Exam 2: NR 442/ NR442 (New 2026/ 2027 Update) Community Health Nursing Guide |Questions & Answers| Grade A| 100% Correct - Chamberlain

…..DLDD Exam 2: NR 442/ NR442 (New 2026/ 2027 Update) Community Health Nursing Guide |Questions & Answers| Grade A| 100% Correct - Chamberlain Q. A nurse is preparing to conduct a windshield survey. Which of the following data should the nurse collect as a component of this assessment? Select all that apply. A. Ethnicity of community members B. Individuals who hold power w/in community C. Natural community boundaries D. Prevalence of disease E. Presence of public protection ANSWERS A, B, C, E Q. A nurse is completing a needs assessment and beginning analysis of data. Which of the following actions should the nurse take first? A. Determine health patterns w/in collected data B. Compile collected data into a database C. Ensure data collection is complete D. Identify health needs of local community ANSWERS B. Compile collected data into a database Q. A nurse is planning a community health program. Which of the following actions should the nurse include as part of the evaluation plan? A. Determine availability of resources to initiate plan B. Gain approval for program from local leaders C. Establish timeline for implementation of interventions D. Compare program impact to similar programs ANSWERS D. Compare program impact to similar programs Q. A nurse is conducting a community assessment. Which of. the following data collection methods is the nurse using when having direct conversations with individual members of the community? A. Key informant interviews B. Participant occupations C. Focus groups D. Health surveys ANSWERS A. Key informant interviews Q. A nurse is collecting data to identify health needs in the local community. Which of the following examples should the nurse identify as secondary data? (Select all that apply). A. Birth statistics B. Previous health survey results C. Windshield Survey D. Community Forum E. Health Records ANSWERS A, B, E Q. A nurse is developing a community health education program for a group of clients who have a new diagnosis of diabetes mellitus. Which of the following learning strategies should the nurse include for clients who are auditory learning? A. Showing photographs of sites for injection B. Providing equipment to practice hands-on skills C. Supplying outlines for note-taking D. Facilitating small group discussions ANSWERS D. Facilitating small group discussions Q. A nurse is talking to a client who asks for additional info about hospice. Which of the following statements should the nurse make? A. "Clients who require skilled nursing care at home qualify for hospice care." B. "One function of hospice is to provide teaching to clients about life-sustaining measures." C. Hospice assists clients to develop the skills needed to care for themselves independently." D. A component of hospice care it to control client's manifestations." ANSWERS D. Controlling the clients manifestations of medical problems or the dying process and improving quality of life are components of hospice care. Q. A school nurse is scheduling visits w/a physical therapist for a child who has cerebral palsy. In which of the following roles is the nurse functioning? A. Direct caregiver B. Consultant C. Case manager D. Counselor ANSWERS C. In the role of case manager, a school coordinates comprehensive services for students who have complex health needs. Q. An occupational health nurse is consulting with senior management of a local industrial facility. When discussing work-related illness and injury, the nurse should include which of the following factors as physical agents? Select all that apply. A. Noise B. Age C. Lighting D. Viruses E. Stress ANSWERS A, C Q. A newly hired occupational health nurse at an industrial facility is performing an initial workplace assessment. Which of the following info should the nurse determining when conducting a work site survey? A. Work practices of employees B. Past exposure to specific agents C. Past jobs of individual employees D. Length of time working in current role ANSWERS A. Work practices of employees Q. A school nurse is planning health promo and disease prevention activities for the upcoming school year. In which of the following situations is the nurse planning a secondary prevention strategy? A. Placing posters w/images of appropriate hand hygiene near restrooms. B. Routinely checking students for pediculosis throughout the school year. C. Implementing age-appropriate injury prevention programs for each grade level. D. Working w/a dietitian to determine carb counts for students who have diabetes ANSWERS B. Routinely checking students for pediculosis throughout the school year. Q. A nurse is completing an ecomap as part of a family assessment. Which the following questions should the nurse plan to ask to gather appropriate data? A. "Do you have a family history of heart disease?" B. "What kinds of foods does your family eat?" C. "Is your family involved in community orgs?" D. "How does your family cultural