Wellness and Health Models, Exams of Nursing

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Health - ANSWER- State of physical, mental and social functioning that realizes the potential of which a person is capable Wellness - ANSWER- State toward a higher level of functioning- improved physical and mental health state Illness - ANSWER- Social construct in which people are in an imbalanced, unsustainable relationship with their environment and are failing in ability to survive and create higher quality of life Disease - ANSWER- failure of a persons adaptive mechanisms to adequately counteract stimuli and stresses, resulting structural or functional damage Wellness-Illness continuum - ANSWER- A paradigm that is bipolar, interactive portrayal of health and illness in myriad configurations, ranging from high level wellness to depletion of health Clinical model of health - ANSWER- absence of signs and symptoms of disease- conventional model of the discipline of medicine Empathy - ANSWER- ability to understand anothers feelings without losing personal identity and perspective Various models of health (4) - ANSWER- Clinical model, role performance model, adaptive model, eudaimonistic Which model of health states that health is absence of disease, illness is presence of disease, danger of not seeking help soon enough - ANSWER- Clinical model

Which model of health is the persons ability to participate in work, family and community - ANSWER- Role-performance model Which model of health is the ability to positively make changes in health conditions - ANSWER- Adaptive model Which model of health states that the exuberant well-being indicates optimal health - ANSWER- Eudamonistic model Helps to guide health system to promote health, helps to form healthcare for everybody, eliminates health disparity, increases healthy life span and provides preventative care. - ANSWER- Health people 2020 Levels of prevention - ANSWER- Primary- prevention Secondary- Assessment and Treatment Tertiary- Follow up care Which level of prevention is the prevention of smoking - ANSWER- Primary Which level of prevention is the care of respiratory patient - ANSWER- Secondary Which level of prevention is promotion strategies to improve life with COPD - ANSWER- Tertiary Gordons 11 functional health patterns - ANSWER- Health-perception/health- management Nutritional-metabolic Elimination Activity-Exercise Sleep-rest Cognitive-Perceptual Self-perception/concept Roles-relationships Sexuality-Reproductive Coping-stress tolerance Values-beliefs Acculturation - ANSWER- Adapting to or borrowing traits from another culture

Culture - ANSWER- Shared patterns of values/behaviors- shaped by cultural group Ethnic group - ANSWER- Group set apart on basis of cultural/national origin characteristics Ethnicity - ANSWER- Sense of collective identity, distinctiveness, sharing of customs, food, dress, language Health disparities - ANSWER- Wide variations in health services/health status among certain population groups Race - ANSWER- Categorizations of people based on physical properties and biological heredity Trans-cultural nursing - ANSWER- transforms health care for diverse populations Values clarification - ANSWER- Method for discovering ones values and the importance of these values What are considered to be the emerging populations in the United States? - ANSWER- Ethnic minorities, homeless, those with AIDS/HIV What are considered to be the primary health concerns for the homeless population? - ANSWER- Survival issues, respiratory or infectious disease; dental/vision problems; mental health and substance abuse What are considered to be the primary health concerns for the Arab population? - ANSWER- Diabetes, coronary heart disease, acculturation, mental health, teen smoking What are considered to be the primary health concerns for the Asian population?

• ANSWER- Hesitancy for care, tuberculosis, mental health What are considered to be the primary health concerns for the Hispanic population? - ANSWER- Stomach cancer, diabetes, CV disease, HIV What are considered to be the primary health concerns for the Black population?
• ANSWER- Cancer, HIV, hypertension, obesity, mental health

