NURS 5461 Quiz 1 – Questions With Fully Explained
Solutions
Save
Terms in this set (230)
Interprofessional education (IPE) is a teaching and
learning approach that involves students from two or
Interprofessional Education
more professions learning together to improve health
outcomes.
Barriers to IPE Communication, Time, Training, Roles, Resources
Risk profile
3 steps to Prevention Dx
Prevention Needs and Deficits
and Plan
Prevention plan
1. Precontemplation
2. Contemplation
Transtheoretical Model of
3. Preparation
Change
4. Action
5. Maintenance
Precontemplation- stage w/ no intention to change
behavior in foreseeable future.
Precontemplation Denial, feel immune to threat, have given up etc.
Have you tried change in the past? What would have to
happen for you to know this is a problem? What warning
signs would let you know it's a problem?
Contemplation- Aware problem exists, thinking of
overcoming, no commitment to action.
Contemplation Feel ambivalent, pros and cons, feel trapped.
What reasons might make you want to change at this
time? What are possible reasons for not changing?
What would keep you from changing at this time?
, Preparation- Intended action in next month, may have
taken past action.
Preparation
Preparing to make specific change.
Action- Modify behavior, experiences, or environment
to overcome problem.
Action
Praise any behavioral change.
-Working to prevent relapse and consolidate gains
secured during action
-Uses strategies to prevent the problem from re-
Maintenance/Relapse
occurring.
Prevention
-Actively engaged in continuing change efforts
-"How do I keep going?"
-screening
Three Main Types of
-behavioral cousenling
Clinical Preventative Care
-preventative meds
Think risk factors for most likely Diseases
Screening
Identify- Age/Gender/Race/Ethnic/ FH/ Personal Risk
United States Public Great tool for Prevention!! Utilize in clinical
Services Task Force
(USPSTF)
• Levels of Evidence:
A: recommends the service. There is high certainty that
the net
benefit is substantial.
B: recommends the service. There is high certainty that
Levels of Evidence
the net benefit is moderate or there is moderate
(USPSTF)
certainty that the net benefit is moderate to substantial.
C: recommends against routinely providing the service -
Benefit small if present
D: recommends against the service -harm > benefit
I: current evidence is insufficient
, Items or services recommended with an A or B rating by
the U.S. Preventive Services Task Force
What services are
considered preventive care
Immunizations recommended by the Advisory
& required by ACA in 2015?
Committee on Immunization Practices (ACIP) of the
CDC
AAA screening ever-smoking men 65-75
ASA Men 45-79, Women 55-79
Behavioral dietary-counseling (increased risk)
HTN & Lipid screening (> 18; M >35/20-45, W >45/20-45)
Disc. Chemoprevention Breast Cancer (High risk)
Pap, Mammo CRC screening
Important A and B level Lung Cancer screening
Evidence Depression screening• *Family HX risk & referral
BRCA eval
Obesity -intensive counseling & behavioral
Tobacco
HIV (pregnant, all 15-65)•
ETOH misuse & counsel
Hep C screen (1945-65)
Cervical cancer screening (PAP & HPV) Q 3 yrs 21-29
PAP, 30-65 Q3yrs Pap or Q5 yrs Pap and HPV
Prostate Cancer screening "D rating"
Changes in Selected Major
Lung Cancer screening: LDCT 55-80 yrs w 30 pkyr &
Screening Guidelines
smoke or quit
within 15 yrs (55/30/15)
Colon cancer screening: 3 options
Behavioral Dietary counseling at risk B
Intensive Dietary counseling risk for CVD B
Discussion chemoprevention breast cancer B
Prevention skin cancer 10-24 B
Counseling topics
Intensive counseling & intervention re Obesity B
Tobacco counseling & intervention A
Reduce alcohol misuse B
Promote breastfeeding B
, Immunizations (see CDC immunization guidelines!!!)
www.CDC.gov
Influenza starting at 6 months
TD q 10 years (Tdap at least once as adult) to protect
pertussis
1X Tdap >65 if around infants (timing does not matter)
Pneumovax (PPSV23)at 65 or >18 if smoker or any
chronic pulmonary
Preventative Medications condition(repeat if given <65 & at least 5 years ago)
and Immunizations 11
Prevnar (PCV3) at 65 then PPSV23 6-12 months later OR
if PPSV23 first, Prevnar 6-12 months
Hep B series as indicated (new: diabetes)
HPV4 vaccinate females & males (9 to 26 years) best at
11-12 yo
Zostavax for zoster prevention at 60 yo (FDA approved
at 50)
Meningococcal as indicated
Pneumococcal conjugate vaccine (PCV13) is
recommended for all children younger than 5 years old,
all adults 65 years or older, and people 6 years or older
with certain RFs (immunocompromised)
Pneumococcal Vaccines
Pneumococcal polysaccharide vaccine (PPSV23) is
recommended for all adults 65 years or older. People 2
years through 64 years of age who are at high risk of
pneumococcal disease should also receive PPSV23 (>18
smokers, chronic diseases, etc).
ASA as indicated 81 mg "A"
Men >45-79 for MI; Women >55-79 (reduced CVA)
Assess risk for GI bleed and decide 2010
Omega 3 fatty acids (fish oil)?? DHA, EPA 1-2 grams QD
Preventative Meds or fatty fish twice weekly
(Vitamin C & E NOT indicated and may cause harm)
Calcium with vit D for FX prevention "D"
Many outstanding questions re MI risk
Dietary sources show no risk so encourage
Mediterranean Diet & DASH diet for everyone!