beliefs influence your health values?" ANSWERS C. An ecomap studies the family's relationships w/groups and organizations A home health nurse is planning care for a client following a stroke. The nurse plans to interview each member of the family to see how they might help the client progress towards recovery. The nurse is using which of the following approaches to family health? A. Family as component of society B. Family as a system C. Family as a client D. Family as context D. Context promotes individual recovery following a disease or event. The client is the focus and members are viewed as a source of support A public health nurse is planning interventions for children in the community. Which of the following topics should the nurse choose to target a major concern for school-aged children? A. Skin cancer detection B. Access to health care C. STI prevention D. Cholesterol Screening B. Caregiver income affects child health A public health nurse is planning an inter-service on older adult health. Which of the following information should the nurse include? A. The percentage of older adults in the population is decreasing. B. Proportion of older adults who live alone is increasing. C. Older adults take one-half of all prescriptions meds D. Older adults have decreased recovery time following injury B. Proportion of older adults who live alone is increasing. A nurse is preparing a list of important topics to discuss w/young adults who are seen at the clinic. Which of the following topics should the nurse plan to address w/this aggregate? A. Preconception counseling B. Managing the common cold C. Detecting congenital abnormalities D. Accessing Medicare benefits A. Plan to ask clients if they want to discuss childbearing, and answer any questions. What are Informant Interviews? A DIRECT formal and/or informal discussion with purpose of gaining ideas or opinions from key informants What are Windshield surveys? descriptive approach tat assesses several community components by driving through community Components of a windshield survey People Place Natural Environment Man-made Environment Housing Societal Systems An ecological model can be used as a guide to examine . . . Determinants of health for a population, and for targeting interventions to multiple factors that affect health Community Assessment Steps 1. Define the community 2. Collect data 3. Analyze data (organize, review, prioritize) 4. Establish community diagnoses 5. Plan programs 6. Implement program 7. Evaluate program Writing a community health diagnoses includes . . . Risk of specific problem Among specific population affected Related to (weakness that influences problem) Examples of social systems Health systems/resources Welfare Systems Legal Systems Recreation Systems Transportation Systems Communication Systems Religious Systems Political Systems When determining the health of a community, consider . . . Status Structure Process Effective community health education requires . . . Planning What does a community assessment begin with? Defining the community to be studied What are the 3 types of communities? 1. Geographic community (shared place) 2. Demographic group (Shared characteristics) 3. Functional community (common interests) What is the ecological model used for? as a guide to examine the determinants of health for a population and for targeting interventions to multiple factors that affect health When collecting data, it is best to... combine several methods of collection Components of ecological model -Individual traits (age, gender biological, mental, behavioral factors) -Social, family, community relationships -Occupational and home environments -Overall conditions created by local, state, national, and worldwide forces and trends Factors to consider when determining the health of a community 1. status: epidemiological data (incidence/prevalence rates), client satisfaction, mental health, crime rates 2. structure: presence of health care facilities, service types and patterns of use, demographic data 3. process: relationships, communication, commitment to and participation in health Community assessment components for people Demographic, biological, social factors, cultural factors Community assessment components for place/environment physical factors & environmental factors Factors when Determining Health of a Community: status examples Epidemiological data (incidence/prevalence rates), Client satisfaction Mental health Crime rates Factors when Determining Health of a Community: Structure examples Presence of health care facilities Service types and patterns of use Demographic data Factors when Determining Health of a Community: Process examples Relationships Communication Commitment to and participation in health What is the first step when developing a needs assessment? Compile data in database The CIRCLE Model of Care means . . . C: Caring I: Intuition R: Respect C: Caution L: Listening E: Emotional Support Informant interview limitations Meeting time and place Built-in bias Community forum limitations Difficulty