Health Promotion Concepts Didactic PDF

**AB Test Didactic** **1A** ***[Communication]*** - ***Compare and contrast verbal, nonverbal, electronic and written communication. What are examples for each? Which would work best for various types of clients?*** - **Verbal: the use of written or spoken words. Ex: Providing ed...

**AB Test Didactic** **1A** ***[Communication]*** - ***Compare and contrast verbal, nonverbal, electronic and written communication. What are examples for each? Which would work best for various types of clients?*** - **Verbal: the use of written or spoken words. Ex: Providing education to a client** - **Nonverbal: gestures, facial expressions, touch, and body language. Ex: active listening involves nonverbal communication.** - **Electronic: involves technology. Ex: email, texting, or social media.\ ** - ***Identify appropriate use of touch and personal space when providing client care.*** **Appropriate use of touch in this setting could be consoling an upset family member or client when receiving a serious diagnosis.** - ***Describe potential barriers to effective communication; provide examples. Discuss strategies to overcome barriers such as vision/hearing loss, developmental/cognitive disorders, cultural/language mis-match, environmental factors.*** **Potential barriers to communication could be a language barrier, hard of hearing, or a mental disorder affecting the communication. To overcome these would be to provide a designated language interpreter, observing more nonverbal cues than relying on verbal communication.*\ *** - ***Differentiate among assertive, passive, aggressive, and passive-aggressive communication styles. What are examples for each?*** - **Assertive: Expresses feelings honestly and appropriately. Acknowledge the feelings of others. Open to discussion. Use "I" statements to express concerns or reduce conflict.** - **Passive: hides or denies their feelings, avoids arguments, and is noncommittal.** - **Aggressive: Engages in heated arguments (with insults), resorts to violence, refuses to accept blame or responsibility, walks out in the middle of arguments.*\ *** - ***Identify effective nonverbal therapeutic communication strategies*** **Effective nonverbal therapeutic communication could look like open body language, making the proper amount of eye contact, nodding, and other active listening strategies.** ***[Communication/Therapeutic Communication]*** - ***Develop a script for each of the types of therapeutic communication strategies presented in the required resources.*** - **Using silence: Waiting for the patient to think and feel emotions so they can communicate feelings with the proper words.** - **Providing general leads: using phrases like "Tell me how it is going for you?" or "Perhaps you would like to talk about..."** - **Being specific and tentative: making specific rather than general statements like "rate your pain from 0 to 10" or "you seem unconcerned about your diabetes" rather than "you don't care about your diabetes and never will".** - **Using open-ended questions: Open-ended questions encourage the client to be more open when discussing feelings or thoughts. Ex: "Tell me about...", "How have you been feeling lately?"** - **Sharing Observations: openly informs the patient of the assessment and observations, especially involving unconscious behaviors ("you are shaking").** - **Restating or Paraphrasing: repeating the clients\' thoughts to convey that the nurse listens and understands the patient\'s message and offers the client a clearer idea of what is said.** - **Seeking clarification: making the client's overall meaning of the message more understandable. Strategies include restating the basic message or confessing confusion and asking the patient to repeat or restate the message.** - **Offering self: suggesting one's presence, interest, or wish to understand the patient without making demands or attaching the conditions that the patient must comply with to receive the nurse's attention. Ex: "We can sit here quietly for a while. We don't need to talk unless you would like to."** - **Giving information: provide in a simple direct manner.** - **Acknowledging: giving recognition, in a non-judgmental way, of change in behavior , an effort the patient has made, or a contribution to communication.** - **Clarifying time or sequence: helping the client clarify an event, situation, or happening in relationship to time.** - **Presenting reality: helping differentiate the real from the unreal.** - **Focusing: Helping the patient expand on and develop a topic of importance. It may be an idea or feeling; however, the nurse often emphasizes a feeling to help the patient recognize an emotion disguised behind words.** - **Reflecting: directing ideas, feelings, questions, or content back to patients to enable them to explore their own ideas and feelings about a situation.** - **Summarizing and planning: stating the main points of discussion to clarify relevant points discussed.** - **Exploring: investigating a patients feelings related to a subject or idea.