Download - Community HESI Study Guide

8/10/2019 Community HESI Study Guide

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Community Study Guide for the HESI

Keep in mind: This guide does not necessarily mean you will see these topics. There maybe other topics that are not included here. I just did an internet search to see which

topics are most frequently covered and have tried to give you some pointers here.

Review Healthy People 2020objectives in the chapters of your textbook- ust

fami!iari"e yourse!f with them# $hese are the basis for community hea!th pro%rams# &a%e

'() *(+

,eadin% Hea!th Indicators

+# ccess to Hea!th Services

*# C!inica! &reventative Services

.# Environmenta! /ua!ity

0# Injury and vio!ence

1# 2aterna!) Infant) and Chi!d hea!th

3# 2enta! hea!th4# 5utrition) physica! activity) and obesity

'# 6ra! hea!th

7# Reproductive and sexua! hea!th

+(#Socia! determinants

++#Substance abuse

+*#$obacco

Population Groups across the Lifespan and their Health Risks

Infants5umber + cause of injury or death is suffocation fo!!owed by 2otor 8ehic!e ccidentthen Homicide#

Sudden Infant 9eath Syndrome

Infection is the most si%nificant cause of i!!ness in infants and chi!dren#

Vertical transmission of infection- Passage of a disease-causing agent(pathogen) from mother to baby during the period immediately beforeand after birth. Transmission might occur across the placenta, in thebreastmilk, or through direct contact during or after birth. Forexample, H! can be a "ertically transmitted pathogen. #lso kno$n

as perinatal transmission.Children

Oesity: Hea!thy peop!e objectives have addressed youth fitness and obesity 9efined by usin% ;2I which is a ratio of wei%ht to hei%ht

Risks for childhood oesity !ere related to oesity in the parents

6besity rates are hi%her in popu!ations such as 5ative merican) Hispanic) andfrican mericans %roups# ,ower socioeconomic %roups in urban settin%s
http://www.medicinenet.com/breast_anatomy/article.htmhttp://www.medicinenet.com/breast_anatomy/article.htm


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have been associated with hi%her rates#

In"uries and #ccidents- 5umber one cause of death in a%es + : *0 yrs#2otor vehic!es accidents are the !eadin% cause of death amon% chi!dren and teena%ers#

$oddlersexperience a !ar%e number of fa!!s) poisonin%s) and motor vehic!e accidents

,ead poison from !ead based paint in o!der homes is a hea!th concern#,ead has detrimenta! effects particu!ar!y on the neuro system#

Can decrease It want ;,, ? 1mc%@d,

Infant %ortality Rate& the measure most common!y used around the wor!d as anindicator of overa!! hea!th and avai!abi!ity of hea!th services# 2ay want to review how to

ca!cu!ate it# Aof infants B+ who die@ A of !ive births in same year

'chool a(e childrenhave the !owest injury death rate however) this %roup has difficu!tyjud%in% speed and distance) p!acin% them at risk for pedestrian and bicyc!e accidents#

Vision screenin(in youn% chi!dren wou!d match shapes or co!ors#

#dolescents& Injury accounts for 41D of a!! deaths and risk-takin% becomes more

conscious at this time especia!!y amon% ma!es#

'uicide is the second leadin( cause of death amon( youths et!een the a(es of )*

and 2+, 'uicide is the third leadin( cause of death amon( youth et!een the a(es of

)0 and 2+ years, Community health pro(rams for adolescents should focus on

suicide preention,

9eve!opin% a smokin% pro%ram for ado!escents- first want to determine the incidence of

smokin% amon% the teena%ers in the community#

%enomune accine%iven to adu!ts youn(er than .0, It prevents infection by certain

%roups of menin%ococca! bacteria# 9ischar%e teachin%- %ive $y!eno!) watch for si%ns andsymptoms of reaction such as fever) behavior chan%e) sei"ures or difficu!ty breathin%#

#cute Illness- a!so a si%nificant cause of i!!ness in chi!dren#

Chronic Health Prolems- improved medica! techno!o%y has increased the number of

chi!dren survivin% with chronic hea!th prob!ems# Examp!es 9own Syndrome) spina

bifida) cerebra! pa!sy) asthma) diabetes) con%enita! heart disease) cancer) hemophi!ia)broncopu!monary dysp!asia) and I9S

Routine immuni/ations hae een ery successful in preentin( selected diseases,

Immuni/ation rates are the amount of people that (et scheduled accines, $hese

rates are used as uality indicators of the health of the population, Reie! the

immuni/ation schedule in children,11


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Good nutrition is essentia! for hea!thy %rowth and deve!opment and inf!uences disease

prevention in !ater !ife# e#%# Chi!dren and ado!escents ca!cium intake affects if they

deve!op osteoporosis in adu!thood#

omen

$he women>s hea!th movement was pivota! in brin%in% nationa! reco%nition to women>shea!th issues#

=omen have a !on%er !ife expectancy than men

=omen are more !ike!y to have acute and chronic conditions that re/uire them to usemore services than men#

frican-merican or b!ack women are statistica!!y more !ike!y to have poor hea!th

outcomes because of poor understandin% of hea!th) !ack of access to hea!th care) and

!ifesty!e practices#Heart disease !eadin% cause of death in women

,un% Cancer !eadin% cause of cancer in women and *nd!eadin% cause of death

%en2en are physio!o%ica!!y the more vu!nerab!e %ender) shorter !ife span and hi%her infant

morta!ity rate,ife expectancy of men in the FS is one of the !owest in the deve!oped countries

2en en%a%e in more risk-takin% behaviors than women

2en tend to avoid dia%nosis and treatment of i!!nesses that may resu!t in serious hea!thprob!ems

3lderly

Steadi!y %rowin% popu!ationIncrease in chronic conditions) demand for services) and strained hea!th care bud%ets

2ore o!der adu!ts !ive in the community- %e in p!ace

4urses address the chronic health concerns of elders !ith a focus on maintainin( or

improin( self-care and preentin( complications to maintain the hi(hest possile

uality of life,

ssessin% the e!der!y incorporates physica!) psycho!o%ica!) socia!) and spiritua! domains#Individua! and community focused interventions invo!ve a!! three !eve!s of prevention

throu%h co!!aborative practice#

hat accines should the elderly receie and ho! often5

-$etanus diphtheria eery )0 years

-Influen/a accine annually

-Pneumonia accine once after a(e 6* 7ask physician aout ooster eery * years8

-Herpes 9oster 7shin(les8 one time dose at a(e 60,

-Hep # and : for those at risk

;,', Healthcare prolems

2ore than 0. mi!!ion peop!e in the Fnited States are uninsured) and many more simp!y

!ack access to ade/uate hea!th care#


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Hea!th care reform measures seek to make chan%es in the cost) /ua!ity) and access of the

present system# Review $


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Parish nurses nurses who respond to hea!th and we!!ness needs within the faith context

of popu!ation of faith communities and are partners with the church in fu!fi!!in% the

mission of hea!th ministry#

Parish nursin( a community-based and popu!ation-focused professiona! nursin%

practice with faith communities to promote who!e person hea!th to its parishionersusua!!y focused on primary prevention#