finding meeting time and place Challenging to get adequate participation Where do home health nurses provide care? Traditional Homes Assisted Living Nursing Homes Skilled Services include: Skilled assessment Wound care Lab draws Med edu and admin parenteral nutrition IV fluids and medication Central line care urinary catheter insertion/maintenance Coordination, delegation, supervision Informant interview strengths MINIMAL COST Participants serving as future supporters Offers insight into beliefs and attitudes of community members Reading/writing of participants not required Can elicit more detailed responses Community forum strengths MINIMAL COST Opportunity for community input Secondary data strengths Database of prior concerns/needs of population Ability to trend health issues over time Secondary data limitations Possibility that data may not represent current situation Can be time-consuming Participant observation strengths Indication of community priorities, environmental profile, and identification of power structures Participant observation limitations Bias Time consuming Inability to ask participants questions Focus groups strengths Possibility of participants being potential supporters Provides insight into community support Reading/writing of participants not required Focus group limitations Possible discussion of irrelevant issues Challenging to get participants Requires strong facilitator Difficult to say that sample is representative of entire community TIME-CONSUMING Surveys strengths Data collected on population and problems random sampling written or online format contact with participants not required Surveys limitations Low response rate EXPENSIVE TIME CONSUMING collection of superficial data requires participants to be literate Windshield survey strengths provides a descriptive overview of a community Windshield survey limitations Need for driver Can be TIME CONSUMING Results based solely on visualization Examples of formal leaders elected leaders; government officials, representatives PEOPLE WHO ARE A BIG DEAL Examples of informal leaders pastors, tribal leader, grassroots leaders Barriers to education Age, cultural barriers, poor reading and comprehension skills, language barriers, barriers to access, and lack of motivation Describe behavioral theory Use of reinforcement methods to change learners' behaviors Describe cognitive theory Use of sensory input and repetition to change learners' patterns of thought, thereby changing behaviors Describe critical theory Use of ongoing discussion and inquiry to increase learners' depth of knowledge, thereby changing thinking and behaviors Describe developmental theory Use of techniques specific to learners' developmental stages to determine readiness to learn and impart knowledge Describe humanistic theory Assists learners to grow by emphasizing emotions and relationships and believing that free choice will prompt actions that are in their own best interest Describe social learning theory Links information to beliefs and values to change or shift learners' expectations Someone who "thinks in pictures" and learns through seeing and uses methods such as note-taking, video-viewing, and presentations is a _________ learner Visual Someone who learns through listening and methods such as verbal lectures, discussion, and reading aloud is a _________ learner Auditory Someone who learns through doing and methods such as trial and error, hands-on approaches, and return demonstration is a _______ learner Tactile-kinesthetic When developing interventions, it's important for the nurse to consider the patient's... health literacy What is the first step to developing a community health education plan? Identifying population-specific learning needs What occurs during the preplanning step of community assessment? Brainstorm ideas -Gain entry into community and establish trust -Obtain community awareness, support, and involvement -Coordinate collaborations that have similar interests in addressing identified problems What are ecomaps? Eco-maps are a visual map of a family's connections to the external world. They provide a useful tool for assessment of family, social and community relationships and highlight the quality of these connections. What are genomaps? What occurs during the assessment part of community assessment? Collect data about community and its members -Complete needs assessment and identify community strengths and weaknesses -Assess availability of community resources -List potential sources for program funding -Evaluate secondary health data What occurs during the diagnosis part of community assessment? Identify and prioritize health needs of the community. -Analyze data to determine health needs -Work with community members, local health professionals, and administrators to develop priorities and establish outcomes What occurs during the planning part of a community assessment? Develop interventions to meet identified outcomes. -Determine possible solutions to meet the health need -Compare resources and interventions required for each