Unit 2 Study Guide:



Unit 2: Personal and Environmental HealthChapter 5: Basic Human NeedsChapter 6: Health and WellnessChapter 7: Community HealthChapter 8: Transcultural Healthcare(This is a compilation of the PowerPoints, notes and the book).(References: Rosdahl, C. B, Kowalksi, M. T. ( 2017). Textbook of Basic Nursing ( 11th ed.). Wolters Kluwer / Sandy McGehee)(This is a compilation of the PowerPoints, notes and the book. THIS IS NOT ALL INCLUSIVE!)Chapter 5: Basic Human Needs (Study Guide)Maslow’s Hierarchy of Needs:Maslow defined the basic needs of all people as a progression from simple physical needs, or survival needs, to more complex ones, called aesthetic needs. Progression from physical needs to aesthetic needs: Physiologic needsSafety needsLove needsEsteem needsSelf-actualization needsRules of 3 for Essentials of Life3 minutes without air3 hours without shelter3 days without water3 weeks without foodRegression:Regression: focusing on a lower-level need that has already been fulfilled. This is common in illness or injury.For example:A client recovering from an illness will focus their physical and emotional energies on recovery (physical needs) before returning to employment (security).Individuals in pain will revert to being concerned about personal appearance or relationships with others only after the pain has been relieved.Basic Physiologic Needs:OxygenWater and Fluids Food and Nutrients Elimination of Waste ProductsSleep and Rest Activity and Exercise Sexual Gratification Temperature RegulationNursing Considerations:OxygenEvaluate the oxygenation status of the client. Water and FluidsMeasure intake and output, weigh the client daily, and observe intravenous infusion of fluids. Food and NutrientsHelp feed the client, monitor calorie counts, or maintain alternative methods of nutrition.Elimination of Waste ProductsGive an enema, catheterize the person, or assist with dialysis.Sleep and RestProvide safe, comfortable, and quiet surroundings. Activity and Exercise Encourage client to walk after surgery or teach to walk with crutches.Sexual GratificationBe aware of sexuality issues when care is given. Temperature Regulation Assist the client to meet the need for temperature regulation. In cases such as a high fever, monitor the client’s temperature. Security and Safety:At this second level of Maslow’s hierarchy of needs, there are both physical and psychological needs.Freedom From HarmRemove threats to the client’s safety.Take preventive measures. Explain procedures, treatments, or medications.AbuseReport any suspected abuse to proper authorities. Healthcare Higher-level coping skills in relationship to planned versus unplanned healthcare.ShelterConduct comprehensive evaluation when interviewing homeless clients. Arrange for regular monitoring and preventive healthcare in the above situations.Nursing Activities That Help Individuals Obtain the Goal of Self-Esteem:The term self-esteem (self-image, self-respect) is related to the person’s perception of self.Those who are ill or injured or who undergo surgery may have altered levels of self-esteem. The nurse will need to help such clients regain positive self-esteem by:Rewarding and encouraging an individual’s progress in rehabilitation Allowing them to perform as much self-care as possible Observing these clients for symptoms of regression, depression, or chemical dependency Self-Actualization:The self-actualized person has “reached his or her full potential.”The nurse can help clients obtain self-actualization by: Assisting in achieving lower-level needs Acknowledging accomplishments of the individualBasic and Aesthetic Needs of Individuals Who Are Homeless, Terminally Ill, or Have No Source of Income:People in this situation must find food and shelter not only for themselves, but for their children as well. These individuals are more concerned with meeting their primary rather than secondary needs. They become ill first and then seek healthcare. Such behaviors are concrete methods of dealing with illness or emergency responses to the stimulus of illness (episodic healthcare).Community or Societal Needs:The community has basic needs concerning the welfare of all its residents: Public healthcare measures (immunization programs)Access to healthcareMaintenance services (water and electricity)Environmental concerns (pollution)Safety (police and highways)Emergency services (ambulances and paramedics) Chapter 6: Health and Wellness (Study Guide)The World Health Organization (WHO):Health, according to the WHO, is a state of complete physical, mental, and social well-being, and not merely the absence of disease or infirmity.United Nations Millennium Development Goals (MDGs):Eradicate extreme poverty and hungerAchieve universal primary educationPromote gender equality and empower womenReduce child mortality and improve maternal healthCombat HIV/AIDS, malaria, and other diseasesEnsure environmental sustainability Develop a global partnership for developmentComponents of Health:Health must be considered in its broadest, holistic sense and must address:Physical healthEmotional healthPsychological or mental healthSocial healthSpiritual healthMorbidity and Mortality:Morbidity The number of people with an illness or disorder relative to a specific populationMortalityThe chances of death associated with a particular illness or disorderNursing Implications Related to Healthcare Financing:The United States spends more on health than other industrialized country.The United States spends billions of dollars every year on HIV/AIDS. More than half of this cost goes to medical care. Some of the funds go to research and preventative educational