Patient Centered Care: Exam 1 (found) Flashcards Preview

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1
Q

Health Promotion: Primary Prevention

A

things we do to prevent disease & promote health

2
Q

Health Promotion: Secondary Prevention

A

screening tests for disease

  • Sensitivity: picks up a disease when disease is present (without too many false positives)
  • Specificity: correctly identifies when disease is not present
3
Q

Health Promotion: Tertiary Prevention

A

taking medicine/ disease management

4
Q

Health Disparities

A

differences in the quality of care received by minorities and non-minorities who have equal access to care.
Based on conscious or unconscious thought process

ex. treating 2 patients with similar conditions differently based on types of insurance they have

5
Q

Six Aims for Improvement of the Healthcare System (IOM):

A
  1. Safe: avoiding accidental injuries
  2. Effective: providing services based on scientific knowledge (evidence-based)
  3. Patient-Centered: providing care that is responsive to individual patient preferences, needs and values
  4. Timely: reducing waits and harmful delays
  5. Efficient: avoiding waste
  6. Equitable: care does not vary in quality because of personal characteristics
6
Q

Attributes of Patient-Centered Care

A

Empathy: treating patients how you want to be treated
Communication: encouraging active communication between the healthcare team & patient

7
Q

Holistic Care:

A

treating a patient based on complete physical, mental, and social well being, not merely absence of disease or infirmity

8
Q

Steps of the Nursing Process

A

ADPIE

  1. Assessment: gathering patient care data through observation, interviews, and physical assessment
  2. Diagnosis: Analyze, validate, and cluster patient data to identify patient problems
  3. Planning: Prioritize the nursing diagnosis and identify short/long term goals that are realistic, measurable, and patient focused
  4. Implementation: Initiate specific nursing interventions and treatments designed to help the patient achieve established goals and outcomes
  5. Evaluation: Determine whether the patients goals are met, examine effectiveness, and decide whether the plan of care should be discontinued or revised
9
Q

Assessment

A

Data collection:
Primary Data: patient interview
Secondary Data:
-Subjective Data: verbal communication, signs/symptoms told by patient
-Objective Data: signs observed/ measured/ tested

10
Q

Nursing Diagnosis

A

Looks at patient problems, clusters to find a common problem

  • Actual Nursing Diagnosis: a problem already exists, trying to prove the problem. Identified by signs/ symptoms
  • Risk Nursing Diagnosis: a potential problem. Assessment findings suggest the patient is at risk
11
Q

Actual Nursing Diagnosis

A

A problem already exists. Trying to prove the problem by identifying signs/ symptoms

3 parts: problem, etiology, symptoms
formula: PROBLEM related to PATHOPHYSIOLOGY as evidenced by SIGNS/ SYMPTOMS

12
Q

Risk Nursing Diagnosis

A

a potential problem, identified by signs/ symptoms

2 parts: problem, risk factors
formula: PROBLEM due to RISK FACTORS

13
Q

Planning

A
  • prioritizes a patients various diagnosis
  • create short & long term goals
  • chooses outcome indicators & identifies interventions to address patient goals

Goals= things the patient will do to improve

14
Q

Goals must be SMART

A
Specific
Measurable
Appropriate to patient
Realistic
Timeframe (have a timeframe specified)
15
Q

Implementation

A

initiation of interventions to meet patient needs.

Clinical Pathways: multidisciplinary resources to guide patient care
Protocols: standard procedures
Standing Orders: to be carried out when certain criteria is met

16
Q

Evaluation

A

Patients response to nursing interventions and goal or outcome attainment

  • care plan evaluation
  • continue or discontinue treatment
  • revise/adapt treatment
17
Q

Development

A

sequence of physical, psychosocial, and cognitive changes that take place over the human lifespan

  • physical growth: measured in numerical changes
  • differentiation: growth @ cellular level
  • developmental tasks
  • maturation
18
Q

Order of Developmental Stages

A
Infant
Toddler
Preschool
School Age
Adolescent
Young Adult
Middle Adult
Older Adult
19
Q

