NR 222: HEALTH AND WELLNESS FINAL EXAM

STUDY GUIDE

CH1 Nursing Today:

As a profession
• Patient centered care
• Professionalism
1. Administer quality care & be responsible/accountable
• Health care advocacy groups
1. Robert Wood Johnson Foundation Future of Nursing: Campaign for Action
2. Institute of Med publication on The Future of Nursing

Science & Art of Nursing Practice

• Requires
1. Current knowledge & practice standards
2. Insightful & compassionate approach
3. Critical thinking
• Benner’s stages of nursing proficiency
1. Novice- brand new nurse
2. Advanced beginner- at least 1yr of nursing
3. Competent- 3-5yrs
4. Proficient- at least 5yrs
5. Expert- at least 10yrs; works in various areas of nursing

Scope & Standards of Practice

• Nursing definitions
• Scope-Standards
1. 1960: Documentation began
2. Standards of practice/Standards of professional performance
• Goal
1. Improve the health/ well-being of all individuals, communities, & populations
through the significant & visible contributions of RN using standards-based practice Standards
of Practice
• (ADOPIE)
1. Assessment
2. Diagnosis
 3. Outcomes identification
4. Planning
5. Implementation
6. Evaluation
Goals can be (within 24-48 hrs)
a. Met
b. Partially met
c. Not at all

Standards of professional Performance

 Ethics:
a. Education
b. Evidence-based practice & research  Quality of practice: a.
Communication
b. Evidence-based practice & research
c. Collaboration
 Professional practice evaluation:
a. Resources
b. Environmental health
Code of ethics
• The philosophical ideals of right & wrong that define principles used to provide care
• Important for you to incorporate your own values & ethics into your practice
• Ask yourself: how do your ethics, values, & practice compare with established standards?
Roles:
• Autonomy & accountability
• Caregiver
• Advocate
• Educator
• Communicator
• Manager
QSEN: Quality & Safety Education for Nursing

CH2 Health Care Delivery System

Challenges to Health Care
• Uninsured patients
• Reducing health care costs while maintaining quality care
Primary, Secondary, & Tertiary Care
Healthcare is moving toward practices that emphasize managing health rather than managing
illness.
1. Primary health care:
 Precedes the disease
 Includes: health screenings, education/awareness about risk factors, receiving
immunizations
 Objective: to decrease vulnerability of the individual/population to disease
2. Secondary Care
 Treating early stages of disease, limiting the disability, interventions similar to
primary but applied to individuals/popluations w/disease
 Objective: identify individuals in early, detectable stages of disease
3. Tertiary Care
 Occurs when a defect or disability is permanent and irreversible
 Objective: to return to the effective individual to a useful place in society,
maximize remaining capacities or both (rehabilitation

CH 6 Health & Wellness

Models of health & Illness
• A model is a theoretical way of understanding a concept or idea
• Health beliefs
• Health behaviors
1. Positive
2. Negative

Illness
• Acute Illness
• Chronic Illness

CH 16 Nursing Assessment
Nursing Process ADPIE
1. Assess:
• “interview” Collection of info from primary source (the pt) & secondary sources
(family, friends previous health professionals, medical records)
 • “physical exam” Interpret & validate of data (physically check pt for what they
are describing/experiencing)
2. Diagnose: identify pt’s problem
3. Plan: set goals of care & desired outcomes
4. Implement
5. Evaluate (did it the plan work or not?)
Type of Assessments
• Patient-centered interview (health history)
• Physical exam
• Periodic assessment (completing rounds)
Types of Data
• Subjective: pt’s verbal description
• Objective: observations or measurements of pt’s health status

CH 22 Ethics & Values

Definitions
Autonomy- the commitment to include pts in decisions about all aspects of care
Beneficence- taking positive actions to help others
Nonmaleficence- the avoidance of harm or hurt
Justice- being fair
Fidelity- agreement to keep promises
Value- a values of personal belief about the worth of a given idea, attitude, custom, or object
that sets standards that influence behavior
Ethics of care- emphasizes the importance of understanding relationships, especially as they’re
revealed in personal narratives
Processing an Ethical Dilemma
1. Ask if this is an ethical dilemma
2. Gather all relevant info
3. Clarify values
4. Verbalize the problem
5. Identify possible courses of action
6. Negotiate the outcome
7. Evaluate the action
CH 9 Cultural Awareness
Health Disparities
• A particular type of health difference that is closely linked w/ social, economic, and/or
environmental disadvantages
• Differences among populations in the availability, accessibility, and quality of health care
services

Culture
• Norms, values, & traditions
• Ethnicity, race, nationality, & language
• Gender, sexual orientation, location, class, & immigration status
Intersectionality
• Belonging simultaneously to multiple social groups
Oppression
• A system of advantages & disadvantages tied to our membership in social groups
Cultural Competency
• Enabling of health care providers to deliver services that are respectful of & responsive to
the health beliefs, practices, & cultural/linguistic needs of diverse pts.
Cultural competence VS. patient-centered care
• PCC: provides individualized care & restores an emphasis on personal relationships 
CC: aims to increase
Iceberg Analogy *see pg. 106
• maortal changes, family transitions, care of aging prents)

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wellness-study-material