the definition of health was to be free from disease

(1)

n the 19th century, the definition of health was to be free from disease. Disease was widespread at the time due to poor sanitation habits such as, purification of water or removal of waste. With time measures were implicated to reduce poor sanitation habits thus leading to diseases to being manageable. (Falkner, “Chapter 2”, 2018) In the 20th century health was defined as being a functional part of society which was free from disability or the inability to fulfilled roles in society. With the discovery of immunization vaccines disease prevention came to the for front. In 1948, the World Health Organization (WHO) was formed and the focus was on illness prevention.

Currently the definition of health is to preserve the necessary components to be healthy which are, physical, mental and spiritual wellness. In the United States, healthy living is the major focus. Health Promotion and disease prevention is how to have a healthy living. Every 10 years Health People 2020 identify what the nation’s health concerns are. They are to provide prevention measures.

It is important for nurses to implement health promotion interventions based on evidence-based practice because evidence has shown that if certain habits are practiced it increases a better living for the patient. According to the Healthy People 2020 the website provided great evidence-based information on the prevention of or management of illnesses. Such as, family history and/or eating habits with a high caloric intake of starches makes a person more prone to develop diabetes.

Reference:

Healthy People 2020. (n.d.). Retrieved February 4, 2020, from http://www.healthypeople.gov/

Falkner, A. (2018). Chapter 2. In Health Promotion: Health & Wellness Across the Continuum. Grand Canyon University. Retrieved from https://lc.gcumedia.com/nrs429vn/health-promotion-health-and-wellness-across-the-continuum/v1.1/#/chapter/2

Final Recommendation Statement: Abnormal Blood Glucose and Type 2 Diabetes Mellitus: Screening. U.S. Preventive Services Task Force. April 2018.
https://www.uspreventiveservicestaskforce.org/Page/Document/RecommendationStatementFinal/screening-for-abnormal-blood-glucose-and-type-2-diabetes

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Health, being a basic necessity of every human being has developed overtime to what it is currently. In the early 19th century, health was viewed as being free of disease as infectious diseases were predominant and hard to bottle up mainly because of poor sanitation including; insufficient disinfection of drinking water and poor waste disposal. As time went by, disease became more controllable through institution of proper sanitation measures in the early 20th century thus, shifting the definition of disease to be the ability to remain a functional part of society (Falkner, 2018). Due to the disease’s ability to cause chronic disabilities; the aspect of prevention became a priority whereby the invention and administration of vaccines helped in total eradication of many diseases (American Academy of Pediatrics, 2015).

With the emphasis of disease prevention taking precedence, health evolved into more than being disease free and with the WHO coming into existence, the focus changed and continues to be health promotion which has been defined to be the process of helping people to increase control over, and to improve their health, thus moving beyond a focus on individual behavior to a wide range of social and environmental interventions (WHO n.d.a). Given the goal to create a culture of maintaining healthy living and disease prevention rather than seeking treatment after disease infestation, this concept of health promotion has further advanced to include collaboration and partnerships of the US office of disease prevention with different states to address public health and provide funding for hospital expansion in an effort to meet the increasing needs for health promotion in the nation (Mallee, 2017). Besides this effort, there has been creation of a federal program for health; Healthy People 2020 which was designed to help decrease rising morbidity and mortality rates associated with diseases through setting new goals every 10 years.

Due to the impact of the above aspects, wellness has continually improved through factors such as health screenings, proper nutrition, healthy living behaviors and choices. Nurses who are usually the first contact of patients, are tasked with the responsibility of advocating health promotion to ensure quality care. Through their role as educators, they continually strive to be knowledgeable caregivers who base their practice on sound scientific evidence founded research. The incorporation of latest evidence, clinical expertise and patient preference and values helps to influence positive outcomes that ultimately enhance health promotion (Falkner, 2018).

References.