programs. Childhood immunizations represent a cost-effective and very efficient use of healthcare monies. Preventive Healthcare Measures:Prevention services or primary healthcare servicesPrenatal care for mothers and infants, antismoking campaigns, and mammography for women Secondary healthcare services Medical or surgical therapies, generally in acute care settingsRehabilitation or tertiary servicesChronic illness or disability The Wellness–Illness Continuum:An individual’s daily state of health falls somewhere on a continuum from high-level wellness to death. The components that contribute to a state of wellness are:Good physical self-carePrevention of illness or injuryUsing one’s full intellectual potentialExpressing emotions Managing stress appropriatelyComfortable and congenial interpersonal relationshipsConcern about environment and world conditionsImplications of Acute and Chronic Illnesses as Part of the Continuum:Acute illnesses Interfere with the wellness–illness continuum for a short period of time, such as the common coldChronic illnesses Arthritis, asthma, or HIV/AIDS result in a long-term health disturbanceA person may have an acute illness, a chronic illness, or both. It is very common for an individual with a chronic illness to become acutely ill.Wellness and Maslow’s Hierarchy:Maslow’s hierarchy and the responsibilities of the nurse relate to the health–illness continuum. If clients have survival needs but other needs are threatened, they function at a lower level on the hierarchy and move toward the illness end of the illness–wellness continuum. When basic needs are satisfied and they move toward self-actualization, the trend is toward the wellness end. Lifestyle and Risk Factors:Lifestyle FactorsPatterns of living that an individual chooses to follow Risk Factors May or may not be preventable Certain risk factors relate to occupation, environment, or age Nursing ConsiderationsPhysical activityNutritionUse of tobacco productsSubstance abuseStressViolence and abuseHealthcare Education and Information:Formal courses in school (e.g., mine safety)Informal courses (e.g., prenatal and birth courses)Public service announcements and advertisementsInformational flyers, brochures, and booksNonprofit organizations (e.g., American Cancer Society, American Lung Association)Healthcare providersInternet WebsitesAge-Related Health Concerns:InfantsLow birth weightCongenital anomaliesSIDSRespiratory distress syndromeChildrenAccidental injuryAsthmaObesityAdolescents and Young AdultsMotor vehicle accidentsFirearmsBinge drinkingSuicideEating disordersSexual health and safe sexPregnancyMature Adults Heart disease CancerDiabetes mellitusOsteoporosis Older AdultsHeart diseaseCancerStrokeCOPDPneumoniaInfluenza Categories of Deviation from Wellness:DiseaseOrganic and functional diseasesHereditary disordersCongenital disordersInfectious diseasesDeficiency diseasesMetabolic disordersNeoplastic diseasesTraumatic injuriesOccupational disordersChapter 7: Community Health (Study Guide)Types of Communities:Community A group of individuals who interact with each other for the mutual benefit of their common interests to support a sense of unity or belongingTypes of CommunitiesFamily, school, place of employment, retirement home, health maintenance organization town or city, state or province, nation, and the world Community Health:Health concerns are based on a community’s demographics as well as a nation’s overall health and economy, and world and national munity health is the aggregate health of a population: a town, state, nation, or planet. Health-Related Functions of the WHO:GuidelinesInternational standards for sanitation, chemical safety, water purification, immunizations, and infectious diseases ObjectivesTo emphasize growth and development of significant internal, governmental changesThe WHO sends healthcare professionals to nations to combat diseases and disorders at both the community and the individual level.Health-Related Functions of UNICEF:The United Nations Children’s Fund (UNICEF), helps children, especially those in developing countries.Goals include:Nutrition instruction, development of low-cost food supplementsSupport of general educationChildhood immunization programsProcedures for supplying safe waterInfant rehydration programs Improvements in Public Health That Increased Lifespan in the 20th Century:Because of the USPHS, life expectancy of Americans which was about 45 years in the early 1900s lengthened by 30 years, to more than 78 years in the 21st century. Advances in public health contribute to at least 30 of these additional years.United States Public Health Service:Since 1798 ,the United States Public Health Service (USPHS) has undertaken investigation and control of communicable diseases, control of sanitation, and control of the manufacture and sale of biologic products.Achievements:Vaccinations, control of infectious diseases, safer and healthier foods, and healthier mothers and babiesMotor-vehicle safety, safer workplacesDeclines in deaths from coronary artery disease and strokeRecognition of tobacco use as a health hazard Health and Human Services:Some of the agencies that constitute the HHS include:Administration for Children and Families (ACF)Administration on Aging (AOA) Agency for Healthcare Research and Quality (AHRQ), Agency for Toxic Substances and Disease RegistryCenters for Medicare & Medicaid Services (CMS) Centers for Disease Control and Prevention (CDC) Food and Drug Administration (FDA) National Institutes of Health (NIH)Centers for Disease Control and Prevention:The mission of the CDC is to promote health and quality of life by preventing and