NUR 425 Quiz 1
overdosing on dilaudid
- can lead to tolerance and dependence
cromolyn action
- can prevent bronchospasm in children subject to exercise induced astham - should be admin 15 mins prior to anticipated exertion
IDENTIFYING community problems
- clear identification of the specific problem faced by the community - specifying the persons in the community affected by the problem - the factors that led to the problem
The public health nurse deals with the examination of a community setting to determine the community's health status. Which of the following activities should be considered in the assessment phase? SATA - coll, anal, diss what - what to evaluate about the pop [soc,eco,env] -what do they question about health services in the community?
- collecting, analyzing, and disseminating info - eval the social, economic, and env characteristics of the population - questioning the availability of health services to the community
Which of the following factors assisted such community-oriented nursing pioneers as Lillian Wald to develop approaches and programs to solve the health care and social problems of the late 1800s? SATA
- community healths focus on teaching and prevention - establishment of settlement houses - middle and upper class fear of disease
The major sources of information for program evaluation are SATA
- community indexes - program clients - program records
HYDROMORPHONE (Dilaudid)
- potent narcotic analgesic appropriate for a pain 10/10 - monitor respiratory function
A community-oriented nurse has identified obesity as a problem in the middle school. The next step in a population-focused practice is to MAKE INFO AVAILABLE about the health of the middle school students. This describes the public health core function of
- assessment
CHAP 4: Evolve Qs The ethical question, "Are persons assigned to develop community knowledge adequately prepared to collect data on groups and populations?", is based on an ethical tenet that supports the community-oriented core function of
- assessment
core functions of public health
- assessment - policy development - assurance
how to develop cultural competence
- avoid seeing all individuals as alike - broad open attitude - promote mutual respect for differences - be culturally aware - assess your biases [FIRST step to being culturally competent]
primary health care services - prim care and pub health - meet the basic needs of people in the communities at what cost
- both primary care and public health services - designed to meet the basic needs of people in communities at an affordable cost
PHARM Epinephrine - action
- vasoconstricts the peripheral circulation and shunts the blood to the central cilrculation in pts who do not have a heart beat - first adx during a code
community oriented nursing - focus on health care of whom [people / entire communities] - what is the goal - prev, prese,promo, resto, protect - what is the focus - health PROMO
- broader than CBN - focus on HEALTH care of ENTIRE communities and populations - as well as healthcare of individuals, families, and groups * goal is to prevent disease, preserve, promote, restore and protect health for the community and the populations within it HEALTH PROMOTION
morphine side effects
- can cause spasm of the pancreatic ducts and the sphincter of oddi
A client is scheduled to receive phenytoin 100 mg orally at 6 PM but is having difficulty swallowing capsules. What method should the nurse use to help the client take the medication?
- Administer 4mL of phenytoin suspension containing 125 mg/5 mL
CHAP 2: Hx of Public health nursing elizabethan poor law of 1601
- American social welfare influenced by tradition of british settlers - established a system that guaranteed medical care for poor, blind, lame, those without famility
Lillian Wald
- Basis of VNA w/ friend Mary Brewester - community based direct physical care to patients - Set up the nurses settlement house that later became the Henry street settlement house - visiting nurses service for the poor - basic nursing care into streets - traveling tenement house roofs as the shortest distance from patient to patient
which best support the concept of community oriented nursing practice -
- Direct nursing care of individuals w/ tb - nursing intervention to stop elder abuse - nutrition education programs for teenagers and their families
framework for implementing healthy people 2020
- Mobilize partners - assess the needs in the community - plan interventions - imlement interventions - track changes MAPIT
data gathering
- Obtaining existing, readily available data - age, gender of residents -* vital statistics are a great source of sata to assess a community's health
community oriented nursing goals
- PREVENT disease and disability - promote, protect and maintain health - FOCUS on healthcare of individuals, families, and groups in the community - provide health care to promote quality of life - community diagnosis, health surveillance, monitoring and evaluation of community and population
CHAP 5: Culture most imp for a nurse to do with immagrants
- PRIORITY is to assess you own attitudes, values, knowledge, and beliefs - SELF assessment
lilian wald school based nursing
- RNs should be placed in school to address the alrge numbers of children excluded from school d/t illness -
++4 overreaching goals of healthy people 2020
- To eliminate preventable disease, disability injury, an premature death - To achieve health equity, eliminate disparities, and improve the health of all groups - To create social and physical environments that promote good health for all - To promote healthy development and healthy behaviors across every stage of life
qs to ask to assess cultural differences
- Where is your family from? - Who lives in your home? - Do you practice any type of religious faith? - I am unfamiliar with that, can you tell me how your faith impacts your health? - What are your beliefs? - Please tell me about what foods you prefer? - Who makes the decisions in your household in regards to health? - What types of activities do you do to stay healthy? - Please tell me how you feel about taking prescription medication?