American Academy of Pediatrics. (2015). History of immunizations. Retrieved from https://www.healthychildren.org/English/safety-prevention/immunizations/Pages/History-of-Immunizations.aspx

Falkner, A. (2018). In GCU’s Health Promotion: Health and Wellness Across the Continuum. Retrieved from

https://www.gcumedia.com/digital-resources/grand-canyon-university/2018/health-promotion_health-and-wellness-across-the-continuum_1e.php

Mallee, H. (2017). The evolution of health as an ecological concept. Retrieved from https://sustainabilitycommunity.nature.com/posts/20580-science-paradigms-health-environment-evolution

World Health Organization. (n.d.a). Health promotion. Retrieved from http://www.who.int/topics/health_promotion/en/

 

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Haemophilus influenzae

Question 1 A 15-year-old boy is being carefully monitored for a skin infection and is being given ciprofloxacin. The nurse will observe for which of the following?

A) Arthropathy
B) Colitis
C) Hepatitis
D) Hypotension

Question 2 A patient has been admitted to the critical care unit of the hospital with bacterial septicemia that has failed to respond to initial antibiotic treatment. The patient’s most recent blood cultures reveal the presence of methicillin-resistant Staphylococcus aureus (MRSA) in the patient’s blood. The nurse will anticipate that this patient will likely require intravenous administration of what antibiotic?

A) Vancomycin
B) Penicillin G
C) Cefazolin
D) Doripenem (Doribax)

Question 3 Mr. Laird is a 49-year-old electrician who experienced severe burns on his trunk, arms, and hands in a workplace accident 2 weeks ago. Part of his current wound care regimen involves the daily application of silver sulfadiazine to his wounds.The nurses who are providing care for Mr. Laird in the burns and plastics unit of the hospital should perform what action when administering this medication?

A) Apply a layer of silver sulfadiazine that is sufficiently thick to make the wound bed invisible.
B) Cleanse the wound of debris prior to applying the silver sulfadiazine
C) Apply a thin layer of the drug to Mr. Laird’s wound beds using clean technique.
D) Perform thorough wound care immediately after the application of silver sulfadiazine

Question 4 A patient is prescribed ganciclovir to treat a CMV infection. An oral dosage is prescribed. To help increase bioavailability of the drug, the nurse will encourage the patient to take the medication

A) with high-fat meals
B) with orange juice
C) on an empty stomach
D) with high-protein meals

Question 5 A patient has endocarditis and is taking gentamicin. The nurse will be sure to monitor which of the following?

A) Potassium level
B) Creatinine clearance
C) Serum albumin level
D) Prothrombin time

Question 6 A 30-year-old woman who is in the first trimester of pregnancy has presented to her primary care provider with a 4-day history of a reddened, itchy left eye that is crusted with purulent exudate. The clinician suspects a bacterial, rather than viral, etiology. How will the patient’s pregnancy affect the potential use of ciprofloxacin to treat her conjunctivitis?

A) Ciprofloxacin is safe to use in pregnancy and the patient may use to same dose and route as a nonpregnant patient
B) The use of ciprofloxacin is contraindicated in pregnancy
C) It is safe for the patient to use topical ciprofloxacin but the oral route is potential teratogenic
D) The patient will require a lower dose and longer course of ciprofloxacin than a nonpregnant, adult patient

Question 7 A nurse has questioned why a patient’s physician has prescribed a narrow-spectrum antibiotic rather than a broad-spectrum drug in the treatment of a patient’s infection. Which of the following facts provides the best rationale for the use of narrow-spectrum antibiotics whenever possible?

A) Broad-spectrum antibiotics confound the results of subsequent culture and sensitivity testing.
B) Narrow-spectrum antibiotics normally require a shorter duration of treatment
C) The efficacy of most narrow-spectrum antibiotics has not been proven
D) The use of broad-spectrum antibiotics can create a risk for a superinfection

Question 8 A 72-year-old patient is prescribed ophthalmic ciprofloxacin for a bacterial infection in her right eye. The nurse will teach her to observe for which of the following adverse effects of the drug?

