Health Care Participant Exam 1: Midterm Flashcards | Knowt (2024)

Disease centered care

- Defines patients by their disease
-Sorts patients into rigid treatment pathways
-Takes a one size fits all approach based on the lowest cost care

Patient centered care

-Treats patients as individuals
-Relies on a strong clinician, patient relationship built on trust and shared decision making
-Gives patients in healthcare providers of course in treatment decisions

Principles of a patient centered medical home (PCMH)

1-7

Culture

-A pattern of shared attitudes, beliefs, self-definitions, norms, roles, and values that can occur among those who speak a particular language, or live in a defined geographical region.3• Giddens, J. Concepts for Nursing Practice;Concept: Culture (2013). Elsevier

Ethnicity

-A common ancestry transmitted over generations by the family and community

Race

-A social construct

Western biomedical view

-Disease is a response to physiological causes explained by pathophysiology and manifested by symptoms and signs

Traditional health beliefs

-Illness is defined in terms of mind, body, and spiritual and social connections. All illnesses reflect the influence of the environment, including an individual's cultural experiences.

Kleinman's 8 Questions

1) What do you call your problem? What name does it have?
2) What do you think caused your problem?
3) Why do you think it started when it did?
4) What does your sickness do to you? How does it work?
5) How severe is your sickness? How long do you expect it to last?
6) What do you fear most about your illness?
7) What are the biggest problems your illness has caused for you?
8) What kind of treatment do you think you should receive? What are the most important results you hope to receive from this treatment?

Challenges and barriers related to culture

-Stereotyping
-Prejudice
-Racism
-Ethnocentrism
-Culturalimposition
-Culturalconflict
-Culture shock

Healthy People 2030 seeks to close the gaps in healthcare by eliminating __________________.

-disparities

Definition of spirituality

-A way of bringing meaning to life and experiences
-Individual, self-determined, life long•
-Faith & Beliefs• Connectedness (self, others, higher power)
-Transcendence (reaching higher levels of understanding)
-Personal energy
-Religion: a particular system of attitudes, belief, and practices, -usually including worship of superhuman power(s)

Regarding culture and spirituality, nurses need to (knowledge)

-Define spirituality using current, accepted resources.
-Assess the healthcare participant's spiritual well-being using a comprehensive tool (e.g.HOPE Questionnaire, FICA Spiritual History Tool, and the SPIRITual history.)
-Identify factors affecting the healthcare participant's spiritual well-being.
-Identify additional resources necessary to meet the spiritual needs of the care recipient(e.g. clergy, indigenous healing ceremonies and rituals, important artifacts, written resources, social services)
-Develop plans of care that are care participant centered and focused on their spiritual well-being.
-Identify and understand their own personal spiritual beliefs, values, and goals.

Regarding culture and spirituality, nurses need to (skills)

-Engage with the care participant and develop a trusting relationship.
-Perform a comprehensive spiritual assessment
-Use open-ended questions.
-Recognize and respond to the individual needs.
-Use intentional, active listening and focused presence. (Burkhardt& Nagai-Jacobson, 2016)
-Be comfortable with silence and recognize those times when silence is appropriate.
-Be comfortable with therapeutic touch and recognize those times when it touch is appropriate to use and when it is inappropriate to use.
-Foster connectedness. (Burkhardt & Nagai-Jacobson, 2016) -Make a referral to a chaplain or a representative of an individual's spiritual tradition/community

Regarding culture and spirituality, nurses need to (attitudes)

-Care
-Value themselves and healthcare participants.
-Refrain from promoting their own beliefs and values above others.
-Collaborate with members of the healthcare team to meet the needs of the healthcare participant(s).

HOPE Spiritual Assessment

-Sources of Hope, strength, and comfort
-Organized religion
-Personal spirituality and practices
-Effects on medical care and end of life decisions

Risks for individuals with IDD (Intellectual and DevelopmentalDisability)

-Fatal Four Illnesses: Constipation/bowel disease, Aspiration or GERD (contributors to PNA), Dehydration, Seizures
-Health Care Disparities: Disparities -often in the setting of modifiable determinants
-Caregivers: Caregiver role strain, Caregivers aging
-Abuse
-Neglect
-Exploitation

Medically Fragile Waiver, "Med Frag"

-Medically Fragile and have a Developmental Disability

Traditional Developmental Disabilities Waiver- "DD Waiver"

-Multidisciplinary Care
-Nursing Oversight/Care Plans
-Family Living
-Customized Community Supports

Mi Via Self Directed Waiver- "My Way"

-How do you want to spend your time and resources within the allotted budget.
-Customized Community Supports
-Family Living

Nursing role: Waiver Nurse

-Medication Management/PRNs
-Medical Appointments
Interpreting Medical Plan of Care
-Care Plans- Yes we use them!
-Nursing Standards Medical Procedures