What are considered to be the primary health concerns for the Native American population? - ANSWER- Smoking, substance abuse, cirrhosis, diabetes, suicide Advanced Practice nurses - ANSWER- Nurses with advanced education beyond BA- manage and deliver health care services to all Advocate - ANSWER- One who pleads the cause of another Health care reform - ANSWER- Obamacare Health Maintenance Organization - ANSWER- the prototypical managed care structure that encompasses 2 possibilities: health plan where providers assume the financial risk OR a health plan that uses primary care providers as gatekeepers. Hospitalist - ANSWER- a physician whose professional focus is caring for hospitalized individuals Lobbyist - ANSWER- Registered representative of a special interest group Managed care - ANSWER- System that seeks to manage the cost, quality, and access of health care. Medicaid - ANSWER- Combined federal and state program- provides access to care for the poor and medically needy of all ages Medicare - ANSWER- federal health insurance program that finacnces health care for those over 65, those disable, and those with end-stage renal disease Preferred Provider Organizations - ANSWER- Network of providers who agree to deliver serviced for discounted fee -no financial risk to provide Primary Care - ANSWER- basic health care that emphasizes health needs rather than specialized care- PREVENTION What is CMS and what do they do? - ANSWER- Centers for Medicare/Medicare and CHIP. Branch of US dept of health and human services. Federal agency which administers Medicare, Medicaid and CHIP; and provides info to health professions, regional governments and consumers.

What is WHO and what do they do? - ANSWER- World Health Organization- responsible for providing leaderships on global health matters, shaping health research agenda, setting norms and standards, evidenced based policy options, providing tech support to countries, monitoring and assessing health trends How do official agencies impact nursing and healthcare? - ANSWER- They provide information and promote changes that will improve healthcare. Provide federal funds to help promote health changes. Communication process - ANSWER- Process by which information is exchanged between individuals through a common system of symbols, signs and behaviors Feedback - ANSWER- Monitoring systems through which a person/group controls the internal/external responses to behavior and accommodates the responses appropriately. Metacommunication - ANSWER- Phenomenon that refers to a message about a message (reading between the lines) Nonverbal communication - ANSWER- type of communication that is not verbal Rapport - ANSWER- harmony and an affinity between people in a relationship Self-disclosure - ANSWER- sharing aspects of the self Self- esteem - ANSWER- the affective component of self-perception, how one feels about themselves Therapeutic use of self - ANSWER- application of cognition, perceptions and behaviors to create interpersonal encounters that promote health in anaother person, family, group or community Verbal communication - ANSWER- Transmission of messages using spoken or written words What are the steps involved with communication - ANSWER- Exchange information, thoughts and feelings List factors for effective communications - ANSWER- Value clarification- know our own values and what we are comfortable with Do not impose own values on clients

Therapeutic use of self (self concept and self esteem) What are the barriers to effective communication - ANSWER- Language, cognitive impairment, hearing/visual impairment, unresponsiveness Stages of a therapeutic relationship - ANSWER- Orientation/introductory phase (meet and greet); Working Phase (interactions/building relationship), Termination Phase (handing over care, ending relationship) Accountability - ANSWER- ability to answer for ones own actions Autonomy - ANSWER- the right to determine what treatments or interventions one will accept Beneficence - ANSWER- the quality or state of doing or producing good Competence - ANSWER- ability to provide care Confidentiality - ANSWER- status of maintaining privacy Consent - ANSWER- process of ensuring that a person has all of the appropriate information necessary to come to a decision about participation Dilemma - ANSWER- Questions of what is right and what should be done Ethical issues - ANSWER- Situations that present dilemmas involving right and wrong Malfeasance - ANSWER- Performance by a public official of an act that is legally unjustified, harmful, wrongdoing Moral - ANSWER- Feelings and values related to right and wrong Non-malfeasance - ANSWER- avoidance of harm or hurt Responsibility - ANSWER- willingness to respect obligations and to follow through on promises Self-determination - ANSWER- Free choice of ones own acts without external compulsion

