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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 may
be 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 2020 objectives in the chapters of your textbook- Just
familiarize yourself with them. These are the basis for community health programs. Page
80, 201
Leading Health Indicators
1. Access to Health Services
2. Clinical Preventative Services
3. Environmental quality
4. Injury and violence
5. Maternal, Infant, and Child health
6. Mental health
7. Nutrition, physical activity, and obesity
8. Oral health
9. Reproductive and sexual health
10.Social determinants
11.Substance abuse
12.Tobacco

Population Groups across the Lifespan and their Health Risks

Infants
Number 1 cause of injury or death is suffocation followed by Motor Vehicle Accident
then Homicide.
Sudden Infant Death Syndrome
Infection is the most significant cause of illness in infants and children.
Vertical transmission of infection- Passage of a disease-causing agent
(pathogen) from mother to baby during the period immediately before
and after birth. Transmission might occur across the placenta, in the
breast milk, or through direct contact during or after birth. For
example, HIV can be a vertically transmitted pathogen. Also known
as perinatal transmission.
Children
Obesity – Healthy people objectives have addressed youth fitness and obesity
Defined by using BMI which is a ratio of weight to height
Risks for childhood obesity were related to obesity in the parents
Obesity rates are higher in populations such as Native American, Hispanic, and
African Americans groups. Lower socioeconomic groups in urban settings

, have been associated with higher rates.

Injuries and Accidents- Number one cause of death in ages 1 – 24 yrs.
Motor vehicles accidents are the leading cause of death among children and teenagers.
Toddlers experience a large number of falls, poisonings, and motor vehicle accidents
Lead poison from lead based paint in older homes is a health concern.
Lead has detrimental effects particularly on the neuro system.
Can decrease IQ. If on WIC and have lead poisoning the program will provide additional
foods high in calcium and iron.
Review treatment of lead poison. – Chelation therapy and a diet high in calcium, vitamin
C and iron. Don’t want BLL > 5mcg/dL

Infant Mortality Rate: the measure most commonly used around the world as an
indicator of overall health and availability of health services. May want to review how to
calculate it. #of infants <1 who die/ # of live births in same year

School age children have the lowest injury death rate; however, this group has difficulty
judging speed and distance, placing them at risk for pedestrian and bicycle accidents.
Vision screening in young children would match shapes or colors.

Adolescents: Injury accounts for 75% of all deaths and risk-taking becomes more
conscious at this time especially among males.
Suicide is the second leading cause of death among youths between the ages of 15
and 24. Suicide is the third leading cause of death among youth between the ages of
10 and 24 years. Community health programs for adolescents should focus on
suicide prevention.

Developing a smoking program for adolescents- first want to determine the incidence of
smoking among the teenagers in the community.

Menomune vaccine given to adults younger than 30. It prevents infection by certain
groups of meningococcal bacteria. Discharge teaching- give Tylenol, watch for signs and
symptoms of reaction such as fever, behavior change, seizures or difficulty breathing.

Acute Illness- also a significant cause of illness in children.

Chronic Health Problems- improved medical technology has increased the number of
children surviving with chronic health problems. Examples: Down Syndrome, spina
bifida, cerebral palsy, asthma, diabetes, congenital heart disease, cancer, hemophilia,
broncopulmonary dysplasia, and AIDS

Routine immunizations have been very successful in preventing selected diseases.
Immunization rates are the amount of people that get scheduled vaccines. These
rates are used as quality indicators of the health of the population. Review the
immunization schedule in children.**

, Good nutrition is essential for healthy growth and development and influences disease
prevention in later life. e.g. Children and adolescents calcium intake affects if they
develop osteoporosis in adulthood.

Women
The women’s health movement was pivotal in bringing national recognition to women’s
health issues.
Women have a longer life expectancy than men
Women are more likely to have acute and chronic conditions that require them to use
more services than men.
African-American or black women are statistically more likely to have poor health
outcomes because of poor understanding of health, lack of access to health care, and
lifestyle practices.
Heart disease leading cause of death in women
Lung Cancer leading cause of cancer in women and 2nd leading cause of death

Men
Men are physiologically the more vulnerable gender, shorter life span and higher infant
mortality rate
Life expectancy of men in the US is one of the lowest in the developed countries
Men engage in more risk-taking behaviors than women
Men tend to avoid diagnosis and treatment of illnesses that may result in serious health
problems

Elderly
Steadily growing population
Increase in chronic conditions, demand for services, and strained health care budgets
More older adults live in the community- Age in place
Nurses address the chronic health concerns of elders with a focus on maintaining or
improving self-care and preventing complications to maintain the highest possible
quality of life.
Assessing the elderly incorporates physical, psychological, social, and spiritual domains.
Individual and community focused interventions involve all three levels of prevention
through collaborative practice.

What vaccines should the elderly receive and how often?
-Tetanus diphtheria every 10 years
-Influenza vaccine annually
-Pneumonia vaccine once after age 65 (ask physician about booster every 5 years)
-Herpes Zoster (shingles) one time dose at age 60.
-Hep A and B for those at risk


U.S. Healthcare problems
More than 43 million people in the United States are uninsured, and many more simply
lack access to adequate health care.

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