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chapters 5, 12, 13, 18, 22, 24

Terms in this set (105)

school health nursing

what is the specialized practice of professional nursing that advances the well‐being, academic success, and lifelong achievement of students?

- health assessment (individual, population based, health promotion, school health needs)
- health educator
- emergency preparedness

what is the role of a school nurse?

PL 94‐142

Since the passage of _____________ in 1975, school nurses provide more complex care for several conditions.

Americans with Disabilities Acts (ADA)

what is the name of the wide‐ranging federal legislation enacted in 1990 that is intended to make American society more accessible to people with disabilities?

Early Periodic Screening, Diagnosis, and Treatment (EPSDT)

what program mandated by a federal law passed in 1969, which required that children and adolescents younger than 21 years of age have access to the periodic screenings?

Individuals with Disabilities Education Act (IDEA)

what federal law enacted in 1990 and reauthorized in 1997, designed to protect the rights of students with disabilities by ensuring that everyone receives a free, appropriate public education, regardless of ability?

Individuals with Disabilities Education Act (IDEA)

__________________________________________ strives to grant equal access to students with disabilities and to provide additional special education services and procedural safeguards.

Youth Risk Behavior Surveillance Survey (YRBSS)

Data from the ___________________________________, a biannual report of the common risk behaviors influencing the health of our nation's youth, can be used by the school nurse as a tool for monitoring trends both locally and nationally

- drugs and alcohol
- smoking
- sexual behavior and teenage pregnancy
- sexually transmitted infections
- nutrition
- violence (including electronic bullying)

what are some common health concerns in schools that school nurses often must address?

- school climate
- peer influences

what can help prevent face-to-face violence?

electronic/cyber bullying

This type of bullying is considered part of youth violence and can lead to suicide.

advocate

as a school nurse, you act as a child _____________

- Provide education and communication necessary to ensure that the student's health and educational needs are met
- Implement strategies to reduce disruptions in the student's school activities
- Communicate with families and healthcare providers as authorized
- Ensure the student receives prescribed medications and treatments and that staff who interact with the student on a regular basis are knowledgeable about these needs
- Provide a safe and healthy school environment to promote learning

in what ways does a school nurse act as a child advocate?

- Blood pressure and glucose monitoring
- 'Breathing treatment' administration for asthma attack
- Staff and student education
- Training for medication administration
- Meeting with parents to collaborate on management of blood glucose and healthy food choices

what are some tasks performed by school nurses?

- Schedule parent conferences as needed for discussion of student health issues
- Teaching a student how and when to use her EpiPen
- Teaching a class about the consequences of electronic bullying
- Counseling student about tobacco use
- Teaching students with eating disorders healthy views about food

what are some examples of patient education a school nurse may give?

Whole School
Whole Community
Whole Child

what is the "WSCC" in WSCC model stand for?

collaborative design that uses the resources of a community to provide structured preventive services such as after‐school programs, parent outreach, and crisis intervention

what is the WSCC model?

FALSE

rationale: Early Periodic Screening, Diagnosis, and Treatment (EPSDT)—program mandated by a federal law passed in 1969, which required that children and adolescents younger than 21 years of age have access to the periodic screenings.

TRUE/FALSE: Early Periodic Screening, Diagnosis, and Treatment (EPSDT)—program mandated by a state law passed in 1969, which required that children and adolescents younger than 21 years of age have access to the periodic screenings in several states.

- individuals living on margins of society, lacking key resources
- homeless, immigrants, migrants, chronically disabled
- minorities, women, children, veterans, victims of trafficking
- underserved or not served at all

what defines a person as vulnerable?

the conditions in which people are born, grow, live, work and age

Social determinants of health and health disparities is defined as...

the study of genes, functions and related techniques

what is genomics?

- a designation designed to improve access to healthcare by keeping essential services in rural areas
- reduces the financial vulnerability of rural hospitals

Critical Access Hospitals are defined as...

2,500

rural areas have a population of ______________ people not adjacent to an urbanized area

- specific for use in rural areas
- helps identify needs and design for interventions

what is the Rural Active Living Assessment?

social injustices and economic problems

After release from incarceration, inmates often face _______________ injustices and ______________ problems

- Rural and social isolation
- Lower incomes, especially in rural areas
- Less options for leisure and recreation
- Transportation issues- driving limitations, lack of public transportation
- Chronic diseases and disabilities
- Less active network of family, friends

what are some challenges people face as they age?

- Availability
- Accessibility
- Affordability
- Awareness
- Adequacy
- Acceptability
- Assessment

what are the 7 A's of challenges to elders in rural areas?