table 5.2 food preferences
- a nurse must understand the food preference of cultures but also of individuals or families within those cultures to formulate plans they can stick with when it comes to dietary mens of trx and preventing illness
6 ethical principles for effective advocacy
- act in the pts best interest - act in accordance w. the pt wishes and instrucions - keep the pt properly informed - carry out instructions with diligence and competence - act impartially and offer frank, independent advice - maintain client confidentiality
important role for PHN and CHN nurses
- advocacy
NARCAN pt taking dilaudid, RR 8 what is the FIRST action by the RN
- adx narcan, narcotic analgesic
ibuprofen pt teaching
- adx with food to minimize GI upset - medication may have an anticoagulant effect - nausea, vomiting, bleeding and ulceration can happen when taken long term
provision 1 of the ANA Code of Ethics
- also states that an individuals rights may be limited when there are public health concerns - Tb cases where the pt must take their medication
PLANNING the community health
- analyzing problems - problem priorities - establishing goals and objectives - iding intervention activities
Tylenol action
- antipyretic - analgesix - dec acidity in urine - relieves HA in pts taking NSAIDs - drug of choice to decrease discomfort in children - good for older adults because it has fewer side effects
summative evaluation
- assesses program outcomes or as a follow up of the results of a programs activites - usually occurs at a specified time end of program or after 1 yr, 5 years
The nurse engaging in formative program evaluation would most likely: A. Conduct medical record audits for quality assurance B. Make a home visit before a client is discharged from the program C. Participate in new client evaluation D. Write policy for risk management
- conduct medical record audits for quality assurance [formative occurs on an ongoing basis while the program exists
A community-based HIV/AIDS clinic would be concerned about which aspects of the Public Health Code of Ethics?
- confidentiality when possible - promoting advocacy for disenfranchised persons
singulair and NSAID
- contraindicated to take together
cultural competent nurse
- culturally congruent behaviors, practice attitudes, and policies that allow RN to work effectively in cross cultural situatoins - lear about cultures you serve and respect and value diversity - must be culturally competent to meet the needs of our clients
ASSESSING community health
- data collection and interpretation - data gathering - data generation - composite database analysis - data collection methods - collection of direct data
While conducting a community health assessment, a nurse in community health meets with local religious leaders to understand the values, norms, perceived needs, and influence structures within the community. This process of data collection can best be described as
- data generation [dev. of data that does not already exist through the interaction with community members]
restorative care - what services - what instructions should be provided
- day care services - instructions about home self care
CHAP 12: Community Assessment Box 12.1 on 211 - core competencies for public health professionals (public health officials should be able to do the following...)
