Community Nursing Questions & Answers correct

Community Nursing Questions & Answers correct What is a community? -A group of people that share geographic, civic, or social parameters. -A group that shares one or more personal characteristics -Vary in characteristics and health needs -Determined by the degree to which the community's collective health needs are identified and met What is community health nursing? -Nursing practice in the community with the primary focus on the health care of individuals, families, and groups in a community. -The goal is to preserve, protect, promote, or maintain health. How is a community's health status determined? -Mortality/Morbidity -Environmental -Disability Rates -Socioeconomics -Nutritional status -Health policy -Health care delivery -QOL (quality of life) indicators -Utilization rates -Social/mental health By looking for health indicators... -we can track a community's health -we can assess needs, promote health, prevent disease within a specific population Community based nursing Focus of care: -individuals -families Nursing activities: -Illness Care: Management of acute/chronic conditions in setting specific care (in the community where people are) Community oriented nursing your client is the community at risk individuals, families, groups in the community Focus of care: -Health care: determining health needs of a community, and intervening at the individual, family, and group level to improve collective health of the community Nursing activities: -Concern for connection between health status of the population and the environment in which the population lives, promoting health care to promote quality of life, preventing disease and disability Public Health Nursing your client is the population How does a population differ from a community? -Scientific discipline that includes epidemiology, statistics, and assessment, with attention to behavioral, cultural and economic factors, as well as program planning and policy Focus of care: -healthcare of communities/populations rather than on individuals, groups, families Nursing activities: -Prevent disease, promote, protect health for the overall population, doing the greatest good for the greatest number Utilitarianism: -the doctrine that actions are right if they are useful or for the benefit of a majority Who am I? community based, community oriented, or public health? 1. A hospice nurse provides pain management for a terminally ill patient 2. An occupational health nurse provides a class on stress management 3. A parish nurse teaches a class on the stages of grief 4. A school nurse teaches a diabetic student about healthy snacking 5. A researcher evaluates data to determine the effectiveness of WIC benefits 1. community based 2. community oriented 3. community oriented 4. community oriented 5. public health nursing role of the community nurse -clinician -educator -advocate -manager -collaborator -leader -researcher clinician promotion of health/prevention of illness for the community client Educator facilitate client learning on self-care, illness prevention/health promotion Advocate assist client to learn what services are available, how to obtain necessary services Manager Oversee client care, supervise ancillary staff, case management, run clinics, conduct community health needs assessment projects Collaborator cooperate with community partners toward common goals for the client Leader influencing change at local/state/national levels Researcher systematic investigation, collection, analysis of data to enhance community health practice Utilizing the continuum of care Based on recommendations, a nurse links a client to: Healthcare Services: -Support services: This happens through referrals, discharge planning, case management -Referral process: partnership with client, criteria for referral, exploring available resources to suit issue, will client use a resource, make the referral, facilitate the referral, evaluate the outcome -Barriers: motivation, information, accessibility, culture, time, experience of staff Health & Wellness Theory What is health? (1948 WHO) -Health is a "state of complete physical, mental and social well being and not merely the absence of disease or infirmity." What is wellness? -The quality or state of being healthy in body and mind, especially as the result of deliberate effort -An approach to healthcare that emphasizes preventing illness and prolonging life, as opposed to emphasizing treating diseases external vs internal health and wellness Wellness and quality of life Determine client's perception of: -Physical well being: overall health status -Functional well being: satisfaction with ADL's, role performance -Emotional wellbeing: coping, distress, enjoyment -Spiritual wellbeing -Social well being: social activity, family, relationships Wellness and Holism -Nurses are concerned with the individual as a whole, not just pieces, parts or processes. -The ultimate QOL occurs when all facets are in balance Healthy People 2020 -Healthy People provides science-based, 10-year national objectives for improving the health of all