Workbook for Introductory Medical-Surgical Nursing RATED A+ UPDATE

Workbook for Introductory Medical-Surgical Nursing, 11e Chapter 1 SECTION 1: ASSESSING YOUR UNDERSTANDING Activity A 1. Illness 2. Client 3. Healthcare delivery system 4. Health 5. Medicaid Activity B 1. Holism 2. Healthcare team 3. Medicare 4. Diagnosis-related groups 5. Wellness Activity C 1. C 2. D 3. E 4. A 5. B Activity D 1. The major difference between illness and disease is that illness is highly individual and personal, whereas disease is something more definitive and measurable. For example, a client with arthritis presents with distinct pathologic changes associated with the disease. A person, however, may or may not be ill with arthritis. The degree of pain, suffering, and immobility varies from person to person. 2. Health maintenance refers to protecting one’s current level of health by preventing illness or deterioration, such as by complying with medication regimens, being screened for diseases such as breast cancer or colon cancer, or practicing safe sex. Health promotion refers to engaging in strategies to enhance health such as eating a diet high in grains and complex carbohydrates, exercising regularly, balancing work with leisure activities, and practicing stress-reduction techniques. 3. Medicare covers individuals who are 65 years or older, permanently disabled workers of any age with specific disabilities, and persons with end-stage renal disease. 4. The team includes physicians, nurses, psychologists, pharmacists, dietitians, social workers, respiratory and physical therapists, occupational therapists, nursing assistants, technicians, and insurance company staff. All members of this team collaborate on client issues (medical, social, and financial) to achieve the best possible outcomes. 5. Groups such as children, older adults, ethnic minorities, and the poor are most likely to be underserved by the healthcare system. Activity E 1. Point-of-service (POS) organizations involve a network of providers. Clients select a primary care physician within the group who then serves as the gatekeeper for other healthcare services. Clients can use healthcare providers in or out of the provider group, but may pay additional fees, such as a higher deductible or copayment, for providers outside the group, unless the primary physician approves. 2. Clients select a primary care physician within the group who then serves as the gatekeeper for other healthcare services. As with other types of managed care organizations, the focus is on prevention as the best way to manage healthcare costs. 3. Benefits for the insurer include discounted services, reduced services, and elimination of unnecessary referrals (Chitty & Black, 2011). 4. All are types of managed care networks. They provide a number of services within the network at a controlled cost. All provide incentive to stay within the network by providing lower cost services. Seeking services outside each of the organizations would incur higher costs for the client with the exception of the point-of service (POS) plan, which allows it if approved by the primary care physician who serves as the gatekeeper. The goal of all the organizations (POS, PPO, and PHO) is to maintain high-quality service and conta