Fundamentals of Nursing: Test #3 Flashcards

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created 6 years ago by ghostridermb300
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Fundamentals of Nursing
Chapters 6, 9, 12-14, 33
Based on IPASS from October 4, 2016
updated 6 years ago by ghostridermb300
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Health Belief Model

  • Relationship between a person’s beliefs and behaviors
  • Perception of susceptibility to illness
    • Recognition of factors making him/her susceptible
  • Perception of seriousness
    • Influenced and modified by demographic and sociopsychological variables
    • If the patient doesn’t take it serious, he won’t take care of himself
  • Likelihood of preventative action
    • Results from a person’s perception of the benefits and barriers to taking action

Health Promotion Model

  • Complimentary counterpart to the health belief model
  • Defines health as a positive dynamic state, not merely the absence of disease
  • Directed at increasing a patient’s level of wellbeing
  • Multidimensional nature of people as they interact with their environment to improve health
  • Individual characteristics and experiences
  • Behavior-specific knowledge and affect
  • Behavioral outcomes, in which the patient commits to or changes a behavior

Maslow's Hierarchy of Needs

  • Certain human needs need to be met before others
  • Needs don’t always need to be fulfilled in a strict hierarchal order
  • Emergent physiological need takes precedence over higher level needs
  1. Self-Actualization
  2. Self-Esteem
  3. Love and Belonging
  4. Safety and Security
    1. Physical needs
    2. Psychological needs
  5. Physiological
    1. Basics for survival
      1. Oxygen, Fluids, Nutrition, Body temperature, Elimination, Shelter, Sex

Focus on Older Adults

  • Encourage regular physical activity tailored to individual’s ability
  • Consider social environment and strengthen social support
  • Injury prevention is a key strategy
  • Promote community based exercise programs
  • Factors affecting older adults include socioeconomic, beliefs and attitudes of patients and providers, encouragement by a health care professional, specific motivation based on efficacy beliefs, access to resources, age, number of chronic illnesses, mental and physical health, marital status, ability for self-care, gender, education, and support system.
  • Encourage well-balanced meals

Primary prevention

  • Health Promotion - Health Education, Standards of nutrition, Personality development, Provision of adequate housing and recreation, Marriage counseling and sex education
  • Specific Protection – Immunizations, hygiene, sanitation, protection against occupational hazards, protection from accidents, use of specific nutrients, protection from carcinogens, Avoidance of allergens

Secondary prevention

  • Early diagnosis & Prompt treatment – Screening, Selective examinations to cure and prevent disease process, prevent spread of disease, complications, and sequelae, and shorten period of disability
  • Disability Limitations – Adequate treatment to arrest disease process and prevent further complications and sequelae, Provision of facilities to limit disability and prevent death

Tertiary prevention

  • Restoration and Rehabilitation – Provision of hospital and community facilities for retraining and education to maximize use of remaining capacities, Education of public and industry to use rehabilitated persons to fullest possible extent, Selective placement, Work therapy training in hospitals, Use of sheltered colony.


  • Not intending to make changes within the next 6 months
  • Not interested in information, may get defensive


  • Considering a change within 6 months
  • Patient more likely to accept information


  • Making small changes in prep for change within next month
  • Believes advantages outweigh disadvantages


  • Actively engaged in strategies to change behavior
  • Lasts up to 6 months
  • Previous habits may prevent taking action relating to new behaviors; identify barriers

Maintenance stage

  • Sustained change
  • Begins after 6 months, and continues indefinitely
  • Change needs to be integrated into lifestyle


  • Making small changes in prep for change within next month
  • Believes advantages outweigh disadvantages


  • Actively engaged in strategies to change behavior
  • Lasts up to 6 months
  • Previous habits may prevent taking action relating to new behaviors; identify barriers

Maintenance stage

  • Sustained change
  • Begins after 6 months, and continues indefinitely
  • Change needs to be integrated into lifestyle

Teaching strategies

  • Teaching strategies
    • Active listening
    • Ask how patient prefers to learn
    • Begin with determining information that the patient knows regarding health risks related to lifestyle choices
    • Ask what holds patient back from planned changes
    • Help patient establish goals
    • Help patient establish timelines for modification of eating and exercise
    • Reinforce process
    • Use written resources appropriate to reading level
    • Ensure education materials are culturally important
    • Include family
  • Evaluation
    • Ask patient to repeat teaching
    • Have patient maintain a calendar to document regimen
    • Provide positive reinforcement
    • ask patient to discuss success, such as time spent exercising, or number of fruits/vegetables eaten

Health Disparity

A particular type of health difference that is closely linked with social, economic, and/or environmental disadvantage

  • Don’t have equal access to health care
  • Can’t get to a health care center
  • Illegal immigrant and afraid to
  • Marginalized Groups

Open-Ended Questions

Questions that allow the patient to answer openly and freely.