Veracity - ANSWER- Devotion to the truth Types of ethics - ANSWER- Deontology, Utilitarianism, Feminist, Ethics of care Deontology Ethics - ANSWER- Defines actions as right or wrong Utilitarianism Ethics - ANSWER- Actions that are good and aimed at yielding the greatest amount of pleasure/happiness, causing the least amount of pain/harm Feminist Ethics - ANSWER- Inequality of care between people Ethics of care - ANSWER- importance of understanding relationships especially as they are revealed in personal narrative Describe the Code of Ethics - ANSWER- Set of guiding principles - group expectation and standards of behavior that all members of a profession accept created by ANA What are the principles of the Code of Ethics - ANSWER- Responsibility, Accountability, Advocacy and Confidentiality Provisions of Ethics - ANSWER- 1- Practices with compassion and respect for all 2-Primary commitment is the patient 3- Promote, advocate and strive to protect health, safety and rights of patient 4- Responsible and accountable for practice 5- Owes same duties to self, preserve integrity/safety and learning 6- Establishes, maintains and improves health care 7- Participates in advancement of professions thought practice, education, knowledge development 8- Collaboration with other professional to promote health 9- Responsible for articulating nursing values, integrity of profession and shaping social policy Process of solving an ethical dilemma - ANSWER- 1. Ask if this is an ethical dilemma

2. Gather all relevant information
3. Clarify values
4. Verbalize the problem
5. Identify possible courses of action
6. Negotiate a plan
7. Evaluate the plan

Family function - ANSWER- Process of continual change in the system as information and energy are exchanged between the family and environment Risk factor theory - ANSWER- Theory that a risk estimate can be obtained by comparing the frequency of deaths, illnesses , or injuries from a specific cause in a group that has a specific trait. Systems theory - ANSWER- Theory that provides an overall framework in which otherwise unconnected parts can be integrated Coping - ANSWER- ability to deal with difficulties by finding a balance between acceptance and action and between letting go and taking control Distress - ANSWER- chronic or excessive stress Eustress - ANSWER- stress that can be challenging and useful Stress - ANSWER- Negative physical, psychological, social, and spiritual effects of life's pressures and events Stress response - ANSWER- an adaptive, short-term, acute response to a stressor Stressor - ANSWER- any psychological, social, environmental, physiological, or spiritual stimulus that disrupts homeostasis Allopathic medicine - ANSWER- system of medicine which focuses and treatsthe disease Alternative/complementary theories - ANSWER- focus on healing mind, body, spirit. Holism - ANSWER- People are not just physical bodies- have emotions and spirits Denver DevelopmentalScreening (DDST II) - ANSWER- Standardized tool that screens for developmental problems in children birth to 6 yrs Learning - ANSWER- process of gaining knowledge or skills that results from exposure, experience, education and evaluation

Maturation - ANSWER- Increase in competence and adaptability - function at higher level Erickson theory : Infancy - ANSWER- Trust vs. Mistrust Erickson theory : Toddler - ANSWER- Autonomy vs. shame/doubt Erickson theory : Preschool - ANSWER- Initiative vs. guilt Erickson theory : School-age - ANSWER- Industry vs. Inferiority Erickson theory : Adolescence - ANSWER- Identity vs. Role Confusion Erickson theory : Young Adult - ANSWER- Intimacy vs. Isolation Erickson theory : Middle Adult - ANSWER- Generativity vs. Stagnation Erickson theory : Older Adult - ANSWER- Ego integrity vs. despair Failure to thrive - ANSWER- infants who fail to gain weight, resulting from faily to obtain or use necessary calories SIDS - ANSWER- Sudden Infant Death Syndrome- unexplained and unexpected death of infant who has been healthy Infant development- physical changes - ANSWER- Head circumference, height and weight, teeth formation Weaning from sippy cup begins at what age? - ANSWER- 5-6 months Primary safety concerns for infant - ANSWER- Choking, burns, falls, poisoning Egocentrism - ANSWER- outlook on an individual characterized by seeing everything through his/her eyes only Parallel play - ANSWER- Social encounter - doing similar things yet independently Nutritional concerns for Toddlers - ANSWER- Iron intake, milk, no bedtime bottle, juice overconsumption, appetite decrease, set mealtimes