solution and select best option -Establish goals and objectives -Select strategies/interventions -Determine available and needed resources -Assess personnel needed and special training required -Determine funding opportunities -Plan for program evaluation What occurs during the implementation part of the community assessment? Carry out the plan -Initiate interventions -Monitor intervention process and community response What occurs during the evaluation part of the community assessment? Examine the success of the interventions. - Helpful strategies for planning a community health program Thorough assessment Accurate interpretation of data Collaboration with community partners Effective outreach and communication patterns Sufficient resources Logical planning Skilled leadership Barriers to planning a community health program Inadequate assessment Inadequate or misconstrued data No involvement with community partners Impaired communication Inadequate resources Lack of planning Poor leadership What is the key priority for home health nurses? SAFETY Wound care, lab draws, parenteral nutrition, IV fluids, and central line care are all examples of... Skilled services Home health nurses often use these two models to implement the nursing process Omaha & Oasis Steps of the Omaha system Collecting and assessing data Stating the problem Identifying an admission problem rating using a problem classification scheme Planning and intervening Re-rating problems during the span of care delivery and at discharge Evaluating the end problem outcome Hospice focuses on providing care to a patient who has less than ______ months left to live 3 What is a function of an ecological model? A. examine the determinants of health B. reverse biodiversity loss C. Provide genetic information D. provide an optimal environment A. examine the determinants of health What is an example of structure in a community? A. patterns of service use B. patient satisfaction C. crime rates D. community communication A. patterns of service use What is a limitation of community forums in data collection? A. cost B. built in bias C. time consuming D. adequate participation D. adequate participation Which learning theory uses ongoing discussion to change behavior? A. critical theory B. humanistic theory C. cognitive theory d. behavioral theory A. critical theory What is the first step in developing a needs assessment? A. identify the needs of the community B. analyze data for missing information C. Identify themes in collected data D. compile data into database D. compile data into database Which agent factor makes an employee more susceptible to illness or injury? A. ventilation B. stress C. lighting D. Age C. lighting What is an example of a control strategy? A. health screening B. waste disposal C. job requirements D. injury incidence A. health screening What is a component of the circle model of care? A. empathy B. education C. caution D. investigation C. caution What is a secondary level of prevention in school nursing? A. maintenance of immunization records B. maintenance of emergency supply inventory C. participation in IEP D. provide parenting education B. maintenance of emergency supply inventory What is a medicare requirement for homecare reimbursement? A. 30 day case review B. IPREPARE service C. intermittent service D. CIRCLE assessment C. intermittent service What is included in a comfort kit? A. blankets B. antibiotics C. pillows D. anxiety medications D. anxiety medications also meds for nausea vomiting and pain What is a priority assessment in home care? A. transportation B. Safety C. medication access D. lighting B. safety What can provide intermittent relief for caregivers? A. comfort care B. respite care C. faith based care D. palliative care B. respitte care What is the key principle of forensic nursing? A. respect B. Justice C. intuition D. safety D. safety What is the leading health concern in adolescents? A. congenital anomalies B. suicide C. diabetes D. dental caries B. suicide What is used to investigate family illness patterns? A. ecological model B. Environmental risk C. ecomap D. genogram D. genogram Which nursing approach does a nurse use when interviewing individual family members? A. family as a system B. family as context C. family as a client D. family as a societal component B. family as a context What is an example of a health indicator? A. morbidity B. education C. stress D. nutrition A. morbidity Wbhich is a sustainable development goal? A. increase longevity B. clean water C. prevent falls D. environmental competence B. clean water Which is an epidemiological transition? A. high fertility and mortality B. decline in mortality and fertility C. low global burden of infectious disease D. high fluctuating mortality D. high fluctuating mortality What is an example of a social system in a community? A. public transportation B. garbage disposal C. military installations D. well marked roads A. public transportation What is the first step in community assessment? A. collect data B. define the community C. implement