Nutrition and Health: A Comprehensive Study Guide, Exams of Nursing

Download Nutrition and Health: A Comprehensive Study Guide and more Exams Nursing in PDF only on Docsity! NR 222 Unit SEVEN Final Exam 2024 fully answered COMPLETE STUDY GUIDE NR 222 Final Exam Health and Wellness University 2024 fully answered Unit 7 Edelman: Ch 11 (Skipped Food, Nutrition, and Poverty Part and parts in Nutritional Risk Factors and last few sections) 1. Nutrition in the US: Looking Forward from the Past a. Classic Vitamin-Deficiency Diseases a.i. 1940s, many nutrient-deficiency diseases, such as rickets, pellagra, scurvy, beriberi, xerophthalmia, and goiter, were still prevalent in US a.i.1. Disappeared because of availability of abundant food supply, fortification of some foods with critical nutrients, and the implementation of better methods of determining and improving the nutrient contents of foods a.i.2. introduction of iodized salt in the 1920scontributed greatly to eliminating iodine-deficiency goiter a.i.3. pellagra disappeared after discovery that inadequate niacin levels a.i.4. few cases of protein-energy malnutrition that are listed annually as causes of death generally occur as secondary results of severe illness or injury, premature birth, child neglect, problems of the homebound aged, alcoholism, or some combination a.ii. once-prevalent diseases of nutritional deficiency have been replaced by diseases of dietary excess and imbalance 2. HEALTH PROBLEMS RELATED TO POOR NUTRITION HEALTH PROBLEM∗ CONTRIBUTING LIFESTYLE AND NUTRITION PRACTICES† Anemia Diet with inadequate iron, folate, or vitamin B12 intake (depending upon type of anemia) Cancer (breast, cervical, andExcessive calorie intake, belly fat; low fiber intake colon) Cirrhosis Excessive alcohol intake Constipation Inadequate fiber or fluid intake; high fat intake; sedentary lifestyle Dental caries Excessive, frequent consumption of concentrated sweets or sugar-sweetened HEALTH PROBLEM∗ CONTRIBUTING LIFESTYLE AND NUTRITION PRACTICES† beverages; lack of fluoride; poor dental hygiene NR 222 Unit SEVEN Final Exam 2024 fully answered COMPLETE STUDY GUIDE NR 222 Final Exam Health and Wellness University 2024 fully answered Type 2 diabetes Excessive calorie intake; excessive fat intake (in particular saturated fat, trans fat); sedentary lifestyle Cardiovascular/heart disease Excessive calorie intake; excessive fat intake (in particular saturated fat, trans fat); excessive sodium, inadequate fiber intake; sedentary lifestyle Hypertension Excessive sodium and insufficient potassium intake; excessive calorie intake; possible excess alcohol intake; sedentary lifestyle Obesity Excessive calorie intake; excessive fat intake; sedentary lifestyle Osteoporosis Low calcium intake; low vitamin D intake; excessive intake of protein, sodium, and caffeine; sedentary lifestyle; excessive alcohol intake Underweight and growth failure Inadequate calorie intake; poor diet a. Dietary Excess and Imbalance a.i. Four leading causes of death directly associated with diet are coronary heart disease (CHD), some types of cancer, stroke, and diabetes mellitus a.ii. Four more major causes of death (accidents, cirrhosis of the liver, suicide, and homicide) are associated with excessive alcohol intake a.iii. two in three American adults and one in three children are either overweight or obese 3. Healthy People 2020: Nutrition Objectives a. food insecurity- access to adequate food is limited by lack of money and other resources, so are more likely to be overweight because the relatively lower cost of junk foods can promote overconsumption of calories b. Food and Nutrition Recommendations b.i. Dietary reference intake (DRI) b.i.1. reflect the latest understanding about nutrient requirements based on optimizing health b.i.2. developed to reflect a range of values with lower and upper limits to mitigate risk of adverse effects b.i.3. micronutrients- vitamins and minerals NR 222 Unit SEVEN Final Exam 2024 fully answered COMPLETE STUDY GUIDE NR 222 Final Exam Health and Wellness University 2024 fully answered c.v.1.c. Foods to reduce (Compare sodium in foods such as soup, bread, and frozen meals and choose the foods with lower numbers; Drink water instead of sugary drinks) d. Food Guidance System (MyPlate) d.i. MyPlate visually “reminds” consumers what a healthy “plate” looks like using a familiar place setting d.ii. new food guidance system puts four of the food groups on the plate (grains, vegetables, fruits, and protein group [which replaced meat and bean group]) with dairy (including milk and dairy substitutes) on the side d.iii. reflects general eating patterns of Americans and it has enough flexibility for different cultural traditions and eating patterns including vegetarian d.iv. ChooseMyPlate website includes an emphasis on resources for eating on a budget and how to access nutrition assistance programs e. Dietary Supplements and Herbal Medicines e.i. most U.S. adults take one or more dietary supplements either daily or occasionally And Almost 18% take other natural products such as fish oil, echinacea, flaxseed oil, and ginseng e.ii. dietary supplements- vitamins, minerals, herbals and botanicals, amino acids, enzymes, and others in a variety of forms (traditional tablets, capsules, and powders, as well as drinks and energy bars) e.iii. Dietary supplements are unregulated by the FDA in the sense that they do not require pre–market review or approval by the FDA, but supplement company is responsible for showing evidence that their products are safe and their label claims are truthful and not misleading and they do not have to provide that evidence to the FDA before marketing NR 222 Unit SEVEN Final Exam 2024 fully answered COMPLETE STUDY GUIDE NR 222 Final Exam Health and Wellness University 2024 fully answered e.iv. Reasons for these recalls include microbiological, pesticide, and heavy metal contamination; absence of a dietary ingredient claimed to be in the product; or the presence of more or less than the amount of the dietary ingredient claimed on the label e.v. Vitamin and Mineral Toxicity e.v.1. important to advise individuals not to overuse vitamins of the fat-soluble class (vitamins A, D, E, and K) e.v.2. an excess of vitamin A may be teratogenic during pregnancy (Excess preformed vitamin A (during the first trimester has been linked to birth defects of the