- define a problem - dtermine appropriate uses and limitations of both quant and qual data - select and define variables relevant to the define public health problems - ID relevant and appropriate data and info sources - evaluate the integrity and camprability of data and id gaps in data sources - apply ethical principles to the collection, maintenance, use, and dissemination of data and info - partner with communities to attach meaning to collected quant and qual data - make relevant inferences from quant and qual data - obtain and interpret info regarding risks and benefits to the community - apply data collection processes, information technology application, and comp systems storage and retieval strategies - recognize how the data illuminate ethical, political, scientific, economic and overall public health issues
caring
- demonstrating caring is the basis of nursing practice is the most important goal in nursing today - caring is the essence of nursing and as the ethical and moral ideal of nursing
morphine education
- do not ambulate without assistance
TYLENOL children with measles
- do not suggest aspririn - measles does not cause itchy skin - Tylenol elixirs are a good choice to assist with mild discomfort in children
A nurse overhears the doctor saying, "Do not give him milk; he is from Africa." The nurse reflects on the comment and determines that the: SATA
- dooctor is culturally competent - dr planning care based on racial enzymatic differences
What are the community health implications of characteristics of function?
- economic system: emplyment and educational opportunies, availability of services - resources: police, hospitals, schools, recreational activities
policy development - policies support what of the population - what do they use to make policy decision
- efforts to develop policies that support the health of the population - using a scientific knowledge base to make policy decisions
program evaluation process
- engage stakeholder - describe the program - focus the evaluation design - gather credible evidence - justify conclusions - ensure use and share lessons planned
most effective way to know if interventions are successful
- examining morbidity and mortality rates - evidence not opinion
inhaler teaching
- exhale completely - place the mouthpiece between his lips - inhale deeply, hold breath for 10 seconds and exhale - wait 3-5 minutes before the second inhalation
IMPLEMENTING for community health
- factors influencing implementation - nurses role
CHAP 4: Ethics PHNs role in ethics
- first point of contact for pts and fam in the community - RN are in a unique position as we work to establish trust to their clients but also community groups and law makers
CHAP 1: Community and prevention oriented community BASED nursing (CBN)
- focus is on family centered "illness care" of individuals and families across the life span
ADAPTIVE QUIZZES what are the benefits of standard formal RN dx statements SATA - fosters whos knowledge - provides precise defitions of - what does it say about the RNs role
- foster dev of RN knowledge - provides precise definitions of the pts problem - distinguishes the nurses role from other providers
NSAIDs
- given for mild-moderate pain - take with food - let HCP if there is bright red bleeding - dizziness and lightheadedness can indicate internal bleeding - black tarry stools indicate GI bleeding - used to decrease inflammation on the joints - do not give to pt w/ a hx of ulcers - give acetaminophen when pt that is taking NSAIDs has a ha
a comm may be resistnat to change if memebers:
- have a strong commitment to current policies and processess - have a long hx of dependence on the comm resources and staff members - have strong traditional beliefs and values
CHAP 2: Evolve Qs instructive district nursing was coined in the 19th cent to describe the relationship of nursing to
- health education
community focused nursing process
- identifying community problems - planning the community health
Nightingale influence on public health nursing
- identifying the need for nurses - origins of organized nursing (school nursing) - principles of nursing - demonstrateed that public health principles are central to health care services - nursing should strive to promote health and prevent illness - focused on nutrition, rest, sanitation and hygiene necessary for health - sanitation reform - concerned about the env. determinant associated with health and disease - improved health untilizing a pop based approach that led to improvement in env conditions - simple epidemiology documented a drecrease in mortality rates - demonstrated the value of utilizing statistics to describe population factors
aspirin pt eduction