programs B. define the community What is an example of a skilled service? A. education B. healthcare delegation C. emotional support D. home safety assessment B. healthcare delegation Who regulates workers' compensation? A. employer B. state C. OSHA D. federal government B. state Who might be a victim of human trafficking? A. nanny B. high school student C. department store cashier D. nurse A. nanny This type of nurse works to promote a healthy work environment to foster the health and safety of workers occupational health nurse What are host factors and what are some examples? Host factors are worker characteristics ex: job inexperience, age, pregnancy Examples of biological agents Viruses, bacteria, fungi, bloodborne or airborne pathogens Examples of chemical agents Asbestos, smoke Examples of mechanical agents Musculoskeletal or other strains from repititive motions, poor workstation-worker fit, lifting heavy loads Examples of physical agents Temperature extremes, vibrations, noise, radiation, lighting Examples of psychological agents Threats to psychological or social well-being resulting in work-related stress, burnout, violence Examples of physical factors heat, odor, ventilation, pollution examples of social factors sanitation, overcrowding examples of psychological factors addiction, stress occupational health history includes the following info.. Current and past jobs Current and past exposure to specific agents and any relationship of current manifestations to work activities Any precipitating factors (underlying illness, previous injuries) Essential components of work-site walk through Observation of work processes and materials Job requirements Actual and potential hazards Employee work practices Incidence/prevalence of work-related illnesses Control strategies to eliminate exposure Examples of control strategies Engineering Altering work practices Providing PPE and education Workplace monitoring Health screening Employee-assistance programs Job-task analysis Design, risk management, emergency preparedness What does OSHA do? Develops and enforces workplace health regulations to protect the safety and health of workers. Provides education to employers about workplace health and safety What does NIOSH do? A part of the centers for disease control and prevention, it focuses on identification of workplace hazards and research for prevention of work-related injury and illness. Provides education to safety and health professionals about workplace safety Faith community nurses are governed by the same license as _______ RNs T/F faith community nurses provide direct care false CIRCLE model of spiritual care Caring Intuition Respect for religious beliefs & practices Caution Listening Emotional support Roles of school nurse case manager community outreach consultant counselor direct caregiver health educator researcher T/F nurses are obligated to report any suspected abuse/neglect True Key principle of forensic nursing SAFETY What does the sexual assault nurse examiner (SANE) do? collects detailed medical, physical, and emotional data from clients following sexual assault, manages samples, and provides support to clients Leading causes of death for children Perinatal conditions and congenital anomalies SIDS Motor vehicle injuries Leading causes of death for adolescents Motor vehicle injuries Homicide Suicide Leading causes of death for adults Heart diseases Diabetes Mental health disorders STIs Colorectal cancer Leading causes of death for females reproductive health malignant neoplasm Leading causes of death for males unintentional injuries erectile dysfunction malignant neoplasm What does the Administration on Aging do Promotes health services for older adults through states, using local nonprofit agencies funded by US govt Which approach is the nurse taking if he/she is monitoring how families interact with other institutions in a community? family as component of society Which approach is the nurse taking if he/she is studying how interactions among family members affect whole family function? family as a system Which approach is the nurse taking if he/she is examining the family unit functioning first, then individual needs next? Family as a client Which approach is the nurse taking if he/she is focusing on an individual first, and the family next? family as context Birth/adoption of child, death of family member, child moving out, marriage, and divorce are all examples of... transitions The study of genetic info and how it is influenced and expressed is called... genomics Demographic transitions show the transition from... from high birth rates and high death rates to lower birth rates and lower age-specific death rates Epidemiological transitions show a change in... disease patterns and causes of death examples of demographic transitions high fertility and high mortality, resulting in slow population growth improvement in hygiene and nutrition, leading to less infectious disease examples of epidemiological transitions high and fluctuating mortality, due to poor health, epidemics, and