eyes, lungs, skull, and heart) or may increase the risk of lung cancer for current or former smokers e.v.3. water-soluble vitamins such as vitamin C and the Bcomplex vitamins pose less danger, because the body is able to excrete them through the urine e.v.4. Nutrient imbalances and toxicities are less likely to occur when nutrients are derived from foods e.v.5. Most nutrient toxicities occur through supplementation, and in some cases with a combination of supplementation and fortification of foods (older women, who may be at risk at the 95th percentile of UL for calcium) f. Food Safety f.i. New disease-causing organisms have emerged and food imports from countries without the same safety standards as the US are on the rise f.ii. more consumers are demanding fresh produce and more seafood be available throughout the year as well as accessibility to less-processed foods, such as raw milk and fresh juices that are not cooked or pasteurized to kill bacteria f.iii. Consumers may also ignore warnings about unsafe food habits because of preferences for foods such as raw oysters, rare hamburgers, fresh juices, unpasteurized cheese, and runny egg yolks NR 222 Unit SEVEN Final Exam 2024 fully answered COMPLETE STUDY GUIDE NR 222 Final Exam Health and Wellness University 2024 fully answered f.iv. Causes: f.iv.1. Biological contaminants include bacteria, viruses, parasites, and fungi (yeasts and mold) f.iv.2. Chemical contamination refers to the presence of pesticides, kitchen cleaning supplies, and toxic chemicals in food that have been leeched out of worn metal cookware and equipment f.iv.3. Physical contamination includes dirt, glass chips, crockery, wood, splinters, stones, hair, jewelry, metal shavings from dull can openers, and an unintended allergen added to a food product that typically does not include that ingredient (such as peanuts) during food processing in the same location f.v. Examples of Common Food-Borne Pathogens f.v.1. Salmonellosis f.v.1.a. an infection caused by Salmonella f.v.1.b. most frequently reported cause of food-borne illness f.v.1.c. Foods of animal origin such as beef, poultry, milk, and eggs are often the source of infection f.v.1.d. all foods, including seafood from polluted water and vegetables, may become contaminated f.v.1.e. Contamination may also occur from unsanitary handling of foods and utensils by infected food handlers and contact with the feces of some pets, especially those with diarrhea f.v.1.f. abdominal cramping, mild to severe diarrhea, nausea, vomiting, and fever within 8 to 72 hours after infection f.v.2. E.Coli infection NR 222 Unit SEVEN Final Exam 2024 fully answered COMPLETE STUDY GUIDE NR 222 Final Exam Health and Wellness University 2024 fully answered i.iii. Choose fewer and smaller portions of high-fat or calorie-dense foods and beverages i.iv. Eat at least 2½ cups of a variety of fruits and vegetables every day i.v. Choose whole-grain breads, cereals, pastas, brown rice, and beans i.vi. Limit processed meat (bacon, sausage, luncheon meats) and red meats such as beef, pork, or lamb i.vii. Be physically active: Achieve and maintain a healthy weight i.viii. Limit alcohol consumption j. Osteoporosis Prevention j.i. bone disease characterized by low bone mass leading to fragile bones and an increased risk of hip, spine, and wrist fractures j.ii. balanced diet, adequate calories, and appropriate nutrients are the foundation for developing all tissues, including bone j.iii. Factors contributing to low calcium intake are restriction of dairy products because of food preferences or lactose intolerance, a generally low level of fruit and vegetable consumption, and a high intake of low- calcium beverages such as soft drinks Edelman: Ch 12 1. Exercise a. A holistic approach to physical activity involves exercise for cardiorespiratory health (endurance), exercise for musculoskeletal health (strength, flexibility, and bone density), and body awareness b. Body awareness and mindfulness during exercise facilitate self-inquiry and selfacceptance, helping to relieve psychological stress and preventing physical injury 2. Defining Physical Activity in Health a. Physical activity: body movement that is produced by the contraction of skeletal muscles and that substantially increases energy expenditure; includes transportation and vocational and leisure-time activity NR 222 Unit SEVEN Final Exam 2024 fully answered COMPLETE STUDY GUIDE NR 222 Final Exam Health and Wellness University 2024 fully answered b. Leisure-time activity can be further categorized into sports, recreational activities, and exercise training c. Exercise (exercise training): planned, structured, and repetitive body movement performed to improve or maintain one or more components of physical fitness d. Aerobic exercise: activity that uses large muscle groups in a repetitive, rhythmic fashion over an extended period to improve the efficiency of the oxidative energyproducing system and improve cardiorespiratory endurance; uses stored adipose tissue as a major fuel source e. Anaerobic exercise: high-intensity, short-duration activity that improves the efficiency of the phosphocreatine and glycolytic energy-producing systems and increases muscle strength, power, and speed of reactivity; uses phosphagens and glucose-glycogen as major fuel sources f. Physical fitness: a set of attributes (cardiorespiratory fitness, muscular fitness, and flexibility) that people have or achieve that relates to the ability to perform physical activity without undue fatigue or risk of injury g. Muscular fitness: the strength and endurance of muscles that allows for participation in daily activities with low risk of musculoskeletal injury h. Flexibility: adequate muscle length and joint mobility to allow free and painless movement through a wide range of motion (ROM) 3. Healthy People 2020 Objectives a. The goal of the Physical Activity and Fitness focus area is to “improve health, fitness, and quality of life through physical activity” b. recommend that children be active at least 60 minutes daily and advise adults to perform at least 150 minutes of moderate-intensity or 75 minutes of vigorous activity per week c. list for both aging and inactivity includes an increase in body fat and a decrease in all of the following: aerobic capacity, muscle mass (sarcopenia), metabolic rate, strength and flexibility, bone mass, sexual function, mental