Developmental Milestones

A

Specific skills most individuals achieve at a certain age

Used to identify developmental delay or regression

20
Q

Principles of Intervention

A
#1 Early identification and early intervention are critical
#2 Specific interventions are dependent on category, age & type of developmental delay
#3 Management requires interdisciplinary collaboration
21
Q

Sigmund Freud: Psychoanalytic/Psychosexual Development

A

Personality grows, develops, & changes during lifespan

ID: Unconscious, present @ birth, generates impulses that seed immediate satisfaction
EGO: view of self/ what one wants others to see
SUPEREGO: 3-5 yrs. delays immediate gratification for socially appropriate reasons, recognition of good and bad, moral guide/ conscience

*5 stages of psychosexual development

22
Q

5 Stages of Psychosexual Development (Freud)

A
  1. Oral (0-1): Mouth/sucking
  2. Anal (Toddler): Self-control of bowels/ potty training
  3. Phallic (Preschool): self-centered, masturbation, identifies with parent of opposite sex
  4. Latency (School Age): focuses on industry, achievement & skills
  5. Genital (Puberty): seeks mutual pleasure with a partner, sexual urges
23
Q

Oral Stage of Development

A

0-1 yr

focuses on mouth & need to suck

24
Q

Anal Stage of Development

A

Toddler

learning self control of bowels

25
Q

Phallic Stage of Development

A

Preschool

self-centered, masturbation, child identifies with parent of opposite sex

26
Q

Latency Stage of Development

A

School Age

surprises sexual urges, focuses on achievement & skills

27
Q

Genital Stage of Development

A

Puberty

sexual urges involving opposite sex, seeks mutual pleasure with partner

28
Q

Defense Mechanisms for Coping

A
  • Rationalization: excuse for behavior
  • Repression: Forced forgetfulness
  • Projection: onto another person
  • Agression/Regression: going backward in developmental stages
29
Q

Jean Piaget: Cognitive Theory of Development

A

4 stages of development related to learning to understand and relate logically to the world

cognitive milestones involving sensory & motor interactions with the world

30
Q

Sensorimotor Stage of Cognitive Development

A

Piaget’s 1st stage:

0-2:
object permanence, cause & effect, time of day

31
Q

Preoperational Stage of Cognitive Development

A

Piaget’s 2nd stage:

2-7:
pretend play, self-centered, language explosion

32
Q

Concrete Operations Stage of Cognitive Development

A

Piaget’s 3rd stage:

7-11:
understands more than 1 piece of info, realistic understanding, present focused

33
Q

Formal Operations Stage of Cognitive Development

A

Piaget’s 4th stage:

Adolescent:
abstract & logical thinking, future oriented, social & moral rules

34
Q

4 Stages of Cognitive Development (Piaget)

A
  1. Sensorimotor (0-2): object permanence, cause/effect, time awareness
  2. Preoperational (2-7): pretend play, self-centered, language explosion, logic development
  3. Concrete Operations (7-11): Realistic, present oriented, processes more than 1 idea
  4. Formal Operations (12+): abstract thinking, future oriented, scientific understanding, social & moral rules
35
Q

Erik Erikson: Psychosocial Theories of Development

A
personal development dependent upon social environment & interactions. 
each stage involves a social crisis that must be positively resolved to successfully pass on to the next stage
Trust v. Mistrust
Autonomy v. Shame & Doubt
Initiative v. Guilt
Industry v. Inferiority 
Identity v. Role Confusion
Intimacy v. Isolation
Generativity v. Self Absorption 
Integrity v. Despair
36
Q

Trust vs. Mistrust

A

Eriksons 1st stage:

Infant: 0-1
develops trust to meet personal needs, begins to trust himself/herself

37
Q

Autonomy vs. Shame and Doubt

A

Eriksons 2nd stage:

Toddler: 1-3
independent, potty training, trusting oneself to be good

38
Q

Initiative vs. Guilt

A

Eriksons 3rd stage:

Preschool: 3-6
imitates role models, follows rules, self control in social interactions

39
Q

Industry vs. Inferiority

A

Eriksons 4th stage:

School age:
ability to make friends, individually achieve school tasks

40
Q

Identity vs. Role Confusion

A

Eriksons 5th stage:

