community health exam 2
what are primary levels of prevention for substance abuse?
-community needs assessment to identify risk factors - decriminalization versus war on drugs - community based programs to reduce underlying causes of abuse and addictions
how long can the brain survive without oxygen?
4 minutes
what are the 5 A's for access to healthcare?
1. availability 2. accessibility- location 3. accommodation- schedules 4. affordability 5. acceptability- attitudes
how to treat heroin overdose
1. assess if they have overdosed 2. verbal stimulation, sternum rub 3. call 911 4. check airway 5. 1 breath every 5 seconds for 30 seconds 6. give naloxone 7. 1 breath every 5 seconds for 3 minutes 8. give naloxone
what is the fastest growing age group?
80+
a newly hired occupational health nurse at an industrial facility is performing an initial workplace assessment. Which of the following information should the nurse determine 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
A
a nurse at a community clinic is conducting a well‑child visit with a preschool‑age child. the nurse should identify which of the following manifestations as a possible indication of child neglect? (Select all that apply.) a. underweight B.Healing spiral fracture of the arm C.Genital irritation D.Burns on the palms of the hands e. poor hygiene
A, E
environment
extrinsic factors that sustains the host.. PHYSICAL- geography, water/food supply, presence of reservoirs/vectors SOCIAL- access to health care, high risk working conditions, poverty
septicemic plague manifestations
fever chills weakness abdominal pain shock disseminated intravascular coagulation gangrene of nose and digits- dead tissue
pneumonic plague manifestations
fever headache weakness pneumonia with SOB chest pain cough bloody/watery sputum
7 ways to prevent heart disease
get active control cholesterol eat better manage BP maintain a healthy weight lower blood sugar stop smoking
what is the leading cause of death in women?
heart disease/cardiovascular disease/ CVD
three types of immunity
herd- most of community not exposed natural aquired- develops through exposure to agent
portals of entry
how the agent gets into the host respiratory passages GI tract skin mucous membranes eyes blood vessels
portals of exit
how the agent leaves a host secretions feces blood semen skin lesion exudates
what are the progression stages for substance abuse?
initiation/experimentation continuance/use transition from use to abuse abuse addiction and dependency
aireborne diseases
measles chickenpox TB pertussis influenza severe acute respiratory syndrome viral fevers
aireborne isolation precautions
negative pressure room mask
what does an overdose look like?
no/slow breathing blue/gray lips/skin unresponsive slow/no pulse eyes rolled back pinpoint pupils
foodborne diseases
norovirus salmonella Hep A trichinosis E. coli
disengagement theory
older adults should retire and stay at home in their rockers while younger generation works
what is the assessment triad for substance abuse?
person substance context
10 types of ACEs
physical abuse verbal abuse sexual abuse physical neglect emotional neglect parent alcoholic mother that is a victim of DV family in jail family with mental illness disappearance of parent
droplet diseases
pneumonic plague seasonal influenza meningococcal disease mumps parvovirus B19 pertussis
what is the significance of ACE?
provides a link between adverse childhood events and chronic diseases
tertiary preventions for violence
rehab
secondary preventions for violence
screening and assessment referral and support
secondary preventions for substance abuse
screening: CAGE early and appropriate referral
life span development theory
share natural theories towards things. areas of inherent change and development toward growth. we continue developing and growing as long as we are living.
primary preventions for violence
stop before it occurs; break the cycle education- parenting, family wellness, anger management, conflict resolution
geriatrics
study of age related disease
gerontology
study of everything about aging
bubonic plague manifestations
swollen and tender lymph nodes fever headache chills weakness
vaers
vaccine adverse event reporting system form for reporting adverse events that ultimately may or may not be associated with vaccination reports events requiring medical attention that occur within 30 days of vaccination
vectorborne
west nile virus lyme disease rocky mountain spotted fever malaria zika
host
what is susceptible to the agent.. age gender genetics ethnicity immunological status physiological state occupation
vector
what the disease is carried through. nonhuman. insect
continuity theory
whatever you were middle age, you will continue at an old age
activity theory
you need to be active, energetic, involved, social
a nurse at an urban community health agency is developing an education program for city leaders about homelessness. Which of the following groups should the nurse include as the fastest‑growing segment of the homeless population? a. families with children B. adolescent runaways C. intimate partner abuse survivors D. older adults
A
a nurse is caring for a client who is experiencing alcohol withdrawal. Which of the following findings should the nurse identify as a manifestation of withdrawal? a.Decreased blood pressure B.Diaphoresis C. pinpoint pupils D.Bradycardia
B
how long until naloxone wears off
30-90 minutes
A nurse is using the "I PREPARE" mnemonic to assess a clients potential environmental exposures. which of the following questions should the nurse ask when assessing for "A" in the mnemonic? A. what do you like to do for fun? B. what year was your residence built? C. What jobs have you had in the past? D. what industries are near where you live?
A Investigate... potential exposures Present work... exposures Residence... age of home Environmental concerns... Past work... exposures Activities... Referrals and resources... Educate...
A nurse is preparing an educational program on cultural perspectives in nursing. The nurse should include that which of the following factors are influenced by an individual's culture? (Select all that apply) A. Nutritional practices B. Family structure C. Health care interactions D. Biological variations E. Views about illness
A, B, C, E
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
A, C
what to do for suspected abuse and neglect of a dependent or vulnerable person?