HIV‐related research

Few population‐based studies have been conducted in LGBT groups, with the exception of ___________________, particularly in men who have sex with men.

TRUE

TRUE/FALSE: There is a need for civilian nurses to understand military culture in order to better care for veterans.

2; 1

_____ million reintegrated veterans in the civilian sector
_____ million veterans suffering from nonvisible or visible trauma

recruitment and transportation of people for exploitation (slavery)

human trafficking is defined as...

13%

Nurse's role of recognizing victims and responding based on approved protocol... estimated at least _____% of healthcare providers have been in contact with human trafficking victims unknowingly

- avoids eye contact/social interaction
- appears to have few/no personal possessions
- is not allowed or able to speak for him/herself
- is "just visiting" and can't say where he/she is staying
- looks malnourished and/or shows signs of physical abuse
- is not in control of his/her own money or identification
- is fearful or anxious, especially around law enforcement
- has numerous inconsistencies in his/her story

what are some human trafficking victim warning signs?

- show respect and use a positive approach, which builds trust
- support primary (ex: advocacy), secondary (ex: tuberculosis screening), and tertiary (ex: "detox" treatment) prevention to make it easier to cope with difficult, challenging lives

what should a nurse's approach be to homeless people?

D. All of the above

Rationale: Social injustice involves the denial of economic, sociocultural, political, civil, or human rights of certain populations or groups based on the belief of those with power that others are inferior. In healthcare, it manifests as disparity in access.

Which of the following are included in the notion of social injustice?

A. Belief of those in power that others are inferior
B. Denial of human rights to certain populations
C. Disparities in access to services, such as healthcare
D. All of the above

False

Rationale: Availability—insufficient number and diversity of formal services and providers; lack of acceptable services and human service infrastructure.
Accessibility—shortages of adequate, appropriate, and affordable transportation; cultural and geographic isolation.

TRUE/FALSE: Accessibility is insufficient number and diversity of formal services and providers, or lack of acceptable services and human service infrastructure to elders in rural areas.

two or more persons who share emotional closeness and identify themselves as members of a family

family is defined as...

- apply general systems theory principles to explain family interaction
- family can be described as a social system comprised of interacting subsystems (individuals)
- a system works on the principle that each part contributes to the functioning of the whole

what is the family systems theory?

- this theory views the family as a social system but emphasizes the organization or structure of the family
- defines ordered set of relationships among the parts and between family and among other social systems
- from a sociological point of view, the family serves as the basic sociocultural and economic unit in society

what is the Family Structural-Functional Theory?

- development of life-cycle theory proposes families progress through typical stages
- based on a nuclear, heterosexual, middle class family experience

what is the Family Developmental Theory?

a graphic representation of a family tree that displays detailed data on relationships among individuals

what is a genogram?

a diagram often used by social workers or nurses showing the social and personal relationships of an individual with his or her environment

what is an ecomap?

- family assessment: Families are complex social systems and multiple factors influence health and illness experiences
- structural assessment:
*Internal
*External
*Context
*A developmental assessment (detailed and multidimensional)
- functional assessment:
*Emphasizes the interaction between family members (how they behave with each other and focus on the present)
*Family functioning (instrumental and expressive)
- developmental assessment: Unique path constructed by a family (typical lifestyle events and unique makeup/ dynamic and changing)

what is the Calgary Family Assessment Model (CFAM)?

an organizing framework conceptualizing the intersect between a particular domain (i.e., cognitive, affective, or behavioral) of family functioning and a specific intervention offered by a health professional

what is the Calgary Family Interventions Model (CFIM)?

diversity

____________ embraces every aspect of family life and finds expression in family history, heritage, and language, as well as the ways that families manifest and maintain health

1. manners
2. therapeutic conversation
3. ecomaps and genograms
4. therapeutic questions
5. acknowledging family strengths

what are the five leading principles of a family interview?

1. improve pregnancy outcomes
2. improve child health and development
3. improve the economic self-sufficiency of families by helping create a vision for the future

what are the 3 goals of the Nurse-Family Partnership Program?

significant stressor on the primary care giver
- physical and emotional illness over time
- a type of interfamily strain

what is "caregiver burden"?

- 'informal family caregiver'
- unpaid
- includes care to a child
- cares for family members with complex and debilitating chronic diseases

- majority female (60%) but male caregiving is increasing (40%)

what are the characteristics of a family caregiver?

False

Rationale: Family health practices, routines, and responses to difficult situations evolve from complex, not simple, environmental and interpersonal interactions.

TRUE/FALSE: Family health practices, routines, and responses to difficult situations evolve from simple environmental and interpersonal interactions.