Parish nurse coordinator a parish nurse who has comp!eted a certificate pro%ramdesi%ned to deve!op the nurse as a coordinator of a parish nursin% service#

&arish nurse services respond to hea!th) hea!in%) and who!eness within the context of the

church# !thou%h the emphasis is on hea!th promotion and disease prevention throu%houtthe !ife span) the spiritua! dimension of nursin% is centra! to the practice#

$he parish nurse partners with the we!!ness committee and vo!unteers to p!an pro%rams

and consider hea!th-re!ated concerns within faith communities

$o promote a carin% faith community) usua! functions of the parish nurse inc!ude persona!hea!th counse!in%) hea!th teachin%) faci!itatin% !inka%es and referra!s to con%re%ation and

community resources) advocatin% and encoura%in% support resources) and providin%

pastora! care#

&arish nurses co!!aborate to p!an) imp!ement) and eva!uate hea!th promotion activities

considerin% the faith community>s be!iefs) ritua!s) and po!ity#Healthy People*(+(

%uide!ines are basic to the partnerin% for the pro%rams#

5urses workin% in the parish nursin% specia!ty must seek to attain ade/uate educationa!

and ski!! preparation for the accountabi!ity to those served and to those who haveentrusted the nurse to serve

5urses are encoura%ed to consider innovative approaches to creatin% carin% communities#$hese may be in con%re%ations as parish nurses) amon% severa! faith communities in a

sin%!e !oca!e) or re%iona!!y or in partnership with other community a%encies or mode!s

such as b!ock nursin%#

$o sustain onese!f as a parish nurse hea!er) the nurse takes heed to hea! and nurture se!f

whi!e supportin% individua!s) fami!ies) and con%re%ation communities in their hea!in%

process#

Hospice&pa!!iative system of hea!th care for termina!!y i!! peop!e takes p!ace in the

home with fami!y invo!vement under the direction and supervision of hea!thprofessiona!s) especia!!y the visitin% nurse# Hospice care takes p!ace in the hospita! when

severe comp!ications of termina! i!!ness occur or when fami!y becomes exhausted or does

not fu!fi!! commitments# patient admitted into hospice usua!!y is expected to die within

3 months# $he care in hospice is pa!!iative care for the dyin% patient#


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=isaster Preparedness

&rofessiona! &reparedness Re/uires nurses and other personne! to be aware of and understand the disaster

p!ans at their workp!ace and community- participate in mock dri!!s

de/uate!y prepared nurses wi!! function in !eadership capacity and assisttowards smoother recovery phase ie!dwork) she!ter mana%ement re/uires creativeness and wi!!in%ness

merican Red Cross provides trainin% for hea!th professiona!s to adapt existin%

ski!!s to disaster settin%

Ro!e of Community Hea!th 5urse

Can initiate or update disaster p!ans at workp!ace and community and ensure

education) dri!! participation

Jnow!ed%e of vu!nerab!e popu!ations) avai!ab!e community resources

ssessin% and reportin% of environmenta! ha"ards) unsafe e/uipment) fau!ty

structures) disease outbreaks) e#%#) meas!es) f!u

:efore anythin( happens& &repare for Safety in a 9isaster our steps

+# ind out what cou!d happen to you

a# 9etermine what types of disasters are most !ike!y to happenb# ,earn about warnin% si%na!s in community

c# sk about care for pets

d# Review the disaster p!ans at workp!ace) and other p!aces where fami!ies

spend time to%ethere# 9etermine how to he!p the e!der!y or disab!ed

*# Create a disaster p!ana# 9iscuss types of disasters that are !ike!y to happen and review what to do

b# &ick * types of p!aces to meet

c# Choose an out-of-state friend to contactd# Review evac# &!ans

.# Comp!ete this check!ist

a# &ost emer%ency numbers next to phoneb# $each how to ca!! 7++

c# 9etermine when and how to turn off water) %as) and e!ectricity

d# Check ade/uacy of insurance covera%e

e# ,ocate and review use of fire extin%uishersf# Insta!! and maintain smoke detectors

%# Conduct a home ha"ard hunth# Stock emer%ency supp!ies

i# C&R certification

j# ,ocate a!! escape routes

k# ind safe spots


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0# &ractice and maintain your p!an

a# Review every 3 mos#

b# Conduct dri!!sc# Rep!ace stored water every . mos# and stored food every 3 mos#

d# $est and rechar%e fire extin%uisher

e# $est smoke detectors

Personal Preparedness

5urses who are disaster victims themse!ves and provide care to others wi!! experienceconsiderab!e stress#

#merican Red Cross and >ederal 3mer(ency %ana(ement #(ency 7>3%#8are two

we!! known authorities on disaster preparedness) response) and recovery

$hree !eve!s

+st!eve! : &ersona! &reparedness

*

nd

!eve!- &rofessiona! &reparedness.rd!eve!- Community &reparedness

%ost states and counties hae an Office of 3mer(ency %ana(ement 7O3%8 that is

responsile for deelopin( and coordinatin( emer(ency response plans !ithin their

defined area, $he state office supports local O3%s and other state a(encies that

participate in disaster response, It proides plannin( and trainin( serices to local

(oernments? includin( financial and technical assistance, =urin( an actual

emer(ency or disaster? the state O3% coordinates a state response and recoery

pro(ram if necessary, County O3%s are in char(e of creatin( a comprehensie? all-

ha/ard plan that should address realistic dan(ers to the community and list

aailale resources,

114urses need to reie! the disaster history of community? includin( ho! past

disasters hae affected the health care deliery system? ho! their particular

or(ani/ations fit into the plan? and !hat role they and their or(ani/ations are

e@pected to play in a disaster,

Sta%es &reparedness) Response) and Recovery

Preparedness&Jnow who is at risk) &ersona!) &rofessiona! and Community

&reparedness

&ersona! &reparedness

Entai!s p!an for keepin% onese!f ready for disaster) both menta!!y and physica!!y

Individua!s not persona!!y prepared wi!! have !ess to %ive to fami!y) community)

job) and other disaster victims

5urses can be disaster victims- persona! preparation needed to attend to patients

Check!ist he!pfu! to prepare


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&rofessiona! &reparedness

Re/uires nurses and other personne! to be aware of and understand the disaster

p!ans at their workp!ace and community- participate in mock dri!!s

de/uate!y prepared nurses wi!! function in !eadership capacity and assist

towards smoother recovery phase

ie!dwork) she!ter mana%ement re/uires creativeness and wi!!in%ness merican Red Cross provides trainin% for hea!th professiona!s to adapt existin%

ski!!s to disaster settin%

merican Red Cross ounded in +''+ by C!ara ;arton

9ifferent from E2 or 6E2 because it is a non%overnmenta!

