Health Promotion, Teaching and Learning Module 7&41 Student PDF

Nursing: A Concept-Based Approach to Learning Volume One, Fourth Edition Module 41 and 7 Health, Wellness, Illness, and Injury...

Nursing: A Concept-Based Approach to Learning Volume One, Fourth Edition Module 41 and 7 Health, Wellness, Illness, and Injury Teaching and learning Copyright © 2023, 2019, 2015 Pearson Education, Inc. All Rights Reserved  LEARNING OBJECTIVES Apply the nursing Summarize the Outline the effects of process to identify Describe the benefits recommendations for exercise on body health promotion of physical fitness. physical activity across systems. needs. the lifespan Outline the Analyze the nurse’s relationship between Summarize the art of Analyze aspects of role in teaching and teaching and learning teaching. learning. learning. and other concepts. Differentiate considerations related Outline the steps of Summarize the aspects List special teaching to teaching and developing a teaching of identifying learning strategies. learning throughout plan. needs. the lifespan. Copyright © 2023, 2019, 2015 Pearson Education, Inc. All Rights Reserved   Well-Being  Outcome from feeling positive and satisfied with life  CDC definition  Positive emotions and moods HEALTH AND  Absence of negative emotions WELLNESS  Satisfaction with life  Fulfillment and positive functioning  Judging life positively  Feeling good  Resilience from life stressors  Dimensions of wellness to be taken into consideration  HEALTH AND WELLNESS  Wellness and dimensions of wellness  Dimensions of wellness  Physical  Emotional  Financial  Intellectual  Career  Social  Creative  Environmental  Spiritual  Each dimension impacts other dimensions  HEALTH AND THE HEALTH CONTINUUM WHO definition of health Health continuum State of complete physical, mental, and Health is relative and dynamic social well-being and not merely the Perception of health can change on a daily absence of disease or infirmity basis No boundary to move from wellness to illness  ILLNESS AND DISEASE  Acute illness  Severe symptoms of relatively short duration  Symptoms appear abruptly, subside quickly  May or may not require intervention  Chronic illness  Lasts for an extended period  Usually last >3 months  Slow onset, often periods of remission, relapse, or exacerbation  ILLNESS AND DISEASE Illness Disease Injury Experience of being Disorder of structure or Act or event that causes unhealthy or unwell function damage, harm, or loss to Highly personal state Can feel ill without having a the body’s functioning Diminished physical, disease Can be caused by emotional, financial, Can have a disease without Unexpected accidents, intellectual, career, social, symptoms of an illness Intentionally violent creative, environment, or activities spiritual functioning Outcomes range from May or may not be related minor to life-threatening to disease  HEALTH PROMOTION  National goals for health promotion  Access to health services  Clinical preventive services  Environmental quality  Injury and violence  Maternal, infant, and child health  Mental health  Nutrition, physical activity, and obesity  Oral health  Reproductive and sexual health  Social determinants  Substance abuse  Tobacco use  Primary prevention services Focus on health promotion, illness prevention TYPES OF Secondary prevention services PREVENTIVE Include diagnosis, treatment of SERVICES disease Tertiary prevention services Seek to restore health after illness or accident Include rehabilitation, palliative services   Older adults HEALTH  Strategies to maximize functioning PROMOTION  Physical activity ACROSS THE  Home environment to prevent falls LIFESPAN  Social support  Use of preventive health services HEALTH BELIEFS AND BEHAVIORS  Identify risk factors  Nonmodifiable  Age  Family heath history  Ethnicity  Act or event that causes damage, harm, or loss to body’s functioning  Can be caused by  Unexpected accidents  Intentionally violent activities  Outcomes range from minor to life-threatening INTEGRATIVE HEALTHCARE  Alternative healthcare  Substitutes conventional care with nonmainstream approaches  Complementary healthcare  Mind body practices  Integrative healthcare  Evidence-based practices of traditional healthcare with wellness strategies of complementary healthcare NURSING PROCESS FRAMEWORK FOR PROVIDING PROMOTION ACTIVITIES, PROGRAMS  Appraisal of subjective and objective information Chief concern ASSESSMENT Subjective history History of present illness of health and and wellness Health history wellness Family history Social history Objective physical Physiologic status examination for Mental status status of wellness Body habitus Other and illneses assessments  DIAGNOSIS AND PLANNING Diagnosis Planning  Identify goals using SMART  Identification of problems  Specific  Health problems  Measurable  Risks for illness or injury  