Primary environmental/safety concerns for toddlers? - ANSWER- Accidental injury, structural hazards, toys, sports, drowning, burns. Leading cause of death in toddlers? - ANSWER- Motor vehicle injuries Nightmares - ANSWER- Anxiety dreams Night terrors - ANSWER- sleep disturbances, child cries out but does not wake and cannot be aroused for several minutes Snellen chart - ANSWER- Tool that can provide a reliable estimate of the actual visual acuity of a child Primary safety concerns for preschool - ANSWER- Motor vehicle, firearms, poison, burns and drowning Dental carries - ANSWER- cavities Obesity is a BMI over... and overweight is a BMI of - ANSWER- 30 or more; BMI 26- Primary safety concerns for school-age - ANSWER- seasonal influence, drowning, firearms, sports and recreation Primary safety concerns for adolescents - ANSWER- Accidents, sports injuries, violence Achievment-oriented stress - ANSWER- stress of an overachiever Full growth ages for men and women - ANSWER- Men-21; women - 17 Leading cause of death for Young adults - ANSWER- automobile accidents- due to substance abuse Legal document that is prepared while individual is alive, competent to make decisions- provides guidelines for health care in the future when individual can no longer make decisions - ANSWER- Advanced directives Document in which an individual designates another person to make health care decisions when individual can no longer - ANSWER- Durable Power of Attorney

Written document in which individual voluntarily informs doctors and family about type of medical care desired should they become terminally ill, unconscious or unable to communicate - ANSWER- Living will Leading cause of death in Middle Age Adult - ANSWER- heart disease and cancer Delirium - ANSWER- Condition of severe confusion and rapid changes in brain function Dementia - ANSWER- Pathological condition that affects cognition in old age Successful and unsuccessful tasks for this age? - ANSWER- Successful- honest acceptance of life at peace Unsuccessful - fear of death/despair Primary safety concerns for Older Adults? - ANSWER- Suicide- highest in elderly; falls, osteoporosis, preveninting injury (car), alcohol and drug use Assault - ANSWER- any intentional threat to bring harm to someone Battery - ANSWER- Intentional touching without consent Civil Law - ANSWER- protects the rights of the individual (fine) Common Law - ANSWER- Judicial decision concerning individual cases (negligence/malpractice) Criminal Law - ANSWER- Prevent harm to society and to provide punishment for crimes (felonies/misdemeanors) Defamation of character - ANSWER- Insult of ones character Felony - ANSWER- serious crime usually with penalty of imprisonment for longer than 1 year Libel - ANSWER- Written defamation of character Malpractice - ANSWER- professional negligence, below standard of care Negligence - ANSWER- Conduct that falls below standard of care

Nurse practice act - ANSWER- describes and defines the legal boundaries of nursing practice in each state Who determines the Nurse Practice Act - ANSWER- Legislatures Risk Management - ANSWER- System of ensuring appropriate nursing care that attempts to identify potential hazards and eliminate them before harm occurs What must happen to prove negligence? - ANSWER- 1. Nurse owes duty 2. Nurse did not carry out duty or breached it 3. Patient was injured 4. Injury due to nurses failure to carry out duty Americans with Disabilities Act - ANSWER- Protects rights of disabled/HIV-AIDS Emergency Medical Treatment and Active Labor Act - ANSWER- Patient dumping act- hospitals mandated to treat and stabilize Mental Health Parity Act - ANSWER- Mental health coverage equal to physical health coverage Uniform Anatomical Gift Act - ANSWER- Individual 18+ can decide to donate organs HIPPA - ANSWER- Provides rights to patients and protects employees Restraints guidelines - ANSWER- Ensure safety of others and patients, less restrictive measures have failed, written order with specific time frames. Examples - Advanced Directives - ANSWER- Living wills, durable power of attorney What are the state statutes that impact nurses - ANSWER- States licensure- NCLEX; Good Samaritan laws; Public Health Laws; Uniform Determination of Death Act; Physician Assisted Suicide. MAGNET hospitals provide - ANSWER- strong leadership, reasonable amount of supplies, CEU, distinction, honor, improved and strengthened healthcare. 6 Standards of practice identified by ANA - ANSWER- ADPIE- Assessment, Diagnosis, Outcomes, Planning, Implementation, Evaluation

What does the scope of practice describe? - ANSWER- Who, what, when, where, why and how of nursing practice