vo!unteer a%ency# 2ana%es b!ood service and bone marrow re%istry

ssist with mi!itary !eaves

&rovides disaster trainin% for hea!thcare professiona!s

$akes part in disaster preparedness) response) and recovery#

Responsibi!ities durin% disaster operates she!ters) provides feedin%

services) provides individua! and fami!y assistance) provides disasterhea!th services) hand!es in/uiries from concerned fami!ies) coordinates

re!ief efforts with other a%encies and the %overnment) seeks contributions

Community &reparedness ,eve! of preparedness on!y as hi%h as peop!e@ or%ani"ations in the community

make it

=e!!-prepared communities have written disaster p!ans) conduct dri!!s) have

ade/uate warnin% system) and backup evacuation p!an

6ffice of Emer%ency 2ana%ement- state@ county office coordinatin% re%iona!

p!ans Fnderstandin% past disasters can inf!uence p!annin% for future) !iabi!ities in

resources

Response

$he primary objective of disaster response is to minimi"e morbidity and morta!ity#

$he !eve! of disaster determines E2>s response# Leels are not determined y the

numer of casualties ut y the amount of resources needed,

>3%# Leels of =isaster Response

,eve! III- a minor disaster) invo!ves a minima! !eve! of dama%e but cou!d resu!t in

the president dec!arin% an emer%ency# minima! re/uest for federa! he!p

,eve! II- moderate disaster- !ike!y to resu!t in major disaster bein% dec!ared#

Re%iona! federa! resources en%a%ed) other outside area may be ca!!ed on


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,eve! I- massive disaster) severe dama%e or mu!tistate scope# u!! en%a%ement of

federa! re%iona! and nationa! resources Citi"ens and hea!th professiona!s must be attached to officia! a%encies with

disaster mana%ement responsibi!ities to avoid further risk

#merican Red Cross. ways to c!assify a disaster

$ype- a%ent that caused the event) such as hurricane) ha"mat) transportation

,eve!- anticipated or actua! Red Cross response and re!ief costs

Leel I, costs less than A)0?000

Leel II costs A)0?000 or more? ut less than A*0?000

Leel II costs A*0?000 or more? ut less than A2*0?000

Leel IV costs A2*0?000 or more ut less than A2,* million

Leel V costs A2,* million or more

Scope- ma%nitude of the event) units affected and respondin% )e#%#) sin%!e-fami!y)!oca!) state) major) federa!!y dec!ared

'in(le family: affects an individua! or sin%!e fami!y- occurs within the

jurisdiction of a sin%!e Red Cross chapter

Local =isaster- ffects more than one fami!y) occurs within the jurisdiction of asin%!e Red Cross chapter

'tate =isaster- ffects mu!tip!e fami!ies) occurs within the jurisdiction of one or

2ore Red Cross chapters within a sin%!e state

%a"or =isaster- has one or more of the fo!!owin% characteristics

-coordinated response of mu!tip!e Red Cross units

- affects more than a sin%!e state

- creates nationa! news- resu!t in emer%ency or disaster dec!aration by the &resident etc#

Presidentially =eclared =isaster- re/uires fu!! or partia! imp!ementation of the5ationa! Response &!an

$he 4ational Response Plan

6nce a federa! emer%ency has been dec!ared) the 5ationa! Response &!an may take effect)dependin% on specific needs arisin% from the disaster# $he 5R& is a concerted effort to

prevent terrorist attacks within the FS reduce merican>s vu!nerabi!ity to terrorism)major disasters) and other emer%encies and minimi"e the dama%e and recover from

attacks) major disasters) and other emer%encies that occur#

Role of the 4urse

Ro!e in disaster response depends on nurse>s past experience) ro!e in community

disaster preparedness) specia!i"ed trainin%) specia! interest


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Community hea!th nurses va!ued for ski!!s in community assessment) case

findin%) prevention) education) survei!!ance) workin% with a%%re%ates

&!ans for tria%e must be%in as soon as rescue workers arrive- hi%hest priority

%iven to !ife-threatenin% injuries with hi%h probabi!ity of surviva!- nurse>s accurate

assessment info wi!! he!p match avai!ab!e resources to popu!ation>s emer%ency needs#

Recoery

$he recovery sta%e of disaster occurs as a!! invo!ved a%encies pu!! to%ether to restore the

economic and civic !ife of the community# or examp!e the %overnment takes the !ead

in rebui!din% efforts whereas the business community tries to provide economic support#

4urseBs Role in Recoery

%ultifaceted responsiilities- fle@iility reuired to assist in successful

recoery

$eachin( health promotion? disease preention? assessment of physical?

psycholo(ical prolems incurred in cleanup efforts? as !ell as threat of

communicale disease

Case findin(? referral for mental distress

#ssessment and reportin( of enironmental health ha/ards resultin( from

eent

Get community ack to normal? deal !ith emotional matters and after effects

ssess what mi%ht be %oin% on in community usin% primary) secondary and tertiary care

$errorism

Ro!e of the 5urse He!p peop!e cope with the aftermath of terrorism

!!ay pub!ic concerns and fears of bioterrorism

Identify the fee!in%s that you and others may be experiencin%

ssist victims to think positive!y and move to the future

&repare nursin% personne! to be effective in a crisis situation

5urses are concerned with nthrax) Sma!!pox) ;otu!ism) bruce!!osis) pneumonic p!a%ue

and Ricin and shou!d have awareness of these bioterrorism a%ents# Kou need to review

the bio!o%ica! a%ents and review how anthra@ e@posurecan occur from your textbook

outside of a bio!o%ica! attack# &neumonic p!a%ue and Sma!!pox are transmitted from

person to person via! respiratory or inha!ation exposure#nthrax -cutaneous first symptom is sore throat that deve!ops into a b!ister# ;!ister then

deve!ops into a skin u!cer with a b!ack area in the center# $he sore) u!cer and b!ister donot hurt#

- GI the first symptoms are nausea) !oss of appetite) b!oody diarrhea) and fever

fo!!owed by bad stomach pain#


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- Inha!ation first symptoms are co!d or f!u !ike symptoms and can inc!ude a sore

throat) mi!d fever and musc!e aches# ,ater symptoms inc!ude cou%h) chest

discomfort) S6;) tiredness) and musc!e aches#- Exposed) but not infected ntibiotics Cipro) !evof!oxacin) doxycyc!ine) or

penici!!in combined with the nthrax vaccine#

- Exposed and have infection 3( day course of antibiotics- Cutaneous) if !eft untreated) '(D recover# GI is more serious more than ha!f die#

Inha!ation is much more severe#

Sma!!pox 8ario!a virus- transmission is direct) face-to-face) and pro!on%ed# Can a!so be airborne#