A) Lid margin crusting and pruritus
B) Cognitive changes
C) Nephrotoxicity and neurotoxicity
D) Tendon ruptures

Question 9 A patient has been prescribed oral tetracycline.The nurse will instruct the patient to take the drug

A) on an empty stomach 1 hour before or 2 hours after taking any meals or other drugs.
B) with a meal.
C) with milk or fruit juice.
D) at bedtime only.

Question 10 A 20-year-old female patient is receiving topical clindamycin for acne vulgaris. She develops a rash and urticaria along with severe itching where the medication is applied. The nurse will formulate which of the following nursing diagnoses for the patient?

A) Diarrhea
B) Risk for Injury related to allergic reactions
C) Imbalanced Nutrition: Less than Body Requirements
D) Risk of Injury related to blood dyscrasia

drug therapy, including INH and rifampin. A priority assessment by the nurse will be to monitor which combination of laboratory test results?

A) Serum alanine transaminase, aspartate transaminase, and bilirubin
B) Red blood count, white blood count, and differential
C) Thyroid-stimulating hormone, thyroxine, and triiodothyronine levels
D) Fasting blood sugar and 2-hour postprandial blood sugar

Question 12 An immunocompromised cancer patient has developed cryptococcal meningitis and been admitted to the intensive care unit for treatment with amphotericin B. How should the nurse most safely administer this drug?

A) Hang the drug by piggyback with lactated Ringer’s and infuse over several hours to minimize the risk of infusion reaction
B) Infuse the drug over 2 to 4 hours into a central line using an infusion pump
C) Flush the patient’s central line with normal saline and infuse the amphotericin B by intravenous push over 5 to 7 minutes.
D) Place the patient on a constant infusion of amphotericin B at a rate determined by the patient’s body weight.

Question 13 A nurse is aware that the concept of selective toxicity is foundational to antimicrobial therapy. Which of the following statements most accurately describes selective toxicity?

A) A drug harms microbes without harming human cells
B) A drug’s effect on microorganisms is proportionate to dose
C) Most microbes may be collected from a host and cultured on an alternative medium
D) A drug can be isolated and produced in a controlled manner in a laboratory setting

Question 14 An immunocompromised patient in a critical care setting has developed a respiratory infection that has been attributed to methicillin-resistant Staphylococcus aureus (MRSA). The nurse should anticipate that the patient will require treatment with

A) ciprofloxacin
B) clindamycin
C) vancomycin
D) an antistaphylococcic penicillin

Question 15 Laboratory testing has confirmed that a patient has chloroquine-resistant malaria and the patient’s physician has prescribed quinine along with an adjunctive drug. The nurse should question the physician’s order if the patient has a history of

A) osteoporosis or low bone density
B) chronic obstructive pulmonary disease (COPD)
C) diabetes mellitus
D) cardiac arrhythmias

Question 16 A 46-year-old man is receiving a quinupristin/dalfopristin IV infusion for a life-threatening infection. Which of the following would be most important for the nurse to monitor?

A) Increased heart rate
B) Breathlessness
C) Infiltration, edema, or phlebitis at the infusion site
D) Nausea and vomiting

Question 17 A patient with AIDS has developed a number of secondary infections in recent weeks, including Kaposi’s sarcoma. As a result of this most recent diagnosis, his care team has opted to begin treatment with interferon alfa-2a. The nurse is aware that this drug will address the etiology of Kaposi sarcoma by

A) inhibiting tumor growth by enhancing inflammation
B) potentiating the effects of phagocytes and macrophages
C) causing mutations in the DNA of cancerous cells
D) increasing the production of B cells and T cells

Question 18 Sulconazole has been prescribed for a patient with tinea pedis. The nurse will instruct the patient to use the topical agent

A) once a day
B) twice a day
C) three times a day
D) as needed

Question 19 Which of the following is critical to helping prevent development of resistant strains of microbes in patients?

A) Limit the exposure of bacteria to an antimicrobial agent
B) Keep the antimicrobial drug dosage high
C) Maintain the optimum duration of the antimicrobial agent
D) Maintain the maximum safe frequency of antimicrobial drug ingestion

Question 20 Which of the following nursing actions is most important in achieving successful antimicrobial therapy with vancomycin?