Obesity BMI Higher BMI > risk for DM, CVD, HLD, HTN, OA
Solutions
Save
Terms in this set (230)
Interprofessional education (IPE) is a teaching and
learning approach that involves students from two or
Interprofessional Education
more professions learning together to improve health
outcomes.
Barriers to IPE Communication, Time, Training, Roles, Resources
Risk profile
3 steps to Prevention Dx
Prevention Needs and Deficits
and Plan
Prevention plan
1. Precontemplation
2. Contemplation
Transtheoretical Model of
3. Preparation
Change
4. Action
5. Maintenance
Precontemplation- stage w/ no intention to change
behavior in foreseeable future.
Precontemplation Denial, feel immune to threat, have given up etc.
Have you tried change in the past? What would have to
happen for you to know this is a problem? What warning
signs would let you know it's a problem?
Contemplation- Aware problem exists, thinking of
overcoming, no commitment to action.
Contemplation Feel ambivalent, pros and cons, feel trapped.
What reasons might make you want to change at this
time? What are possible reasons for not changing?
What would keep you from changing at this time?
, Preparation- Intended action in next month, may have
taken past action.
Preparation
Preparing to make specific change.
Action- Modify behavior, experiences, or environment
to overcome problem.
Action
Praise any behavioral change.
-Working to prevent relapse and consolidate gains
secured during action
-Uses strategies to prevent the problem from re-
Maintenance/Relapse
occurring.
Prevention
-Actively engaged in continuing change efforts
-"How do I keep going?"
-screening
Three Main Types of
-behavioral cousenling
Clinical Preventative Care
-preventative meds
Think risk factors for most likely Diseases
Screening
Identify- Age/Gender/Race/Ethnic/ FH/ Personal Risk
United States Public Great tool for Prevention!! Utilize in clinical
Services Task Force
(USPSTF)
• Levels of Evidence:
A: recommends the service. There is high certainty that
the net
benefit is substantial.
B: recommends the service. There is high certainty that
Levels of Evidence
the net benefit is moderate or there is moderate
(USPSTF)
certainty that the net benefit is moderate to substantial.
C: recommends against routinely providing the service -
Benefit small if present
D: recommends against the service -harm > benefit
I: current evidence is insufficient
, Items or services recommended with an A or B rating by
the U.S. Preventive Services Task Force
What services are
considered preventive care
Immunizations recommended by the Advisory
& required by ACA in 2015?
Committee on Immunization Practices (ACIP) of the
CDC
AAA screening ever-smoking men 65-75
ASA Men 45-79, Women 55-79
Behavioral dietary-counseling (increased risk)
HTN & Lipid screening (> 18; M >35/20-45, W >45/20-45)
Disc. Chemoprevention Breast Cancer (High risk)
Pap, Mammo CRC screening
Important A and B level Lung Cancer screening
Evidence Depression screening• *Family HX risk & referral
BRCA eval
Obesity -intensive counseling & behavioral
Tobacco
HIV (pregnant, all 15-65)•
ETOH misuse & counsel
Hep C screen (1945-65)
Cervical cancer screening (PAP & HPV) Q 3 yrs 21-29
PAP, 30-65 Q3yrs Pap or Q5 yrs Pap and HPV
Prostate Cancer screening "D rating"
Changes in Selected Major
Lung Cancer screening: LDCT 55-80 yrs w 30 pkyr &
Screening Guidelines
smoke or quit
within 15 yrs (55/30/15)
Colon cancer screening: 3 options
Behavioral Dietary counseling at risk B
Intensive Dietary counseling risk for CVD B
Discussion chemoprevention breast cancer B
Prevention skin cancer 10-24 B
Counseling topics
Intensive counseling & intervention re Obesity B
Tobacco counseling & intervention A
Reduce alcohol misuse B
Promote breastfeeding B
, Immunizations (see CDC immunization guidelines!!!)
www.CDC.gov
Influenza starting at 6 months
TD q 10 years (Tdap at least once as adult) to protect
pertussis
1X Tdap >65 if around infants (timing does not matter)
Pneumovax (PPSV23)at 65 or >18 if smoker or any
chronic pulmonary
Preventative Medications condition(repeat if given <65 & at least 5 years ago)
and Immunizations 11
Prevnar (PCV3) at 65 then PPSV23 6-12 months later OR
if PPSV23 first, Prevnar 6-12 months
Hep B series as indicated (new: diabetes)
HPV4 vaccinate females & males (9 to 26 years) best at
11-12 yo
Zostavax for zoster prevention at 60 yo (FDA approved
at 50)
Meningococcal as indicated
Pneumococcal conjugate vaccine (PCV13) is
recommended for all children younger than 5 years old,
all adults 65 years or older, and people 6 years or older
with certain RFs (immunocompromised)
Pneumococcal Vaccines
Pneumococcal polysaccharide vaccine (PPSV23) is
recommended for all adults 65 years or older. People 2
years through 64 years of age who are at high risk of
pneumococcal disease should also receive PPSV23 (>18
smokers, chronic diseases, etc).
ASA as indicated 81 mg "A"
Men >45-79 for MI; Women >55-79 (reduced CVA)
Assess risk for GI bleed and decide 2010
Omega 3 fatty acids (fish oil)?? DHA, EPA 1-2 grams QD
Preventative Meds or fatty fish twice weekly
(Vitamin C & E NOT indicated and may cause harm)
Calcium with vit D for FX prevention "D"
Many outstanding questions re MI risk
Dietary sources show no risk so encourage
Mediterranean Diet & DASH diet for everyone!
Obesity BMI Higher BMI > risk for DM, CVD, HLD, HTN, OA