- S@S hi%h fever) fati%ue) severe headache) rash that turns to pus-fi!!ed !esions)

vomitin%) de!irium) excessive b!eedin%

- $reatment no cure) just supportive care hydration) pain meds) antipyretics#- &revention vaccine provides +(-year immunity) but it is not rea!!y provided

anymore since sma!!pox has been eradicated#

- $he discovery of a sin%!e case of sma!!pox wou!d be an internationa! hea!th

emer%ency 9epartment of Home!and Security wou!d be invo!ved;otu!ism spread from contaminated food

;ruce!!osis comes from !ivestock or somethin%&neumonic p!a%ue airborne and can be spread person to person

Ricin airborne poison# Cannot be spread person to person# Re/uires an antitoxin) but

there isn>t one yet) so treatment wou!d just be supportive care unti! one is avai!ab!e#

5eed to have vaccine for sma!! pox when exposed as a hea!th care provider#

Leels of preention rt =isaster %ana(ement

Primary Preention- &articipate in deve!opin% a disaster mana%ement p!an for thecommunity

'econdary Preention- ssess disaster victims and tria%e for care

$ertiary Preention- &articipate in home visits to uncover dan%ers that may cause

additiona! injury to victim or cause other a!ready harmed

Population at Greatest Risk for =isruption #fter a =isaster

&ersons with disabi!ities

&ersons !ivin% on a !ow income) inc!udin% the home!ess5on-En%!ish speakin% persons and refu%ees

&ersons !ivin% a!one

Sin%!e-parent fami!ies&ersons new to the area

Institutiona!i"ed persons or those with chronic menta! i!!ness

&revious disaster victims or victims of traumatic events&eop!e who are not citi"ens or !e%a!!y documented immi%rants


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Substance abusers

$he five components to a comprehensive pub!ic hea!th response to outbreaks of i!!nessare the fo!!owin%

- 9etectin% the outbreak

- 9eterminin% the cause- Identifyin% factors that p!ace peop!e at risk

- Imp!ementin% measures to contro! the outbreak

- Informin% the medica! and pub!ic communities about treatments) hea!thconse/uences) and preventative measures

$ria%e the process of separatin% casua!ties and a!!ocatin% treatment on the basis of the

victims> potentia!s for surviva!#- Hi(hest priorityis a!ways %iven to victims who have !ife threatenin% injuries but

who have a hi%h probabi!ity of surviva! once stabi!i"ed

- 'econd priorityis %iven to victims with injures that have systemic comp!ications

that are not yet !ife threatenin% and cou!d wait 01 : 3( minutes for treatment- Last priorityis %iven to those victims with !oca! injuries without immediate

comp!ications and who can wait severa! hours for medica! attention#

Reie! the tria(e color system#ssess usin( the )-minute (uideline& )stcheck for respirations? 2ndcheck perfusion

y pinchin( the nail eds and assessin( reaction? .rdcheck mental status y askin(

simple uestions like? Dho are you5E

Green 7delayed8& In"ured or ill ut stale and not likely to deteriorate if treatment is

delayed 2 hours or more, Commonly referred to as !alkin( !ounded, alkin(?

respirations F.0? cap refill F2s? ale to follo! commands, 73@- minor in"uries? strain

or sprain8ello! 7ur(ent8& #cute prolem and stale? ut may deteriorate, Reuires treatment

!ithin 20 min-2hrs, 73@-open fractures? chest !ound8,

Red 7critical8& ;nstale !ith acute prolem, Immediate interention is likely to sae

life or lim, Life threatenin(? transport immediately, RR .0? cap refill 2s? doesnBt

oey commands, 73@- compromised air!ay? shock? hemorrha(e8,

:lack 7e@pectant8& dead or unsala(eale (ien the aailale resources, Lo! priority

transport, 73@- massie head in"ury? e@tensie full thickness urns8,

Rationale from 'aunders

In an emer%ency department) tria%e is c!assifyin% c!ients accordin% to their need for careand inc!udes estab!ishin% priorities of care# $he kind of i!!ness) the severity of the

prob!em) and the resources avai!ab!e %overn the process# C!ients with trauma) chest pain)severe respiratory distress or cardiac arrest) !imb amputation) acute neuro!o%ica! deficits)

and those who sustained chemica! sp!ashes to the eyes are c!assified as emer%ent and are

the number + priority# Remember the c!ient must be ab!e to survive#


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C!ients with conditions such as a simp!e fracture) asthma without respiratory distress)

fever) hypertension) abdomina! pain) or the c!ient with a rena! stone have ur%ent needs

and are c!assified as number * priorities#C!ients with conditions such as a minor !aceration) sprain) or co!d symptoms are

c!assified as non-ur%ent and are the number . priority#

Older adult health risks

5utrition) safety) socia! iso!ation) and depression

4eed to assess the health literacy of the client first efore !e teach

Pro(ram outcomes& smokin% cessation) wei%ht mana%ement) diabetic mana%ement

- !ook at the eva!uation of the specific outcome- Identifyin% chan%es in the c!ient>s hea!th status that resu!t from nursin% care

provides nursin% data that demonstrate the contribution of nursin% to the hea!th

care de!ivery system#

- 6utcome eva!uation is a chan%e in a c!ient>s hea!th status as a resu!t of pro%ramimp!ementation#

Research studies usin% the tracer or sentine! method to identify c!ients> outcomes and

c!ient satisfaction surveys can be used to measure outcome standards#

rom data) stren%ths and weaknesses in nursin% care de!ivery can be determined#

$he most common measurement methods are direct physical oserations and

interie!s,

Primary Care- refers to or%ani"ed community efforts desi%ned to preent disease and

promote health 7education8,

'econdary Care- an intermediate !eve! of hea!th care that inc!udes dia%nosis and

treatment# Screenin%#

$ertiary Care-rehabi!itation and return of a patient to a status of maximum usefu!ness

and a minimum risk of recurrence of a physica! or menta! disorder

Leels of Preention

Primary Preention- Counse! c!ients in hea!th behaviors re!ated to lifestyle

'econdary Preention- Imp!ement a fami!y-p!annin% pro%ram to preent unintended

pre%nancies#

$ertiary Preention- &rovide a se!f-mana%ement asthma pro%ram for chi!dren with

chronic asthma to reduce their need for hospita!i"ation prevent from %ettin% worse


14/26

>ederal #(encies

2any federa! a%encies are invo!ved in %overnment hea!th care functions# $he a%encymost direct!y invo!ved with the hea!th and we!fare of mericans is the F#S# 9epartment

of Hea!th and Human Services

;,', =epartment of Health and Human 'erices 7;'=HH'8

,ar%est hea!th pro%ram in the wor!d) its mission is to enhance the health and wellbeing

of the !merican peoplethrou%h the fo!!owin%

- !coho!) dru% abuse) and menta! hea!th pro%rams

- 9isease trackin% and identification- Hea!th care access for a!! and inte%rity of the nation>s hea!th entit!ement and

safety net pro%rams

- Identification and correction of hea!th ha"ards

- %edical assistance after disasters- 2edica! research

- &romotion of exercise and hea!thy habits- &rotection of the nation>s food and dru% supp!y