famine further decline in mortality, increasing life expectancy and predominance of noncommunicable diseases Define global burden of disease the risks to health and health outcomes in different demographic populations and social settings related to a set of diseases and injuries What factors affect the global burden of disease? climate, public policy, aging of the population, socioeconomic conditions, and risk factors Risk factors affecting disease burden Childhood and maternal undernutrition Other nutrition-related risk factors and inactivity Addictive substances Sexual and reproductive health Environmental risks 4 categories of health indicators morbidity and mortality risk factors health service coverage health system resources Which groups are considered vulnerable populations? - The homeless - LGBTQ population - Racial/ethnic minorities - Veterans - Older adults LGBTQ populations are at higher risk for.. - Chronic diseases - Drug abuse - Bullying - Suicide - HIV Vulnerable Populations Those that are susceptible to poor health, chronic diseases, disability, and early mortality - May have limited resources ANA's Code of Ethics - Provision 1 Nurse practices with compassion/respect for unique attributes of every person ANA's Code of Ethics - Provision 2 Nurse's primary commitment is to the patient (individual, group, community, population) ANA's Code of Ethics - Provision 3 Nurse promotes, advocates, and protects the rights of the patient ANA's Code of Ethics - Provision 4 Nurse collaborates with other healthcare professionals to promote and protect human rights and health diplomacy, and reduce health disparity ANA's Code of Ethics - Provision 5 Articulate nursing values, maintain integrity, and integrate principles of social justice into healthcare Healthy People Goal (Older Adults) 1. More likely to be hospitalized (ex. diabetes, dementia, UTI, pneumonia) - Educate and improve primary care 2. High risk for injury and death from falls - Increase physical activity and safety at home 3. Higher risk for oral health problems - Improve preventative oral health The Veterans Health Administration (VHA) Most veterans recieve all/part of their healthcare through this federal program that provides care in EVERY SETTING Benefit Eligibility Veterans are eligible for healthcare benefits when they have served on active duty for 24 consecutive months and were discharged for any reason BESIDES DISHONORABLE DISCHARGE - Must qualify and enroll Health Risks for Veterans - Trauma - Stressors - Loss of friends (Survivor's Guilt) - Traumatic brain injury (TMI) - Amputations - PTSD - Military sexual trauma - Chronic pain - Substance abuse - Suicide Interventions for Veterans - Address PTSD with cognitive-behavioral therapy & medications - Suicide prevention programs - Long-term care for amputees - Assistance in transitioning to civilian life (counseling) What are the 4 federal programs to improve the health for minority groups? 1. National Breast and Cervical Cancer Early Detection Program 2. Ryan White Comprehensive AIDS Resources Emergency (CARE) 3. Racial and Ethnic Approaches to Community Health (REACH) 4. National Institute on Minority Health and Health Disparities Health Disparities Differences in the presence of disease, health outcomes, or access to healthcare among different groups or populations - Racial/ethnic groups (ex. African Americans, Native Americans, and Hispanics) - Discrimination, healthcare access/use, occupation, education, income, and housing National Breast and Cervical Cancer Early Detection Program Federal program that provides breast and cervical cancer screening, diagnosis, and treatment for low-income, medically underserved, and uninsured women with a focus on minorities Ryan White Comprehensive AIDS Resources Emergency (CARE) Federal program that providers services to persons living with HIV with a focus on minorities Racial and Ethnic Approaches to Community Health (REACH) Federal program that aims to support community strategies in 6 priority areas: 1. Cardiovascular disease 2. Immunizations 3. Breast and cervical cancer screening and management 4. Diabetes 5. HIV/AIDS 6. Infant mortality Culture Knowledge, beliefs, values, and customs of a group of people - Learned from birth and shared by members of the same cultural group - Adapted based on the environment of the group - IS DYNAMIC Subcultural Groups Groups within a larger cultural group - May be based on ethnicity, occupation, health-related characteristics, age, sex, or geographic location The Cultural Assessment (ABCD) 1. A - Attitude - assess patient's meaning of illness 2. B - Beliefs - explore beliefs 3. C - Context - context of patient's life 4. D - Decision-Making Style - individual or family decision-making process Madeleine Leininger's Transcultural Nursing Theory Prioritizes understanding the cultural dimensions of human care and caring - Builds on the Transcultural Nursing Theory Madeleine Lininger's Transcultural Nursing Theory (3 Steps) 1. Maintenance (Cultural Care Preservation) - help retain values 2. Negotiation (Cultural Care Accommodation) - negotiate for better health outcome 3. Restructuring (Cultural Care Repatterning) - modify for better health outcome Federally Qualified Health Centers (FQHCs) Receive federal funding to provide services for underserved populations and some receive additional funding to provide primary healthcare and substance abuse services for the homeless Market Justice Idea that people that are entitled to valued ends such as status, income, and happiness based on their own individual effots - Individual responsibility and minimizes collective burden Social Justice Idea that ALL people are equally entitled to key ends such as access to healthcare and minimum standards of income - Society must accept collective burdens to ensure FAIR distribution of these ends Downstream Thinking Aimed at treating or alleviating healthcare problems Upstream Thinking Aimed at eliminating the primary contributors to homelessness 5 Social Determinants of Health 1. Economic stability 2. Education 3. Social and community context 4. Health and health care 5. Neighborhood and built environment Mental Illness Condition that may disrupt activities of daily function - Requires a follow-up when symptoms significantly impact functions of daily life What is the most common model used for treatment of mental illness? Community-based treatment US Surgeon General's Report on Mental Health in 1999 Legislative act acknowledging mental illness as a disease Serious Mental Illness (SMI) Condition that severely limits a client's functional level What are the causes of mental illness? 1. Biological factors (conditions) 2. Genetic factors 3. Social factors (poor nutrition) Schizophrenia Condition causing a loss of touch with reality - Verbal/auditory hallucinations, paranoia, insomnia, and psychosis Bipolar Disorder Condition associated with significant mood swings causing erratic behavior and severe depression - Psychosis, risk of suicide, and severe depression General Anxiety Disorder (GAD) Condition causing intense sympathetic nervous system activation due to an underlying sense of danger or doom - Associated with irrational fears Post-Traumatic Stress Syndrome (PTSS) Caused by experiencing a traumatic event - Recurrent nightmares, insomnia, severe anxiety, depression, and risk of substance abuse Eating Disorders - Anorexia (not eating enough) - Bulimia (eating and forced vomiting) - Overeating/Binge Eating (low self-esteem, trauma) Attention Deficit Hyperactivity Disorder (ADHD) Causes lack of concentration and focus Major Depressive Disorder Condition causing significant anhedonia, insomnia, or hypersomnia, fatigue, and low self-esteem - High risk of suicide Substance Use Disorder Condition where a client cannot stop using a substance though it may be harmful to them if continued The Substance Abuse and Mental Health Services Administration (SAMHSA) Branch of the Department of Health and Human Services tasked with identifying and treating mental illness - Government agency Violence The intentional use of physical force or power, threatened, or actual, against oneself, another person, or against a group or community that either results in or has a high likelihood of resulting in injury, death, psychological harm, maldevelopment, or deprivation - Disrupts the SAFETY level of Maslow's Hierarchy of Needs and higher-level will not be met until safety is restored Maslow's Hierarchy of Needs Steps of Preventing Violence 1. Define the problem - collect data (who, what, where, when, and how) 2. Identify risk and protective factors - research specific info about your community 3. Develop and test prevention strategies - do your strategies work 4. Adopt successful strategies - continual assessment and refining strategies Socio-Ecological Model Help us to understand how these factors interact, preventative efforts 1. Societal - social/cultural norms, health, economic, educational, and social policies - Prevention - promote social norms that protect against violence and policies that affect the structural determinants of health 2. Community - explore settings - Prevention - improving physical and social environment (safe spaces) 3. Relationship- social group/people - Prevention - include parenting or family-focuses prevention programs to promote healthy relationships 4. Individual - biological and personal history factors - Prevention - promote attitudes, beliefs, and behaviors that prevent violence (conflict resolution and life skills training) Frontier (Rural Areas) Less than 6 people per square mile Rural (Rural Areas) Less than 20,000 Urban (Rural Areas) 20,000-49,999 or 1 million or more Critical Access Hospitals (CAH) Designation given to eligible rural hospitals by the Centers for Medicare and Medicaid Services (CMS) - Must meet the following to obtain CAH designation: o Have 25 or fewer acute care inpatient beds o Be located more than 35 miles from another hospital o Maintain an annual average length of stay of 96 hours or less for acute care patients o Provide 24/7 emergency care services Project ECHO Shares low-cost, scalable solutions that increase people and organizations in the areas of health, education, and social justice - Increase knowledge - Increase support of K-12 educations and schools in rural communities - Support first responders - Collaborate with Indian Health Services - Focus on miners' wellness What are 3 disabilities with S/S at birth? 