*[\ ]*** ***[Collaboration]*** - ***Describe the benefits of collaboration to clients and health care team members*** - ***Discuss members of the healthcare team and their role in client care/client outcomes.*** **Nurse:** **Provider:** **Occupational Therapist:** **Physical Therapist:** **Dietician:** **Speech/Language Therapist:** **AP:*\ *** - ***What is the professional nurse's role in coordinating client discharges?*** **The nurse's role in coordinating client discharge is to assess the client's progress, evaluate for improvements or lack of, inform the provider of any recommendations, and educate the client on any questions and instructions.*\ *** - ***Identify communication tools the nurse will use during patient handoff. What are the components of the SBAR tool and what is included in each? When and why is it important to complete handoff when a client's care is transferred from one healthcare team member to another?*** **SBAR is the guideline for transferring or providing info to a provider and is used to inform them of RELEVANT information that affects the client's care. It stands for:** - **S - Situation: relevant information about the situation with the client (Illness or injury).** - **B -- Background: relevant background information. Ex: chief complaint at admission, allergies, pain, etc.** - **A -- Assessment: What the nurse has assessed through the collection of subjective and objective information and provides essential knowledge about the client.** - **R -- Recommendation: What the nurse recommends for a course of action.** **2A** ***[Managing Care]*** - ***Discuss ways the professional nurse can contribute to delivery of quality, cost-effective care in the role of case manager.*** - ***Anticipate how telehealth visits can be completed; develop a sample script for clients who may be resistant to this care delivery method. What principles guide the nurse's participation in this form of care delivery?*** ***[\ ]*** - ***What factors are considered when Centers for Medicare and Medicaid as well as some insurance companies set reimbursement rates for hospitals? How can nursing care impact costs, efficiency, safety, and quality?*** ***[Professional Behaviors, including Advocacy]*** - ***Summarize how the professional nurse can advocate for clients in various settings, including refusal of treatment and end-of-life decisions and care.*** **A nurse can advocate for clients by providing info to providers about last-minute mind changes of a procedure or treatment, but it is important for nurses to provide clear education of possible consequences of choices.** **A nurse can advocate for a client at end-of-life care by providing information on all appropriate alternatives of care.*\ *** - ***Define the principles and practices of ethical decision-making; formulate an example for each regarding nurse delivery of care to the client.*** **The basic principles of practicing ethical decision-making are:** - **Advocacy: defending clients' health, wellness, safety, wishes, and personal rights, including privacy. (When a client comes to the hospital and does not want people to know they are there and abiding by their wishes).** - **Responsibility: doing the job obligations and following through on promises and actions.** - **Accountability: answering for one's actions (especially mistakes).** - **Confidentiality: keeping the client's info private.** **For client care, they are: Autonomy, Beneficence, Fidelity, Justice, Nonmaleficence, and Veracity.** - ***Compare and contrast the ANA (American Nurses Association) Code of Ethics for Nurses and various states' nurse practice acts; how does each guide the nurse's practice?*** ***[Legal Issues including but not limited to Delegation, Communication and Documentation]*** - ***What is the impact of a state's nurse practice act on a professional nurse's practice?\ \ *** - ***What are the different types of Advance Directives (include examples), and how do they impact a nurse's delivery of care to clients and family members?\ *The different types of Advance Directives could be:** - **A Living will that describes the care the client would make if they were in a situation but they're unconscious and could not inform the providers verbally.** - **A power of attorney names an individual to make the health decisions if the client is unable to.** - **DNR (do not resuscitate) informs caretakers to take resuscitative actions.\ ** - ***What are the responsibilities of the provider, client and nurse regarding informed consent?*** **The responsibility of the provider is to inform the client of the procedure in all aspects, including why, how, and the possible complications of the procedure. The responsibility of the nurse is to witness this interaction and make sure the client has understood the info from the provider and verify there are no misunderstandings and/or coercion of this decision.*\ *** - ***What practices assist the nurse to keep client protected health information secure? Why is this important?