Achievable  Wellness strengths  Relevant  Time-bound  Evidence based  Strategic  IMPLEMENTATION Therapeutic communication Specific skills Empathy Affirmations Open-ended questions Reflection  EVALUATION Has well-being Reassessment of Evidence-based improved goals plan Plan of care Reset short- and Patient-centered adapted according long-term goals to evaluation data EXEMPLAR 7.A PHYSICAL FITNESS AND EXERCISE  OVERVIEW  Benefits of physical fitness include  Cardiovascular endurance  Muscular strength and endurance  Mobility  Agility  Balance  Coordination  Rapid reaction time  PHYSICAL ACTIVITY Physical activity Participating in Activity tolerance Health benefits physical activity has independent of body direct benefits weight Bodily movement produced by Amount and type of physical skeletal muscle contraction activity that a person can Increases energy expenditure perform without excessive fatigue or exhaustion  EXERCISE  Physical activity that is planned, purposeful, and repeated with the goal of achieving, improving, or maintaining physical fitness  Types  Aerobic  Amount of oxygen taken into the body is greater than amount used to perform the activity  Target heart rate  Talk test  Anaerobic  Muscles cannot draw out enough oxygen from bloodstream, anaerobic pathways used for additional energy  Functional strength  Body’s ability to perform ADLs without pain, injury, or limitation  EXERCISE Categories of exercise for Isotonic physical fitness Endurance training Muscle movement against tension, weight, or Strength training resistance Interval training Build bone density Flexibility training Increase strength Improve ROM  TYPES OF EXERCISE Isometric Low-impact Tension on muscles without movement of the joint Strengthen and stretch the body Isokinetic Controlled form of strength training Movement as a constant set speed Treadmill, stationary bike  Cardiovascular system Helps to prevent stroke, cardiovascular disease Increases heart rate, strength of heart muscle BENEFITS OF Mediates harmful effects of stress EXERCISE ON Adapts to the increased demands of exercise PHYSIOLOGIC FUNCTION Respiratory system AND HEALTH Improves overall lung capacity and efficiency Improves endurance and decreases dyspnea in lung disease Pulmonary rehabilitation improves exercise tolerance and quality of life  Musculoskeletal system Muscles hypertrophy Increased efficiency of muscular contraction Joints receive nourishment through activity BENEFITS OF Bone density, strength maintained through weight bearing EXERCISE ON Improves stability, decreases risk of falls in older adults PHYSIOLOGIC FUNCTION Gastrointestinal (GI) system AND HEALTH Enhances gut microbiome Reduces risk of colon cancer, IBS, obesity, metabolic diseases Prevents obesity Decreased body fat Improves metabolism  Endocrine system Improves glycemic control and insulin sensitivity BENEFITS OF Natural anti-inflammatory treatment Prevents and manages chronic diseases: type 2 EXERCISE ON diabetes and heart disease PHYSIOLOGIC Immune system and cancer FUNCTION reduction AND Improved immune response and decreased cancer risks HEALTH Reduced risk of cancer: bladder, breast, colon, endometrial, esophageal, kidney, stomach, uterus, lung Should be recommended for cancer survivors BENEFITS OF EXERCISE ON PHYSIOLOGIC FUNCTION AND HEALTH  Neurocognitive system  Improves cognition across the lifespan  Improves neuroplasticity  Reduced risk of dementia  Improved memory, attention, impulse control, processing speed  Decreased depression/anxiety  Improved sleep; reduced daytime sleepiness  Improved quality of life  Improved sense of well-being  GUIDELINES FOR PHYSICAL ACTIVITY ACROSS THE LIFESPAN RECOMMENDATIONS CHOOSE ACTIVITIES SAFETY WHEN WALKING AND CHANGE BY AGE GROUP APPROPRIATE FOR LEVEL OF TEXTING FITNESS AND HEALTH GOALS  NURSING INTERVENTIONS TO SUPPORT PHYSICAL FITNESS Model Facilitate Teach Encourage Use Reinforce Advocate Model healthy Facilitate Teach patients Encourage to Use products Reinforce Advocate for exercise patient self-care increase to assist with personal and physical fitness attitudes, involvement in strategies physical exercise family in a health behaviors setting activity To enhance activities participation in environment goals fitness physical To deal with activity and possible aches, exercise pains of increased exercise Visual aids to show stretching EXEMPLAR Hypertension 16.G  OVERVIEW  Hypertension defined as  Systolic BP  140 mmHg or  Diastolic BP  90 mmHg  Classification of BP for adults  Prehypertension: 120 – 139 / 80 – 90  Hypertension stage 1: 140 – 159 / 90 – 99  Hypertension stage 2:  160/  100  Major risk factor for CHD, heart failure, stroke, renal failure Copyright © 2023, 2019, 2015 Pearson Education, Inc. All Rights Reserved   Etiology  Primarily in middle-age, older adults  Higher prevalence in Black patients than White, Hispanic