performance, immune function, and sleep quality 4. Effects pf Exercise on the Aging Process NR 222 Unit SEVEN Final Exam 2024 fully answered COMPLETE STUDY GUIDE NR 222 Final Exam Health and Wellness University 2024 fully answered a. older adults, exercise can improve health, prevent disability and hospitalizations, improve blood lipid profiles, and reduce body fat b. malnutrition, a common problem for older adults, is associated with a decline in muscle strength and thus poorer outcomes, such as decreased function c. health of the musculoskeletal system depends on movement and activity d. Bone strength depends on stresses applied by muscular and weight-bearing activity e. joints must do what they are designed to do—move and bear weight f. only way the cartilage can receive nourishment is through the manufacture and distribution of synovial fluid, which delivers nutrients, removes waste products, and lubricates joint surfaces g. older adults require at least 2 hours and 30 minutes of moderate-intensity aerobic activity weekly, as well as muscle strengthening on 2 or more days a week h. most common interventions to increase activity are self-monitoring, general health education, goal setting, supervised center-based exercise, problem solving, feedback reinforcement, and relapse prevention education 5. Cardiac Risk Factors a. risk of coronary heart disease (CHD) decreases as physical activity increases and that a plausible relationship between the decreased risk and a number of potential physiological and metabolic mechanisms exists a.i. Increasing levels of high-density lipoprotein (HDL) cholesterol a.ii. Decreasing levels of low-density lipoprotein (LDL) cholesterol a.iii. Decreasing serum triglyceride (TRG) levels a.iv. Decreasing high blood pressure a.v. Improving glucose tolerance and insulin sensitivity a.vi. Decreasing obesity; altering distribution of body fat a.vii. Reducing the sensitivity of the myocardium to the effects of catecholamines, thereby decreasing the risk of ventricular arrhythmias a.viii. Enhancing fibrinolysis and altering platelet function NR 222 Unit SEVEN Final Exam 2024 fully answered COMPLETE STUDY GUIDE NR 222 Final Exam Health and Wellness University 2024 fully answered h. low-to-moderate impact weight-bearing exercises combined with resistance and/or agility training facilitate the most effective gains in BMD 8. Arthritis a. upsets the balance of joint health and impaired joint function is the result b. rheumatoid arthritis and osteoarthritis have different causes and attack different parts of the joint c. Cartilage is destroyed and irregularities occur in the bone ends d. there is an ongoing progression in arthritis that cannot be reversed by exercise, physical activity nevertheless helps to restore health to synovium and cartilage, improve strength and flexibility, decrease joint vulnerability, and delay the onset of dysfunction e. exercise has been shown to reduce pain and joint stiffness, reduce fatigue, and improve function and psychological well-being in persons with arthritis f. emphasize exercises to develop joint ROM and flexibility (performed before aerobic or strength activities) and should also include muscle-strengthening (two to three times per week) and aerobic exercises (5 to 10 minutes with progression to 30-minute session 3 to 5 days per week) g. aquatic exercise is great for osteoarthritis but not fall risk but does greatly decrease pain levels h. aerobic exercise in persons with fibromyalgia can increase function and reduce some symptoms i. combination of aerobic and strength exercises to improve outcomes in those with rheumatoid arthritis j. further evidence is needed to determine if postponing exercise is appropriate during exacerbations of rheumatoid arthritis 9. Low back pain a. multifactorial disorder that is unlikely to be caused by a single factor b. Obesity is associated with an increased risk of low back pain c. lack of evidence that sedentary lifestyle is a risk factor for onset of low back pain NR 222 Unit SEVEN Final Exam 2024 fully answered COMPLETE STUDY GUIDE NR 222 Final Exam Health and Wellness University 2024 fully answered d. exercise can effectively reduce pain and improve function in persons with chronic low back pain, but there was no clear advantage to any one form of exercise e. health of the bony vertebrae and the cartilaginous disks depends on movement f. cartilage receives its nutrients from cyclical compression and decompression as a function of weight-bearing and non–weight-bearing movement g. effective in persons with low back pain include training of the deep and superficial paraspinal muscles as well as unweighted or suspended exercise h. Aerobic conditioning, such as walking, swimming, and stationary bicycling, is recommended to maintain endurance and prevent debilitation from inactivity 10. Immune Function a. erobic exercise, either alone or in conjunction with progressive resistance exercise, can be safely performed by adults living with HIV/AIDS b. aerobic exercise groups with nonexercising groups and found no significant differences in CD4 count c. regular exercisers and athletes are less likely to become ill than sedentary d. evidence also suggests that athletes are also at increased risk for infection during increased periods of training or after competition e. moderate exercise may decrease the risk of upper respiratory tract infection (URTI) below that of a sedentary individual, but high-intensity exercise may raise the risk above average f. Moderate exercise increases the release of immunostimulatory hormones, such as growth hormone and endogenous opiates, which have positive effect on NK cells g. Physical activity appears to lower the risk for many conditions, in particular breast cancer 11. Mental Health a. People who exercise regularly generally state that they feel better, have increased self-esteem, and have a more positive outlook on life NR 222 Unit SEVEN Final Exam 2024 fully answered COMPLETE STUDY GUIDE NR 222 Final Exam Health and Wellness University 2024 fully answered b. physical activity may be associated with reduced symptoms of depression and anxiety and improvements in positive affect and general sense of well-being 12. Exercise Prescription a. F(Frequency) a.i. 3 to 5 times a week of aerobic exercise a.ii. 2 to 3 times a week of resistance training b. I (Intensity) b.i. Moderate to vigorous, by