ATI Community Health Proctored Exam 221 with complete solution

nursing community theories Ans- nightgale's theory of environment Ans- *focuses on the impact of a person's environment on their health -focus is on preventative care -washing hands, maintaining a clean environment == in order to prevent a disease or spread of a disease health belief model Ans- *assumes the person's primary motivation in taking positive health actions it to avoid getting a disease -the likelihood that they will take these actions are based on: 1. modifying variables: age, gender, race, economy and education 2. perceived severity and susceptibility of getting a disease 3. perceived benefits vs. barriers of taking action 4. cues to action: advice from doctors, media campaigns, etc. community health nursing Ans- *the client is the community or population as opposed to an individual *two parts that fall underneath this community based nursing Ans- *providing illness care: helping to take care of clients with acute or chronic conditions *treating individuals and families *ex: home health nurse, school nurse community oriented nursing Ans- *not focused on illness care *focused on education, disease prevention, trying to improve collected health of the community *focus on health education, health promotion, and disease promotion *ex: public health nurses respect for autonomy Ans- *uplifting a patient's right for self-determination nonmaleficence Ans- *not doing any harm beneficience Ans- *doing good or what is best for the patient distributive justices Ans- *fair allocation of resources in the community epidemiology Ans- *the study of the spread, transmission, or incidence of the disease or injury 3 components of the epidemiology triangle Ans- *agent: the thing that is causing the disease *host: the human or animal that is being affected by the disease *environment incidence Ans- *number of new cases of disease or injury in a population during a specified period of time prevalence Ans- *the number of all cases (which includes new or previous cases) of disease or injury in a population during a specified period of time. obsticles to education Ans- *age *culture *illiteracy *language barrier *lack of access *lack of motivation visual Ans- *respond better to videos or presentations auditory Ans- *respond better to verbal lecture or discussion tactile Ans- *respond best with hands on demonstration and return-demonstration to show what the client has learned healthy people 2020 Ans- *care of people with diabetes, cancer, older age, and LGBT health (priorities) primary Ans- *actions that help prevent initial occurrence of a disease -ex: immunizations, providing education (written at an 8th grade level or lower) secondary Ans- *early detection of the disease and limiting the severity of the disease -ex: screening for a disease, disease surviallence, controlling outbreaks teritary Ans- *maximizing recovery after an injury or illness -ex: rehabilitation, support groups, physical therapy chapter two Ans- aculturation Ans- *when someone adopts the traits of a different culture ethnocentrism Ans- *belief that one's culture is superior to all others -view the world from their own culture viewpoint, close minded culture assessment Ans- *ethnic background *religious preferences *family structure *food patterns *health practices *always incorporate patient's preferences into nursing care when possible when to use an interpreter Ans- *don't use a family member (not recommended) * patient education/teaching materials Ans- *should be available in patient's primary language environmental risks Ans- *toxins: lead, pesticides, radon *air pollution: carbon dioxide, tobacco, airborne lead contamination *water pollution: waste products, chemical runoff from the soil *questions for environmental assessment: *what is the condition of your housing? *any remodeling activities? *what is water temperature heater set at? (less then 120 degrees F) *occupation? exposure to chemicals/toxins *tobacco smoke present? *quality of drinking water? lead exposure Ans- *ask when house was built -pre 1978 is at risk for lead-based paint -screen children 6 months to 5 years for lead exposure *avoid children playing right outside the house: paint may reside in soil *wet mop the floor as opposed to vacuum *wet sanding technique as opposed to dry sanding technique *children are getting enough iron and calcium in diet, decrease absorption of lead in the body *encourage use of cold water vs hot water because lead dissolves more quickly in hot water medicare eligibility Ans- *over 65, who have been receiving disability for at least two years or have been diagnosed with ALS or end stage renal disease and are receiving dialysis part A Ans- *cover inpatient hospital expenses *limited skilled nursing facilities and home health care part B Ans- *covers outpatient care -diagnostic services, physical therapy, occupational therapy part C Ans- *combines part A and B *offered through private insurance companies part D Ans- *prescription drug coverage medicade Ans- *low socioeconomic status, no other insurance options may be eligible *based on house hold size and income level state department of health Ans- *manages the WIC (women, infant, and children) program *oversee the CHIP (children's health insurance) program *manage medicade *report notifiable communicable diseases to the CDC state board of nursing Ans- *organization licenses LPNs and RNs *oversee state school of nursing *develop state nursing practice acts local health departments Ans- *help meet the needs of the local community *report notifiable communicable diseases to CDC chapter 3 Ans- community health program planning Ans- assessing people in the community Ans- *demographics: density and distribution of people *biological factors: race, age, gender, health and disease status *social factors: occupation, education, income, and crime rates *culture factors: history, customs, religion assessing environment Ans- *geography *where are the location of health services *what is the housing like *what is the climate? how to gather data Ans- *informate interviews == to people in the community *community forums: public meetings, a challenge could be to get people to participate *secondary data: existing data === birth certificates, morbidity data, health records === have already been created *participate observations: observe community activites *windshield survey: drive through a community and look at the environment *focused groups: meet with a representative of the community *surveys: send out written survey, expensive and has low response rate windshield survey Ans- *observe the community *appearance of the people: signs of violence, illness *quality of the housing *drug abuse *access to healthcare facilities *types and availability of the grocery stores *public transportation community health help plan Ans- *preplanning stage: brainstorm ideas *assessment: data collection *diagnosis: analyze collected data to determine health needs of the community and set priorities *plan: interventions, establish goals, identify responsibilities, set a budget *implementation: execute plan *evaluation: determine effectiveness of intervention chapter 4 Ans- home health nurses Ans- *provide care in a patient's home or assistive living *provide patient education *provide direct nursing care *care coordination *assess home for safety -no scattered rugs, house is free of clutter, adequate lighting on the stairs, colored tape on the step's edges, keep locks or alarms on exit doors (for dementia patients) hospice nurses Ans- *provide pallative care for patients that are dying *focus on symptom management only parish nurses Ans- *work with pastoral staff to improve health of the faith community *provide health education *facilitate support groups *do NOT provide bedside nursing care (no hands on nursing task) occupational health nurse Ans- *promote health and wellness of employees *prevent workplace illness and injury *through survalence, identify risks within work environment *identify ways to decrease or eliminate workplace hazards *primary: provide safety education *secondary: screenings *tertiary: provide limited duties programs for employees that have been hurt *be closely informed on OSHA standards school nurse Ans- *provide direct nursing care to children at school *provide health education *act as a case manager for children who have health needs *make referrals, help to schedule appointments, help coordinate services for children *primary: assessing immunization status of children *secondary: screenings: vision, hearing, oral health, scoliosis, infestations, assess for neglect/abuse *tertiary: administer medications, nursing care to children with chronic diseases, assess children with disabilities health concerns for infants Ans- *SIDS (big concern): encourage parents to do back to sleep health concerns for children Ans- *receiving immunizations *free from injury: encourage helmets, and using seatbelts health concerns for adolescents Ans- *motor vehicle accidents are a big risk: wearing seatbelts, and risk of alcohol and drug abuse *risk of sex: safe sex practices *assess mental health health concerns for women Ans- *osteoporosis: big concern as get older and after menopause -engage in weight bearing exercises and supplementation of calcium and vitamin D *heart disease, diabetes, and cancer prevention: have mammograms and pap smears health concerns for men Ans- *heart disease, cancer prevention: encourage prostate screenings and testicular exams *lung disease: smoking *liver disease: excess alcohol intake health concerns for older adults Ans- *heart disease *CADs and COPD *pnemonia *polypharmacy: taking lots of medications and having interactions, metabolism isn't as great == could cause toxicity *cancer *injury prevention: falls times of transition Ans- *include birth and adoption of child *death in family *chronic illness *divorce *loss of income *these times of transition create high risk for families *tools to use: -genogram: show patterns of illness and graphical representation of relationships within the family (enhanced family tree) -develop eco map: graphical representation of family interaction with outside groups of organization, provide information of family support chapter 5 Ans- violence Ans- *homacide: often related to substance abuse, the victim is usually known to the perpetrater, males are more at risk *rape: often underreported, let the patient know not to bathe after assult to avoid damaging evidence *suicide: most high in men over 65 *abuse: physical, sexual, emotional (humilitation, intimidation), neglect (failure to provide food, shelter, emotional care, medical care, health care to someone you are responsible for), economic abuse (misuse of money, failure to provide for victim or theft of money) *community factors that increase risk of violence: *employment *poverty *social icilation *child abuse is more common with spousal abuse signs of child abuse Ans- *presence of wounds or injuries in various stages of healing *unexplained bruises or injuries *fear of others *small round burns *spiral fractures signs of child neglect Ans- *poor hygiene *inappropriate dress for the weather *signs of malnurishment *withdraw from school activities alcohol abuse Ans- *things that effect body's metabolism of alcohol: -weight and size -time elapsed while drinking -gender -present of food in stomach *manifestations of