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Nursing Process, Health Promotion, & Special Considerations, Study notes of Nursing

Ridgewater CollegeNursing

This document provides a comprehensive overview of key concepts covered in NURS 2710, including the nursing process, health promotion, developmental stages, and special considerations for various populations. It outlines the test blueprint for exam #2, detailing the number of questions allocated to each concept. The document explores Erikson's stages of psychosocial development, health promotion strategies, cognitive impairment, and pain management. It also includes a discussion of the Glasgow Coma Scale, neurological flow sheet, and Mini-Mental State Examination.

Typology: Study notes

2023/2024

Uploaded on 10/30/2024

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NURS 2710 Concept Outcomes & Test Blueprint – Exam #2
Concepts: Nursing Process, Health Promotion, Developmental, Special Considerations, Cognition, Sensory
Impairments, & Pain (Weeks 5 – 8)
Concept: Nursing Process = 16 questions
1. Use the nursing process as a framework in the delivery of nursing care.
What's the framework?
-ADOPIE
oAssessment
Involves subjective and objective
oDiagnosis
oOutcomes Identification
oPlanning
oEvaluation
Who is your primary?
-Client / Patient
Who is secondary?
-Family
-Lab results
-Their chart
Assessment is first and then you come up with their diagnosis which is an unmet healthcare need.
Actual –
Problem Statement ([related to] R/T) Etiology ([as evidence by] AEB) Defining characteristic Unmet
Healthcare Need) (Cause) (Signs & Symptoms)
Risk for –
Problem Statement ([related to] R/T) Etiology
(Potential unmet healthcare need) (Cause)
Wellness/Health Promotion Nursing Diagnosis –
Readiness for enhanced ([as evidence by] AEB)
Actual trumps everything.
Risk for trumps wellness/health promotion
Next a nurse should come up with a plan for your outcomes
What’s a goal?
-A broad statement
What’s an outcome?
-Measurable criterion
-Measure the behavioral change
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Download Nursing Process, Health Promotion, & Special Considerations and more Study notes Nursing in PDF only on Docsity!

NURS 2710 Concept Outcomes & Test Blueprint – Exam

Concepts: Nursing Process, Health Promotion, Developmental, Special Considerations, Cognition, Sensory

Impairments, & Pain (Weeks 5 – 8)

Concept: Nursing Process = 16 questions

1. Use the nursing process as a framework in the delivery of nursing care.

What's the framework?

  • ADOPIE o Assessment  Involves subjective and objective o Diagnosis o Outcomes Identification o Planning o Evaluation Who is your primary?
  • Client / Patient Who is secondary?
  • Family
  • Lab results
  • Their chart Assessment is first and then you come up with their diagnosis which is an unmet healthcare need. Actual – Problem Statement  ([related to] R/T)  Etiology  ([as evidence by] AEB)  Defining characteristic Unmet Healthcare Need)  (Cause)  (Signs & Symptoms) Risk for – Problem Statement  ([related to] R/T)  Etiology (Potential unmet healthcare need) (Cause) Wellness/Health Promotion Nursing Diagnosis – Readiness for enhanced  ([as evidence by] AEB)  Actual trumps everything. Risk for trumps wellness/health promotion Next a nurse should come up with a plan for your outcomes What’s a goal?
  • A broad statement What’s an outcome?
  • Measurable criterion
  • Measure the behavioral change

And then you have your interventions And then your evaluations

  • Goal met, partially met, not met If you have met that outcome, then you discontinue it and then start with the next care plan on your list If you have partially met or not met the outcome then you go back to the drawing board

2. Discuss the following classification of nursing interventions: Independent / Dependent / Collaborative /

Individualized.