*** **The actions a nurse can take to keep sensitive information secure is by locking a computer after use, not using social media at work, and only informing members that provide direct care to a client of their info. Failure to do so can result in penalties for the nurse and the organization.*\ *** - ***What factors will the nurse consider when making decisions about delegating to unlicensed assistive personnel (UAP)? Develop a script for the professional nurse to utilize when delegating an appropriate task to the UAP.*** - ***Discuss what the nurse will include in each of these documentation systems: Flow Chart, Charting by Exception, Narrative, and Problem-Oriented Medical Record.*** **Flow Chart:*\ *Charting by exception:** **Narrative:** **Problem-Oriented:*\ *** - ***What should the nurse include/not include when completing an incident report?\ \ *** - ***A client asks the nurse, "Why are all my records in the computer now?" How will the nurse respond?*** **I would respond by informing the client that the Electronic Health Record system provides easier access to healthcare team members giving care and provides any updates or notifications on care that need to be addressed. If the client is concerned about access to records, I would let them know they are available at any time and just need to be requested.*\ *** - ***What assessment findings are considered "mandatory" for the professional nurse to report?*** **Mandatory assessment findings are suspected suspicions of abuse and communicable diseases (like TB).** **1B** ***[Culture and Diversity]*** - *Summarize nurse-client communication guidelines when utilizing a medical interpreter.\ \ * - *Define components of the LEARN model which may assist the nurse to practice cultural competency.\ \ * - *Determine acceptable/unacceptable communication strategies for use with non-English or limited-English speaking clients; include volume/tone and nonverbal techniques.\ \ * - *How can the nurse incorporate culturally responsive nursing care into encounters with clients? How will the nurse plan to assess pain for clients of diverse cultures?\ \ * - *Practice gathering subjective data about a client's culture using the Sunrise Enabler model.* ***[Sexuality]*** - ***Anticipate the impact of a client's developmental level on their sexuality.\ \ *** - ***Recognize physical characteristics associated with Tanner stages.\ \ *** - ***Develop interview questions that facilitate nursing assessment of sexual health, risk factors and potential illness; practice with a friend/family member.\ \ *** - ***Role play a nurse informing a client about safer sex guidelines. Anticipate client questions; provide answers.\ *** - ***Prepare to answer client questions regarding various types of contraception/family planning (situational, spermicides, barrier methods, intrauterine, hormonal).\ *** - ***Discuss common genetic disorders detected during pregnancy.*** **2B** **[Self]** **[ATI Review Module FUNDAMENTALS Chapter 34 ]** **[ATI Engage Fundamentals \>\> Self-Concept]** **[Pearson Module 29 Page 2018-2019]** - **Identify factors, including growth and development, that potentially impact a client's body image; discuss nursing interventions related to body image.** **The factors affecting a client's body image could be puberty for adolescents who feel pressured by societal standards and the continuous changes throughout these years. For adults later in life, a chronic disease or the physical effects of aging can affect body image.\ ** - **Recognize role problems clients may have and when/why these problems might occur.** **Role problem examples are role conflict (when individuals are faced with 2 or more role expectations and find themselves unable to meet these expectations), role ambiguity (a lack of clarity about the actions that need to be taken to achieve. Proposed goals), and role overload (when roles and responsibilities placed on an individual are greater than their ability to manage them effectively).** - **Discuss interventions the nurse can use for a client who is experiencing role problems.** **To intervene in a client experiencing role problems, a nurse could create a comprehensive, holistic plan involving the client's family and friends with short and long-term goals. These goals could be verbalizing acceptance and showing adaptation to the altered health condition, developing a realistic plan to adapt to changes, taking steps towards achieving independence at home and work and utilizing coping strategies and support systems. Additionally, while in a nurse's care, they could encourage the client to express emotions and feelings related to body image and functioning, provide an environment to promote independence and discuss available resources for support and rehabilitation.** - **How does self-concept impact a client's ability to achieve health goals?** **An example of negative effects caused by a low self-concept view could be doubt and lack of self-confidence in dealing with health alterations; it can reduce a person's quality of life and, if it persists for long periods, may lead to mental health issues such as depression and anxiety.