heart rate and perceived exertion b.ii. Able to complete each resistance exercise, 8 to 12 repetitions, without strain c. T (Time) c.i. 20 to 60 minutes, plus warm-up and cool-down periods c.ii. 15 to 30 minutes to complete a series of 8 to 10 resistance exercises d. T (Type) d.i. Aerobic (walking, jogging, biking, swimming, rowing, cross-country skiing, elliptical trainer, NordicTrack, StairMaster, aerobics, dancing, skating, or rollerblading) d.ii. Resistance training (weight machines, free weights, and calisthenics such as push-ups, sit-ups, or pull-ups) (ACSM, 2006) 13. Aerobic Exercise a. frequency of three to five times a week is recommended b. Cross-training- performing different types of exercise on different days of the week or performing different types of exercise within one session b.i. Benefits: decreased risk of musculoskeletal injury, increased potential for total body conditioning, and improved long-term compliance because variety decreases boredom and removes exercise barrier of limited choices c. Borg Scale for rating perceived exertion (RPE) is a psychophysical category scale for subjective rating of sensations associated with the intensity of physical work c.i. scale uses ratings based on the individual’s overall feeling of exertion and physical fatigue NR 222 Unit SEVEN Final Exam 2024 fully answered COMPLETE STUDY GUIDE NR 222 Final Exam Health and Wellness University 2024 fully answered a. When a person is not feeling well, the exercise effort should be decreased or stopped until the individual is feeling better b. With an infection, a cold, or influenza, the body is under stress and overexertion will only increase that stress and possibly lengthen the healing time c. During an acute exacerbation, activity should be limited to necessary activities of daily living (ADLs), but on a regular basis staying active is important, adjusting activity levels as tolerated d. Extremes of heat and cold affect performance as the body adjusts to different temperatures and wind conditions e. Changing the time of day for exercise (early morning or later evening are better choices for humid days), adjusting fluid intake, and varying the length of warmup and cool-down periods will improve tolerance for environmental conditions and enhance exercise safety 16. Special Considerations a. men older than 40 years of age and women older than 50 years of age who plan a vigorous program (intensity more than 60% of MHR or VO2max) or who have either chronic disease or risk factors for chronic disease should consult an appropriate health care provider before starting exercise b. People with CHD or diabetes have special exercise needs b.i. Before starting, these individuals should have a medical evaluation, including an exercise tolerance test (ETT), to determine functional capacity and severity of disease c. CHD c.i. With exercise training, the increase in VO2max in persons with CHD averages approximately 20% after 3 months c.ii. With a decrease in submaximal HR or a decrease in systolic blood pressure (SBP) resulting from conditioning, myocardial oxygen demand is decreased and individuals are able to do a greater amount of work before reaching the anginal threshold NR 222 Unit SEVEN Final Exam 2024 fully answered COMPLETE STUDY GUIDE NR 222 Final Exam Health and Wellness University 2024 fully answered c.iii. increase in functional capacity allows for progression of exercise tolerance and progression with daily activities and leisure or vocational activities c.iv. parameters of the exercise prescriptions are the same as those for the general population, including frequency, intensity, duration, and mode of exercise and professional needs to determine the parameters d. Diabetes d.i. Exercise has long been regarded as part of the triad in the management of diabetes in conjunction with diet and medication d.ii. exercise lowers the blood glucose concentration of people with diabetes d.iii. individuals who have poor control (i.e., excessive blood glucose levels), exercise may induce a further increase in blood glucose levels, resulting in ketosis d.iv. teach individuals to incorporate activity into their daily life, pursue an exercise program if they wish, and develop strategies to avoid the complications of exercise d.v. regular physical activity is an important modality in the prevention and treatment of type 2 diabetes d.vi. People with type 2 diabetes should monitor their blood glucose levels and determine their responses to exercise d.vii. individuals with type 2 diabetes usually can follow the same exercise prescription parameters as those of the general population 17. Building a Rhythm of Physical Activity a. Adherence and compliance a.i. Physiological, behavioral, and psychological variables all influence the decision to be physically active a.ii. each person is unique, and success with exercise over the long term comes from recognition of personal motivation or core desire and support from the social environment NR 222 Unit SEVEN Final Exam 2024 fully answered COMPLETE STUDY GUIDE NR 222 Final Exam Health and Wellness University 2024 fully answered a.iii. individual’s biopsychosocial factors and spiritual beliefs affect the behavioral and attitudinal factors that influence the motivation and ability to adhere to an active lifestyle a.iv. Educating the public about physical activity helps to provide guidelines for safe and effective exercise, to reinforce potential benefits, and to alleviate misperceptions that may interfere with the decision to change behavior b. Creating a Climate that Supports Exercise b.i. Other people and organizations in the individual’s social environment can influence the adoption and maintenance of physical activity b.ii. Healthcare Professionals b.ii.1. Clinicians inquire about exercise habits, communicate the benefits of increased activity, assist the person in initiating activity, and provide adequate follow-up b.ii.2. Recognizing the stages of behavioral change helps in meeting people at their stage of readiness to change behavior b.ii.3. individual in precontemplation is not ready to actively change behavior so may respond better to support and information about the benefits of changing behavior rather than being placed in an action environment b.ii.4. Continued follow-up throughout the action phase into maintenance is valuable in helping the individual stay committed