NUR 322 Exam 1 Study Guide Outline
Chapter 6 – Health and Wellness
Definition of Health
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A state of complete physical, mental, and social wellbeing, not merely the absence of disease or
infirmity
A state of being that people define in relation to their own values, personality, and lifestyle.
Patients don’t care how much you know until they know how much you care.
Health Behaviors
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Positive Health Behaviors
o Examples: Eating well balanced meals, exercise, not smoking, avoiding alcohol
Negative Health Behaviors
o Smoking, poor nutrition, not physically active, heavily drinking
Health Models
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Health Belief Model
o Addresses a relationship between patients’ beliefs and behaviors.
o An individual’s perception of susceptibility to an illness
o Example: A person whose both parents have died from MI, recognize the link for coronary
artery disease and perceives a personal risk of heart disease
Health Promotion Model
o Defines health as a positive dynamic state not merely the absence of disease.
o Increases a patient’s level of wellbeing.
o Multidimensional nature of people as they interact with their environment to pursue
health.
o Focuses on:
 Individual characteristics and experiences
 Behavior specific knowledge and affect
 Behavioral outcomes, in which the patient commits to a change or behavior.
Maslow’s Hiearchy of Needs
o Used to understand interrelationships of basic human needs.
o Least important to most important: Self-Actualization-Self Esteem-Love and belonging
needs-Safety and security (Physical and psychological safety) – Physiological (Oxygen,
Fluid, Nutrition, etc.).
Holistic Health Model
o Mind, body, culture, spirit.
o All aspects of life
o I.E Natural Childbirth
Variables Influencing Health and Health Beliefs and Practices
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Internal Variables
o Developmental stage
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o Intellectual background
o Perception of functioning
o Emotional factors
o Spiritual factors
External Variables
o Family role and practices
o Social detriments of health
Health Promotion, Wellness, and Illness Prevention
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Health Promotion
o Either Passive/Active
 Passive: Adding fluoride to water
 Active: exercise
Health education
Illness Prevention
 Three levels of Prevention
o Primary Prevention
 True prevention that lowers chances for a disease to develop
 Vaccines, colonoscopy
o Secondary Prevention
 Focuses on those who have health problems or illnesses, at risk for
developing complications or worsening conditions.
o Tertiary Prevention
 When a deficit or disability is permanent or irreversible (example: rehab after
paralysis)
Risk Factors
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Non-modifiable risk factors
o Cannot be changed (i.e., Impaired gait, impaired vision)
Modifiable Risk Factors
o Can be changed (i.e., Obesity, stopping smoking)
Environment
Risk Factor Modification and Changing Health Behaviors
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Transtheoretical Model of Change
o Precontemplation
 Not acknowledging a problem at this stage, pt is unaware, underestimates or
defensive “There is nothing I need to change.”
o Contemplation
 Considering a change within the next six months “I have a problem I need to work
on.”
o Preparation
 Making small steps to prepare for a change in the next months “I think I am going
to start running again in the next few weeks.”
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Action
 Actively engaged in strategies to change behavior, lasts up to six months “I am
working really hard to stop smoking” (in the process)
Maintenance
 Sustained change over time, begins six months after action, continues indefinitely
“I need to avoid people who smoke so I do not fall into these habits again.”
Illness
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Person’s physical, emotional, intellectual, social, developmental, or spiritual function is
diminished or impaired.
Acute Illness
o Short duration and severe
Chronic Illness
o Longer than 6 months
Illness Behavior
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How people monitor their bodies and interpret their symptoms
o Variables influencing illness behavior.
 Perception of illness and nature of illness
 External variables: visibility of symptoms, social group, cultural background,
economics, and access to health care
Chapter 49 Sensory Perception
Sensory Perception
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Stimulus
o Act that stimulates nerve receptor, need this to get started.
Receptor
o Nerve cell acts as receptor by converting stimulus to impulse.
Impulse Conduction
o Travel of nerve impulse along nerve pathway to spinal cord or directly to the brain
Perception
o Awareness and interpretation of stimuli
Sensory Alterations
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Sensory Deficits
o Deficit in the normal function of sensory reception and perception
o Deficit is what will cause deprivation (example: someone hard of hearing isolating
themselves from social gatherings, leads to deprivation)
Sensory Deprivation (3 types)
o Inadequate quality or quantity of stimulation
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 Reduced sensory input from sight or hearing.
 Deprivation from exposure to strange environments
 Deprivation resulting from confinement in restrictive environments.
Sensory Overload
o Reception of multiple sensory stimuli
Factors Affecting Sensory Function
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Age
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Hearing
 Changes begin at the age of 30.
 Low pitched sounds are easiest to hear.
o Gustatory (Taste)
 Changes begin around 50.
o Olfactory (Smell)
 Changes begin around 50.
o Proprioceptive
 Changes with balance, spatial orientation, and coordination, begins after 60.
o Visual changes
 Changes begin 40-50
 Presbyopia: When lens becomes less flexible and unable to focus, takes longer
to accommodate
 Glasses for reading
Meaningful Stimuli
o Reduce incidents of sensory deprivation.
o Positive Effects: Examples: Pets, music, television, pictures of family member, calendar,
and clock
o Negative Effects: Disruptive roommate, too many visitors, too much light/noise
Amount of Stimuli
o Combining all tasks at one time, meds, assessment, etc.
Social Interaction
o Talking, touching
o Absence of loved ones/friends can increase:
 Loneliness
 Isolation
 Anxiety
 Depression
Environmental Factors
o Occupations, work related injuries, sports & recreational activities.
Cultural Factors
o Americans have higher prevalence of glaucoma; cultural disparities are associated with
vision impairment.
o Certain cultures have higher prevalence of sensory function than others.
Chapter 9 Cultural Competence
Cultural Awareness
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Self-examination of one’s biases toward other cultures and in-depth exploration of one’s own
cultural and professional background
Cultural Knowledge
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Learning or becoming educated about the beliefs and values of other cultures and diverse ethnic
groups.
Cultural Skill
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Ability to conduct a cultural assessment of a patient to collect relevant cultural data about a
patient presenting problem.
Accurately conducting base physical assessment
Cultural Encounter
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Encourages health care professionals to engage face to face cultural interactions and other
encounters with patients from culturally diverse backgrounds.
Helps to modify a providers existing belief about a cultural group to prevent possible
stereotypes.
Cultural Desire
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Motivation of a professional to want to, not have to engage in process of becoming cultural
aware.
LEARN model: Listen, Explain, Acknowledge, Recommendations, Negotiate
Culture
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Learned and shared beliefs, values, norms, and traditions of a particular group
Guide or thinking, decisions and actions.
o Unconscious Bias
 Bias without realizing.
o Implicit Bias
 Bias you are aware of
Health Disparities
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A health difference linked with social, economic and/or environmental disadvantage.
Disease risk factor
Social Determinant of health
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Conditions where people are born, grow, live, work and age.
Intersectionality
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Model that looks at how marginalization affects people’s health and access to care.
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We are all at an intersection of privilege and oppression.
“Iceberg model” Most aspects of a person’s world view are hidden.
Racial, Ethnic and Cultural Identity
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Acculturation
o When an individual or group transitions from one culture and develops traits of another
culture
o The markers of the minority culture are maintained, so they can recognize themselves
as a distinct culture within the majority culture.
Assimilation
o Individual adapts to hosts cultural values, no longer prefers components of origin
culture.
o The minority culture loses its markers that set it apart and move into the cultural
traditions of the majority culture.
Model of Cultural Competence
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Campinha-Bacote
o Cultural awareness
o Cultural skill
o Cultural encounters
o Cultural desire