  • What do you think caused your illness?
  • How do you want us to help you with your problem?
  • Tell me how your beliefs affect your views on medical treatment choices and your willingness to receive care?

Communication Techniques Using Mnemonics







Listen with empathy

Explain your perceptions

Acknowledge cultural differences

Recommend treatment

Negotiate agreement



  • Rapport
    • Connect on social level
    • Seek patients point of view
    • Suspend judgement
    • Avoid assumptions
  • Empathy
    • Remember the patient came to you
    • Seek and understand rationale
    • Acknowledge and legitimize patients feelings
  • Support
    • Try to understand barriers
    • Help overcome barriers
    • Involve family if appropriate
    • Reassure
  • Partnership
    • Be flexible on control
    • Negotiate roles
    • Stress working together
  • Explanations
    • Check for understanding
    • Use verbal clarification techniques
  • Cultural Competence
    • Respct culture
    • Understand patients view
    • Be aware of your own biases
    • Know limitations across cultures
    • Understand your style, and when it doesn’t work


  • Explanation
    • Patient explains perception
  • Treatment
    • What has the patient tried
  • Healers
    • Sought advice from alternative healers
  • Negotiate
    • Mutually acceptable
  • Intervention
    • Agree on appropriate intervention
  • Collaboration
    • Include patient, family, and other health care professionals, healers, resources


  • Calm yourself down. Take a deep breath. Check your pulse
  • Listen to the patients/families perspective
  • Affirm: Connection with something shared
  • Respond: Answer the question
  • Add: Share additional info to consider. Education

Using Interpreters

  • Do not use patients family
  • Request a medically trained interpreter
  • Introduce yourself to the interpreter
  • Determine qualifications
  • Make sure the interpreter can speak the dialect
  • Consider the possible impact of differences between client and interpreter
  • Make sure the patient and interpreter are compatible, and that both understand expectations
  • Introduce interpreter to patient
  • Do not expect word for word interpretation. Just to get the meaning across
  • If you sense problems, stop and address with interpreter
  • Pace your speaking. Wait for patient response
  • Direct questions to the patient, not the interpreter
  • Ask the patient for feedback
  • Observe verbal and nonverbal behavior
  • Thank both patient and interpreter

Teach Back

  • Ask for feedback often
  • Ask the client open ended questions to verify understanding
  • Hints to consider
    • Plan your approach. Think how patient will teach back in a shame-free way. Sometimes teach back is not appropriate
    • Use handouts, pictures, models to reinforce teaching
    • Clarify if a patient is not able to comprehend
    • Practice to make the method easier

6 steps to reduce disparities in health outcomes

  1. Recognize disparities, commit to reduction – ACA identifies data by Race, Ethnicity and Language. Know cultural competency
  2. Implement a basic quality improvement structure and process - Ongoing process for an organization
  3. Make equity an integral component of quality improvement efforts – think of needs for vulnerable patients to improve care
  4. Design the interventions – Use evidence based strategies tailored to fit the population
  5. Implement, evaluate, and adjust the interventions – Start on a small scale (pilot testing), refine through performance improvement cycles.
  6. Sustain the interventions – Changes in practice are continuously evaluated to ensure maintenance

Stages of intrauterine growth

  • Preembryonic stage
  • Embryonic stage
  • Fetal stage


Develops at 3rd week

Provides essential hormones that help maintain the pregnancy



Noxious materials such as viruses, chemicals, and drugs which can pass from mother to child through the placenta

Depends on developmental stage, genetic susceptibility, and quantity of exposure

Embryonic stage most vulnerable - All body organs formed by 8th week.