- inc chance of bleeding - take with food if NOT enteric coated - DO NOT give to children - notify HCP if stools are black and tarry or coffee ground emesis
teaching to 18yo athlete about reversing amenorrhea, which statement indicated effective learning - food intake [inc/dec] - what kind of exercercises
- inc food intake - perform weight training exercises
HEALTHY PPL 2020 larger goals
- inc years of healthy life - eliminate health disparities among different pops
the RN is teaching a pt the correct use of a MDI. which intervention should the RN implement
- instruct the pt to push the top of the medication canister while taking a deep breath
data collection methods
- key informants - participant observation - winshield surveys - secondary analysess of existing data - surveys
health disparaties
- lack of equality - contribute to the health of an individual
nurses working with immigrants
- language barriers - non traditional healing - family conflict - risk factors for the population - religion - know the culture you are working with - get to know the families and their health seeking behaviors - get to know the communities you serve - learn how the community deals with common illness or events - try to see things from the fams viewpoint
The nurse is advised to join a community health center that mainly caters to Latino clients. Which skills should the nurse develop to help reduce health disparities? Select all that apply. - speak what - what rate in the community - what to incorporate in nursing care plans - what to do about beliefs and values in the group
- learning to speak basic medical spanish - learning about the health literacy rate in the community - incorporating the health beliefs of the community in any nursing care plans - learning and respecting unique beliefs and values prevalent among the group
vital statistics
- life expectancy - healthy life style expectancy - years of potential life lost - physical and mental unhealthy days - self assessed health status - limitation of activities - chronic disease prevalance
key informants
- live and work in the community - local politicians, community and school leaders and great source of info -
public health nurse role - community and population is looked at as [whole/half] - raises questions about overall community or pop health such as - provide education about what - intervention at the comm or pop level
- looks at community or population as a whole - raises question about overal community or population health [env, social, cultural] - work within the community to improve health status - provide health education - health and prevention focused - interventions are at the community or population level
assurance - making sure what is available - what to provide for individuals - make sure the public health workforce
- making sure that essential community-oriented health services are available - includes providing essential personal health services for indivduals as well as competent public health workforce (making sure that the services are available)
community based nursing goals
- manage acute and chronic conditions -FOCUS on family centered illness care of individuals - provision of coordinated, comprehensive, and continuous care - setting - practice, care is provided where people work and attend school
A nurse in community health has determined that there is a need for a program for teenage fathers who want to learn about child care. The next step in the program management process would be to:
- meet with the community members to form a planning body * following assessment, planning for the program should occur
narcan RN interventions
- monitor VS, LOC, and EKG after expected peak of blood concentrations - monitor RR closely because opioid effects last longer than the effects of nalaxone - have rescucutation equipment, O2, vasopressors, and mechanical ventilation should be available to supplement naloxone
classification of health indicators
- mortality and morbidity indicators - disability rates - nutritional status indicators - health care delivery indicators - utilization rates - indicators of social and mental health - env indicators - socio economic indicators - health polizy indicators - indicators of quality of life - other indicators
ASPIRIN - drug interactions
- nicotinic acid - inc flushing of face, neck and ears - isuxusprine - inc chance of bleeding - Genko - inc bleeding - Singulair - DO NOT take together - warfarin - inc bleeding - Vit C - crystalluria
cultural competence
- nurses should alter non verbal behaviors to match the pt they are working with
community as a client
- only when nursing focus is on the collective good of the population instead of the individual - pop centered practice - changes are intended to effect the entire community - how does the comm affect the health of individuals, families, and groups?
