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Changes in society and healthcare to expand and adapt because
traditional hospitals are being replaced by community based setting power is being shitfted from traditional model to family centered decision making
Engaging the patient's lived experience throught its intirety
Letting the patient play leading role in developing care plan instead of doing for the patient
Four factors that shaped contemporary family and child health in nursing
- 1) health was viewd as absence of idiseas and presence of optimal functioning
- 2) illness was pathological something healthcare provider worked to get rid of, heal or cure...medical model
- 3) one way channel of communication from health care provider to patient
- 4) Power rested on medical staff
Present day trends in nursing related to health-wellness continuum
- changing from linear (begingin to end) approach - illness to wellness, to a shared experience of trascending or controlling the health threat and changing it into one of purposeful meaning.
- Nurse/patient relationship is now a circular process to promote patient or family promotion, maintenance and restoration of health, health potentia, prevention and self care.
Elements of a health promotion nursing process
understand the health risk factors and adopt lifestyle changes that foster health maintenance, prevent health threats through early detection and recongnition and explore options for health restoration
art of nursing...low tech, high touch artistry of caring that strengthens health process
Why should nurses develop awarness and understanding of cultural practices intended to foster comfort an dpromote healing?
Staying focused on the patient and use of body language that is accepting and demostrates support of their beliefs will help create trust and meaning out of a threatening health expereince
Nursing approach that incorporates engaging transpersonal care
the nurse assess the patient/family trust ot manage healthcare by supporting the patient in their chosen method for dealing with the health threat...shift of decision-making power giving patients and families personal control
Differntiate among family, family structures, and family functions
family - group of people sharing interpersonal bonds, tasks, and activities
family structures - who the members are
family function - roles the members play
What was the central focus of the nurse as a provider of care and teacher before the 1950's
sanitation, nutrition, and family education
Describe how the introduction of the nursing process as a systematic framework changed the nurse's professional role?
Clear differentations were made between nursing and medical diagnoses, interventions and outcomes. This process was used by nurses to identify, prevent, or treat the individual health needs of patients. This process was problem oriented, goal directed and involved critical thinking and decision making.
Four characteristics of acute care hospitaliztion that have changed since the introduciton of family centered care
- 1) earlier discharge
- 2) liberalized family, sibling and children visiting
- 3) 24-hour family partnering with caregivers
- 4) policies and prcedures based on theories of child and family growth and development
Identify at least five community-based care settings in which the nurse may practice family-centered care
- 1) adult and child day care centers
- 2) public and private schools
- 3) churches and religious body parishes
- 4) penal systems
- 5) health and disease related camps
- 6) foster himes nd homeless shelters
- 7) physicians offices
- 8) public health clinics
- 9) nurse managed care centers
Compare and contrast the role of the professional nurse in acute and speicalized care hospitals and alternative care settings?
Nurses have less time to assess, identify risk, counsel and teach patients because the stay will be shorter. The nurse may be responsible for direction of unlicensed assitive personal who may not be highly trained. Follow-up procedures were once performed and monitored by nurses in the acute care setting but now must be taught to patient and family due to rapid return home.
What is the value of a community health map as a nursing assessment tool?
Helps nurses to assess the family structure, funciton and support networks. The map provides a diagram of significant data and helps the nurse focus on the family as it interacts with the social systems within and around them
Five ways nurses can offer support for the patient/family who uses CAM
- assess for and educate about the implications, ccontraindications and benefits
- promote health practices that have been proven safe and effectivein restoring well-being
- allow patient to express concerns, choose interventions and outcomes
- encoursage evidence-based decision making
- the nurse searches databases for current literature or reports that evaluate the safety, quality and credibility of particulare interventions - nurses responsibility to use the best evidnce available and make decisions accordingly
What is evidence based paractice?
encouraging evidence-based decision making in all interventions. This is the premise that all interventions need to be quesitoned, examined and confirmed or refuted in their ability to support healthy outcomes.
Explain how the nurse functions in hte role of patient/family teacher?
the professional nurse teaches the patient and family by helping them gain knowledge and skills about the health risk affecting them, and of behaviors that can assist in accomplishing the health outcome they desire. Nurse still holds responsibility as the provider of care to implement teh chosen intervention or to accept accountability for their delivery.
Aspects of therapeutic nurse-patient collaboration
two-way dialogue and sharing between the patient and nurse of both personal and health-related problems and solutions. Each participant is an equal possessor of knowledge and shares the power of determining what is to be learned.
Describe the need for accountablility on the part of the nurse as a provider of care?
Eventhough family centered care encourages patient and family involvement in therapy delivery, it is still expected that the nurse will be actively involved and skilled in the provision of health assessment, treatment, care, and follow-up evaluation.
Describe Nightingale's focus of nursing?
encouraged a focus on the spiritual, physical/environmental, emotional, mental, and social needs of the patient and is known as a holisitic view of the patient
List three of Watson's goals for caring, threapeutic nurse-patient relational communicaiton?
- to find meaning and develop a wholeness in the body-mind-spirit
- assist the patient in transcending beyond the current health state toward his or her ideal
- give meaning to the patient's being
Discuss Leininger's advice for a nurse who wishes to develop a caring nurse-patient relationship?
Nurse should understand the patient's cultural beliefs, values, methods of providing or showing caring, cause of illness and how it is viewed and how wellness is achieved. Nurses need to develop a trusting relationship which is an ongoing process. Validate through an unprejudiced eye.
Three actions designed to build trust?