A) Provide maximum physical comfort to the patient
B) Monitor serum drug level
C) Taper down the drug dosage gradually
D) Promote adequate intake of fluids and nutrients

Question 21 A patient is being treated for Mycoplasma pneumoniae pneumonia. She is allergic to penicillin and is being given azithromycin (Zithromax) in capsule form. The nurse will inform the patient that she will need to take the capsule

A) with food
B) on an empty stomach
C) with or without food
D) immediately after she eats

Question 22 A patient is taking rifampin (Rifadin) for active TB. When discussing this drug with the patient, the nurse should stress that

A) the drug usually causes cardiac arrhythmias
B) the drug frequently causes seizure activity
C) facial flushing may appear but will go away once therapy is concluded
D) body fluids such as urine, saliva, tears, and sputum may become discolored

Question 23 A nurse is explaining the use of acyclovir therapy to a 72-year-old man. Nephrotoxicity is discussed as a major adverse effect in older patients. To minimize the risk of the patient developing this adverse effect, the nurse will advise him to

A) take the tablets on an empty stomach
B) decrease the drug dosage if initial symptoms of nephrotoxicity appear
C) stay well hydrated by drinking at least eight 8-oz glasses of water daily
D) eat light meals every day

Question 24 A 9-year-old boy was bought to his primary care provider by his mother with signs and symptoms of hookworm infection and will be sent home with a prescription for mebendazole. When provided patient and family education, the nurse should teach the mother with which of the following measures to avoid reinfection following treatment?

A) The importance of vigilant hygiene for the boy and the other members of the family
B) The need for the boy to provide…

Peer Reviewed Article Summary

Please submit a 150 word summary of the article, outlining why you chose the subject and how it might help you with this course.

Behav. Sci. 2014, 4, 423–436; doi:10.3390/bs4040423

behavioral sciences

ISSN 2076-328X www.mdpi.com/journal/behavsci

Review

Wayfinding in Healthcare Facilities: Contributions from Environmental Psychology

Ann Sloan Devlin

Department of Psychology, Connecticut College, 270 Mohegan Avenue, New London, CT 06320, USA; E-Mail: asdev@conncoll.edu; Tel.: +1-860-439-2333; Fax: +1-860-439-5300

External Editor: Jack L. Nasar

Received: 1 September 2014; in revised form: 13 October 2014 / Accepted: 20 October 2014 / Published: 31 October 2014

Abstract: The ability to successfully navigate in healthcare facilities is an important goal for patients, visitors, and staff. Despite the fundamental nature of such behavior, it is not infrequent for planners to consider wayfinding only after the fact, once the building or building complex is complete. This review argues that more recognition is needed for the pivotal role of wayfinding in healthcare facilities. First, to provide context, the review presents a brief overview of the relationship between environmental psychology and healthcare facility design. Then, the core of the article covers advances in wayfinding research with an emphasis on healthcare environments, including the roles of plan configuration and manifest cues, technology, and user characteristics. Plan configuration and manifest cues, which appeared early on in wayfinding research, continue to play a role in wayfinding success and should inform design decisions. Such considerations are joined by emerging technologies (e.g., mobile applications, virtual reality, and computational models of wayfinding) as a way to both enhance our theoretical knowledge of wayfinding and advance its applications for users. Among the users discussed here are those with cognitive and/or visual challenges (e.g., Down syndrome, age-related decrements such as dementia, and limitations of vision). In addition, research on the role of cross-cultural comprehension and the effort to develop a system of universal healthcare symbols is included. The article concludes with a summary of the status of these advances and directions for future research.