\ ** - **Provide examples for components of a client's self-concept. Formulate questions the nurse can use to perform a subjective assessment of a client's self-concept.** **Questions a nurse could ask to identify a client's self-concept would be** - **How would you describe yourself?** - **How would others describe you?** - **What are some accomplishments or qualities that make you feel good about yourself?** - **How would you describe your physical appearance?** - **Which aspects of your body or physical appearance do you like?** - **Which aspects of your body or physical appearance do you not like?\ ** - **Complete a free emotional intelligence assessment; consider how your strengths might contribute to interprofessional relationships, including with clients and nurse colleagues.** **[Spirituality]** **[ATI Review Module FUNDAMENTALS Chapter 35 ]** **[Pearson Module 30 Page 2065-2073]** - **Familiarize yourself with how a client might utilize sacred scriptures, religious symbols and prayer/meditation as well as how clients may observe holy days.\ \ ** - **How can the nurse support religious practices when caring for clients?\ \ ** - **How might religious practices/preferences impact clients' utilization of healthcare services?** **3B** **[Comfort including End-of-Life]** ***ATI Review Module FUNDAMENTALS Chapter 36, Engage Fundamentals \>\> End-of-Life Care, Pearson Module, Page 171-172, 178, Pearson Exemplar 3.B Page 205-210, 213-215, Pearson Skills 3.13 and 3.14*** **Summarize signs/symptoms the dying client may experience; discuss nursing interventions to promote client comfort during the transition (include postmortem care).** - - **Decreased level of consciousness** - **Loss of muscle tone, with obvious relaxation of the face** - **Labored breathing, dyspnea, apnea, Cheyne-Stokes respirations (irregular rate and depth of respirations that include periods of apnea and periods of hyperventilation)** - **Sense of touch is diminished, but the client can feel pressure** - **Incontinence of bowel or bladder** - **Mottling: skin becomes cool, and extremities become purple/grey.** - **Cyanosis occurs with poor circulation** - **Pulse slow and weak** - **Cool extremities** - **Perspiration** - **Hallucinations** - **Decreased and dark urine output** - **Death rattle: the accumulation of secretions in the lungs and throat, causing congestion and a "rattling" sound as the secretions become trapped. The client is unable to clear these secretions.** - **Inability to swallow** - **Promoting comfort by controlling manifestations** - **Administer medications (morphine) that manage pain, air hunger, and anxiety** - **Perform ongoing assessments to determine the effectiveness of treatment and the need for modifications of the treatment plan.** - **Manage adverse effects of medications** - **Reposition the client to maintain airway patency and comfort.** - **Maintain integrity of the skin and mucous membranes** - **Provide a caring touch (holding the client's hand).** - **Provide an environment that promotes dignity and self-esteem (remove elimination products ASAP, offer comfortable clothing, provide grooming).** - **If appropriate, encourage relaxation techniques like music.** - **Promote decision-making in food selection, etc., to give the client as much control as possible.** **Discuss strategies the nurse can use to include family members when caring for a client at the end of life.** - - **Suggest that family members plan visits to promote the client's rest** - **Ensure the family has appropriate information on treatment plan changes.** - **Provide family privacy** - **Determine family members' desire to provide physical care while maintaining awareness of possible caregiver fatigue.** - **Educate the family about physical changes to expect/** - **Allow families to express feelings.** **Compare and contrast how the nurse will care for a patient with the following prescriptions: DNR (do not resuscitate), AND (allow natural death), and CMO (comfort measures only).** - **DNR:** - **AND:** - **CMO :** **Compare and contrast palliative and hospice care.** - **The goal is to learn to live fully with an incurable condition.** - **Palliative care improves the quality of life of clients and their families facing end-of-life issues.** - **Interventions are primarily used when caring for clients who are dying and family members who are grieving but can used for any client who has a chronic or curable illness, regardless of the stage of the disease process. Assessment of the client's family is very important as well.** - **Interventions focus on the relief of physical manifestations (pain) as well as addressing spiritual, emotional, and psychosocial aspects of the client's life.** - **An interprofessional team of physicians, nurses, social workers, PTs, massage therapists, OTs, music/art therapists, touch/energy therapists, and spiritual staff provide palliative care.** - **Palliative differs from hospice care in that palliative care can be provided while the client is still receiving curative treatments and is not subject to time restraints.