CHAP 16: Program Management program
- organized approach to meet the assessed needs of individuals, fams, groups, or communities by reducing or eliminating one or more health problems - Eg. immunization programs
PATCH
- pllaning approach to community health - health education model
what would a public health nurse would be first interested in
- populations with the highest rate of diabetes *d/t pop RN emphasis on the population rather than on individuals or families
stages in assessing client need
- preactive: projecting a future need - reacting: defining problem based on past need id by pt or agency - inactive: defining the prob based on existing health status of the pop servend - interactive: describing the prblem using past and present data to project future population needs
the nurse administered narcan to a 7 yo who drank a large bottle of cough syrup. which intervention should the RN implement SATA
- prepare to adx narcan again in 30 mins - assess the pts resp status
public health nursing goals - what do they focuse on -
- prevent disease and disability and promote and protect the community as a whole - FOCUS community as a whole - effect of the community's health status resources on the helath of individuals, families, and groups
12 principles of the public health code of ethics
- preventing harm - doing no harm - promoting good - respecting both individual and community rights - respecting both individual and community rights - respecting autonomy - diversity - confidentiality when possible - ensuring professional competency - trustworthiness - promoting advocacy for disenfranchised persons within the community
outcome identification for healthy people 2020
- promote healthy behaviors - inc access to quality care - strengthen community perception
formative evaluation
- purpose is assessing whether objectives are met or planned activities are completed - begins with an assessment of the need for a program and is ongoing as the program is implemented * during the process
examples of health disparities
- race/ethnicity - sex/ sex identity - age - disability - socioeconomic status - geographic location - NOT education
singulair action
- reduce inflammation in the airways - used for prophylactic and maintenance drug therapy for chronic asthma
Singulair - montelukast sodium
- regular daily prx - does not stop because asthma is better - NOT a rescue medication
program evaluation aspects
- relevance - adequacy - progress - formative or evaluation of processess - efficiency - summative evaluation - effectiveness - impact - sustainability
principlism
- relies on the ethical principles of autonomy, nonmaleficence, beneficence and justice - respecting AUTONOMY means to respct a pts right and ability to make their own decisions
EVALUATING interventions for community health
- role of outcomes in the evaluation phase
public health - epidio, stati, asses - attention to behavi, culti, econom, - what do they plan... what do they develop - what is the focus... PRO of health and quality of life
- scientific discipline that includes the study of epidimiology, statistics, and assessment - attention to behavioral, cultural, and economic factors - program planning and policy develipment - FOCUS on PROMOTION of health and quality of life
tertiary health care services - what does it do to the progression of disease or disability
- services designed to limit the progression of disease or disability
benefits of program evaluation
- shows whether the program is meeting its purpose - should answer:are the needs for which the program was designed being met? are the problems it was designed to solve being solved?
INHALERS - albuterol, cromolyn etc. use of - pt eduction
- site of action is the lungs - do not hold the med to the mouth d/t risk for fungal infection in the mouth - inhale deeply and hold the breath after the medication is in the lung - rinse mouth with water immediately after using the inhaler to help prevent throat irritation, dry mouth, and hoarseness
characteristics of a population
- size - rural or urban - density - rate of growth - cultural differences - marital status - mean age - mean education - income
nurses working with refugees
- stressfull situations - financially insecure, not have transportation - applying to medicaid difficult d/t language barriers
post op position for neonate who undergoes a colostomy SATA - HOB - two positions
- supine with HOB elevated - side lying with HOB elevated
CHAP 16: Evolve Qs A nurse in community health becomes aware that a teen smoking cessation program offered at the health department is a demonstration project. In evaluating this program, the nurse would be concerned with the program's:
- sustainability
assessment - systematic.... of the population - what do they monitor of the population - what do they make available of the community
- systematic data collection on the population - monitoring the population's health status - making info available about the health of the community
singulair pt teaching
- take in the evening without food - not for acute asthma attacks
what is most important to teach a pt about lowering BP
- take meds exactly as prx
what should be included in the assessment of a school health promotional program for adolescents - assessmen of what - identify individuals at risk for what - teach about safety of what
- the RN should perform a school violence asesssment - the RN should id individuals at risk for drug abuse - the RN should teach the students about gun safety
cultural blindness
- the way we do something is best - treating all the pts the same
aspirin toxicity s/sx
- tinnitus, rining in the ears - serum level: 15-30 mg/dL
MORPHINE - hospice
- titrated up for severe pain until pain relief - still follow guidelines to hold it if resp < 8
IBUPROFEN what can be adx to a child with a fever
- tylenol or ibuprofen
what to do when adx epi sub cut
- use tuberculin needle - monitor pt closely
preventive and primary care
- vaccinations - family planning - road safety (seat belts, air bags, helmets)
PHN questions - assessment - what is the prev - assurance - are there... that can reduce HTN
- what is the prevalence of HTN among various age, gender groups (Assessment) - are there programs that could reduce the problem of untreated HTN among the members of the community (Assurance)
benefits of program planning
-Benefits clients, nurses, and the employing agencies. - Focuses attention on what the organization and health provider are attempting to do for clients. - Assists in identifying the resources and activities that are needed to meet the objectives of client services. - Reduces role ambiguity by giving responsibility to specific providers to meet program objectives. - Reduces uncertainty within the program environment. - Increases the abilities of the provider and the agency to cope with the external environment. - Helps the provider and the agency anticipate events. - Allows for quality decision making and better control over the actual program results.