until the termination phase is reached and the behavior is secure b.iii. Family and Friends b.iii.1. Social support can be a valuable resource for behavioral change b.iii.2. Significant others or friends can serve as buddies, providing a source of companionship and motivation b.iv. Schools NR 222 Unit SEVEN Final Exam 2024 fully answered COMPLETE STUDY GUIDE NR 222 Final Exam Health and Wellness University 2024 fully answered i. Eustress- stress that can be challenging and useful (As stress increases, efficiency and performance also increase, but not endlessly) j. Distress- when stress becomes chronic or excessive, so the body is unable to adapt and maintain homeostasis (At a certain point performance and efficiency start to decrease significantly if stress continues unabated) k. Sociophysiology- a multidisciplinary perspective to integrate the “social” and “biological” worlds and answer the following question: “How do social processes impact the physiology of the organism and how does that altered physiology affect future social behavior?” 3. Physical, Psychological, Sociobehavioral, and Spiritual Consequences of Stress a. Physiological Effects of Stress a.i. Perception of threat stimulates a physiological pattern of neuroendocrine activation and behavioral changes mediated by the central nervous system a.ii. this reaction is adaptive, short-term, acute response to stressor a.iii. First termed the fight-or-flight response and later called the stress response a.iv. individual’s reaction to a real or imagined threat prepares the body for emergency reaction and fosters survival in circumstances of immediate, time-limited threat a.v. hypothalamus signals the sympathetic nervous system to release epinephrine and norepinephrine, along with other related hormones a.vi. resultant state of arousal is characterized by increased levels of: metabolism, pulse rate, blood pressure, respirations, and muscle tension a.vii. physiological arousal proceeds along three main pathways: a.vii.1. the musculoskeletal system a.vii.1.a. increases tension and tone a.vii.2. the autonomic nervous system a.vii.2.a. via the sympathetic branch, orchestrates a generalized arousal that includes increases in heart rate, blood pressure, and respiratory rate NR 222 Unit SEVEN Final Exam 2024 fully answered COMPLETE STUDY GUIDE NR 222 Final Exam Health and Wellness University 2024 fully answered a.vii.2.b. heightened awareness of the environment is triggered, and blood shifts from the visceral organs to large muscle groups a.vii.3. the psychoneuroendocrine system a.vii.3.a. stimulates the hypothalamic-pituitary-adrenal axis and the secretion of corticosteroids (primarily cortisol) and other neuroendocrine substances into the systemic circulation, increasing blood glucose levels, influencing sodium retention, and, in the acute phase, increasing the anti-inflammatory response a.viii. psychological effects of stress are best illustrated by its contributory role in negative mood states, including anxiety, depression, hostility, and anger a.ix. Exposure to stressful stimuli is associated with elevated cortisol levels and resultant effects on the immune system a.x. Duration, intensity, and timing of a stressor have been shown to affect immune responses a.xi. stress and lack of social support predicted self-reported cardiac symptoms, regardless of actual disease severity a.xii. reduce perceived stress by encouraging reappraisal and support seeking, rather than a ruminative, angry coping style b. Sociobehavioral Effects of Stress b.i. Risky behaviors and traits such as a sedentary lifestyle, obesity, overeating high-fat foods, smoking, substance use, and social isolation have been linked to morbidity and mortality b.ii. exercise, healthy diet, smoking cessation, healthy weight maintenance, and social interaction have been identified as leading indicators of health c. Spiritual Effects of Stress c.i. spirituality comprises feelings, thoughts, experiences, and behaviors that arise from a search for meaning and may include interconnectedness NR 222 Unit SEVEN Final Exam 2024 fully answered COMPLETE STUDY GUIDE NR 222 Final Exam Health and Wellness University 2024 fully answered with self, others, nature, and a higher force called God, a life-force/higher power, nature, or the transcendent c.ii. Many individuals feel spiritual without formal religious affiliation or practice c.iii. In response to stress, people often feel disconnected from life’s meaning and purpose; harmful effects on their health and well-being can result c.iv. Stressful events can shatter individuals’ spiritual center or conversely can move individuals to seek comfort in spirituality or religious practice, beliefs, or community 4. Health Benefits of Managing Stress a. specific stressors may differentially affect various physiological systems b. Psychotherapeutic approaches, such as interpersonal and cognitive-behavioral psychotherapies that focus on perception and management of life stressors, are effective treatments for depression and related mental health disorders c. Promoting a positive attitude and development of skills to cope with stress is foundational to many stress-management interventions d. characteristics of stress hardiness are control, challenge, and commitment e. stress-hardy individuals, stress is viewed as a challenge rather than a threat; they feel in control of situations in their lives, and they are committed to rather than alienated from work, home, and family f. Promoting stress management is a key component to disease management and better health outcomes g. Caregiver stress/burden can be described as the appraisal of the experience of caregiving including the taxing nature of behaviors of the recipient of care, role conflict or strain, and physical and mental health effects on the caregiver h. importance of caring for the caregiver to prevent significant burnout grows i. middle-aged adults who are carrying concurrent responsibility for their children and aging parents is at particular risk for severe caregiver burden 5. Assessment of Stress a. includes past and present subjective and objective data NR 222 Unit SEVEN Final Exam 2024 fully answered COMPLETE STUDY GUIDE NR 222 Final Exam Health and Wellness University 2024 fully answered d.iv. psychological changes such as improved mood and behavioral changes, including a reduction in risky behaviors, can