alcohol withdraw appears within 4 to 12 hours -signs of withdraw: tachycardia, hypertension, N/V, headache, anxiety, irritability, sweating, tremors, and seizures *assess when patient had last drink *primary: public education (school) *secondary: screening individuals *teritary: refer patients who have problems with substance abuse to AA meetings, etc. help to promote better coping skills and lifestyle changes homelessness Ans- *fastest growing segment of patients who are homeless include families with children *other risk factors: unemployed, migrant workers, veterans, mental illness, HIV/AIDS, substance abuse, at risk youth *health issues: infestations (scabies/lice), TB, substance abuse, HIV/AIDS, mental illness veterans Ans- *key health issues: mental health issues, substance abuse, suicide, traumatic brain injury, spinal cord injuries, amputations migrant workers Ans- *at high risk: TB, dental disease, skin cancer, diabetes, obesity, suicide, increase work related injuries (toxins, etc.) *primary: reduce exposure to pesticides and accident exposure, help provide with preventative care: dental health/immunizations *secondary: screen for skin cancer, pesticide exposure, and communicable disease exposure *teritary: provide primary care services, and treat exposures chapter 6 Ans- mode of transmission Ans- *airborne: chickenpox, measles, TB, pertussis, influenza *food borne: hep A, samenella, e-coli, botchulism *water borne: cholera, typhoid fever *vector borne: lyme disease, malaria, rocky mountain spotted fever *sexually transmitted: HIV, hep b, c, d, sphyliss, HPV, gongarrhea *contact: lice, scabies, and empitago *saliva: mono herd immunity Ans- *most community members have immunity to specific disease and this causes protection for specific community members who can't get vaccinated *being threatened because more people aren't getting vaccines active-natural immunity Ans- *body produces antibodies in response to exposure to live pathogens *ex: getting sick active-artifical immunity Ans- *getting a vaccine with dead or weakened pathogen that causes antibodies to arise to protect the body passive-natural immunity Ans- *where antibodies are passed from mom to baby (breastfeeding) passive-artifical immunity Ans- *where immunoglobins are administered to a person who is exposed to pathogens communicable disease reporting Ans- *mandated by state and local regulations, not nationally regulated *state reporting to CDC is voluntary communicable diseases Ans- *primary: providing education on immunizations, encouraging hand hygiene, teaching proper food handling, advising of risks of disease when traveling to countries (hep A) *secondary: screening, quarentee, refer suspicion of diseases to get properly diagnosed *tertiary: monitor treatment compliance (may need direct observation therapy) nationally notifiable diseases Ans- *anthrax: a person who is exposed is recommended to receive IV ciprofloxin therapy *lyme disease: bullseye rash *meningitis: college-aged kids, recommended to get vaccines, benefit any other individuals in a crowded environment *pertussis: whooping cough, child in school who is diagnosed with pertussis need to stay home until cough is gone (give erythtomycin to those expose: families, etc) *small pox: starts as a rash on the face and moves down the body *syphallis: early sign is sore on the genital (canker) diaster management Ans- first level Ans- *diaster prevention -survallience -immunizations -inspections -education -risk assessments second level Ans- *disaster prepardness -creating disaster action plan -identifying evacuation routes -creating disaster kit -identifying a meeting place and a communication plan -performing disaster drills third level Ans- *disaster response: -assess the extent of the disaster -perform triage : direct those affected -coordinate evacuations -coordinate quarantenes fourth level Ans- *disaster recovery: begins when there is no longer danger present -coordinate care in shelters -start process of recovery bioterrorism Ans- category A Ans- *small pox, botulism, anthrax, and plaque category B Ans- *typysis, cholera category C Ans- *hantavirus inhaled anthrax Ans- *symptoms: severe dyspnea, fever, shock, and muscle ache *administer: IV ciprofloxin smallpox Ans- *starts as rash on face and moves down *other symptoms: high fever, headache, vomiting *prevention: vaccination chapter 7 Ans- consultation Ans- *provider puts out a request to another provider or another resource who can provide expert advice or services for a patient referral Ans- *requests or recommends management of one or more of the patient's concerns or issues to another provider or recommend support services case management Ans- *help patient move from acute care to skilled nursing facility (community based care) *make sure they have everything they need for equipment *follow up appointments are identified *evaluate patient's medical needs, psychosocial needs and financial constraints *collaborate with patient, family, insurance companies, medical providers, etc *facilitate discussion of patient's needs with interprofessional team *provide referrals as needed informatics Ans- *incorporates nursing and information technology and patient technology to develop and support nursing practice and improve patient outcomes telehealth Ans- *delivery of healthcare through technology versus in person -particular helpful in rural areas where they lack specialists, patients can connect with specialists who don't have access health policy Ans- *nurses can always act as an advocate for changes in health policy *help lobby legislators *serve in public office *help form coaligitions: collaboration of groups to achieve a goal, hopes to improve community health