Classifications of nursing interventions –

  • Independent o Nurse driven o What a nurse can do without an order  Reposition  Ice/hot pack  Position pillow  Talking with patient
  • Dependent o Need an order  Medication  Dressing change for a wound  To do a procedure
  • Collaboration o Working as a team  Therapy  Nutritionist

3. Describe Gordon’s Functional Health Patterns.

  • Gordon's functional health patterns provide a holistic model for assessment of the family because assessment data are classified under 11 headings: health perception and health management, nutritional-metabolic, elimination, activity and exercise, sleep and rest, cognition and perception, self-perception and self-concept, roles and relationships, sexuality and reproduction, coping and stress tolerance, and values and beliefs.

Concept: Health Promotion – Developmental = 14 questions

Stages of Childhood Stage 1 – Infancy period: Trust vs. Mistrust  Virtue: Hope, Maldevelopment: Withdrawal  Concomitant Freudian stage: oral stage  Example: Secure environment provided by the caregiver, with regular access to affection and food Stage 2 – Early Childhood period: Autonomy vs. Shame, doubt  Virtue: Will, Maldevelopment: Compulsion  Concomitant Freudian stage: anal stage  Example: Caregiver promotes self-sufficiency while maintaining a secure environment Stage 3 – Play Age period: Initiative vs. Guilt  Virtue: Purpose, Maldevelopment: Inhibition  Concomitant Freudian stage: genital stage  Example: Caregiver encourages, supports, and guides the child’s own initiatives and interests Stage 4 – School Age period: Industry vs. Inferiority  Virtue: Competence, Maldevelopment: Inertia (passivity)  Concomitant Freudian stage: latency stage  Example: Reasonable expectations set in school and at home, with praise for their accomplishments Stage of Adolescence Stage 5 – Adolescence period: Identity vs. Identity confusion  Virtue: Fidelity, Maldevelopment: Repudiation  Example: Individual weighs out their previous experiences, societal expectations, and their aspirations in establishing values and ‘finding themselves.’ Stages of Adulthood Stage 6 – Young Adulthood period: Intimacy vs. Isolation  Virtue: Love, Maldevelopment: Distantiation  Example: Individual forms close friendships or long-term partnership Stage 7 – Adulthood period: Generativity vs. Stagnation/Self-absorption  Virtue: Care, Maldevelopment: Rejectivity  Example: Engagement with the next generation through parenting, coaching, or teaching Stage 8 – Old Age period: Integrity vs. Despair  Virtue: Wisdom, Maldevelopment: Disdain  Example: Contemplation and acknowledgment of personal life accomplishments A ninth stage was added by Erik Erikson’s wife, Joan Erikson. It considers new challenges experienced with continued aging and incorporates aspects from all previous eight stages of psychosocial development.

Things to remember from Erikson’s development stages

  • Developmental stages
  • You need to satisfy one stage before you can go on to the next stage
  • You need to accomplish one stage before you can go on to the next
  • Stress and anxiety can cause depression

Notes from powerpoint

4. Describe Erickson’s theory of psychosocial development.

  • Life is a sequence of developmental stages or levels of achievement.
  • Each stage signals a task that must be accomplished.
  • The health of a personality depends on the level of success at each stage or crisis.
    • Resolution can be complete, partial, or unsuccessful.
    • Failure to complete a stage interferes with the ability to progress to the next.
  • No stage can be bypassed, people can become fixated at a stage or regress.
  • Stress or anxiety can cause a regression to an unresolved stage.

5. Differentiate between primary, secondary, and tertiary prevention.

  • Primary prevention
    • Intervention includes health promotion, such as education about risk factors, and specific protection such as immunizations.
    • Purpose is to decrease vulnerability of the individual or population to disease.
    • Interventions aim to increase awareness and teach preventive measures. Also, it includes advocating for policies that promote health.
    • ALL ABOUT EDUCATING THEM
  • Secondary Prevention
    • Includes screening, early detection, and limiting disability or delaying the consequences of advanced disease.
    • Screening is an opportune time for health teaching.
    • ALL ABOUT SCREENINGS
  • Tertiary Prevention
    • Occurs when a defect or disability is permanent and irreversible. Minimizes the effects of disease & disability by surveillance and maintenance activities aimed at preventing complications and deterioration. Interventions encourage maximum functioning, resource utilization, rehabilitation, and referral.
    • IT HAPPENED; NOW LET'S PREVENT IT FROM GETTING WORSE o Patient gets blood work and vitals done (Secondary Prevention), then patient has a heart attack, now how do we prevent another one from happening (Tertiary Prevention), reeducate