occur d.v. relaxation response can counteract stress-related disease processes, particularly processes associated with immunological, cardiovascular, and neurodegenerative disorders d.vi. techniques that involve mental focusing: d.vi.1. repetition of a word, sound, phrase, prayer, image, or physical activity d.vi.2. passive disregard of everyday thoughts when they occur d.vii. have the person make a fist and notice what happens to the breathing pattern (Most people have a tendency to hold their breath while tensing a body part) d.viii. Now ask the person to take a few deep diaphragmatic breaths while making a fist (Most people will notice that the tension is much harder to maintain while taking a deep breath) d.ix. This awareness helps to recognize relationship between breath and tension d.x. By stopping and taking a few deep breaths when they become aware of physical changes (holding the breath or clenching the jaw) or emotional changes (feeling anxious or angry), individuals can elicit the relaxation response, reduce sympathetic arousal, calm negative mood states, and gain a sense of control d.xi. Yoga and deep breathing can assist with mindfulness (i.e., awareness of perception) and promote relaxation d.xii. Using Mini-Relaxations d.xii.1. Mini-relaxations can be taught quickly and used throughout the day to help develop awareness and to counter the negative effects of stress on the mind, body, and spirit d.xii.2. Individuals can be taught to monitor minor stress warning signs (jaw and shoulder tension) and to use a mini-relaxation NR 222 Unit SEVEN Final Exam 2024 fully answered COMPLETE STUDY GUIDE NR 222 Final Exam Health and Wellness University 2024 fully answered exercise (few conscious, deep diaphragmatic breaths to several minutes of sitting quietly) to keep these initial symptoms of stress from developing into an incapacitating tension headache e. Alternative and Complementary Therapies e.i. Acupuncture- used to reduce pain and to prevent and manage various disorders by placement of fine needles at specific meridian points on body e.ii. Hypnosis- narrows consciousness and elicits relaxation, inertia, and passivity, like sleep, yet awareness is never lost completely and the hypnotized person can respond e.iii. Reiki- uses energy fields with the intent to affect health e.iv. aromatherapy, reflexology, and chiropractic and herbal therapies e.v. have developed outside the mainstream of traditional Western medicine; however, developing evidence of efficacy has promoted growing acceptance of some of these approaches f. Expressive Writing f.i. Transforming thoughts and emotions related to stressful experiences into written language has demonstrated positive effects on health f.ii. involves telling a “story” about traumatic, emotionally charged, or stressful events and personal reactions f.iii. Journal writing (self-confessional writing)- is a form of expressive writing that typically is done via entries in a journal over time that describe unfolding personal responses to life events f.iv. can help people reflect on stressful events and their reactions to events f.v. Nurses can advise people to get a special notebook for a journal and write about a stressful event for 15 minutes a day, in a setting in which they will not be interrupted g. Nutrition: Healthy Diet g.i. nutrition has moved to the forefront as a major component of health promotion, disease prevention, and symptom management NR 222 Unit SEVEN Final Exam 2024 fully answered COMPLETE STUDY GUIDE NR 222 Final Exam Health and Wellness University 2024 fully answered g.ii. Food is now viewed as a positive influence on health, physical performance, and state of mind, rather than simply a fuel needed to prevent disease and sustain life g.iii. Adaptive eating is characterized by balanced eating patterns and caloric intake as well as appropriate body weight for height h. Physical Activity h.i. one of the most effective ways to lose weight and improve self-esteem is to combine exercise with nutritious eating h.ii. Exercise (physical activity that improves strength, flexibility, and conditioning) and balanced nutrition serve as protective factors against several major chronic diseases h.iii. Regular physical activity helps people adopt a more active lifestyle as they begin to feel better physically and emotionally, thereby breaking the negative stress cycle i. Sleep Hygiene i.i. Many people suffer from sleep deprivation and sleep disorders that can cause or exacerbate conditions such as depression and fatigue and contribute to poor concentration and ineffective problem-solving i.ii. Insomnia can be induced by stress or other cognitive-behavioral factors, such as unrealistic expectations, inappropriate scheduling of sleep, trying too hard to sleep, consuming caffeine, getting inadequate exercise, and a number of other factors including illness, alcohol use, or drug use i.iii. Once factors associated with sleep disturbance are identified, nurses can help individuals improve their sleep patterns by counseling them to follow several sleep hygiene or behavior guidelines (keeping a sleep diary, having a regular sleep-wake cycle, and making prudent dietary changes) j. Cognitive-Behavioral Restructuring NR 222 Unit SEVEN Final Exam 2024 fully answered COMPLETE STUDY GUIDE NR 222 Final Exam Health and Wellness University 2024 fully answered p.ii. people can feel disconnected from life’s meaning and purpose, which in turn affects spiritual health and well-being p.iii. individuals may choose to elicit the relaxation response through prayer p.iv. Expression of anger or confusion in the face of difficulties, trauma, or tragedy also can provide a therapeutic outlet, but conversely may engender spiritual or religious doubt, or a sense of alienation from one’s beliefs p.v. suggest a referral to a chaplain or clergy member, provide spiritual music or art work, recommend spiritual reading material, and provide personal presence q. Clarifying Values and Beliefs q.i. people must recognize the things and values that are important to them, reflect on where they are in life, evaluate what needs to be changed, and generate an action plan for that change q.ii. The first step is to identify what is important, meaningful, and valuable so as to assess whether actions are consistent with beliefs q.iii. When people assess their values and beliefs, they employ the ability to make