacy, use open body posture and relaxed voice, and begin with reproductive history.

What is an example of a nursing diagnosis related to sexuality?

Impaired Sexual Functioning related to contraception, STI risk, or history of physical abuse.

What interventions are used for impaired sexual functioning?

Counseling, education on safe sex practices, and referrals to community resources.

What does health promotion include in the implementation phase?

Sex education, self-examinations, and responsible sexual behaviors.

How does acute care relate to sexuality in nursing implementation?

It addresses concerns impacting sexuality due to health conditions.

What is the focus of restorative/continuing care in sexuality?

Long-term support for sexual well-being.

What is evaluated at the end of the nursing process related to sexuality?

Goal achievement, patient’s readiness, understanding, and comfort with sexual health.

What is PLISSIT?

Permission Giving

Limited Information

Specific suggestions

Intensive therapy

what is silent aspiration?

occurs in patient w/ neurological problems that have decreased sensation

what is undernutrition?

protein energy malnutrition, stunting, wasting, underweight

what is overnutrition?

overweight & obesity, diet related noncommunicable diseases

define health

"a state of complete physical, mental, and social well-being, not merely the absence of disease or infirmity" (WHO). Health is also personalized, shaped by an individual’s values, personality, and lifestyle.

define disease

refers to the malfunctioning or maladaptation of biological or psychological processes.

define illness?

an abnormal process in which any aspect of a person’s functioning is diminished or impaired compared to their previous condition. Illness is influenced by self-perceptions, changes in roles and relationships, cultural factors, and spiritual values.

what are models of health and illness?

refer to conceptual frameworks for understanding health and illness. These models help define how health is perceived and managed in individuals and communities.

what is internal variables?

Personal characteristics that affect health beliefs and practices.

what is external variables?

Social determinants of health (SDOH), which include societal influences such as access to resources, education, socioeconomic status, and healthcare availability.

what is the nurses role in health promotion?

Helps individuals maintain or enhance their health, motivating them to engage in positive behaviors.

what is the nurses role in Health education?

Teaches individuals how to care for themselves and make informed health decisions.

what is the nurses role in illness prevention?

Encourages individuals to avoid declines in health or functional status through proactive measures.

what are Examples of Health Promotion Across the Lifespan?

childhood immunizations, adolescent health education, adult disease prevention measures, and elderly mobility programs.

what are Primary Prevention for health & wellness?

True prevention aimed at reducing disease incidence through activities like immunizations, health education, diet, and exercise.

what are Secondary Prevention for health & wellness?

Focuses on early detection and prompt intervention to reduce disease severity, including screenings (BP, mammograms, glaucoma) and contact tracing.

what are tertiary Prevention for health & wellness?

Occurs when disease or disability is permanent and irreversible, aiming to minimize complications through rehabilitation, PT/OT, and surgical interventions.

define risk factors for health & wellness?

situations, habits, or variables that increase the likelihood of disease or accidents. They make an individual or group more vulnerable to health issues. Categories include genetic, physiological, age, environmental, and lifestyle factors.

what is the Purpose of Healthy People 2030?

began in 1979, outlining national goals to improve the health of Americans. Over time, progress has been made, including decreased infant mortality and increased childhood vaccinations.

Describe how the SDOH impact the health of people

include access to healthcare, socioeconomic status, education, environmental conditions, and other societal factors that affect health equity. These determinants shape health risks and opportunities for individuals and communities.

what is role competence?

the application of knowledge and skills in the utilization of critical thinking, effective communication, interventions, and caring behaviors consistent with the nurse's practice role within the context of the public's health, safety, and welfare

what are The stages of role competence in the context of Benner’s theory of practice?

a.      Novice- beginner (no experience)

b.      Advanced Beginner- around 6 months (can demonstrate basic levels of performance)

c.     Competent- has been working in the job/area for 2 to 3 years  

d.      Proficient- has learnt what to expect in certain situations

e.      The expert- has an intuitive grasp of each situation

what is novice?

beginner (no experience)

what is advanced beginner?

around 6 months (can demonstrate basic levels of performance)

what is competent?

has been working in the job/area for 2 to 3 years

what is proficient?

has learnt what to expect in certain situations

what is expert?

has an intuitive grasp of each situation

what are different roles of professional nurse?

a. Care provider

b. Teacher

c. Counselor

d. Change agent

e. Patient Advocate

f. Researcher

g. Manager

h. Leader

what is delegation?

directing a competent person to perform a selected nursing activity or task in a selected situation under the nurse's supervision and pursuant to administrative regulations promulgated by the board. Getting work done through others.

