NR 222 Final Exam Study Guide Latest 2023 / 2024
Models of Health:
Clinical:
• Defined by the absence of illness, signs, and symptoms of disease.• May not seek preventative care or services.• People who use this model may not seek preventive health services or they may wait until they are very ill to seek care.• You go to the hospital if you need immediate help (such as a broken something not a cold you caught).Role Performance945, with performance based on societal expectations.• Illness would be the failure to perform roles at the ////////////////////////////////////////////////////////////////////////////level of others in society.
o EX: If you are sick, you get medicine to help you get back up and running
Adaptive:
• The ability to adjust positively to social, mental, and physiological change • Illness occurs when the person is unable to adapt
- Go through a traumatic injury and then you get help with adapting to a
new injury (takes a slow process).
Eudemonistic:
• Emphasizes the interactions between physical, social, psychological, and spiritual aspects of life • Goal attainment and meaning • May seek out alternative therapies, council of priest, rabbi, or minister • Strive for equilibrium
- A person dying of cancer may still be healthy if that person is finding
meaning in life at this stage of development.
Reasons why the Eudemonistic model is a better, more cost effective model to use today?• This was adopted by the healthcare system because it pays the hospitals, doctors, etc more money because people only come when they are in dire need of medical care thus needing more tests, medicine, procedures done to them and since every little thing costs money the hospital or facility gets paid either from the patient or insurance company. It is more expensive for the patient. Also it was adopted because people think they are healthy or they do not have enough money to go to the doctor for every little thing that happens to them.Why the Affordable Care Act can move America towards a Eudemonistic model?• This model is better because you are focusing on your health as a whole and emphasizes the interactions within social, spiritual, physical, and psychological aspects of life. You seek out alternative therapies such as ministers, rabbis, etc. It is a more holistic approach to medicine and therefore costs less since you are using different types of holistic treatments instead of the big medications from the big pharmaceutical companies. They don't let their illness slow them down.
Healthy People 2020:
What are the Overarching goals? 1 / 4
- Attain high-quality, longer lives free of preventable disease, disability, injury, and
- Achieve health equity, eliminate disparities, and improve the health of all groups.
- Create social and physical environments that promote good health for all.
- Promote quality of life, health development, and healthy behaviors across all life
premature death.
stages What is the differences from Healthy People 2010?• Healthy people 2010 had only two goals. Healthy 2010 is very vague. In Healthy People 2010, it was to eliminate, not just reduce, health
disparities. In Healthy People 2020, that goal was expanded even further:
to achieve health equity, eliminate disparities, and improve the health of all groups.
Define these terms and give two examples of each:
Primary Prevention • Health promotion Specific Protection • Catch it before it starts and make people aware of it.
o Examples: Periodic examinations, massive immunizations, nutritional
awareness and practice, exercise, safety precautions at workplace.
Secondary Prevention:
• Early Diagnosis, Prompt Treatment, and Disability limitation • Screenings (MRI, BP measurement, Dental Examinations, mammographs, diagnostic tests, HIV testing)
Tertiary Prevention:
• Restoration= highest level of functioning possible despite the limitation caused by injury.• Rehabilitation
- Rehabilitative care, hospice, outreach programs, palliative care
• Goal: prevent further disabilities or deduced functioning when possible
Define these terms and give an example related to nursing for each:
Fidelity • Agreement to keep a promise • Nurses need to follow through actions and interventions • Unwilling to abandon patients regardless of circumstances
- Even though you promised and cannot make it send someone else
to do it Non-maleficence • Avoiding of harm • Healthcare professionals try to balance risks and benefits of care while striving at the same time to do the least harm
o Ex: stopping a medication that would not benefit the patient
Autonomy • The right of independence- making decisions for themselves 2 / 4
• Right to say no • Include patients in decisions • Providers need to inform patients about risks and benefits of treatment plans • Ensure that patient understands and agree to treatment • Always take the time to explain to patient what you are doing
o Ex: Letting the patient go home even though it is against orders.
Justice • Fairness • Often used in discussing about healthcare resources, including distribution of scarce resources
o Examples: health insurance, hospital locations and services be fair with all
of the patients, have no favorites Veracity • Devotion to the truth • People whose health is in question are to various degrees reliant on the person who possesses the knowledge and skills to bring these to bear on their behalf.
o Ex: Always being straight up with the patient and telling the truth.
Beneficence • Best interest for the patient and NOT self interest • Positive actions for others
Understand the difference between these three types of insurance and how people gain access to
these health insurances in the Private Sector:
HMO • Deliver comprehensive health maintenance and treatment services to a group of enrolled individuals who prepay a fixed fee.• The employer pays a monthly or annual rate directly to the HMO.• The individual may also have out-of-pocket expenses such as copayments.• Go to primary doctor and get a referral for a specialty doctor • Can’t go to doctors outside HMO physicians PPO • Contracted providers provide services for discounted price • Additional costs if a provider outside the PPO is used.• To control costs, the provider must receive preauthorization from the PPO for a member to be hospitalized or for some procedures or tests, and second opinions are usually required before major procedures or surgical operations are performed.
POS • POS plans allow members, for an additional fee and higher copayment, to use providers outside the individual HMO network.
IPA • Independent physicians in solo or group practices who provide health care services to members of an HMO • Group practice model: HMO contracts with all physicians and specialists needed by the HMO enrollees, but physicians remain independent.• Some contracts are exclusive, requiring physicians to restrict care to members of an individual HMO, 3 / 4
• Other variations allow physicians to care for members outside the HMO.
• Network model: HMOs contract with individual physicians and with physician
groups for both primary and specialty services.
Understand the difference between Medicare and Medicaid: Who gains access?
Medicare:
-Federal Program -Paid through taxes -For people over 65 -Disabilities -End stage renal failure -Hospice • Part A
- Inpatient care in hospitals, skilled nursing facilities home health care, hospice
- Supplementary voluntary coverage
- Pays doctor’s visits
- Should not have a co-pay
- Pharmaceutical costs
- Growth in elderly population
- Depletion of Medicare resources (trust fund)
- Uncovered services (glasses, hearing aids)
• Part B
• Part D
▪ Multiple plans available ▪ Medication is not covered ▪ Need supplemental plans (extra insurance etc. anta Blue cross blue shield) to cover meds.▪ This company will not move medicate pays for something first • Challenged
Medicaid:
• Federal +State funds • Cost up to 50% of state budgets • Available
- Certain low-income individuals
- No age requirements
o Families with children: 5-year lifetime limit
• Services
- Inpatient and outpatient hospital care
- Prenatal care
- Physicians’ services
- Nursing facility services for persons >2
- Family planning services
- Rural health clinic services
- Laboratory and radiologic tests
- Pediatric, FNP, and nurse midwife services
- Certain federally qualified ambulatory & health center services
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