During the first 15 minutes of administering blood to a client, the client complains of shortness of breath, low back pain, and itching all over the body. Which interventions should the nurse implement? Select all that apply. 1. Administer 0.5 mL of epinephrine, an adrenergic, intravenously. 2. Assess the client's temperature, pulse, and blood pressure. 3. Infuse normal saline at 125 mL an hour via a peripheral IV. 4. Discontinue the blood at the hub of the intravenous catheter. 5. Notify the client's health-care provider of the situation.
1,2,3,4,5
ethical decision making framework
1. ID the ethical dilemma 2. place the thical issue or dilemma within a meaningful context 3. obtain all the relevant facts 4. reformulate ethical issues and dilemmas, if needs 5. consider appropriate approaches to actions or options 6. make the decision and take action 7. evaluate the decision and the action
A nurse exclaims proudly to other nurses at the agency, "The care I provide is the same for everyone. I treat everyone the same." In fact, this nurse is demonstrating what inhibitor to developing cultural competence?
cultural blindness
19. The nurse on a medical unit is providing discharge instructions to a client who is prescribed fluticasone (AeroBid), a glucocorticoid, and a metered-dose inhaler. Which statement by the client warrants intervention? 1. "I will use a spacer when using my inhaler." 2. "I will hold the medication in my mouth for 10 seconds." 3. "I will wait a few minutes between puffs." 4. "I will notify my HCP if I get mouth sores."
2
The client with chronic reactive airway disease is taking the leukotriene receptor in- hibitor montelukast (Singulair). Which statement by the client warrants intervention by the nurse? 1. "I have been having a lot of headaches lately." 2. "I have started taking an aspirin every day." 3. "I keep this medication up on a very high shelf." 4. "I must protect this medication from extreme temperatures."
I have started taking aspiring every day
29. The 28-year-old female client with chronic reactive airway disease is taking the leukotriene receptor inhibitor montelukast sodium (Singulair). Which statement by the client indicates the client teaching is effective? 1. "I will not drink coffee, tea, or any type of cola drinks." 2. "I will take this medication at the beginning of an asthma attack." 3. "It is all right to take this medication if I am trying to get pregnant." 4. "I should not decrease the dose or suddenly stop taking this medication."
I should not decrease the dose or suddenly stop taking this medication
determinants of health
Policy Making Social Factors Health Services Individual Behavior Biology and Genetics
social factors
Social factors and physical conditions in the environment in which people are born, learn, play, work and age - eg. availability of resources, exposure to trash, school availability
SMART Goals
Specific, Measurable, Attainable, Realistic, Timely - relavant - time frame
hispanic outreach program works with the nurse in community health to train hispanic healthcare workers in providing basic sevices and education within the local hispanic community. THe concenpt basic to community oriented nursing practice that is best described by this intervention is
community partnerships
APEXH
addresses the three core competencies of pubilc health (assessment, assurance, and policy development)
The client is having an acute exacerbation of asthma. The health-care provider has prescribed epinephrine (adrenaline) subcutaneously. Which intervention should the nurse implement when administering this medication? 1. Administer the medication using a tuberculin syringe. 2. Dilute the medication to a 5-mL bolus prior to administering. 3. Perform a complete respiratory assessment. 4. Monitor the client's serum epinephrine level.
adx the med using a tuberculin syringe
A mother who notes that her newborn regurgitates after feedings asks the nurse whether her baby is ill. What information should the nurse consider prior to responding?