False

Rationale: Theory—a system of interrelated statements that is used to explain, predict, control or understand a phenomenon. System—a group that works on the principle that each part contributes to the way the whole functions.

TRUE/FALSE: Theory—a group of interrelated statements that is used to explain, predict, control, or understand a phenomenon.

False

TRUE/FALSE: Genogram—a diagram used to identify the direction and intensity of family relationships between members and/or community institutions of importance to the family

A. 15 minutes

Rationale: Focused family interviews of 15 minutes or less can yield a wealth of information.

What is the time frame that nurses have to complete a focused family interview?
A. 15 minutes
B. 30 minutes
C. 45 minutes
D. 60 minutes

- Caregiver Advise, Record, Enable Act
- originated out of the Reinhard, Levine and Samis 2012 study exposing challenges of caregivers providing more complex care to family members

what is the CARE act?

a quality, an ability to adapt to change, or a resource to help cope with challenges and processes of daily living

health is defined as...

a subjective perception of full functional ability as a human being

well-being is defined as...

maximizing health and wellness through strategies that are set in place before illness or injury is present

define primary prevention

maximizing health and wellness through strategies that are set in place at the early and active chronic stages of pathogenesis of illness and injury

define secondary prevention

maximizing health and wellness through strategies that are set in place at the palliation and end stage of disease and injury trajectories

define tertiary prevention

client-centered communication style for eliciting behavior change by helping clients and groups explore and resolve ambivalence to change

define motivational interviewing

models that assist clients, groups, and communities to redirect activities toward health and wellness

define behavior change models

A behavior change model emphasizing reinforcement of social competence, problem solving, autonomy, and sense of purpose

define learning model

A behavior change model that considers the severity of the potential illness or physical challenge, the level of conceivable susceptibility, the benefits of taking preventive action, and the challenges that may be faced in taking action toward the goal of health promotion

define health belief model

- Precontemplation
- Contemplation
- Preparation
- Action
- Maintenance
- Relapse

what are the stages of the Transtheoretical Model?

A behavior model that emphasizes that individual performance of a given behavior is primarily determined by a person's intention to perform that behavior

define Theory of Reasoned Action

A behavior change model that considers environmental influences, personal factors, and behavior as key components of change

define social learning

Family members, friends, neighbors, and adjacent communities influencing change by offering instrumental assistance, informational support, emotional support, and/or appraising support

define Theories of Social Support

- Negative emotional states
- Lack of or limited coping skills
- Decreased motivation
- Stress
- High-risk experiences

what can cause relapse?

Belief that all processes occurring within individual people and their environment should be viewed as interdependent

define ecologic model

False

National, not international, goals and directives to maintain the health of individuals, families, and communities are significant road maps for healthcare professionals.

TRUE/FALSE: International goals and directives to maintain the health of individuals, families, and communities are significant road maps for healthcare professionals.

False

Rationale: Secondary prevention—maximizing health and wellness through strategies that are set in place at the early and active chronic stages of pathogenesis of illness and injury. Tertiary prevention—maximizing health and wellness through strategies that are set in place at the palliation and end-stage of disease and injury trajectories.

TRUE/FALSE: Tertiary prevention—maximizing health and wellness through strategies that are set in place at the early and active chronic stages of pathogenesis of illness and injury.

False

Rationale: Health belief model—a behavior change model that considers the severity of the potential illness or physical challenge, the level of conceivable susceptibility, the benefits of taking preventive action, and the challenges that may be faced in taking action toward the goal of health promotion. Learning model—a behavior change model emphasizing reinforcement of social competence, problem solving, autonomy, and sense of purpose

TRUE/FALSE: Learning model—a behavior change model that considers the severity of the potential illness or physical challenge, the level of conceivable susceptibility, the benefits of taking preventive action, and the challenges that may be faced in taking action toward the goal of health promotion.

- coordination of a plan or process to bring health services together as a common whole
- assessing need and appropriateness of care
- actions taken to attain effective and efficient outcomes
- health utilization management important because of rising medical costs

define care management

an integrated collaborative process of assessment, planning, facilitation and advocacy for options and services to meet and individual's health needs through communication and available resources

define case management

home care

___________ is part of a continuum of care where clients can live and move through the experiences of subacute, chronic, and end-of-life care. The care given in ____________ settings is often managed and directed by a registered nurse. The care given in ____________ settings is interdisciplinary in nature

inflationary

Payments for healthcare is scrutinized due to its ______________ nature

various members of the healthcare team, not just nurses, contribute their expertise to client management in the home

define interdisciplinary care

- usually not-for-profit
- any profits are reinvested back into the home health service

what is a private/voluntary agency?

