NR 222 HW Exam 1 Review Group Chamberlain College of
Nursing
Details of NR 22Group doc started 11/9/17
NR 222 Exam 1 Review
Know the definition of
... [Show More] health promotion
➔ Definitions vary
➔ O’Donnell Definition: “the science and art of helping people change their lifestyle to
move toward a state of optimal health”
➔ Kreuter & Devore Definition: “the process of advocating health in order to enhance the
probability that personal (individual, family, community), private (professional &
business), and public (federal, state, local govt.) support of positive health practices will
become a societal norm”
Know the WHO definition of health and what WHO is
➔ Defined as “the state of complete, physical, mental, and social well-being; not
merely the absence of disease or infirmity”
➔ WHO is an agency of the United Nations that is concerned with international public
health
Know differences of wellness education vs. health promotion
➔ Closely related, overlap to some extent
➔ Wellness education: teaches people how to care for themselves in a healthy way;
includes topics such as
◆ Physical awareness
◆ Stress management
◆ Self-responsibility
➔ Health promotion: promotes activities like routine exercise, good nutrition to help
patients maintain/enhance their present levels of health
Know the levels of prevention
➔ Primary Prevention
◆ True prevention
◆ Precedes disease
◆ Applied to patients considered physically, emotionally healthy
◆ Includes health education programs, immunizations, nutritional programs,
physical fitness activities
➔ Secondary Prevention
◆ Focuses on individuals who are experiencing health problems/illness and are at
risk
◆ Activities directed at diagnosis and prompt intervention
◆ Mostly delivered in homes, hospitals, nursing facilities
◆ Includes screening techniques, treating early stages of disease
➔ Tertiary Prevention
◆ Occurs when defect/disability is permanent and irreversible
◆ Involves minimizing effects of long-term disease/disability by interventions
directed at prevention complications/deteriorations2 HW Exam 1 Reviewof these goals
➔ Healthy People 2020 serves as road-map for improving the health of all people in
the US
➔ Promotes a society in which all people live long, healthy lives
➔ 4 Goals:
◆ Attain high-quality, longer lives free of preventable disease
◆ Achieve health equity, eliminate disparities, improve health of all groups
◆ Create social and physical environments that promote good health for all
◆ Promote quality of life (QoL), healthy development, healthy behaviors across all
life stages
➔ Nurse’s Roles:
◆ Advocate
● Helps individuals obtain what they’re entitled to receive through the
healthcare system
● Try to make system more responsive to individual/community needs
● Help person advocate for themselves
◆ Care manager
● Prevent duplication of services
● Maintain quality and safety
● Reduce costs
◆ Consultant
● May provide knowledge about health promotion and disease prevention
● Some have specialized areas of advanced practice/expertise
(gerontology, women’s health, community/public health)
◆ Deliverer of services
● Core role is delivery of direct services
● ex.) health education, flu shots, counseling in health promotion
◆ Educator
● Individuals are unique in their response to efforts to changing behavior
● Teaching may range from chance remark by nurse or structurally
planned teaching according to individual needs
● Health promotion/protection heavily rely on individual’s ability to use
appropriate knowledge
◆ Healer
● Requires nurse to help individuals integrate and balance the various parts
of patient’s life
● Mindful blending of science and subjectivity
Know the cost of financing health care and its sources of funding
➔ Hospital spending accounts for 31% of national health expenditure
◆ Is expected to continue growing 6.3% per year (as of 2010)
➔ Many other countries spend far less per capita, but life expectancy is greater & infant
mortality rates are lower
➔ US spends more than any other country in healthcare dollars per person
➔ Factors driving costs:
◆ General inflation
◆ Healthcare cost inflation
◆ Application of new/more advanced technologies
◆ Growth in proportion of older adults
◆ Government financing of healthcare services
◆ Growth of prescription drug usage/costs
◆ Maldistribution of healthcare providers/services
◆ Expansion of medical technology & specialty medicine
◆ Growing number of uninsured/underinsured people
➔ Sources of Funding:
◆ American people pay for all healthcare costs
◆ Money is transferred from consumer → provider by different
mechanisms
◆ Major sources:
● Government (federal, state, local monies collected by taxes)
● Third party payment (private insurance)
● Independent plans
● Out of pocket support (totaled $2.6 billion in 2010)
◆ Largest % of nation’s healthcare $$$ came from private health insurances (33%)
◆ 12% were out of pocket payments
◆ Cost of Medicare accounted for 20% of the healthcare $$$
● Medicaid and SCHIP counted for 15%
◆ 31% of healthcare $$$ spent on hospital care
◆ 20% on physicians and clinics
◆ 10% on prescription drugs
◆ 6% on nursing home facilities
◆ 7% on dental care and administrative costs
◆ 14% on non-acute care
Know what Medicare and Medicaid are
➔ Medicaid
◆ Essential health insurance program available for certain low-income
individuals/families who fit into an eligible group
◆ Is an assistance program (referred to as welfare)
◆ Managed jointly by federal and state govt.