Transition from Intrauterine to Extrauterine

  • Profound physiological changes occurring in 1st 24 hours of life
  • Gestational age and development, exposure to depressant drugs before or during labor, and newborns own behavior style influence adjustment to the outside

Physical changes in transition

  • Use the APGAR score
  • HR, RR, muscle tone, reflex irritability, and color

Psychosocial changes in transition

  • Need close physical contact with the parents to promote attachment
  • Needs to be done as soon as possible

Health promotion during pregnancy

  • Normal weight gain is 25 – 35 lbs. over course of pregnancy
  • Fetal growth and hormonal changes result in discomfort
  • Nausea, vomiting, breast tenderness, urinary frequency, heartburn, constipation, ankle edema, and back-ache

Health promotion for infancy

  • Screening tests to determine life threatening conditions before symptoms begin. (inborn errors of metabolism)
  • Car Seats
  • Cribs and Sleep

Gross/Fine Motor Development




"State of complete physical, mental, and social well-being, not merely the absence of disease or infirmity"


Health Behaviors

  • Positive - activities related to maintaining, attaining, or regaining good health and preventing illness.
  • Negative - include practices actually or potentially harmful to health

Holistic Health Model

  • Attempts to create conditions that promote a patient's optimal level of health
  • Patients are involved in their healing process
  • Nurses recognize the bodies natural healing abilities
  • Nurses incorporate complementary and alternative interventions
  • Nurses use holistic therapies either alone or in conjunction with conventional medicine

Variables influencing health and health beliefs and practices

  • Internal - developmental stage, intellectual background, perception of functioning, emotional and spiritual factors
  • External - family practices, psychosocial and socioeconomic factors, cultural background

Developmental stage

How a person's thought and behavior patterns change throughout life


Intellectual Background

Shaped by knowledge, lack of knowledge, or incorrect information about body functions and illnesses, educational background, traditions and past experience


Perception of Functioning

The way you perceive your physical level of health


Emotional Factors

  • Degree of stress
  • Depression
  • Fear

Spiritual Factors

  • How you live your life
  • values and beliefs
  • relationships with family and friends
  • Finding hope and meaning in life

Family Practices

The way your family uses health care service


Psychosocial and Socioeconomic factors

  • Psychosocial
    • Stability of marital or intimate relationship
    • Occupational environment
    • Approval from social circles
  • Socioeconomic
    • Organization of the health care system
    • Economic status affects a persons ability to maintain treatment

Health Promotion

Activities that help maintain or enhance a person's present level of health


Wellness education

Teaches people how to care for themselves in a healthy way


Illness prevention activities

Protect patients from actual or potential threats to health


Passive strategies of health promotion

Individuals gain from the activities of others without acting themselves


Active strategies of health promotion

Individuals adopt specific health programs


Risk factor

Any situation, habit, or other variable that increases the vulnerability of an individual or group to an illness or accident


Genetic and Physiological Factors

  • Physical conditions
  • Heredity


Affects a person's susceptibility to certain illnesses and conditions

  • Premature infants and neonates
  • Older adults


  • Where we live
  • Condition of the area
  • Determines how we live, what we eat, and the disease agents to which we are exposed


Activities, habits, and practices that involve risk factors.

Those with potential negative effects are risk factors



A state in which a person's physical, emotional, intellectual, social, developmental, or spiritual functioning is diminished or impaired


Acute illness

  • Usually reversible
  • Short duration
  • Often severe

Chronic illness

  • Persists > 6 months
  • Irreversible
  • Affects functioning of one or more systems

Illness behavior

The way people who are generally ill act

Involves how people monitor their bodies, define and interpret symptoms, take remedial actions, and use the resources in the health care system


Internal Variables

  • Patient perception of symptoms/illness
  • People with acute illness are more likely to seek care, and comply readily
  • People with chronic illness are less motivated

External Variables

  • Visibility of symptoms
  • Social group
  • Cultural background
  • Economic variables
  • Accessibility of the health care system
  • Social support

Impact of illness

The patient and family deal with changes resulting from illness and treatment.

  • Behavioral and Emotional changes - Short term evokes few behavioral changes in family functions. Severe illness creates more change such as anxiety, shock, denial, anger, and withdrawal.
  • Impact on body image - Subjective concept of physical appearance, Patient's and Familie's reactions differ and usually depend on the type of change, their adaptive capacity, the rate at which change takes place, and the support services available.
  • Impact on Self-Concept - Mental self-image of strengths and weaknesses. Depends in part on body image, but includes other aspects of psychology and spirituality.
  • Impact on Family Roles - When an illness occurs
  • Impact on Family Dynamics - Often changes as a result of the effects of illness. The processes by which the family functions, makes decisions, gives support to individual members, and copes with everyday changes and challenges.