$he Hea!th Resources and Services dministration of the FS9HHS contains the ;ureauof Hea!th &rofessions) this bureau inc!udes separate divisions for nursin%) medicine)

dentistry) pub!ic hea!th) and a!!ied hea!th professions

$he 9ivision of 5ursin% administers nurse education !e%is!ation) interprets trends and

nursin% needs of the nation>s hea!th care de!ivery system) and serves as a !iaison with thenursin% community and with internationa!) state) re%iona!) and !oca! hea!th interests

$wo other a%encies with the 9HHS

$he 4ational Institute for 4ursin( Research 74I4R8and Healthcare Research and


15/26

are chronic or acute) curab!e or preventab!e) human error or de!iberate attack) C9C fi%hts

disease and supports communities and citi"ens to do the same#

C9C increases the hea!th security of our nation# s the nation>s hea!th protection a%ency)C9C saves !ives and protects peop!e from hea!th threats# $o accomp!ish our mission)

C9C conducts critica! science and provides hea!th information that protects our nation

a%ainst expensive and dan%erous hea!th threats) and responds when these arise#

Review 2edicare part ) ; and 9 and 2edicaid 'ocial 'ecurity #ct of )6*JJ-2edicare part provides payment for hospita! services) home hea!th services) and

extended care faci!ities 7'D of e!der!y covered

-2edicare part ; is avai!ab!e to a!! peop!e who wish to pay a month!y premium for thecovera%e# bout 73D of e!der!y are covered# &rovides covera%e for services other than

hospita!i"ations such as physician care) !ab) e/uipment) and ambu!ance services#

-2edicare part 9 covers prescription medication# $here are different options and costs for

part 9 covera%e#-2edicaid &rovides financia! assistance to states and counties to pay for medica! services

for the a%ed poor) the b!ind) the disab!ed) and fami!ies with dependent chi!dren# $hemedica! indi%ent is re/uired to pay a month!y premium#

Voluntary and Priate 4onprofit #(encies

8o!untary and private a%encies are %rouped to%ether as nonprofit home hea!th a%encies

vo!untary a%encies are supported by charities such as Fnited =ay) 2edicare) 2edicaid)

other third-party payers) and c!ient payment#

$he amount of financia! assistance the vo!untary a%ency receives depends on the

community it serves# =ith 2edicare) the private nonprofit a%ency emer%ed as an

a!ternative a%ency to the pub!ic-supported pro%ram# $hese a%encies inc!udedrehabi!itation a%encies) based in either rehabi!itation faci!ities or ski!!ed faci!ities#

5urses use assessment ski!!s to detect potentia! and actua! exposure pathways andoutcomes for c!ients cared for in the acute) chronic) and hea!thy communities of practice#

Risk communication is an important ski!! and must acknow!ed%e the outra%e factor

experienced by communities with environmenta! ha"ards#

Vulnerale populations- are those %roups who have an increased risk to deve!op adverse

hea!th outcomes) vu!nerab!e popu!ations often experience mu!tip!e cumulatie risksandthey are particu!ar!y sensitive to the effects of those risks#

8u!nerab!e popu!ations often are more !ike!y than the %enera! popu!ations to suffer from

health disparities#

Examp!es of areas that show hea!th disparities across popu!ations %roups are infant

morta!ity) chi!dhood immuni"ation rates) and disease-specific morta!ity rates#


16/26

Vulnerale Population Groups of 'pecial Concern to 4urses

- &oor and home!ess peop!e- &re%nant ado!escents

- 2i%rant workers and immi%rants wi!! need immuni"ations and screenin% for $;

- Severe!y menta!!y i!! individua!s- Substance abusers

- bused individua!s and victims of vio!ence

- &ersons with communicab!e disease and those at risk- &ersons who are human immunodeficiency virus HI8 positive or have Hep ; or

sexua!!y transmitted disease#

:ehaioral 7Lifestyle8 Health Risk #ssessment

ami!ies are the major source of factors that can promote or inhibit positive !ifesty!es# It

is important to !ook at risks for the fami!y as a unit#

Critica! dimensions of !ifesty!e risks inc!ude the fo!!owin%- 8a!ue p!aced on behavior

- Jnow!ed%e of the behavior and its conse/uences- Effect of the behavior on the fami!y

- Effect of the behavior on the individua!

- ;arriers to performin% the behavior- ;enefits of the behavior

It is important to assess the fre/uency) intensity) and re%u!arity of specific behaviors# It

a!so is important to eva!uate the resources avai!ab!e to the fami!y for imp!ementin% thebehaviors#

$ranstheoretical Chan(e $heory-be!ief that peop!e are in a sta%e of wi!!in%ness tochan%e# ;ehavior chan%es !ike exercise) wearin% seatbe!ts or he!mets are persona!

decision and cannot be forced# $he community hea!th nurse educates the c!ient in hopes

of movin% them from not en%a%in% in a hea!thy behavior to at !east considerin% doin% itin the next 3 months#

%odifiale Risk and ;nmodifiale Risks

Risk factors that are Lunmodifiab!e)L are thin%s that neither you nor your patients can doanythin% about# Kou need to know the Lunmodifiab!eL risk factors) because they he!p you

to define hi%h-risk individua!s and %roups for whom treatin% or contro!!in% the

Lmodifiab!eL risk factors is a priority#

If a /uestion has modifiab!e risk factors and non-modifiab!e risk factors as choices) pick

the non-modifiab!e one#

2odifiab!e risks can be chan%ed such as smokin%#

3pidemiolo(y K ho! to calculate a rate


17/26

$he denominator inc!udes the numerator

Examp!e Crude birth rate 5umber of !ive births durin% + year M+((( 2idyear popu!ation

ttack Rate A of peop!e exposed N deve!oped disease&opu!ation at risk

OO Expressed in D

3aluatin( Outcomes

6utcomes can be measured by !ookin% at chan%es from before and after the intervention

to so!ve the prob!ems# Chan%es in the fo!!owin% can be used to see the outcomes of the

interventions- 9emo%raphics

- Socioeconomic factors

- Environmenta! factors

- Individua! and community hea!th status- Fse of hea!th services

In the examp!e of infant ma!nutrition) one wou!d !ook for the number of cases of infant

ma!nutrition in the community before providin% education to other hea!th providers about

assessment of infant deve!opment# time period for eva!uation wou!d be chosen andperhaps + year !ater the time frame# $he number of cases of infant ma!nutrition wou!d

be measured to see if a chan%e had occurred and there were fewer cases#

Incidence rate- the fre/uency or rate of ne!cases of an outcome in a popu!ationsprovides an estimate of the risk of disease in that popu!ation over the period of

observation ormu!a P A of new cases &op# t risk

OO &opu!ation at risk is the tota! popu!ation minus the existin% cases

OOExpressed per +()(((

Prealence number of e@istin(cases in a popu!ation at a %iven time

ormu!a P A of existin% cases $ota! popu!ation

OO Expressed per +(()(((

4ursin( Process- !ways assess before startin% an intervention

Community assessment

%ost nurses are familiar !ith the nursin( process as it applies to indiidually

focused nursin( care, ;sin( it to promote community health makes this same

nursin( process community focused,


18/26

Community assessment- the process of critica!!y thinkin% about the community and

invo!ves %ettin% to know and understand the community as partner# $he communityassessment phase invo!ves a !o%ica!) systematic approach to the initia! phase of the

nursin% process# Community assessment he!ps as fo!!ows

- $o identify community needs- $o c!arify prob!ems

- $o identify stren%ths and resources

ssessin% the community hea!th re/uires the fo!!owin% three steps

- Gatherin% re!evant existin% data and %eneratin% missin% data

- 9eve!opin% a composite database

- Interpretin% the composite database to identify community prob!ems and stren%ths