an underdeveloped cardiac sphincter causes regurgitation
The nurse in community health identifies an elder abuse problem related to caregiver stress among families. The nurse further identifies a lack of caregiver support services in the local community. The next step in the community-oriented nursing process would be to
analyze the community problem
program management
assessing, planning, implementing, and evaluating a program
CHAP 5: Evolve Qs A community-based hospice nurse has an Asian male client with terminal stage cancer. The client complains that he is in continuous pain and receives no relief from the codeine prescribed by his primary care practitioner (PCP). The nurse contacts the client's PCP to discuss replacing the prescription of codeine with another pain-reducing non-codeine-based drug. The nurse is demonstrating knowledge of the cultural organizing factor of
biological variance
A nurse in community health is invited to work with a coalition of churches to address safety concerns for children in the local community. The nurse provides training in problem-solving skills, manages conflict, facilitates the process, and provides expertise in interpreting data. This nurse has chosen the implementation role of
change partner [content focused roles]
A client is placed on a heart-healthy diet to control the intake of saturated fats and cholesterol. Which information should the nurse include in a teaching plan to explain best the dietary nature of this diet?
cholesterol is a necessary body constituent and cannot be eliminated
Migrant workers and their families who reside in a specific mobile home park during the summer months would best be classified as a
community
A nurse in community health contacts three individuals who have had sexual encounters with an individual recently diagnosed with syphilis. The concept basic to community-oriented nursing practice that is best described by this intervention is:
community as client
A school nurse teaches three middle school students with asthma conditions techniques to minimize their incidence of bronchial spasms. This is an application of:
community based * goal of community based nursing is to manage acute or chronic conditions while promoting self care among individuals and families
CHAP 1: EVOLVE Qs A nurse in a clinic that provides direct care services to clients with tuberculosis would be classified as practicing
community based nursing * d/t giving direct care to people
A nurse in community health seeks a low-cost evaluation method to learn the perspectives of the largest number of persons regarding a proposed local safe haven program for unwanted infants. The best evaluation method to meet the criteria would be
community forums
A nurse planning a smoking cessation clinic for adolescents in the local middle schools and high schools is providing
community oriented care * comm oriented nurses emphasize health protection, maintenace, and promotion and disease prevention
The nurse administers a dose of an intravenous antibiotic to the client. Twenty minutes later the client is complaining of shortness of breath, itching, and difficulty swallowing. Which intervention should the nurse implement first?
d/c the iv abx
Nonmaleficence
do no harm
Beneficence
doing good
Local officials have requested a program evaluation of a comprehensive teen sex education program offered in the local schools in preparation for potential budget discussions. A nurse in community health conducts a program evaluation and determines that the teen pregnancy rate has gradually declined over the years that the program has been in place. The community is measuring the program's
efficiency *determine whether a program the provides better benefits at a lower cost than does a similar program or whether the benefits to the clients or number of clients served justifies the cost of the program
A major evaluation source for a nurse to use to determine the effectiveness of a teen driver safety program is:
epidimiologic data - mortality and morbidity data measuring health and illness indicators
CHAP 12: Evolve Qs nurse in community health defines goals and measurable objectives during the planning phase of a community health intervention. This also marks the beginning of the
evaluation phase
A nurse is caring for a preschooler who is being prepared for surgery. What does the nurse expect to have the most influence on the child's response to hospitalization?
fear of bodily harm
n caring for a young adult from West Africa, the community nurse is introduced to another individual who is referred to as "auntie." A culturally competent nurse who is aware of the basic organizing factor of culture related to social organization would
find out who is considered to be a member of the family.