patients ETIOLOGY  More White men than women  More Black and Hispanic women than men  Native Americans, Alaska Natives at high risk  All income groups  RISK FACTORS Mineral Family history Age Race intake Excess Insulin Obesity alcohol Stress resistance consumption Physical Vitamin D Depression inactivity deficiency  PREVENTION Healthy lifestyle choices, habits can prevent high BP, reverse prehypertension, help control existing hypertension, prevent complications and long-term problems of hypertension Maintain healthy Regular physical Stress Follow medication Avoid baths that weight, diet activity management regimens are too hot Patients with prehypertension should take steps to avoid progressing to high BP Patients with high BP Regular medical care Follow prescribed treatment plan  COLLABORATION  Primary hypertension cannot be cured, can be controlled  Reduce BP < 140 / 90 mmHg  Goal is to reduce cardiovascular and renal morbidity and mortality Copyright © 2023, 2019, 2015 Pearson Education, Inc. All Rights Reserved  Weight loss Dietary changes Reduce sodium Maintain adequate potassium, calcium Reduce total and saturated fat Restricted alcohol and cigarette use LIFESTYLE MODIFICATIONS Increased physical activity Stress reduction Complementary health approaches that reduce feelings of distress, anxiety Patient should notify primary care provider before adding such approaches   Hypertension in Older adults  BP rises with age, increasing risk of hypertension  Blood vessels lose flexibility  Age 45–64, greater percentage of women than men have hypertension  Isolated systolic hypertension  Systolic BP is in hypertensive range, diastolic BP is normal LIFESPAN  Systolic BP increases with age, diastolic CONSIDERATIONS BP does not  Treatment  Should be closely monitored  Wrong dosage increases risk of orthostatic hypotension  Complications related to polypharmacy  Diuretics are treatment of choice  CCBs may be beneficial NURSING PROCESS Nurses should review smoking history in all patients, promote cessation Risks of obesity, excess alcohol intake Teach patient about hypertension Screen for hypertension and refer patients with elevated BP Reducing oxygen demand of heart for patient in acute heart failure  Observation and patient interview May have no observable signs Morning headache, cervical pain Cardiovascular, CNS manifestations History of hypertension, renal disease, diabetes ASSESSMENT Family history of high BP, heart failure, kidney disease Current medications Physical examination Vital signs BP in both arms, apical and peripheral pulses Ophthalmologic exam  DIAGNOSIS  Nursing diagnoses may include  Ineffective Health Maintenance  Difficulty adhering to treatment plan  Lack of knowledge about nutrition  Fluid volume excess  PLANNING  Goals may include that patient will  Describe lifestyle choices to prevent, reduce, or resolve hypertension  Maintain BP within acceptable range  Reduce sodium consumption  Maintain fluid balance  Verbalize understanding of medication regimen, potential side effects  Promote Promote balanced nutrition Refer to Nutrition Assessment, Nutrition, for more information on measuring waist circumference Promote a weight-loss diet, offer encouragement, reframing when dietary IMPLEMENTATION noncompliance occurs Maintain Maintain fluid volume As part of patient’s role in their chronic disease management If patient is at risk for fluid retention, provide education  Promote health maintenance Because HTN is chronic disease Encourage patients to adopt healthy lifestyle changes to enhance drug therapy Due to the asymptomatic nature of HTN IMPLEMENTATION Promote Adherence to Treatment Plan Follow-up and consistent review of disease management As part of the patient interaction, assess and address any reported noncompliance Provide tips to overcome issues with dietary or activity initiatives  EVALUATION Expected outcomes may include Patient describes components of treatment plan including diet, activity, smoking cessation, weight control, and stress management Patient describes correct medication regimen, side effects, special instructions If initial nursing interventions, lifestyle modifications, medications do not decrease BP, Nurse can advocate for change in medication Combination of medications Additional nonpharmacologic strategies EXEMPLAR 22.B NICOTINE USE DISORDER  Cigarette smoking: single most preventable cause of disease, death in the United States Nicotine: highly addictive chemical found in tobacco. Enters the body via The lungs Oral mucous membranes Commercial tobacco contains >7000 chemicals OVERVIEW Including cancer-causing agents Smoking affects virtually every organ system Vaping Also termed e-cigarettes Contain nicotine Not recommended for youth, young adults, pregnant women  Factors that People of lower influence people to socioeconomic smoke status more likely to Emotions