6. Differentiate between the domains of learning.

  • Cognitive – enhances understanding. Your knowledge
    • Includes all intellectual behaviors and requires thinking.
    • knowledge
  • Psychomotor – requires the patient to have the opportunity to touch and manipulate equipment and practice skills.
  • Significant risk found for men is a history of stroke and/or diabetes.
  • Personal behaviors: chemical exposure and traumatic injury, substance abuse
  • Environmental exposure: toxic substances such as lead and/or pesticides
  • Congenital or genetic conditions: fetal alcohol or exposure to other chemicals in utero, cerebral palsy, chromosomal abnormalities (Down’s, PKU, Huntington’s Chorea)
  • Other comorbidities: F&E imbalance, electrolyte imbalance, sodium imbalance, UTI, hypoglycemia (sugar levels), delirium, etc.

11. Identify individual risk factors associated with impaired cognition.

  • “Cognitive impairment” is a term used to describe impairment in mental processes that drive how an individual understands and acts in the world, affecting the acquisition of information and knowledge.
  • The following areas are domains of cognitive functioning:
    • Attention
    • Decision-making
    • General knowledge
    • Judgment
    • Language
    • Memory
    • Perception
    • Planning
    • Reasoning
    • Visuospatial
  • Intellectual Disability
    • (formerly referred to as “mental retardation”) is a diagnostic term that describes intellectual and adaptive functioning deficits identified during a person‘s developmental period.

12. Differentiate between delirium and dementia.

  • Dementia
    • is a chronic condition of impaired cognition caused by brain disease or injury and marked by personality changes, memory deficits, and impaired reasoning.
  • Delirium
    • is an acute state of cognitive impairment that typically occurs suddenly due to a physiological cause, such as infection, hypoxia, electrolyte imbalances, drug effects, or other acute brain injury.

13. Identify evidence-based tools used to assess delirium and dementia.

  • Delirium – typically sudden onset, reversible if cause is detected and corrected
    • Evidence-based tool is the confusion assessment method (CAM)
  • Dementia – chronic, progressive disease, irreversible. Deterioration of cognitive function with little or no disturbance of consciousness or perception.
  • Evidence-based too is the mini mental or clock drawing

14. Describe the components of an assessment of cognitive function.

  • Month, date, year (Basic orientation)
  • Having a patient draw a clock, shapes (Visuospatial orientation)
  • Puzzles (Problem-solving)
  • Remember these three words (Memory)

15. Identify primary and secondary prevention strategies related to cognition.

  • Primary prevention strategies
    • Regular physical exercise
    • Healthy diet
    • Cognitive stimulation (keeping the brain active)
    • Management of chronic conditions (hypertension, diabetes, obesity)
  • Secondary prevention strategies
    • Cognitive training (target specific cognitive abilities, memory, attention, problem-solving)
    • Medication
    • Lifestyle modifications (quitting smoking, drinking, getting sleep, managing stress)
    • Regular monitoring and screening (to help detect changes)

16. Describe evidence-based tools used in the assessment of neurological status.

  • Glasgow Coma Scale
    • Is one tool that is used for assessing consciousness and neurological function following a

traumatic brain injury or other acute neurological events.

  • Evaluates 3 parameters

 Eye opening

 Verbal response

 Motor response

  • Neurological Flow Sheet
    • Has vital signs and neuro checks (pupil, level of consciousness, movement, hand grasp)
  • Mini-Mental State Examination
    • Detects dementia or cognitive impairment

17. Identify intervention strategies to reduce cognitive decline.

  • Physical exercise
  • Healthy diet
  • Cognitive stimulation (reading, puzzles, socializing)
  • Management of Cardiovascular Risk Factors (hypertension, diabetes, obesity)