Keywords: wayfinding; healthcare; technology; user characteristics

OPEN ACCESS

Behav. Sci. 2014, 4 424

1. Introduction: Environmental Psychology and Healthcare Facility Design

Research from environmental psychology has the chance to improve our lives; this claim is nowhere more evident than at the intersection of environmental psychology and healthcare facility design. In addition, this intersection reflects one of the primary characteristics of environmental psychology: its interdisciplinary quality. Much of the research on healthcare facility design involves collaborations between environmental researchers and those in other professions (e.g., architecture, computer science). Some of the contributions are applications to existing topics (e.g., wayfinding) in the context of healthcare; other findings are specific to healthcare (e.g., the effects of same-handed vs. mirror-image inpatient rooms). Reflecting the interdisciplinary nature of the discipline, literature about these issues is not only found in the mainstays of the discipline (i.e., Environment and Behavior and the Journal of Environmental Psychology), but also in journals specifically developed for this subject matter (e.g., Health Environments Research and Design Journal). Beyond this inner core, research integrating environmental psychology and healthcare facility design is found in a wide array of journals indirectly related to the physical environment including nursing, critical care, pain, ergonomics, emergency medicine, comparative effectiveness research, intensive care, infectious diseases, and public health, among others. Research on wayfinding, the particular focus of this article, is also summarized in compendiums covering wayfinding in health care [1–3].

2. Wayfinding

Despite its fundamental role, wayfinding is often overlooked in the evidence-based design research, although Ulrich, Berry, Quan, and Parish [4] include it as one of their dimensions in a nine-faceted framework for evidence-based design. Reinforcing this assessment of wayfinding as an underappreciated aspect of the designed environment, a map designer quoted in Devlin’s [5] book about doctors’ offices points to the attitude of architects that wayfinding systems are often an afterthought and overlay. This map designer notes that wayfinding systems are infrequently part of the planning process at the programming stages. Facility planners are encouraged to use the master planning process to create effective wayfinding systems [6], but this advice is seldom heeded, despite the fact that wayfinding is one of the variables beyond clinical service that affect patients and staff [7,8]. This lack of recognition about the critical role of wayfinding systems has unfortunate outcomes because an environment that fosters independent wayfinding will reduce costs; people who are unsure where they are and how to reach a destination will interrupt staff engaged in other activities. For example, Nelson-Shulman [9] showed that patients exposed to posted signs in an admitting area made fewer demands on staff and were more knowledgeable about admitting procedures and amenities available, in contrast to patients without this posted information. A cost-estimate by Zimring [10], which is often cited, is that problems in wayfinding at Emory University Hospital cost the institution $220,000 annually. Most of the research using evidence-based design focuses on patients’ interactions with the clinical areas of the hospital, rather than on the more public spaces where wayfinding typically begins, despite the role of such spaces in the experience of patients and visitors.

An early application of wayfinding to the healthcare arena came from the work of Carpman, Grant, and Simmons [11], whose book Design that Cares: Planning Health Facilities for Patients and Visitors

Behav. Sci. 2014, 4 425

is a landmark volume that integrates environmental research and healthcare design. The authors argue that a “coordinated wayfinding system” is needed in healthcare facilities and that the ease of wayfinding will affect stress [11] (p. 19). Research from that book points to a number of themes that have received continued attention, including the importance of nomenclature (i.e., how destinations are named), density (i.e., the number of signs), context, placement, and visibility. Studies conducted for the University of Michigan Patient and Visitor Participation Project (PVP), part of the Replacement Hospital Program, generated much of the research for Design that Cares (both published papers and unpublished research reports) [12,13]. These documents look at such issues as the power of environmental affordance (what the environment “says” to us through its structure) vs. that of manifest cues (the effectiveness of the actual signage posted in the environment) [13].

A good deal of the research on wayfinding taps into the capacity of human cognition, including how much information we can hold in short term memory, for example the seminal article by Miller [14]; difficulties in multitasking [15]; and the schemas we have for the relationship between signage and the physical environment (e.g., that movement forward in space is up on a map) [16,17]. Research with applications for wayfinding in healthcare environments has often come from other institutional settings such as housing for the elderly or long-term care facilities [18,19] and libraries [20], although beyond Carpman et al. [11–13] there is some early work on healthcare environments [21–23]. From the standpoint of plan configuration and signage, wayfinding research on any large building or complex of buildings is applicable to healthcare environments.