smoke Social pressure Less successful in quitting Alcohol use smoking Lack of education Age ETIOLOGY AND EPIDEMIOLOGY Contributes to Approximately 17.2% poverty by diverting of the population household spending smoke cigarettes. from basic needs to tobacco  Risk factors for smoking Age Socioeconomic status Lack of engagement in school, religious, other activities Risk factors from smoking RISK Lung cancer, chronic obstructive pulmonary disease FACTORS (C O P D), coronary heart disease Graves disease Early menopause, dysmenorrhea Impotence Osteoporosis, degenerative disc disease Discolored teeth, fingernails Premature aging, wrinkling Reduced sense of smell and taste  Risk factors from smoking during pregnancy Preterm labor Spontaneous abortion Low-birth-weight infants Sudden infant death syndrome (S I D S) Learning disorders in offspring RISK Risk factors from exposure to secondhand smoke FACTORS Increased risk of lung cancer Exposure to cancer-causing and toxic chemicals in higher concentrations in secondhand smoke than in smoke inhaled by smokers Children at increased risk for SIDS, otitis media, asthma, other respiratory conditions Risks from third-hand smoke inconclusive  PREVENTION Mass media campaigns School-based tobacco-use prevention policies and programs Higher costs for tobacco products through increased excise taxes  CLINICAL MANIFESTATIONS Usually no manifestations in early stages of use Seen only when complication occurs COPD Cancer Heart disease Manifestations in long-time smokers Deep voices secondary to trauma to vocal cords Chronic cough   Nicotine replacement therapy  Helps to relieve physiologic effects of withdrawal, including cravings  Over-the counter (O T C)  Gums  Transdermal patches  Lozenges  Prescription COLLABORATION  Nicotine inhalers  Nasal sprays  Complications  Do not treat underlying psychologic needs, addictive behaviors  Contraindications and warnings  Encourage patients to use in combination with smoking cessation program  THE CONCEPT OF TEACHING AND LEARNING THE CONCEPT OF TEACHING AND LEARNING Teaching: a process that uses planned Learning: an outcome that occurs strategies and approaches with the after being exposed to information goal of changing behavior that adds to knowledge and skill Evidence of learning is a change in Include sharing information and skills behavior that can be observed and to influence or change attitudes, measured and becomes a part of perceptions, values, and/or behaviours routine activities The concept concludes with a discussion of ways in which nurses can use their knowledge of the teaching–learning process to design more successful patient and family education activities  Occurs within the Discovery of personal Consequence of learner meaning and relevance of experience ATTRIBUTES ideas OF LEARNING Collaborative and Evolutionary process Both intellectual and cooperative process that builds on past emotional process learning and experiences   Nurses as teachers  Teaching is an expectation of the nurse when providing care  Main population of focus for teaching is the NURSES AS patient and family  Topics may include TEACHERS AND  Instructions on administering medication LEARNERS  Teaching which symptoms should prompt the parent to call a healthcare provider  Therapies or treatments  May teach other nurses and staff in healthcare settings, students in traditional academic settings  The teaching of patients, families, and other healthcare professionals is monitored by different agencies   Nurses as learners  A science-based education is the foundation for the profession of nursing NURSES AS  Need to remain current with treatments and approaches to care by participating in TEACHERS AND  continuing education programs Continuing education is supported by LEARNERS healthcare organizations and facilities through the use of impromptu and formal continuing education programs  Opportunities range from earning advance degrees to proving competency and becoming credentialed  Programs are also offered to provide information on changes in regulations and requirements  The concepts of development, communication, health, wellness, and illness are directly related to the concepts of teaching and learning CONCEPTS RELATED TO TEACHING AND Knowledge of some basic principles of teaching and LEARNING learning is crucial to empower individuals to lead healthier lives such as: Health, Culture and Wellness, Communication Development Nutrition Safety Diversity Illness, and Injury THE ART OF TEACHING  Effective teaching follows  Series of planned steps with the goal of changing a behavior  Learning a skill  Gaining an understanding about a particular topic or activity  Ability to capture the learner’s attention exemplifies the art of teaching  Nurse should support and encourage the learner to participate in the process through asking questions and seeking clarification  