controlling disease, injury, and disability.Roles of the CDC include:Investigating disease outbreaks at a local, national, or international level or occurrences of bioterrorismProviding current and accurate health-related information to the publicFostering cooperative relationships with national, state, and local organizations to combat dangerous environmental exposures Food and Drug Administration Accomplishments:Requiring that new drugs and complex medical devices be proved safe before they are put into a consumer marketRequiring safety practices in blood bankingRequiring accurate, truthful, and useful labeling for prescription drugs, over-the-counter medications, foods, and dietary supplementsConducting scientific research and providing standards and guidelines to make regulatory decisionsRequesting or requiring that manufacturers recall unsafe productsNational Institutes of Health:MissionTo uncover new knowledge that will lead to better health for everyone There are 27 separate institutes, centers, or offices, and each works in its specific field to:Conduct research on site or through universities, medical schools, hospitals, or other research institutionsTrain research investigatorsPromote improved sharing of medical informationFocus of National Institute for Nursing Research (NINR):Managing clients during illness and recoveryReducing risks for disease and disabilityPromoting needs for underserved or high-risk clientsCaring for individuals at the end of lifePromoting the care of families within a communityOSHA:The Occupational Safety and Health Administration (OSHA) is the subdivision of the U.S. Department of Labor and works to prevent occupational injury and illness. OSHA accomplishments include:Standards for safety and health protection in the workplaceStandards for occupational exposure to blood-borne pathogensStandards published to protect construction workersErgonomic standards to prevent musculoskeletal disordersSocial Security Administration:In 1995, the Social Security Administration (SSA) splits from the HHS to become an independent agency. It provides retirement income for many people and financial assistance for healthcare to special populations.It provides financial support for persons older than 62 or 65 years, and those of any age with special disabilities or handicaps. It also oversees support provided from Medicare and Medicaid.National Safety Council:MissionTo educate and influence society to adopt safety, health, and environmental practices that prevent human suffering and economic losses arising from preventable causes It gathers information regarding safety and health information in the United States, analyzes causes of accidents, suggests preventive measures, and disseminates information derived.The Council influences public opinion, attitudes, and behavior in other areas.Role and Functions of the Red Cross:The American Red Cross is a humanitarian organization led by volunteers.MissionTo provide help to victims of disaster and to help people prevent, prepare for, and respond to emergencies ServicesArmed forces emergency services, biomedical services, community services, health and safety services, and international services Visiting Nurse Association:The Visiting Nurse Association (VNA) is a nationwide, not-for-profit, community-based home care agency that provides care to any person regardless of his or her ability to pay.Direct care services include:Skilled nursing, physical therapy, maternal and child care, medical social work, pain management, hospice, private duty nursing, enterostomal therapies, and IV and enteral therapiesOrganizations Related to Specific Diseases:The American Cancer SocietyThe National Society for the Prevention of BlindnessThe American Heart AssociationThe American Diabetes Association The Cystic Fibrosis FoundationThe National Easter Seal Society–March of DimesOrganizations That Promote Specific Health Goals:Planned Parenthood of AmericaFocuses on family planning and prevention of STIs La Leche LeagueFocuses on maternal and newborn health by encouraging breastfeeding Programs Common to State Healthcare Services:State health laws must conform to federal laws, but states also have the right to make their own health laws, if necessary.Programs on state levels address many specific healthcare concerns including aging, children’s health, families in need, mental health, special populations, alcohol and substance abuse, environmental health, communicable diseases, and safety and disability issues.Functions of the Community Health Center:Community health centers usually belong to an organization called the National Association of Healthcare Centers (NAHCC)Provides healthcare services in locations where populations with special healthcare needs exist Provides cost-effective healthcarePromotes better compliance with follow-up careProvides testing for various disorders as well as immunizations and prenatal services Causes and Significance of Various Types of Pollution:Air Pollution Caused by exhaust from automobiles and industriesResponsible for increases in respiratory infections, such as chronic bronchitis and emphysema, and an increase in the incidence of asthma Water PollutionCaused by inadequately treated and contaminated water Transmits a number of diseases, including typhoid fever, dysentery, and infectious hepatitis Land PollutionLandfills for dumping trash contribute to diseases (including cancer), particularly in children.Noise PollutionChronic exposure to loud noise, such as loud music, poses the greatest hazard to hearing. Noise pollution also causes stress.Other Types of PollutionLead poisoning (plumbism), radiation, and