Geriatric 5 M's

-Mind
-Mobility
-Medications
-Multi-complexity
-Matters most

Geriatric 5 M's: Mind

-Mentation
-Dementia
-Delirium
-Depression

Geriatric 5 M's: Mobility

-Impaired gait and balance
-Fall injury prevention

Geriatric 5 M's: Medications

-Polypharmacy, deprescribing
-Optimal prescribing
-Adverse medication effects and medication burden

Geriatric 5 M's: Multi-complexity

-Multimorbidity
-Complex biopsychosocial complications
-An increased risk for chronic diseases, increases frailty risk

Geriatric 5 M's: Matters most

-Each individual's own meaningful health outcome goals and care preferences

The aging adult: cognitive interventions

-Monitor cognitive status with a standardized tool•
-Promote physical activity
-Adopt healthy nutrition (low sugar/fat, high fresh fruits/vegetables)
-Identify mentally stimulating activities (puzzles, crafts, Sudoku)• Encourage excellent sleep hygiene
-Consider safety (driving, fall risk, financial, etc.)
-Consider assisting the patient to appoint a legal decision maker

Geriatric depression scale

-Short form includes 15 questions
-Works with healthy, ill, and mild-moderately cognitively impaired adults
-Questions ask about perception

MOCA (Montreal Cognitive Assessment)

-Type of Assessment: Cognition, memory, function
-Assesses different cognitive domains: attention and concentration, executive functions, memory, language, visuoconstructional skills, conceptual thinking, calculations, and orientation

The aging adult: mobility interventions

-Screen for fall risk
-Decreased mobility loss of independence, social isolation, poor health outcomes
-Utilize interdisciplinary health team (physical therapy, occupational therapy, home health)

The aging adult: fall with injury risk factors

-Chronic conditions/meds causing pain or loss of bone mineralization
-History low body weight or fractures (hip)
-Chronic pain or peripheral neuropathy
-Neuromuscular disorders
-Frailty
-Dizziness
-Syncope/pre-syncope
-Heavy alcohol consumption

Katz Index of Independence in ADLs (activities of daily living)

The aging adult: Medication reconciliation

-Identify what medications are prescribed for the patient
-Ask the patient to show you ALL of their medications
-Compare each prescription bottle to the medication recorded in the provider record.
-Assess the patient's knowledge of each medication: What are they using it for? How is it working for them?
-Discuss risks, benefits, and side effects of each medication.
-Did you find something not as prescribed? What barriers is the patient encountering?
-Assess the patient's willingness to take the medication, its affordability, and whether the regimen is realistic.
-How they dispense the medication to themselves?
-Assess the patient's ambulatory status and dexterity to determine the need for physical or occupational therapy.
-Work with the patient to find a dispensing method that facilitates adherence.
-Medication duplications? Drug-to-drug interactions? Drug-to-disease interactions? High risk medications?•
-Eliminate any unnecessary medications and discuss safe disposal options.
-Conclude with a plan that will enable the patient to take medications as prescribed.

The Frailty Index for Elders

The aging adult: frailty interventions

-Optimize disease management
-Manage pain
-Exercise: resistance and aerobic
-Vitamin D supplementation• Caloric and protein support
-Reduction of polypharmacy

The aging adult: matters most interventions

-Patient centered care
-Considers culture and religion
-Educates and empowers the patient to set realistic goals
-Discusses decision making, quality of life, end of life
-Communicates this across the interdisciplinary team

The aging adult: home environmental assessment

-Looks for fall risk
-Assesses the patient's self-care ability and degree of functioning in their environment
-Assesses social support
-Assesses resources, environment, social determinants of health

Older adult screenings

-Frailty
-ADLs and instrumental activities of daily living (IADLS)
-Continence
-Exercise
-Cognition
-Mental health (social isolation, anxiety, depression, etc.)
-Polypharmacy
-Nutrition

Duvall's Family Development Theory

Characteristics of Healthy Families

-Members interact, alternatively listening and communicating
-Family set priorities and work together toward them
-Members affirm, support, and respect one another
-Members engage in flexible roles, share power, respond to change, support growth, make decisions to support all family members
-Family teaches values, beliefs, and religious ideas
-Family fosters responsibility and values service to others
-Family has a sense of play/humor, shares leisure time
-Family copes with stress and using positive coping to grow from crisis. Family seeks outside help as needed

Genograms

-Diagrams with various figures that serve to illustrate relationships between family members

Ecomaps

-A visual representation of the relations between social network members. Members of the network are represented by points, and lines are drawn between pairs of points to demonstrate a relationship between them; also called a sociogram

Note

Note

Note

Note

Note

Note

Note

Note

Flashcard58 terms

Flashcard46 terms

Flashcard48 terms

Flashcard60 terms

Flashcard24 terms

Flashcard23 terms

Flashcard38 terms

Flashcard45 terms