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53 Cards in this Set
- Front
- Back
3 Types of prevention
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Primary, Secondary, Tertiary
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Primary Prevention
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True prevention. It precedes disease and dysfunction and applies to patients considered physically and emotionally healthy.
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Secondary Prevention
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Directs activities at diagnosis and prompts interventions [pap smears, mammogram, colonoscopy]
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Tertiary Prevention
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involves preventing further disability or reduced functioning [example: wellness plan for diabetic- to minimize risks for further problems]
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What is a risk factor?
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A risk factor is any situation, habit, environmental condition, physiological condition, or other variable that increases the vulnerability of an individual or group to an illness or accident.
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Modifiable risk factors
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stress, smoking/drugs, pregnancy, weight, environment, financial status, access to healthcare, job lifestyle
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Non-modifiable risk factors
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genetics, age, gender
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Internal/External Variables
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affect illness behavior such as the likelihood of seeking health care and the participation in therapy, which ultimately affect health outcomes.
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Internal Variables
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influence the way patients behave when they are ill. If patients believe their symptoms disrupt their normal routine they are more likely to seek health care assistance. Acute illness is more likely for a patient to seek treatment, than a chronic illness where they may not adhere to the therapy plans.
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External Variables
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A patient with visible symptoms is more likely to seek assistance than a patient who does not have visible symptoms.
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Types of Assessments
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Comprehensive, Focused, Follow-up
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Comprehensive Assessment
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involves a detailed history and physical examination performed at the onset of care in a primary care setting or on admission to a hospital or long-term care facility The comprehensive assessment encompasses health problems experienced by the patient; health promotion, disease prevention, and assessment for problems associated with known risk factors; or assessment for age and gender-specific health problems.
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Focused Assessment [Problem Based]
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The problem-based or problem-focused assessment involves a history and examination that are limited to a specific problem or complaint. This type of assessment is more commonly used in a walk-in clinic or emergency department. Although the focus of data collection is on a specific problem, the potential impact of the patient's underlying health status also must be considered.
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Follow-up Assessment [Episodic]
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usually done when a patient is following up with a health care provider for a previously identified problem.
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What helps enhance data collection? [8]
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Active Listening, Facilitation, Clarification, Restatement, Reflection, Confrontation, Interpretation, and Summary.
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Active Listening
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listening with a purpose to spoken words as well as noticing nonverbal behaviors.
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Facilitation
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uses phrases to encourage patients to continue talking (“go on”, “uh huh”, “then?” head nodding, shifting forward in your seat)
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Clarification
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used to obtain more information about conflicting, vague, or ambiguous statements
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Restatement
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repeating what patients say to confirm the interpretation of what was said.
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Reflection
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asks patient a question to clarify a phrase or sentence.
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Confrontation
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when consistencies are noted between what the patient reports and observations or other data about the patient.
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Interpretation
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to share with patients the conclusions drawn from data they have given.
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Summary
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condenses and order data obtained during the interview to help clarify a sequence of events.
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What diminishes data collection? [5]
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Using Medical Terminology, Expressing Value Judgments, Interrupting the Patient, Being Authoritarian or Paternalistic, and Using "Why" Questions.
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Using Medical Terminology
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interferes with the communication process if the patient does not know the meaning of the medical terms.
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Expressing Value Judgments
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might cause the patient to feel guilty or defensive when he or she must answer the contrary
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Interrupting the Patient
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allow patients to finish their sentences, don't finish it for them. The ending you add may be different from which the patient might used.
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Being Authoritarian or Paternalistic
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nurses who use the approach “I know what's best for you, and you should do what I say” risk alienating the patient.
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Using "Why" questions
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can be perceived as threatening and may put patients on the defensive. The implication is that they must defend their choices.
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Phases of the Interview
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Introduction, Discussion, Summary
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Introduction Phase
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Introduces self to patient.
Describes purpose of interview. Describes interview process. |
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Discussion Phase
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Facilitates and maintains patient-centered discussion.
Uses various communication techniques to collect data. |
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Summary Phase
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Summarizes data with patient.
Allows patient to clarify data. Validates to patient that he or she understands problems. |
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Techniques used during Health Assessment
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Inspection, Palpation, Percussion, and Auscultation
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Inspection
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refers to visual examination of the body, including body movement and posture.
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Palpation
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using hands to feel texture, size, shape, consistency, pulsations, and location of certain parts of the patient's body and also to identify areas the patient reports as being tender or painful. Uses palmar surface of fingers, not fingertips.
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Percussion
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performed to evaluate the size, borders, and consistency of internal organs; detect tenderness and determine the extent of fluid in a body cavity.
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Two types of Percussion
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Direct and Indirect
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Direct Percussion
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striking a finger or hand directly against the patient's body.
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Indirect Percussion
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performed by placing the distal aspect of the middle finder of the nondominant hand against the skin over the organ being percussed and striking the distal interphalangeal joint with the tip of the middle finger of the dominant hand.
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Auscultation
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listening to sounds within the body.
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Clinical Judgment
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“an interpretation or conclusion about a patient's needs, concerns, or health problems and/or the decision to take action (or not), use or modify standard approaches, or improvise new ones as deemed appropriate by the patient's response. Although clinical judgment requires accurate collection of assessment data, it is the nurse's interpretation of the data that impacts the decisions made. Clinical judgment is influenced more by the nurse's experiences, knowledge attitudes, and perspectives than the data alone.
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Four components of Clinical Judgment
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The process of clinical judgment includes four components: noticing, interpreting, responding and reflecting.
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Components of the Health History
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Biographic data
Reason for seeking care History of present illness Past health status Past health history Family history Personal and psychosocial history Review of systems |
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Health Belief Model description
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Addresses the relationship between a person's beliefs and behaviors. It provides a way of understanding and predicting how patients will behave in relation to their health and how successful they will be in following health care therapies and regimens.
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Health Belief Model Diagram
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.
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Health Promotion Model description
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defines health as a positive, dynamic state, not merely the absence of disease.
Focuses on three areas 1. Individual characteristics and experiences 2. Behavior-specific cognitions and affect Behavioral outcomes |
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Health Promotion Model diagram
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.
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Primary Prevention examples
(Health Promotion & Specific Protection) |
Health education, Immunizations, Genetic screening, personal hygiene, environmental sanitation, protection from accidents, carcinogens, occupational hazards, avoidance of allergies
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Secondary Prevention examples
(Diagnosis and Prompt Treatment & Disability Limitations) |
cure and prevention of disease process to prevent spread of communicable disease, prevent complications, and shorten period of disability,
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Tertiary Prevention examples
(Restoration and Rehabilitation) |
Provision of hospital and community facilities for training and education to maximize use of remaining capacities.
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Maslow's Hierarchy of Needs
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humans needs using a pyramid divided into five levels. As people meet the needs of one level, they move to the next level. Unsatisfied needs motivate human behavior.
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Maslow's Hierarchy of Needs diagram
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