The historical nursing figure who contributed to establishing the foundation for current community health and nursing in community health by working in military field hospitals using a population-based approach that improved nursing care and environmental conditions was
florence nightingale
assessment issues
gaining entrance/acceptance trust confidentiality
The client has a severe anaphylactic reaction to insect bites. Which priority discharge intervention should the nurse discuss with the client? 1. Wear an insect repellent on exposed skin. 2. Keep prescribed antihistamines on their person. 3. Have an "EpiPen" available at all times. 4. Wear a MedicAlert identification bracelet
have an epi pen available at all times
A nurse is assessing the growth and development of a 6-month-old infant. What behavior indicates that the infant has reached the expected level of development?
hold a bottle without help
the nurse in community health is meeting with staff to systematically plan for a new outreach program. doing so helps them to
id the resources and activites that will help them meet their program objectives
In a federally funded preschool program such as Head Start, nursing services that include conducting developmental-level screening for cognitive and psychomotor development of individual children would most likely be considered community-oriented nursing care when
individual results are compared with established standards for children of the same age group
The most important contribution made by Florence Nightingale to community-oriented nursing was:
introduction of professional schools of nusing in the US
In applying Ethical Principles for Effective Advocacy, the ethical principle that empowers the client (groups or communities) to make knowledgeable decisions is
keep the pt well informed
Community-oriented nursing in the 21st century has been influenced by historical events and government initiatives that support the approach of
keeping the public healthy
A nurse in community health is visiting with an older adult Asian woman for the first time. The nurse has not encountered many clients from this culture. An effective way to ensure client-centered care is performed is to
listen to the client's perceptions of the problems
The parent of a 3-month-old infant asks the nurse about selecting toys for the infant. Which toy should the nurse tell the parent is most appropriate at this age?
metallic mirror (baby interested in self recognition and playing with the baby in the mirror)
A nurse in community health is participating in a community service board strategic team that is currently assessing the community's strengths, the local public mental health system, the community's mental health status, and other variables. This best describes what strategic program planning model used today in the public health arena?
mobilizing for action through planning and partnerships (MAPP) *helps community helath workers be facilitators as communities stablish priorities in their health issues and id resources to address the issues
The historical figure whose work in providing care to poor people, primary prevention, and environmental health established that individual as nursing's first moral leader and community-oriented nurse was
nightingale
A 2-year-old child with developmental dysplasia of the hip has a spica cast applied. The mother asks the nurse how to keep the cast clean. How should the nurse respond? - where to place pastic wrap or duct tape
place plastic wrap or duct tape around the pernial edges of the cast
The most significant commonalities between the ANA's Scope and Standards of Public Health Nursing Practice and the Public Health Code of Ethics assert that advocacy is conducted in the
policy arena
if a family decides to have their family off life support
priority is patient AUTONOMY and upholding ethical principles
In 1902, Lillian Ward introduced the concept of school nursing to address the problem of school absenteeism. The primary model for the school nurse program was to work with children in the schools and make home visits for the purpose of:
providing and obtaining medical trx for absent students
how is public health nursing different from community health nursing
public health nursing focuses on population
secondary health care services - det and trx disease in what stage
services designed to detect and treat disease in the early acute stage
The nurse in community health reviews the monthly and year-to-date health service use report for the local community to monitor trends as correlates of the community's health. The nurse is viewing community health through the dimension of
structure
In a community clinic that screens and treats individuals for cardiovascular disorders, the nurse practicing public health/population-focused nursing would most likely ascertain - what rate, among who
the prevalence rate of cardiovascular disorders among various groups
Provision 1 of the Code of Ethics for Nurses addresses practicing with compassion and respect for the person being cared for regardless of the person's status, attributes, or the nature of the health problem. In applying this provision to practice, the public health nurse understands that
there are times when individual rights may be limited because of health concerns
35. The child diagnosed with reactive airway disease is prescribed a cromolyn inhaler. The mother asks the nurse to explain how this medication helps control her child's asthma. Which statement is the best explanation to give to the mother? 1. This medication diminishes the mediator action of leukotrienes. 2. This medication blocks the release of mast cell mediators. 3. This medication causes relaxation of the bronchial smooth muscle. 4. This medication decreases bronchial airway inflammation.
this medication block the release of mast cell mediators
The community-oriented nursing care function of policy development is supported by the ethical tenet of
what is ethical is also good policy
s/sx of withdrawal from opiates
yawining, rhinorrhea, cramps