biohazardous waste disposalChapter 8: Transcultural Healthcare:Culture, Subculture, Race, Minorities, and Ethnicity:Culture It is the accumulated learning for generational groups of individuals within structured or nonstructured societies. Subcultures These are groups within dominant cultures. They form because individuals share characteristics that belong to an identifiable group. Race Large groups of humankind that share common biologic and sociologic characteristicsMinority Global shifts of multiple groups of individuals who are continually revising cultures and subculturesEthnicity Common heritage shared by a specific culture Barriers to Culturally Competent Care:PrejudiceBelief based on preconceived notions about certain groups of people Ethnocentrism Belief that one’s own culture is the best and only acceptable culture Stereotyping Categorizing people and believing that all those belonging to a certain group are alike Culturally Competent Nursing Care:Cultural sensitivityUnderstanding and tolerance of all cultures and lifestyles Enables the nurse toUnderstand more accurately and to accept the behavior of othersProvide better care by being sensitive to cultural factors involved in the client’s health or illness Nursing Considerations/Cultural Assessment:Note the effect of socioeconomics: a client may divide one prescription for use by several individuals who may have similar symptomsAsk the client if anyone else in the family needs to be aware of any healthcare situation: the client may or may not traditionally have a say in important decisionsUnderstand that some family members like to assist with care of the client Educate the client and family caregivers whenever the opportunity arisesValues and Beliefs:BeliefsMay be based on fact, fiction, or a combination of both and can be difficult to changeValues Shape how an individual perceives right or wrong and what is desirable or valuable Nurses must recognize that different beliefs and values exist and affect nursing. Taboos and Rituals:TaboosMembers of the culture cannot violate taboos without discomfort and risk of separation from the group. RitualsMembers are often required to practice rituals for comfort, acceptance, and inclusion.Often, taboos and rituals are associated with religious or spiritual services pertaining to healing, death, or dying. Concepts of Health and Illness:Culture greatly influences an individual’s concepts of health and illness. Each society has norms relating to the meaning of illness, how an ill person should behave, and what means should be used to assist him or her.These also transmit to treatment and healing beliefs and practices, and attitudes toward mental illness.Nurses must strive to accommodate clients’ healthcare beliefs and practices (as long as they are safe), even if they do not fully understand or agree with them.Language and Communication:The nurse and the clients may speak different languages. Facilitate communication:Professional interpreterFamily as interpreter Nurse as interpreterDiet and Nutrition:Cultural eating rituals vary and some religions maintain strict dietary practices.The nurse should take into account each client’s nutrition and dietary customs as nutrition and diet constitute an important part of health and treatment of illness.Elimination:People of various cultures treat the elimination of bodily wastes differently. Many cultures consider elimination to be a private function. Nurse need to consider that some people are unable to void or to use a bedpan or commode unless they have complete privacy.Death and Dying:Each cultural group has an attitude or series of beliefs about death and dying. Nurses must respect the client’s beliefs even if they are different from their own beliefs.Many Asian cultures consider death to be preordained, believing that when a person’s time to die has come, nothing can stop it. Traditional Western culture tries to prevent death and to prolong life at all costs. Religious and Spiritual Beliefs:The interrelationship among cultures, religious beliefs, and healthcare is very strong. Each individual is unique and often has a mixture of belief systems, so it is important not to stereotype a client with any one religion. With knowledge of the individual’s belief system, the client and the client’s community of significant others will be more accepting of necessary medical interventions, lifestyle changes, dietary changes, and treatment regimens.Health Belief Systems:Magicoreligious: The belief that supernatural forces dominate. Scientific/biomedical: The belief that physical and biomedical processes can be studied and manipulated to control life. Holistic medicine: The belief that the forces of nature must be kept balanced. Yin–yang and hot–cold theories: The belief that illness develops when life forces are out of balance. Cultural Aspects of Personal Space and Touching:Personal spaceComfort zoneIntimate space (reserved for close family members) Personal space (for contact with the general public) Many cultures consider touching a member of the opposite sex or making the first move to offer the hand to a superior to be improper.Cultural Aspects of Eye Contact:Eye contact can give important cues about clients. This action is culturally influenced. In most European-based cultures, direct eye contact is considered normal.In Native American, Arab, and some Southeast Asian cultures, members believe that looking a person in the eye during conversation is improper and impolite. Facial expressions may be totally absent. The nurse must take care not to misinterpret these nonverbal cues. ................
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