1. Cystic Fibrosis 2. Down syndrome 3. Spina bifida Which conditions are more likely to result in complications/death more frequently in children with intellectual or developmental disabilities? - Reflux - Constipation - Seizures Disability An umbrella term describing impairments, activity limitations, and participation restrictions - The Americans with Disabilities Act of 1990 and the Rehabilitation Act of 1973 define having a disability by how it limits carrying out a major life activity, such as the ability to breathe, walk, see, hear, speak, work, care for oneself, performing manual tasks, and learn PWD A person with disabilities CWD Children with disabilities Impairment Specific physical or mental limitation particular to a body or organ - Person may have multiple Handicap Experience related to the presence of a disadvantage in fulfilling or completing a role or task Disability is a.... Social construct - Society and culture define disability Autism Spectrum Disorder Disorder that can affect social, emotional, or behavioral skills - Appears more community in boys and children of older parents Down Syndrome Disorder caused by changes to the chromosomes before birth - Results in physical and intellectual characteristics - Can include but not limited to cardiac and pulmonary abnormalities Cerebral Palsy Disorder associated with complications that occur during brain development during pregnancy or birth - Impacts motor movement resulting in postural problems - Dyskinesia, ataxia, and spasticity - Visual/hearing deficits Spina Bifida Disorder caused by the non-closure of the spinal canal before birth - Often preventable with folic acid - Can cause motor, sensory, and other physical deficits and other problems including hydrocephalus and epilepsy Cystic Fibrosis Genetically inherited condition causing damage to the lungs and digestive tract caused by changes in the consistency of the sweat and mucous producing glands - Frequent lung infections, poor nutrient absorption, and in some cases delayed development CADS (The Fatal Four) C - constipation and bowel obstruction A - aspiration and gastroesophageal reflux disease D - dehydration S - seizures Acquired Disability Result from a variety of sources, disability from accident or illness - Require more interdisciplinary support (social services) - Ex. Osteoarthritis, spinal cord injury, heart failure Rehabilitation Act of 1973 Existing laws concerning state vocational rehabilitation services extended (expanded research and training programs, protects those with disabilities from discrimination) Individuals with Disabilities Education Act (IDEA) Guarantees free and appropriate public education to children with disabilities based on needs The Americans with Disabilities Act of 1990 (Amended 2008) Prohibits discrimination of persons with disabilities by guaranteeing equal opportunities for employment, transportation, public services and accommodation, and telecommunications (protects those with disabilities) Patient Self-Determination Act (PSDA) or 1990 Mandated health decisions are protected and communicated (clarified ethical issues around children and persons with disabilities regarding medical decision-making and instructions for when someone cannot make their own medical decisions) Ticket to Work and Work Incentives Improvement Act (1999) Legislation that redefined disability benefits to reduce disincentives for those who wish to be employed and improve beneficiaries' economic self-sufficiency (more flexibility for those persons with disabilities who want to gradually return to the workforce without entirely losing their disability benefits due to employment) What are the two public assistance programs in the US? 1. Social Security Income (SSI) 2. Social Security Disability Insurance (SSDI) Social Security Income (SSI) o Funded through general tax revenues o To quality, the person with disabilities (PWD) must have limited income and resources o SSI disability benefits are payable to adults and children who are disabled or blind and are eligible o SSI recipients receive Medicaid health benefits o Some states may elect to pay a state supplement to some PWD in SSI programs Social Security Disability Insurance (SSDI) o Funded through disability trust fund monies (SS taxes paid by workers, employers, and self-employed workers) o To qualify, the PWD must be insured through Federal Insurance Contributions Act (FICA) earnings of self, parents, and/or spouse o SSDI disability benefits are payable to workers or widows who are disabled or adults who have been disabled since childhood and are eligible o SSDI recipients receive Medicare health benefits o PWD in SSI programs are never provided with state supplements