- Nurse is cognizant of both personal and the patient's feelings and meaning of the health experience
- listening and observing for cues as to
- what the health event means to the patient
- what the patient views as her needs and how they should be met.
Three ways that comunication is translated in caring behavior?
- gentleness in touch,
precise, disiplined thinking tha tpromotes accuracy and depth of data collection and seeks to clearly identify the problems, issues, and risks at hand
Four avenues for developing successful analytical critical thinking?
- knowledge seeking
- practiced hands-on work
- contextual discernment
Discuss personal skills that help build critical thinking analysis?
- persistence in seeking the most reasonable answer
- comfort and confidence iwth calculated risk-taking
- devotion to listening with a passion for true comprehension and understanding.
Explain why listening skills are important to the nurse's orle as provider of care?
Listening carefully allows the nurse to recieve key informatoin though subtle tones of voice and snippets of dialogue.
Discuss five areas of readiness to learn that the nurse must assess before teaching begins?
- basic needs are met
- language development
- current level of knowledge and experience with the topic
- growth and development state of life and capabilities
- emotional skills
- learning environment
Clarify the professional nursing role of collaborator as it relates to patient teaching?
addressing physical, emotional, spiritual and learning needs of the patient - involve memebers of multiple health disciplines
Describe the differences between "best Practice and evidence-based practice"?
evidence based practices are practices that have been researched and are controlled by quantitive and qualitive studes and nursing research...evidence based practice only becomes "best practice" it combines the investigaitonal guidelines and scientifically sound interventions with clinical expertise
Explain six key elements to look for when evaluating the quality of evidence-based data found in journals or on Web sites?
- Ensure data have been reviewed by at least two or three experts in an area
- check the author's and publisher's credentials
- evaluate for prejudice, bias, or vested in trest of author
- check timeliness of data
- check for balance between explanatory graphs and text.
- Ensure consistency across populations, settings, and time
Compare and contrast the licensed Registered Nurse and the Advanced Paractice Nurse's role and preparation?
The advanced practice nurse has more eductaion and enjoys the highest level of autonomy usually has master's level and can work as Certified nurse midwife, Family nurse practitioner, Clinical nurse specialist, Pediatric nurse practitioner and certified nurse anesthetist
Discuss the two overarching goals of Healthy People 2010?
- To increase the quality and years of healthy life
- To eliminate health disparities within America's population
Define the three levels of prevention and give an example of each?
- Primary prevention - health promotion as well as activities specifically meant to prevent disease from occurring
- Secondary prevention - early identification and prompt treatment of a health problem before it has an opportunity ot spread or become more serious
- Tertiary prevention - restoration of health to the highest functioning state
Describe prevention measures that have made a difference in reducing heart disease, the leading cause of death in the United States?
Healthy lifestyle and cholesterol-lowering medications.
Define epidemiology and describe how analysis of epidemiological data may guide public health?
Epidemiology is the statistical analysis of the distribution and determinants of disease in populations over time. The data helps to measure the health of a nation.
Discuss why mortality/morbidity biostatistics about disease and illness are useful.
These rates provide information about where nursing efforts should be focused and identify populations where the illness ocures most frequently
Describe three health problems in the United States today that are of particular concern?
(AIDS), drug abuse, family violence and homelessness
Identify both the age and racial/ethnic diversity trend of the U.S. population and discuss what that means in terms of nursing and health care provisions?
Population of persons ages 65 and up is one in eight and by 2030 will be one in five. More chronic illness is expected with the increase of length of life. Miniority populations are increasing. This will create challenges for health care to meet these needs and deliver health care within a culturally appropriate framework.
Describe the greatest factor that limits access to health care.
The status of one's health insurance.
Explain the roles that descrimination, Sterotypes, and racism play in prpetuating health inequities
These result in unfair and harmful treatment and includes attitudes nd behaviors wheich can be overt or covert, individual and instutional.
Discuss U.S. fertility trends and trends toward surgical birth and what it means for women's health?
Women are waiting until they are older to have children which increases chances for infertility. Also, more women are choosing to have cessarean births even when it is not medical necessary which is controversial because it encompases all the risks associated with major surgery.
Discuss the trend toward inactivity in the United Staes and describe what consequences might be seen in the future health care status of Americans as a result?
Only 13% of American women engage in the recommended physical activity. This increase the risk for obesity and cardiovascular disease.
Describe the role poverty plays in increasing health care disparities?
Persons form lower classes live shorter lives and less healthy lives. Life and health choices are limited by socioeconomic status.
Describe two benefits of preconceptual health guidance and early intervention?
Folic acid supplementation helps to prevent certian birth defects and a fetus harm could be potentially prevented if a women were councelled before pregancy about things that cause harm during pregnancy and early intervetions help because some interventions are not effective once children become school age.
Discuss major causes of child mortality and describe nursing interventions that can make a differnce?
SIDS leading cause of death amongs infants between 1 - 12 mo. Nursing interventions include teaching on ways to prevent SIDS and deaths associated with accidents violence and safety hazards.
Compare and contrast communication stragies for children
A child's understanding is not always taken in to consideration the same as it would be for an adult patient. It is important to listen to children because they are aware of there illness and could provide valuable insight.
Discuss how recent national trends have affected families access to health insurance?
There is an ever increasing number of uninsured citizens in the U.S. and that means there are people who do not get the healthcare they need because they can't afford it. Sometimes there is a gap in medical coverage which causes people to miss appts and sometimes not get all perscribed meds because they can't afford it.
Identify the three leading causes of death in women in the United States?
Heart disease, Cancer, Cebral Vascular disease (stroke)