their own choices rather than relying on beliefs and values dictated to them by others q.iv. ask them to identify what is important or meaningful to them r. Setting Realistic Goals r.i. Developing an action plan for change to work toward a more balanced health-promoting lifestyle that is consistent with a person’s values and beliefs is an important stress-management strategy r.ii. Goals should be specific, concrete, measurable, and achievable r.iii. facilitate this process by respecting the individual’s input and using a values clarification exercise to facilitate a more complete database to guide individuals to identify and prioritize problems to be addressed, and set mutually agreed on long-term and short-term goals NR 222 Unit SEVEN Final Exam 2024 fully answered COMPLETE STUDY GUIDE NR 222 Final Exam Health and Wellness University 2024 fully answered r.iv. encourage individuals to challenge themselves when their behaviors aren’t consistent with what they identified as important and meaningful to them s. Humor s.i. can open different perspectives on problems and facilitate objectivity, which increases a sense of self-protection and control s.ii. Humor has potential as an accessible, enjoyable, and inexpensive stressreduction strategy that can offer people new perspectives on their world and themselves s.iii. recognizing that humor can mask conflict or be hurtful is critically important in judging when and how to use it in clinical and work setting 7. Effective Coping a. stressful situation is perceived as a challenge rather than a threat b. When people believe that their lives are more balanced and under control, they are productive, but not driven; are aroused, but not anxious; and may even be physically or mentally tired, but not exhausted c. coping is the ability to find a balance between acceptance and action, between letting go and taking control d. stress-management strategies help individuals distinguish these differences by providing a format for observing or objectifying their experiences Edelman: Ch 14 1. Holistic Vs Allopathic a. holistic nursing- all nursing that has healing the whole person as its goal and integrates complementary and alternative medicine (CAM) approaches into clinical practice b. Whole health is comprised of five dimensions—physical, spiritual, emotional, intellectual, and social; other sources add environmental as a sixth element NR 222 Unit SEVEN Final Exam 2024 fully answered COMPLETE STUDY GUIDE NR 222 Final Exam Health and Wellness University 2024 fully answered c. allopathic medicine traditionally supports the physical dimension, and most often promotes curative interventions rather than preventive modalities d. allopathic medicine focuses on identifying diseases and conditions by a physician and using drugs and surgery to treat bacteria and other ailments e. Too often in modern health care practice an individual seeking care is identified by the disease or condition causing the ailment f. alternative styles of health care focus on seeing care recipients as whole people, increasing well-being, and giving consumers greater control over self-care g. Holism entails a focus on proactive, healthy living and considers not only prevention but also the root cause of the illness h. CAM - a group of diverse medical and health care systems, practices, and products that are not generally considered part of conventional medicine or Western allopathic medicine and the traditional medical providers in the United States health care system i. complementary therapy - the use of CAM in conjunction with and as a complement to allopathic traditional medicine j. Alternative therapy- uses CAM in place of traditional medicine k. Integrative therapy- is the scientific, evidence-based use of combined CAM and traditional medicine with an emphasis on safety and effectiveness 2. Holistic Nursing a. nurses must understand the interventions that constitute holistic practice in order to discuss these practices with individuals who are using them to facilitate integrative care b. Nurses also find that holistic interventions such as energy work, bodywork, aromatherapy, prayer, meditation, massage, imagery, music therapy, and the movement arts of yoga, tai chi, and qi gong provide a useful adjunct to current nursing theory c. holistic nursing- nursing practice that heals the whole person; specialty practice that draws on nursing knowledge, theories, expertise and intuition to guide nurses in becoming therapeutic partners with people in their care. This practice NR 222 Unit SEVEN Final Exam 2024 fully answered COMPLETE STUDY GUIDE NR 222 Final Exam Health and Wellness University 2024 fully answered g.iv.1. promotion of foods high in iron to treat anemia and caloric restrictions for promotion of weight loss g.v. herbal therapy- use of herbs or their chemical properties to treat specific conditions or to enhance the function of various body systems, such as boosting the immune system, treating allergies, or preventing a cold g.vi. probiotics- live microorganisms found in the human digestive tract, such as “friendly bacteria” g.vi.1. taken to enhance the digestive system either as a supplement or in natural forms, such as yogurt or other fermented foods g.vii. hydrotherapy- use of water, ice, steam, and hot and cold temperatures to maintain and restore health g.vii.1. treatments include full body immersion, steam baths, saunas, spas, and the application of hot and/or cold compresses g.viii. aromatherapy- uses aromatic plant materials and the essential oils of plants to treat physical imbalances as well as to achieve psychological and spiritual well-being through inhalation, external application, or ingestion g.viii.1. essential oils have pharmacological, physiological, and psychological effects h. Manipulative and Body-Based Practices h.i. focus on the manipulation of bones and joints, soft tissues, and circulatory and lymphatic systems h.ii. Spinal or Bone Manipulation- application of controlled force on a bone or joint and is performed by chiropractors, physical therapists, osteopathic physicians, and some conventional medical doctors NR 222 Unit SEVEN Final Exam 2024 fully answered COMPLETE STUDY GUIDE NR 222 Final Exam Health and Wellness University 2024 fully answered h.ii.1. Chiropractic medicine- focuses on manipulation of the spine and joints, focusing on spinal alignment for optimal nervous