=ata Collection and Interpretation

$he primary %oa! of data co!!ection is to %et usab!e information about the community andits hea!th# $he systematic co!!ection of data about community hea!th re/uires the

fo!!owin%- Gatherin% or compi!in% existin% data

- Generatin% missin% data

- Interpretation of data- Identifyin( community hea!th prob!ems and community abi!ities

9ata %atherin% is the process of obtainin% existin%) readi!y avai!ab!e data# $he fo!!owin%

data usua!!y describe the demo%raphy of a community- %e of residents

- Gender distribution of residents

- Socioeconomic characteristics- Racia! distributions

- 8ita! statistics) inc!udin% se!ected morta!ity and morbidity data

Identify needs? prolems? stren(ths? and resources and apply !hat you kno!,

indshield sureys- are the motori"ed e/uiva!ent of simp!e observation# $hey invo!ve

the co!!ection of data that Qwi!! he!p define the community) the trends) stabi!ity) andchan%es that wi!! affect the hea!th of the community

'chool 4urse&

- &rimary -$he schoo! nurse monitors the chi!dren for a!! of their state-mandated

immuni/ationsfor schoo! entry#

- Secondary- Schoo! nurse is invo!ved in screenin% chi!dren for i!!nesses andprovidin% direct nursin% care

- $ertiary : $he schoo! nurse cares for chi!dren with !on%-term hea!th needs)

inc!udin% asthma and disab!in% conditions


19/26

Schoo! nurses carry out catheteri"ations) suctionin%) %astrostomy tube feedin%s) and other

ski!!s in schoo!#

$he concern for hea!th promotion of adolescents is safetybecause of their propensity to

take part in risky behavior#

111$o effectiely reach a population (roup you must connect !ith someone in the

community and estalish trust,

Occupational 3@posure

ob cate%ories Exposure =ork-re!ated diseases and conditions

arm workers pesticides) infectious H$5) mood disorders) cardiovascu!ar

%ents) %ases) sun!i%ht disease

Chemica! workers so!vents) c!eansers) etc# Cancer) etc#

OReview the !ist onpa%e 3+( textbookO

%edicare

&rovides hospita! insurance and medica! insurance to persons a%es 31 years and o!der)

permanent!y disab!ed persons) and persons with end-sta%e rena! fai!ure

Part #: covers hospita! care and home care home care or hospice : can>t have both)ski!!ed nursin% care

Part :- covers non-institutiona! care insurance 2edica! care) dia%nostic services and

physiotherapy#

$o obtain payment for 2edicare services) a documentation of skilled care sericemust

be done durin% the visit#

%edicaid- inancia! assistance to states and counties to pay for medica! services for poor

o!der adu!ts) the b!ind) the disab!ed) and fami!ies with dependent chi!dren#

11Pulic #ssistance Pro(rams-

IC- a specia! supp!ementa! food pro%ram administered by the 9epartment of

%ricu!ture throu%h the state hea!th departments provides nutritious food that add to the

diets of pre%nant and nursin% women) infants) and chi!dren youn%er than 1 years#

E!i%ibi!ity is based on income and nutritiona! risk as determined by a hea!th professiona!#

11$otal


20/26

Outreach !orker&a hea!th worker who makes a specia!) focused effort to find peop!e

with specific hea!th prob!ems for the purpose of increasin% their access to hea!th services-eva!uate effectiveness find out if successfu! and use ways to measure success

3pidemiolo(y- attempts to link the a(ent to the disease or conditions,

3pidemiolo(ic trian(le 7or epidemiolo(ical triad8 K a%ent) host) and environment :

chan%es in one of the e!ements of the trian%!e can inf!uence the occurrence of disease byincreasin% or decreasin% a person>s risk for disease# Risk is the probabi!ity that an

individua! wi!! experience an event#

- #(ent&an animate or inanimate factor that must be present or !ackin% for a

disease or condition to deve!op# $he toxic substance or environmenta! factors#examp!e E# co!i

- Infectious a%ents bacteria) viruses) fun%i) parasites

- Chemica! a%ents heavy meta!) toxic chemica!s) pesticides

- &hysica! a%ents radiation) heat) co!d) machinery

Hosta !ivin% species human or anima! capab!e of bein% infected or affected by ana%ent# Host can a!so be viewed as a susceptib!e person or popu!ation#

- anythin% capab!e of bein% infected

- Genetic susceptibi!ity- Immutab!e characteristics a%e) sex

- c/uired characteristics immuno!o%ic status

- ,ifesty!e factors diet) exercise

3nironment- a!! that is interna! or externa! to a %iven host or a%ent and that is

inf!uenced and inf!uences the host and@or a%ent# Environmenta! factors are associated

with disease deve!opment#

- anythin% externa!

- c!imate temperature) rainfa!!- &!ant and anima! !ife a%ents or reservoirs or habitats for a%ents

- Human popu!ation distribution crowdin%) socia! support

- Socioeconomic factors education) resources) access to care

- =orkin% conditions !eve!s of stress) noise) satisfaction

Relationship et!een the aoe . cause disease? try to reak the connection? if a

reak then there !ill e no disease,

e of Causality- comp!ex interre!ations of factors interactin% with each other to

inf!uence the risk for or distribution outcomes#- reco%ni"es the comp!ex interre!ationships of many factors interactin%) sometimes

in subt!e ways) to increase or decrease the risk of disease#

- ssociations are sometimes mutua!) with !ines of causa!ity %oin% in both

directions


21/26

- Inc!udes phenotype) socia! or%ani"ation) behavior) environment) workp!ace)

unknown factors) %enes) and microbes

>amily assessment

3comap- represents the fami!y>s interactions with other %roups and or%ani"ations)accomp!ished by usin% a series of circ!es and !ines#

- It is represented by a circ!e in the midd!e of the pa%e

- 6ther %roups and or%ani"ations are then indicated by circ!es- ,ines representin% the f!ow of ener%y are drawn between the fami!y circ!e and the

circ!es representin% other %roups and or%ani"ations

- n arrowhead at the end of each !ine indicates the direction of the f!ow of ener%y

into or out of the fami!y- $he wei%ht of the !ine indicates the intensity of the ener%y