What is one way to create an empowering work environment for nurses?

Through the Magnet Recognition Program.

What does the Magnet Recognition Program empower nurses to do?

Make changes and be innovative.

What are the six standards of the Magnet Recognition Program?

Shared decision making, leadership, safety, quality, well-being, and professional development.

what are the rights of delegation?

 Right Task – caregiver is trained and competent in the task- are in job

description

 Right Circumstance - consider patient status-need to be stable

 Right Person – best person for patient, knowledge and skills needed for

the task

 Right Direction/Communication - clear, concise description of the task,

including its objective, limits and expectations.

 Right Supervision and Evaluation - appropriate monitoring, evaluation,

intervention and feedback.

what are RN only duties?

 Tasks that involve nursing judgment

 Assess patient’s response to care

 Interventions that require independent, specialized nursing knowledge or skill

What types of care can a Nurse Aide/UAP/CNA/PCA provide?

Hygiene, comfort, exercise, safety, and elimination needs.

What is the role of a Licensed Practical Nurse (LPN)?

 Provide nursing care and health promotion under direction of the RN

 Provide basic patient needs, wound care and some medications

What tasks should not be delegated to an LPN?

Plan of care, care for unstable patients, transcribing/taking verbal orders, admissions, initial assessments, initial teaching, discharge teaching, central line flushes.

What types of assessments can’t be delegated to an LPN?

Admissions, transfers, returns from surgery, changes in condition, and “first of anything.”

What tasks should not be delegated to a Nurse Aide/UAP?

 Charting

 Treatments

 Except soap suds enemas

 Medications

 Except OTC topicals

 Assessments

 Except vital signs and blood glucoses (unless patient is unstable)

 Interpretation of data

 Nursing Care Plan

 Care of invasive lines

 Client Education

 MAY delegate ADLs

What are the purposes of patient education?

Maintenance & promotion of health and illness prevention,

restoration of health

coping with impaired functions.

what is the role of nurses in patient education?

 One of the most important nursing interventions

 Independent nursing function

 Patients have the right to know and be informed about their diagnosis, prognoses, treatment options

 Nurses have ethical responsibility to teach their patients

 Part of patient-centered care

What is the role of the SPEAK UP campaign in nursing education?

It promotes patient engagement and active learning.

what is cognitive domain?

learning comprises knowledge and material that is remembered

what is psychomotor domain?

learning incorporates physical movement and the use of motor skills into learning.

what is affective domain?

learning recognizes the emotional component of integrating new knowledge. ONE-SELF

Define teaching in nursing education.

The process of helping patients gain new knowledge, change attitudes, adopt behaviors, or perform new skills.

What is learning in the context of patient education?

Acquiring new knowledge, skills, or attitudes that can be measured.

What is motivation to learn?

An internal force that drives behavior and influences attitude or value change.

What is self-efficacy in patient education?

A person's belief in their ability to succeed—an important predictor of healthy behaviors.

What factors influence readiness to learn?

Health status, attentional set, mental state, and stages of grief.

What indicates a learner's readiness to learn?

Willingness to engage, ability to focus, and time to process illness.

Name four nursing diagnoses related to patient education.

Lack of knowledge, impaired health maintenance, impaired ability to manage regimen, self-care deficit.

What should be included in a patient education-related nursing diagnosis?

A “related to” (r/t) statement to guide teaching

What does the ABCD framework stand for in writing learning objectives?

Audience, Behavior, Condition, Degree.

Give an example using the ABCD framework.

"The client will demonstrate inhaler use for the nurse with 100% accuracy."

Name four methods to evaluate patient learning.

Teach-back, demonstration, verbal instruction, role play/simulation.

What is the focus of the nursing process?

Assessing health conditions, planning care, and evaluating outcomes.

What is the focus of the teaching process?

Assessing learning needs, setting goals, teaching, and evaluating understanding.

What do the nursing and teaching processes have in common?

They require individualized approaches, critical thinking, and assessment.

what is an actual loss?

Loss where a person can no longer feel, hear, see, or know a person/object (e.g., body part, job).

What is a perceived loss?

A loss uniquely defined by the individual, intangible to others. EX: loss of independence, loss of sense of self esteem, financial independence

What is physical/psychological loss?

Loss of a body part or altered self-image.

What is a necessary loss?

Expected life change; often positive and replaced by something better.

What is a maturational loss?

Loss due to normal life transitions (e.g., child gaining a sibling, child going to school).

What is a situational loss?

Unpredictable loss caused by events like trauma or illness.

What is normal grief?

Uncomplicated grief with a typical healing process.