- developed to save $$ and maintain control
- also provides services as part of continuum of care

what is a hospital-based agency?

- private agencies that plan to and want to make a profit
- any profits benefit the owner

what is a proprietary agency?

- supported by public monies and may come from taxes
- mandate to serve all people without exception

what is a official agency?

- Local, state and federal funds
- Private insurance
- Private individuals
- Government: Medicare and Medicaid
- TRICARE: federal funds for military and dependents and veterans
- Independent insurance companies
- Health Maintenance organization - case management organizations

what are options for financing home care?

- State and federal government
- Insurance companies align themselves with these regulations but may add their own
- Certain conditions must be present for the Home Health agency to be able to provide care
- Home health agencies must be certified in order to provide services and receive reimbursement
- Medicare: Criteria for eligibility: homebound, intermittent care needs

how is home care regulated?

- Homebound
- Plan of Care
- Skilled needs
- Intermittent care needs (60 days)
- Necessity

what are the Medicare criteria for eligibility?

Telehealth

_______________ is a form of electronic communication used to deliver: acute care and specialty consultations, home telenursing Electronic referrals to specialists in expert health facilities

Model of care delivery with 5 components:
1. Comprehensive care
2. Patient-centered care
3. Coordination of care
4. Accessible services
5. Quality and safety

what is the medical home model?

- sharing of practice and skills by several disciplines
- an integration strategy with patients and families in home and healthcare settings

what is interprofessional collaboration?

- medication errors
- falls
- abuse and neglect

during an in-home visit, a nurse should assess for risks of...

- Less than 6 months or less to live
- Sign for hospice care
- Medicare-approved program

what is Medicare Part A eligibility?

a written statement detailing a person's desires regarding their medical treatment in circumstances in which they are no longer able to express informed consent, especially an advance directive

what is a living will?

- Decisions about level of care
- Comfort measures only
- Advance directives
- Artificial nutrition and hydration
- CPR
- Euthanasia and physician-assisted suicide

what is nursing care when death is imminent?

- Nonopioid analgesics
- Opioids
- Adjuvant analgesics

which pain medications are often used in palliative care?

- Oral
- Oral mucosa
- Rectal
- Transdermal
- Topical
- Parenteral
- Intraspinal

what routes are used for pain medication in palliative care?

TRUE

TRUE/FALSE: Short-acting or immediate-release agents are excellent PRN medications, and their only use should be for control of breakthrough pain.

- Constipation
- Delirium
- Dyspnea
- Decubitus ulcers
- Cough
- Anorexia/cachexia
- Nausea/vomiting
- Fatigue
- Anxiety

what are common symptoms of dying patients?

emotion felt after the loss

define grief

recovery from the loss

define mourning

- interdisciplinary team-based care that is focused on the relief of suffering for clients with serious illness
- best possible quality of life not only for clients but also for their families

define palliative care

- Controlling symptoms
- Coordinating care
- Reducing unnecessary tests and futile interventions
- Ongoing conversations with the client and family

what is the focus of palliative care?

- Acupuncture
- Massage
- Reiki
- Chiropractic
- Herbal medicine

what are some complementary and alternative therapies to palliative care?

False

Rationale: American healthcare system has serious shortcomings in the care of their seriously ill and dying patients

TRUE/FALSE: Studies have documented that the American healthcare system has the best care in the world of seriously ill clients and their families.

False

Rationale: A dying person may not exhibit all of these stages, or may move quickly through a stage, only to return to it at a later time.

TRUE/FALSE: A dying patient will go through denial, anger, bargaining, and acceptance stages of dying.

1. numb shock
2. anger
3. emotional turmoil or depression
4. reorganization
5. resolution

what are the phases of grief?

can be provided in the home and in health care facilities, involves caring for a deceased patient's body with sensitivity and in a manner that is consistent with the patient's religious or cultural beliefs

what is postmortem care?

1. Provide privacy throughout the process.
2. Obtain a death pack or gather supplies.
3. Wash hands and put on gloves.
4. Close the eyes.
5. If the resident wore dentures, place them in the mouth. If unable to do so, put them in a labeled denture cup to go with the body.
6. Give a complete bed bath.
7. Dress the body in a clean gown and put a pad in the perineal area.
8. Depending on policy and instructions of the coroner, tubes or lines may or may not be removed. Check before removing any of them.
9. Depending on policy, wrap the body in a sheet.
10. Place the body in a plastic bag designated for the purpose.
11. Attach identification or ensure that there is a tag or bracelet on the body.
12. Close the bag, tie the zipper shut, and slide the body onto a morgue cart, with the assistance of co-workers.

what are the steps of postmortem care?

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