Geno(ram- is a pictoria! disp!ay of a persons fami!y re!ationshipsand medica! history# It

%oes beyond a traditiona! fami!y treeby a!!owin% the user to visua!i"e hereditary patternsand psycho!o%ica! factors that punctuate re!ationships# It can be used to identify repetitive

patterns of behavior and to reco%ni"e hereditary tendencies# It is a too! to determinec!ients> risk factors for deve!opin% disease and to focus hea!th promotion efforts# !so)

vio!ence and abusive tendencies can be traced back over %enerations and nurses can he!p

c!ients to break these patterns#

Preention 'trate(ies for Violence

Indiidual and >amily leels

- ssess durin% routine examination secondary

- ssess for marita! discord secondary

- Educate on deve!opmenta! sta%es and needs of chi!dren primary- Counse! for at-risk parents secondary

- $each parentin% techni/ues primary

- ssist with contro!!in% an%er secondary- $reat for substance abuse tertiary

- $each stress-reduction techni/ues primary

Community Leel

- 9eve!op po!icy

- Conduct community resource mappin%

- Co!!aborate with community to deve!op systematic response to vio!ence- 9eve!op media campai%n

- 9eve!op resources such as transition housin% and she!ters

Hi(h school students and middle school students- important to steer them a!ay

from iolence and teach them to !ork on their o!n skills and uild their self-esteem,

>urther Reie!
http://en.wikipedia.org/wiki/Family_relationshipshttp://en.wikipedia.org/wiki/Medical_historyhttp://en.wikipedia.org/wiki/Family_treehttp://en.wikipedia.org/wiki/Family_relationshipshttp://en.wikipedia.org/wiki/Medical_historyhttp://en.wikipedia.org/wiki/Family_tree


22/26

Review care if the dyin% patient with emphasis on %rief) depression and !e%a! and ethica!

issues#

Review si%ns and symptoms of Hepatitis ) ;) C and know how they are transmitted#

5ewborns are at risk for Hep ; from an infected mother#Hepatitis # &erson to person) feca! ora! route) contaminated food) water) she!!fish#

Genera! popu!ation is at risk# &robab!e immunity fo!!owin% infection# E!iminate common

sources of infection by sanitation# dminister vaccine and IG within * weeks ofexposure# Fse universa! precautions# S@S acute fever) anorexia) ma!aise) dark urine)

jaundice usua!!y !astin% * months# ,ow fata!ity rate) but can !ast up to 3 months#

$reatment is supportive care#

Hepatitis : Hi%hest in youn% adu!ts) homosexua! men) persons en%a%in% in unprotectedsex) injection dru% users) hea!th care and pub!ic safety workers# 9irect and indirect

contact with b!ood and serum-derived f!uids) sexua! contact) perinata!# Routine!y

immuni"e infants) chi!dren) and hi%h-risk %roups# &ractice safe sex) use universa!

precautions) screen a!! donated b!ood and b!ood products# 2om can pass to baby# S@Sinsidious onset and nonspecific symptoms) anorexia) 5@8) jaundice) sometimes fata!

hepatitis# $reatment is supportive care#

Hepatitis C direct!y re!ated to preva!ence of injection dru% use in the popu!ation) HC8

in donated b!ood supp!y) and !ack of use of parentera! precautions in hea!th care# Sexua!

and mother-to-chi!d transmission are un!ike!y# 5o vaccine exists# S@S insidious onset)symptoms vary from asymptomatic '(D to fu!minatin%) fata! disease# $reatment with

ribavirin and s!ow re!ease interferons pe%y!ated interferons#

Ro!e of case mana%er

Risks for deve!opin% community ac/uired pneumonia very o!d and very youn%) crowded

p!aces

$he nurse focusin% on a community hea!th project based on a report from the =H6

wou!d focus on number of peop!e without access to hea!th care#

Review 22R and other vaccines

Review poisonin% from asbestos !un% cancer@respiratory issues) workp!ace@mo!dexposure) si!ica dust occupationa!- coa! minin%# 9ust is inha!ed and causes nodu!es and

inf!ammation in upper !obes of !un%s) histop!asmosis bat droppin%s) and carbon

monoxide co!or!ess) odor!ess) taste!ess emitted by burnin% %aso!ine) kerosene) propaneand charcoa! C6 takes the p!ace where oxy%en is supposed to bind on R;Csand

anthrax

%eals on heels

Lillian aldwas very important in the history of nursin%#

9eve!oped pub!ic hea!th nursin% practice : Started the Henry Street Sett!ement


23/26

$he Henry Street Sett!ement provided care to immi%rants

Estab!ished the first nursin% service of occupationa! hea!th

Estab!ished the committee that was the forerunner of the 5,5 Instituted a s!idin% sca!e fee for service

#dditional Info >rom Po!er Points- chi!d>s !ife expectancy is predicted more by his "ip code than %enetic code

-S2R$ objectives Specific as possib!e measurab!e achievab!e re!evant to the %oa!s)

needs and interests of the community time frame-$wo !eve!s of eva!uation

-ormative is instituted for the purpose of assessin% the de%ree to which

objectives are met or p!anned activities are conducted# $his is done a!on% the way#

-Summative is instituted to assess pro%ram outcomes or as a fo!!ow-up of theresu!ts of pro%ram activities# $his is what you do at the end of a pro%ram to

determine if it worked overa!!#

Sta%es of Chan%e

-&recontemp!ation no intention to take action within the next 3 months#-Contemp!ation intends to take action within the next 3 months#

-&reparation intends to take action within the next .( days and has taken somebehaviora! steps in this direction#

-ction chan%ed overt behavior for !ess than 3 months

-2aintenance chan%ed overt behavior for more than 3 months-sthma is the most common chronic i!!ness for chi!dren# $he most common cause is

second-hand smoke exposure#

-&overty is the %reatest threat to chi!d hea!th# access to care) nutrition) safe environment

-2edicaid is important to chi!dren# $hey can be%in receivin% care in infancy andparticipate in E&S9$#

-unctiona! definition of a%in% is better measure of a%e than chrono!o%ica! a%e#

-5ursin% care for o!der adu!ts focuses on he!pin% them to remain independent andfunctiona!# Hea!thy &eop!e *(*( seeks to increase /ua!ity and years of hea!thy !ife#