system functioning h.ii.2. Cranial and cranio-sacral therapies- focus on a natural configuration of the skeletal system, focusing on the skull and the cranio-sacral system for the treatment of body imbalances h.ii.2.a. using gentle pressure to restore free movement of cerebrospinal fluid, allowing for normal functioning h.ii.3. Physical Therapy- integrates a variety of modalities including massage, manipulation, heat and cold, movement, and electrical impulses to treat the body after damage or injury, reduce swelling, relieve pain, and restore function and range of motion (ROM) to the body h.iii. Massage- incorporates different techniques in the manipulation of muscles and soft tissues of the body, such as stroking, kneading, pulling, or pinching the skin for pain relief, in order to increase circulation, to facilitate healing, and to reduce stress and increase relaxation i. Mind-Body Medicine i.i. focus on the interactions between the brain, the body, and behavior, using the mind to affect the body and the body to affect the mind i.ii. Meditation- focused attention to increase relaxation, quiet the mind, and reduce stress. Although it is often a part of many religious cultures, it is not necessarily a religious activity and can be practiced while being still or while being active, such as during walking i.iii. Imagery- gentle but powerful technique that focuses and directs the imagination in order to, among other things, promote a sense of well- being and to help people relax NR 222 Unit SEVEN Final Exam 2024 fully answered COMPLETE STUDY GUIDE NR 222 Final Exam Health and Wellness University 2024 fully answered i.iii.1. images are presented verbally but are designed to evoke all the senses, causing the person to focus attention on the image and thus relax as if they are actually there i.iv. Hypnotherapy- form of guided relaxation and focused attention of the unconscious mind i.iv.1. used for memory recall and for behavior changes such as discontinuing the use of tobacco products i.v. Biofeedback- relaxation technique concentrating on vital functions such heart rate, breathing rate, and blood pressure j. Movement Therapy j.i. use movement and bodywork to promote physical, mental, emotional, and spiritual well-being j.ii. Qi gong- part of traditional Chinese medicine, combining relaxed movements with a meditative aspect and controlled breathing to move qi energy through the energy channels and increase vital energy j.iii. Tai chi- Chinese martial art and combines physical movement, breath control, and meditation in a dancelike sequence of poses based on the movements of animals j.iv. Yoga- uses postures, controlled breathing, and meditation; comes from the Hindu tradition, originated as a form of spiritual practice, and aids in flexibility, agility, balance, and relaxation j.v. Hatha yoga- yoga of physical practice of various postures called asanas and of breath control, is most familiar to Western cultures j.vi. Dance therapy- another movement-based mind-body modality, using dance to allow the body and mind to move freely in response to the music k. Energy Work k.i. People are animate beings with energy, a life force present in all living and nonliving elements of the universe NR 222 Unit SEVEN Final Exam 2024 fully answered COMPLETE STUDY GUIDE NR 222 Final Exam Health and Wellness University 2024 fully answered the person to replenish depleted energy (modulation), and to balance or redistribute the individual’s energies (modulation) k.xii.2. Healing touch- adds full-body techniques for moving energy and disorder-specific energetic interventions to the modulation phase of TT k.xii.3. Reiki- In addition to teaching the hand placements and symbolic gestures used in Reiki, the master attunes the student k.xii.3.a. Attunement opens the energy channel, enabling the student to bring universal energy through the body and to the recipient k.xii.4. Jin Shin Jyutsu- uses fingertips pressed to specific healing point combinations to balance energy along specific pathways k.xii.5. Polarity therapy- a combination of energy work, caring intention, movement exercises, and dietary regimens and is aimed at clearing energy blockages and building health k.xii.6. Prayer- focuses on the subtle energy life force known by different names k.xii.7. Music therapy- use of specific kinds of music (or sounds) to produce desired changes in behaviors, emotions, and physiological processes k.xii.7.a. influences the limbic system, the area of the brain involved with emotions and feelings 4. Nursing Presence a. The way people interact with one another can cause pain or promote healing and is determined by a person’s presence b. Subjects maintained that nurse interactions followed a continuum from lifedestroying to life- sustaining to life-giving NR 222 Unit SEVEN Final Exam 2024 fully answered COMPLETE STUDY GUIDE NR 222 Final Exam Health and Wellness University 2024 fully answered c. Individuals perceived life-giving nurses as a healing force; they were perceived as “being present with,” rather than simply being there for, the individuals d. when nurses are “being with” subjects, the nurses’ attention was focused rather than merely attentive, their touch was caring rather than task oriented, and nurses did not merely hear, they listened 5. Safety and Effectiveness a. Most CAM therapies lack a strong scientific evidence base, as many have not been studied with rigorous, well-designed clinical trials b. NIH is sponsoring research to fill the knowledge gap and build this foundation for safety, efficacy, and suitability for specific conditions c. U.S. Food and Drug Administration (FDA) regulates dietary supplements, but the regulations are less strict than those for prescription or over-the-counter medications d. For example, safety and efficacy do not have to be proved before marketed, although, once on the market, it does monitor label claims and inserts e. Most CAM providers are not credentialed in a standardized national system, so credentialing regulations and standards vary nationally f. Some require training, testing, and continuing education, but most do not g. Carefully select CAM practitioners with appropriate training and experience. h. Take time to research and understand the treatment and ensure it is appropriate for the individual and the purpose. i. Be aware of scams. j. Treatment may not be covered by insurance. k.