◆ Provides partial or full payment of medical costs for people/families of any age
who are too poor to pay for the care
◆ Provides coverage for:
● 29 mil. children
● 15 mil. adults in low-income families
● 15 mil. elderly & persons with disabilities
● More than 1 mil. Medicaid recipients live in skilled nursing facilities
◆ Medicaid pays Medicare premiums, deductibles, and coinsurance for
certain low-income Medicare recipients
➔ Medicare
◆ Federal health insurance program
◆ Finances care for:
● People older than 65
● Disabled people who are entitled to social security benefits
● People with end-stage renal disease that require dialysis/kidney
transplant
◆ Original intent was to protect older adults against financial debt often incurred in
managing chronic illness
◆ 4 Parts of Medicare:
● Part A
○ Financed largely through mandatory tax of 2.9% earnings paid by
employees/their employers into Hospital Insurance Trust Fund
○ Covers inpatient care in hospitals, skilled nursing facilities
(not custodial or long-term care), home health services,
hospice care
○ For individuals who have contributed to/have had a spouse
contribute for 10 years of Medicare-covered employment, there’s
no monthly premium
● Part B
○ Supplementary voluntary medical insurance
○ Financed through combination of general tax revenue +
beneficiary paid premiums
○ Covers physician visits, outpatient services, preventive
services, home health visits
● Part C
○ Refers to Medicare Advantage program
○ 25% of beneficiaries (12 mil. older adults) are enrolled in these
private plans
○ Account for 21% of benefit spending
● Part D
○ Voluntary, subsidized outpatient prescription drug benefit
○ Additional subsidies are available for low-income beneficiaries
○ Offered through private plans that contract w/ Medicare
○ Has Medicare Advantage prescription plans and stand-alone ones
○ Accounts for 12% of benefit spending (more than 29 mil. people
are enrolled in this program)
○ Part D prescription drug coverage gap is known as the donut
hole
Know the models of health & illness, health beliefs, and variables/risk factors that
influence health beliefs and practices
➔ Clinical Model
◆ Health is defined by the absence and illness by the conspicuous presence
of signs/symptoms of disease
◆ People who use this model may not seek preventive health services or wait
until they’re very ill
◆ Conventional model of the discipline of medicine
➔ Role Performance Model
◆ Defines health in terms of people’s ability to perform social roles
◆ Role performance includes work, family, social roles
◆ Performance based on societal expectations
◆ Illness would be the failure to perform roles @ the level of others in society
◆ Basis for occupational health evaluations, school physicals, physician-excused
absences
➔ Adaptive Model
◆ People’s ability to adjust positively to social, mental, physiological change is
measure of their health
◆ Illness occurs when person fails to adapt/becomes maladaptive to these changes
➔ Eudaimonistic Model
◆ Emphasizes interactions between physical, social, psychological, spiritual
aspects of life and environment
◆ Illness is reflected by lack of involvement with life
◆ Aspects of this model predate clinical model of health
➔ Health Belief Model
◆ Addresses relationship b/t person’s beliefs + behaviors
◆ First component involves individuals perception of susceptibility to illness
◆ Second component is individual’s perception of the severity of the illness
Is influenced + modified by demographic and sociopsychological variables,
perceived threats of illness, cues to action
◆ Third component is the likelihood that person will take preventive action
Results from person’s perception of benefits + barriers to taking action
Can include lifestyle changes, increased adherence to medical therapies, search
for medical advice/treatment
➔ Health Promotion Model
◆ Complementary counterpart to models of health protection
◆ Health is defined as positive, dynamic state
◆ Directed at increasing patient’s lvl. of well being
◆ Focuses on the following 3 areas:
1) individual characteristics and experiences
2) behavior specific knowledge and affect
3) behavioral outcomes in which patient commits to/changes a behavior
➔ Maslow’s Hierarchy of Needs
◆ Certain human needs are more basic than others
◆ Self-actualization is highest expression of one’s individual potential
● Allows for continual self-discovery
● Fulfill bottom needs before fulfilling top needs (in most
circumstances)
➔ Holistic Health Models
◆ Attempts to create conditions that promote a patient’s optimal level of health
◆ Emphasis on the idea that patient is the ultimate expert concerning their own
health
self-actualization
self-esteem
Love and belonging needs
Physical safety Psychological Safety
Oxygen Fluids Elimination Shelter Sex
Body
Nutr. Temp.
◆ Respects patient’s subjective experience as relevant in maintaining
health/assisting in healing
◆ Nurses using HHM should recognize natural healing abilities of the body
● Incorporate complementary/alternative interventions
○ Meditation
○ Music therapy
○ Reminiscence
○ Relaxation therapy
○ Therapeutic touch
○ Guided imagery
◆ Can use alone or in conjunction with conventional medicine Group Chamberlain College of Nursing [Show Less]