-$heories of %in%

-Stochastic random) accumu!ate over time-Error theory accumu!ation of errors in protein synthesis resu!ts in

impaired ce!!u!ar function

-Somatic mutation theory when ce!!s are exposed to x-ray radiation of

chemica!s) a!teration of 95 occurs#-ree radica! theory hi%h!y reactive mo!ecu!es possess an extra e!ectric

char%e free e!ectron that can cause dama%e# $he body produces

antioxidants to scaven%e these free radica!s#-Cross-!ink theory a%in% causes body chemica!s to become cross-!inked#

bnorma! activity deve!ops) causin% waste products to accumu!ate in

ce!!s#-=ear and tear theory human body eventua!!y wears out#

-5onstochastic predetermined

-&ro%rammed theory ce!!s divide on!y a certain number of times) which is

proportionate to the !ife span#


24/26

-Immuno!o%ic theory !teration of ; and $ ce!!s occurs# utoa%%ression

Ce!!s are not identified by the body and are attacked by the immune

system#-In +'1( the Shattuck Report proposed that hea!th education was a vita! component in the

prevention of disease part of schoo! hea!th nursin%# It is a fundamenta! document that is

sti!! used today# ,i!!ian =a!d was ab!e to show that the presence of schoo! nurses cou!dreduce absenteeism by 1(D#

-+'7. da 2ayo Stewart was the Qfirst industria! nurse at the 8ermont 2arb!e

Company# ;etty 2o!der was a nurse for the coa! minin% company in +'''#-or the e!der!y c!ient

-!ways check bowe! and b!adderT

-5ot a!! opiates are e/ua! dosa%e wi!! need to be adjusted

-entany! patchP no heatT-If they have nausea@vomitin% caused by cancer@chemo) use Ha!do!#

-If S6;) coo! the room and move air with a fan#

-&revention in 9isasters

-&rimary prevention-imed at preventin% the occurrence of a disaster or !imitin% the

conse/uences miti%ation#-6ccurs in nondisaster and predisaster sta%es#

-Secondary prevention

-Inc!ude search) rescue) and tria%e of victims-ssessment of destruction and devastation

-Imp!emented once the disaster occurs

-$ertiary prevention

-ocuses on recovery and restorin% the community to previous !eve!s offunctionin%#

-imed at preventin% a recurrence of minimi"in% the effects of future

disasters#-$ria%e is the process of separatin% casua!ties and a!!ocatin% treatment based on the

victim>s potentia! for SFR8I,T

-S$R$ tria%e system QSimp!e tria%e and rapid treatment-Fsed in mass casua!ties

-$o occur in !ess than one minute

-Fses peop!e with minor injuries to assist

-&erson is ta%%ed with a co!ored tria%e ta% and victims are moved to thetreatment area

-;ioterrorism a%ents can be easi!y disseminated or transmitted from person to person#

$hey resu!t in hi%h morta!ity rates and have the potentia! for major pub!ic hea!th impact#It mi%ht cause pub!ic panic and socia! disruption and re/uire specia! attention for pub!ic

hea!th preparedness# 9etectin% the outbreak is the most crucia! aspect in minimi"in%

dama%e from the attack and determinin% the cause#-History of Environmenta! Hea!th

-!orence 5i%htin%a!e c!eaned environment and reduced infection durin% the

Crimean =ar


25/26

-2ary ;rewster worked to improve the environment of the Henry Street

nei%hborhood and aimed to improve physica! environment and socia! conditions

that affected hea!th# She he!ped ,i!!ian =a!d#-,ead

-remains in the body for decades stored in the bone

-interferes with R;C production may present with anemia-2ay cause dama%e to the brain) !iver) and other vita! or%ans#

-;,, ?1 is considered abnorma!# $here is no safe !eve! even !ow !eve!s can cause

neuro!o%ica! dama%e-Common symptoms vomitin%) intermittent abdomina! cramps) headaches)

irritabi!ity) weakness) and constipation

-;!acks experience more environmenta! !ead exposure than whites

-0#0D of chi!d B1 have b!ood !eve!s hi%h enou%h to cause dec!inin% inte!!i%enceand this fi%ure doub!es for chi!dren in poverty

-5eed to increase iron) ca!cium) and vitamin C in their diet nurse cannot chan%e a

chi!d>s environment) so recommend dietary chan%es

-I&8 identify hi%h-risk situations %ive safety p!ans and community resources-ohn Snow is the father of epidemio!o%y

-Ca!cu!ation of rates rates are arithmetic expressions that he!p practitioners consider acount of an event re!ative to the si"e of the popu!ation from which it is extracted

-Incidence rate is better app!ied to acute disease and outbreaks) whi!e preva!ence rates are

better app!ied to the study of chronic disease#-Screenin% secondary prevention

-Re!iabi!ity how precise is the measurementU Is it consistent and repeatab!eU 9o

you %et the same measure every timeU

-8a!idity is the measurement rea!!y measurin% what we think it isU Exact!y howU-Eva!uated by sensitivity and specificity

-ramin%ham Heart Study study by the Fnited States &ub!ic Hea!th Service on factors

re!ated to the deve!opment of heart disease# 9one by a town in Connecticut that fo!!owedpeop!e every year and co!!ected data that he!ped define the cardiovascu!ar risk factors# It

has now expanded to inc!ude diabetes) H$5) and other chronic diseases# It is the !ar%est

pub!ic hea!th survei!!ance study post ==II# Infectious disease is now movin% towardcardiovascu!ar risk#

-Spectrum of infection not a!! contact with an infectious a%ent !eads to infection not a!!

infection !eads to an infectious disease#

-Subc!inica! infection no overt symptomatic disease-Infections entry and mu!tip!ication of infectious a%ent in host

-Infectious disease and communicab!e disease pathophysio!o%ica! responses of

the host to the infectious a%ent) manifestin% as an i!!ness considered a case-Carriers peop!e who continue to shed infectious a%ent without any symptoms of

disease

-8ector transmission occurs when an infectious a%ent is carried by a vector non humancarrier such as an anima! or an insect# Indirect transmission#

-,yme disease

-2ost at risk peop!e who !ive) work) or p!ay in wooded areas


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-S@S red) circu!ar rash at site of bite# Clear center !ith ulls-eye pattern#

$iredness) fever) chi!!s) joint pain) musc!e aches) headache) stiff neck) and swo!!en

!ymph nodes-Preention use an insect repe!!ant when in tick-infested areas keep arms and

!e%s covered wear hi%h rubber boots because ticks are usua!!y found c!ose to

%round tuck shirt into pants and pants into socks or boots wear a hat and keep!on% hair pu!!ed back shower and wash c!othin% after bein% in tick-infested areas

inspect skin and hair once inside

-$reatment few weeks of antibiotics# If untreated) can affect joints) heart) andnervous system#

-nthrax is often transmitted throu%h drum circ!es anima! skin# $his can cause the GI

form#

-Sheppard $owner ct the !aw that has had the most si%nificant impact on pub!ic hea!thpo!icy) community hea!th nursin%) and socia! we!fare po!icy in the FS# $his act made

nurses avai!ab!e to provide services for women and chi!dren) offered we!!-chi!d

deve!opment services) provided ade/uate hospita! services and faci!ities for women and

chi!dren) and provided %rants-in-aid for the estab!ishment of materna! and chi!d we!farepro%rams#

Download - Community HESI Study Guide

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