** - **Comprehensive care for the client and their family. It can be provided in a variety of settings, such as a home, health care facility, or extended care facility, and is implemented when a client is not expected to live longer than 6 months.** - **Medical care aimed towards a cure is stopped, and the focus becomes enhancing quality of life and supporting the client toward a peaceful and dignified death.** **[Grief and Loss]** Differentiate among various types of loss and grief. How will the nurse plan and provide care for clients across the lifespan experiencing grief? Discuss nursing interventions to assist clients/families experiencing grief/loss or who are in mourning. **Facilitate mourning:** - **allow time for the grieving process** - **use therapeutic communication related to the client's stage of grief (name the emotion)** - **use active listening, open-ended questions, paraphrasing, clarifying, and summarizing while using therapeutic communication** - **use silence and personal presence to facilitate mourning,** - **avoid communication that inhibits the open expression of feelings** - **Offering false reassurance, giving advice, changing the subject, and taking the focus away from the grieving individual** Put the stages of grief in the order clients are expected to work through them; anticipate client statements/behaviors associated with each stage. **The Kubler-ross proposed stages of grief are:** 1. **Denial:** 2. **Anger: individuals' direct anger towards anyone around them, one of the most difficult stages.** 3. **Bargaining: bargaining with God or others in perceived power.** 4. **Depression: is normal but need to express emotions to work through them** 5. **Acceptance: free from anger and depression, but not a happy stage** Describe assessment findings associated with a client who is experiencing grief/loss. Normally, individuals will experience sadness, anxiety, guilt, anger, confusion, sleep disturbances, and loss of appetite, among other reactions. What is the impact of caring for a client/family during grief/loss in light of spiritual/cultural preferences (Jewish, Catholic, Muslim as outlined in the Pearson and Engage resources)? Develop and practice therapeutic statements the nurse can utilize with clients experiencing grief according to the NURSE pneumonic. A family member or loved one states: "This is overpowering." **N -- Name: Identify what the person stated. Identifying the emotion expressed by the client.** **U -- understand: "There is a lot happening right now. What can I do to assist you?" The nurse demonstrates understanding by recognizing the client's feelings and providing an opportunity for the client to discuss those feelings.** **R -- respect: "I'm very impressed with your ability to manage everything." Voice your respect for the client under these circumstances.** **S -- Support: "I'm here for you." Inform the client that you are available to them.** **E -- Explore: "What is the most difficult aspect?" Asking open-ended questions will extend the conversation and provide a more detailed expression of the client's feelings and beliefs.** **4B** ***[Family, ATI Review Module FUNDAMENTALS Chapter 33, Pearson Module 26 Page 1900-1911]*** - **What types of sociological trends are currently impacting the health of families and individuals?** - **65 and older growing is the fastest-growing population, leading to caregiver issues** - **Declining economic status of families (increased unemployment)** - **Family violence** - **Any acute or chronic illness that disrupts the family unit.** - **Homelessness** - **Utilize questions in Pearson resource Page 1911 to interview a friend; correlate questions with priority assessment data the nurse can collect during a family interview.** - **How do family coping mechanisms impact clients' ability to manage stress?** - **Compare and contrast client-centered and family-centered nursing care.** - **Family-centered care focuses on the client's family's involvement in maneuvering through stress and situations, and the nurse uses strategies to help the family. Engage in behaviors that enable productive communication and decision making.** - **Summarize alterations in family function and related appropriate nursing interventions.** - ***[Stress and Coping, ATI Review Module FUNDAMENTALS Chapter 33,] ATI Engage Fundamentals \>\> Stress and Coping, [Pearson Module 31 Page 2085-2094 ]*** - **Summarize physical assessment findings the client may exhibit when they are exposed to a stressor. Are there differences based on the stages in the General Adaptation Syndrome?** - - **What are potential stressors the client/family may experience related to health/illness?** - - **Recognize examples of defense mechanisms clients may employ to balance tensions in times of stress.** - - **Provide examples of healthy coping behaviors.** - **Healthy diet and nutrition** - **Exercise** - **Time management** - **Building personal resilience** - **Rest and relaxation** - **journaling** - **Provide examples of barriers to client compliance/adherence to a proposed plan of care; how can the nurse impact adherence.**