Nurses should have a firm understanding of personal strengths as well as personal limitations on knowledge of a particular topic or skill  CHARACTERISTICS OF EFFECTIVE TEACHING Identifies the learner’s Asks the learner to Uses several methods Involves the learner in preferred learning identify areas of major of teaching the learning process styles interest Uses accurate and Is appropriate for the Sets realistic goals Helps the learner current evidence-based learner’s age, condition, directed at helping the believe that learning is information from and abilities learner meet objectives possible and likely reliable sources Supports the learner with optimistic, positive Is cost-effective reinforcement and feedback   Learning need: an identified deficit in knowledge, information, or skills needed to achieve a particular goal  Compliance: the extent to which an individual’s behavior follows medical or health advice coincides with medical advice  Best illustrated individual accepts need to learn, follows through with actions reflecting learning ASPECTS OF  Important not to quickly label a patient as noncompliant LEARNING  Important to determine why a patient is not following a recommended course of action before applying this label  Adherence: attachment to a prescribed regimen promotes and encourages patients to be committed, active participants in maintaining personal health and wellness  In mutual agreement patient plays an active role in determining the course of treatment  LEARNING THEORIES  Adult learning theory  Adult learners differ from child learners  Need to know why they should learn something  Prefer others to treat them as capable of self-direction  Have accumulated experiences that can enhance current learning  Are often ready to learn what must know to take care of themselves  Time perspectives  Implications for teaching  Communicate how/why information is important, useful  Identify previous experiences, help learner incorporate new information with previous experiences FACTORS AFFECTING LEARNING  Factors that facilitate learning  Motivation  Readiness  Active involvement  Relevance  Feedback  Nonjudgmental support  Information that proceeds from simple to complex  Repetition of key concepts and facts  Timing  Environment  Depending on the type of instruction, patients might need to have a support person in attendance FACTORS AFFECTING LEARNING  Factors that inhibit learning  Emotions: fear, anger, depression, anxiety  Physiologic status:  pain  fatigue  Cultural considerations: native language  Provision of verbal information as well as written teaching materials  Psychomotor ability  Muscle strength  Motor coordination  Energy  Sensory acuity   Teaching adults  Nurse must seek to determine patient’s unique learning preferences  Even if nurse has worked with this patient in the past  Essential to gather subjective, objective data about patient  Personal demands, responsibilities  Education level, cultural influences LIFESPAN  Motivation to learn CONSIDERATIONS  Nurse’s awareness of own learning style may help in developing teaching plans  Important to allow time for questions and practice  Provide feedback, reassurance, support  Emphasize, promote importance of positive health practices  Actively involve patients in their care  Remember that nurses cannot control patients’ responses or change their habits  Primary goals: providing knowledge and awareness   Teaching older adults  Teaching focuses on  Teaching with regard to chronic illnesses is essential for symptom control and prevention  Teaching plans center on  Nutrition LIFESPAN  Physical activity CONSIDERATIONS  Personal safety  Medication  Need for follow-up healthcare appointments  Address aging factors that influence comprehension  Develop teaching plans ensuring that maximal learning can occur   Teaching older adults cont.  Ability to learn affected by  Sensory alteration, energy level  Physical abilities  Cultural influences  Memory, response time, stress  Include patient in developing teaching plan, setting goals LIFESPAN CONSIDERATIONS  Allow adequate time for processing information, provide repetition  Include significant others or primary caregivers  Calm approach in peaceful environment  Allow time for questions, practice  Provide feedback, encouragement  Evaluate effectiveness of teaching and learning, reinforce teaching as needed  Document teaching intervention   Each patient’s individual needs should inform the teaching plan  Patient may have an impairment of mobility or cognition, whereas another may have an illness affected by environmental issues  Before planning individual teaching, perform LIFESPAN complete assessment of CONSIDERATIONS  Home environment  Support system  Developmental level  During teaching, may need to stress importance of interprofessional interventions to meet patient’s health and wellness needs