2.1. Plan Configuration and Manifest Cues

Wayfinding is a particular challenge in large healthcare complexes with numerous buildings [7], often lacking distinctive appearance, which are linked to one another as the complex grows over time. Early on in the research on wayfinding, plan configuration was shown to be a correlate of wayfinding performance [24,25]. More recent research substantiates that finding. Using architecture students as newcomers to polyclinics that differed in their symmetry, Baskaya, Wilson, and Özcan [26] used reactions to a tour and a sketch map task to show the benefits of a regular but asymmetrical setting over a regular and symmetrical setting. Strikingly, 63.2% of the participants in the regular, symmetrical building felt “completely lost” during a tour in contrast to only 6.5% of those in the regular, asymmetrical setting [26] (p. 851). Baskaya et al. [26] showed that symmetry and repetition of similar elements could be a drawback to wayfinding, pointing again to layout as an element to be considered in the initial plan. The authors remark that landmarks to create distinctiveness may be particularly important in a building with symmetry. At the neural level, researchers are developing more sophisticated explanations of how landmarks may be coded, and the spatial layout itself has been described as a kind of landmark [27].

As the comment by Baskaya et al. [26] shows, wayfinding includes both attention to the floor plan (the building structure) and environmental cues (e.g., landmarks, signage) overlaid on that floor plan [28]. These distinctions are also reminiscent of the idea introduced by Carpman et al. [13] that we have the environmental affordance (what the structure suggests can occur) and the manifest cues (e.g., signage) that are used to elucidate the floor plan configuration. Some research [29] has placed environmental affordances (i.e., corridor width, brightness) in direction competition with manifest cues (i.e.,…

ping Psychoeducational Materials for Children

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n this interactive assignment, you will create a story for children to educate them about psychological assessment. To begin, select a targeted developmental or reading level pre-K through grade 6. Review the elements required for each section of your storybook below. Visit the My Storybook website (Links to an external site.) to familiarize yourself with this technology. Please review the instructions on the home page for Take a Writing Lesson, Build your Storybook, and Keep your Stories by selecting the link for Try it Now. After you create your free account and develop your story book, make sure you select Publish Public so that you can share your story book. You will be provided a link that you can share in the Week Two Interactive Assignment page so that other students can review your story. Do not select “share” or “download” as those require you to pay, which is not necessary for this assignment. As an alternative, you can develop a PowerPoint presentation with a screenshot of each page of your book for each slide. Please contact your instructor if you have any questions.

Your username will become the professional author name for your book. Therefore, when you register for your My Storybook account it is recommended that you use the following format for your username: first initial followed by last name (e.g., JSmith). If you receive a message that your username has been taken, it is recommended you include your middle initial (e.g., JASmith). Do not use Internet handles and/or other unprofessional appearing pseudonyms.

Review the information in Chapter 5 of your textbook corresponding to the assessments appropriate for the age group you selected and review the Mental Health Assessment (Links to an external site.) (2013) article for examples of information provided to the public about psychological testing. You may choose any appropriate title for your story. Be sure to address each of the following questions in your storybook in an age-appropriate manner:

Why is the character in the story being referred for testing?
Who will conduct the assessment?
What is being measured?
How long will testing take?
Who will be present during the assessment process? If not in the room, where will parents and/or guardians be while the character in the story is being tested?
How will the results be used? Who will have access to the results (e.g., medical doctor, family, the court, teachers), and why? This will vary depending on the character and plot in your story.
How will the tests be taken?
What will be the outcome of the assessment? How will the information be used? How might this information impact the life of the character in your story?

Include content to address any developmentally appropriate fears that individuals of the age group you selected may have. For example, young children commonly associate going to the doctor with getting a shot.

Be sure to include all the required material from the instructions above in your online storybook. Once you have created your storybook, include the link in your initial post. In your initial post, note the age or grade level for the target audience of the story. Briefly analyze and comment on the challenges and benefits related to explaining psychological assessment concepts using language that is developmentally appropriate for children. Compare at least two assessment instruments used to assess intelligence or achievement for the age group you selected. Include in-text citations and references for all sources used.

 

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