Adolescent:
learns to know oneself & what one believes (career goal)

41
Q

Intimacy vs. Isolation

A

Eriksons 6th stage:

Young Adult:
ability to share all aspects of life with others (intimate relationships)

42
Q

Generativity vs. Self Absorption

A

Eriksons 7th Stage:

Middle Adult:
contributes to society in a meaningful way

43
Q

Integrity vs. Despair

A

Eriksons 8th stage:

Older adult: geriatric
reflecting on life, sense of life achievement

44
Q

Maslow’s Hierarchy of Needs

A

Basic needs must be met in order to move toward self-fulfillment

45
Q

Kohlberg’s 3 Stages of Moral Development

A

a set of social rules that enables a person to differentiate between right and wrong

Preconventional (toddler, early childhood): obeys rules to avoid punishment

Conventional (school age): conforms to rules to gain recognition/ reward

Postconventional (adolescent, adult): follows rules leading others to believe they are “good”, sense of responsibility

(older adult): develops own sense of principles, independent

46
Q

The period of infancy

A

4 weeks to 1 year

47
Q

toddler age period

A

1-2 years

48
Q

preschool age period

A

2-6 years

49
Q

school age period

A

6-12 years

50
Q

adolescent age period

A

12 plus years

51
Q

separation anxiety begins at this age

A

6 months

52
Q

pincer action

A

grasp small objects with the thumb and forefinger around 9 months of age

53
Q

weight of a child of 1 year

A

triple the birth weight

54
Q

tasks to be mastered during early childhood

A

walking, bowel control, visual maturity

55
Q

toddler-age child in which of Erikson’s stages?

A

autonomy vs. shame and doubt

56
Q

preschool-age child is in which of Erikson’s stages?

A

initiative vs. guilt

57
Q

between 12 and 24 months of age, child’s speech includes

A

three to four word sentences

58
Q

best disciplinary technique

A

rewarding good behavior

59
Q

middle childhood includes children between the ages of

A

6 and 12 years

60
Q

a major developmental task of middle childhood

A

developing positive self esteem and a positive self image

61
Q

middle childhood play activities

A

competitive games

62
Q

middle childhood includes Erikson’s stage of

A

industry

63
Q

length & weight of typical newborn

A

20 inches long

7.5 lbs

64
Q

length at 1 year old

A

birth length increases 50%

65
Q

infant’s weight at 6 months

A

double birth weight

66
Q

infant’s weight at 1 year

A

triple birth weight

67
Q

emotional development of infant

A

mimic facial expressions

68
Q

stranger anxiety

A

begins at 9 months; doesn’t feel comfortable with strangers

69
Q

Language development of infant

A

receptive before expressive, nonverbal, few words by 1 year

70
Q

sleep patterns of infants

A

self-regulating skills to return to sleep without prompting

71
Q

Infant nutrition

A
breast milk/ formula for 1 year
feed every 2-3 hours
no solid food before 6 months
high fat cows milk at 1 year
introduce 1 food at a time (allergies)
vegetables 1st, fruits 2nd
meat & eggs at 11 months
can move to normal eating schedule at 1 year
72
Q

Infant: Teeth

A

primary teeth begin at 5-7 months
#months-6= #teeth
teething/chewing/fussy/ drooling

73
Q

Early Childhood: Walking

A

begins 12-15 months

74
Q

Early Childhood: Nutrition

A

solid foods

plate= fruits, veggies, grains and protein

75
Q

Toddler: Language

A

receptive before expressive
1st clear word
responds to simple commands

76
Q

Preschooler: Language

A

occurs rapidly

5 years= more than 2000 words

77
Q

Middle Childhood: Physiological

A

grows 1-2 inches/year on average
bones growing
starts to lose teeth
mature GI tract & sensory organs

78
Q

Three phases of moral behavior

A
  1. Knowledge- knowing what is right
  2. Emotion- feeling good/bad about what you did
  3. Action- behaving according to the rule of what is right
79
Q

Parallel Play

A

1-3 years

playing side by side without interaction

80
Q

Cooperative Play

A

3-5 years

playing together

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