Americans -Goals specific to a community or individual can be created from this site. Overarching Goals/Prevention Agenda for the U.S. -Attain high quality, longer lives free of preventable disease, disability, injury and premature death Achieve health equity, eliminate disparities and promote the health of all groups Create social and physical environments that promote good health for all Promote health development and healthy behaviors across every stage of life primary prevention Prevent disease and promote health (healthy diet, exercise, adequate rest, vaccines) Example: -Teaching elementary school children about healthy food and exercise patterns Secondary prevention Screenings for early detection for health maintenance (mammogram, colonoscopy, lab work) Example: -Performing annual height and weight measurements on elementary children to determine BMI Tertiary prevention Treating problems and limiting disease progression; involves rehab and preventing complications associated with existing disease Example: -Enrolling a child and his parents in a feeding clinic when the school nurse notes that the child's BMI is out of range Complementary & Alternative Medicine (CAM) in Promoting Health and Wellness -CAM therapies: part of holistic care, connecting mind, body and spirit -Used in hospital and outpatient settings i.e. acupuncture, homeopathy, chinese/oriental medicine, chiropractor, yoga, reiki, art, dance, meditation. etc. Behavioral change theory - Rosentock's Health Belief Model Four core premises involved in the client response to needed change: 1. Perceived susceptibility -personal risk assessment regarding illness/disease Individual must perceive a personal risk/threat before action/change is likely 2. Perceived severity -of the condition/ disease/ consequences 3. Perceived barriers -influences that may hinder change 4. Perceived benefits -recognizing positive consequences of changing behavior Florence Nightingale's Environmental Theory -Pure fresh air -Pure water -Effective drainage- -Cleanliness -Light (especially direct sunlight) "Any deficiency in one or more of these factors could lead to impaired functioning of life processes or diminished health status." Health Promotion: the Teaching-Learning process Learning: a change in behavior that persists over time, is practiced repeatedly and is reinforced Learning requires: -Readiness - use techniques specific to developmental stage to determine readiness to learn (Developmental Theory) -Participation -Relevance Empower the client to attain/maintain an optimal level of health and wellness. Nurses need to foster client independence in meeting this goal. Characteristics of the Adults Learner -Adults have a lifetime of experience and knowledge to use as a resource for ongoing learning -Adult learners are goal-oriented -Adults need to know why they are learning something -Timing can increase effectiveness -Adults tend to be practical -Adults need to be shown respect Facilitating adult learning 1. Assess the client's goals/willingness to learn/readiness to change. 2. Before teaching, assess comfort level (physical, psychological). 3. Include family/significant others when possible. 4. Gear teaching strategies to level of development 5. Visual aids for reinforcement. 6. Break down complex into small parts 7. Provide hands-on learning and teach-back. 8. Offer health-care resources for follow-up Barriers to learning Can be learner or educator related Internal: -Physical - pain, limited vision or mobility -Social - lack of support or acceptance -Psychological - fear, anxiety, depression External -Environment - noise, distraction -Situation - poor timing/methods not agreeable to the client learning styles Visual - Seeing, think in pictures Auditory - listening Kinesthetic/Tactile - doing, hands-on Learning theories used in teaching Behavioral Theory: Use of reinforcement to change behaviors -A patient who participates in therapy all week is rewarded with a day pass. Cognitive Behavior: Use of sensory input, awareness repetition to change patterns of thought -A patient recognizes that a doctor who did not call her back in a timely manner was probably busy and not angry at her or ignoring her. Developmental Theory: Use of techniques specific to developmental stage to deliver material/knowledge -A nurse uses pictures to communicate with a stroke patient who has lost the ability to speak Social Learning Theory - learn by observing others -A patient recognizes that she needs to lose weight because her neighbor died of a heart attack Nursing Interventions: Wellness & Health Promotion Health promotion activities YOU can implement: 1. Encourage/Plan behaviors/activities that result in wellness. 2. Motivate individuals to attain the highest state of wellness, overall fitness, self-actualization (becoming the best they can be). Learning domains Cognitive: -includes all intellectual behaviors and requires thinking Affective: -deals with expression of feelings and acceptance of attitudes, opinions, or values Psychomotor: -involves acquiring skills that required integration of mental and muscular activity