Ask Validate Document Refer
A nurse is caring for a client who is from a different culture than himself. when beginning the cultural assessment, which o the following actions should the nurse take first? A. Determine the client's perception of his current health status B. Gather data about the clients cultural beliefs C. Determine how the client's culture can affect the effectiveness of nursing actions D. Gather information about previous client interactions with the health care system.
B
a community health nurse is determining available and needed supplies in the event of a bioterrorism attack. the nurse should be aware that community members exposed to anthrax will need access to which of the following medications? a. metronidazole b.Ciprofloxacin C.Zanamivir D.Fluconazole
B
a newly hired public health nurse is familiarizing himself with the levels of disaster management. Which of the following actions is a component of disaster prevention? a. outlining specific roles of community agencies b. identifying community vulnerabilities C.Prioritizing care of individuals D.Providing stress counseling
B
a nurse is conducting health screenings at a statewide health fair and identifies several clients who require referral to a provider. which of the following statements by a client indicates a barrier to accessing health care? A. I dont drive, and my son is only available to take me places in the mornings B. i cant take off during the day, and the local after hours clinic is no longer in operation C. Only one doctor in my town is a designated provider by my health maintenance organization D. i would like to schedule an appointment with the local doctors in my town who speaks spanish and english
B
a school nurse is planning health promotion 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 with 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 with a dietitian to determine carbohydrate counts for students who have diabetes mellitus
B
a nurse is reviewing information about the local health department to prepare for an interview. which of the following services should the nurse expect the local health department to provide? (Select all that apply) A. managing the women, infants, and children program B. providing education to achieve community health goals C. coordinating directives from state personnel D. reporting communicable diseases to the CDC E. licensing of registered nurses
B, C The others are from state departments
a home health nurse is discussing portals of entry with a group of newly hired assistive personnel. Which of the following locations should the nurse include as a portal of entry? (select all that apply.) a. respiratory secretions b. skin C.Genitourinary tract D. saliva e. mucous membranes
B, C, E
a community health nurse is developing strategies to prevent or improve mental health issues in the local area. in which of the following situations is the nurse implementing a tertiary prevention strategy? a. providing support programs for new parents B.Screening a client whose partner recently died for suicide risk C. teaching a client who has schizophrenia about medication interactions D.Discussing stress reduction techniques with employees at an industrial site
C
a school nurse is scheduling visits with 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
C
a nurse is preparing a community health program on communicable diseases. When discussing modes of transmission, the nurse should include which of the following illnesses as airborne? a.Cholera b. malaria C. influenza D. salmonellosis
C cholera- waterborne malaria- vector-borne influenza- airborne samonellosis- foodborne
a community health nurse is educating the public on the agents of bioterrorism. Which of the following agents should the nurse include as Category a biological agents? (select all that apply.) a.Hantavirus b. typhus C.Plague D. tularemia e. botulism
C, D, E Hantavirus- C typhus- B plague- A tularemia- A botulism- A
agent
CAUSES the disease.. CHEMICAL- drugs, toxins PHYSICAL- noise, temperature INFECTIOUS- viruses, bacteria
what are the most common chronic diseases in women?
Coronary vascular disease metabolic syndrome HTN diabetes arthrisis osteoporosis cancer (breast, lung, gynecological) mental disorders and stress
a community health nurse is developing an education program on substance use disorders for a group of adolescents. Which of the following information should the nurse include when discussing nicotine and smoking? a.Smoking is the fifth‑most preventable cause of death in the united States. B. nicotine is a central nervous system depressant. C.Withdrawal effects from smoking are minimal. D. tolerance to nicotine develops quickly
D
a nurse is talking to a client who asks for additional information 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 is to control the client's manifestations."
D
botulism manifestations, prevention, treatment
MANIFESTATIONS double/blurred vision slurred speech difficulty swallowing progressive muscle weakness difficulty breathing PREVENTION none TREATMENT airway management with possible mechanical ventilation antitoxin
ebola manifestations, prevention, treatment
MANIFESTATIONS fever severe headache joint and muscle aches fatigue and weakness hemorrhage vomiting and diarrhea shock PREVENTION no vaccine gown, double gloves, booties, apron, mask droplet TREATMENT IV fluids dialysis airway management pychological counseling minimize invasive procedures
anthrax manifestations, prevention, treatment
MANIFESTATIONS headache fever/chills muscle aches chest discomfort severe dyspnea shock PREVENTION vaccine ciprofloxacin and doxycycline TREATMENT antitoxin and IV antibiotics
smallpox
MANIFESTATIONS high fever fatigue head and body aches rash face and tongue; trunk, arms, legs; hands and feet vomiting PREVENTION vaccine every 10 years TREATMENT no cure contact and airborne precautions
tularemia manifestations, prevention, treatment
MANIFESTATIONS sudden fever chills headache diarrhea muscle aches joint pain dry cough progressive weakness if airborne, life threatening pneumonia and systemic infection PREVENTION vaccine under review by FDA TREATMENT streptomycin or gentamicin doxycycline or ciprofloxacin in mass causality
plague prevention and treatment
PREVENTION vaccine no longer available contact precautions till decontaminated droplet till 72 hour after antibiotics TREATMENT gentamicin and fluoroquinolones
direct contact diseases
STDs (HIV/AIDS, chlamydia, gonorrhea, syphilis, HPV, genital herpes, hep B, C, D) infectious mononucleosis enterobiasis (pinworm) impetigo lice, scabies
common acute illnesses in women
UTI dysuria disease of the reproductive tract (vaginitis, vulvovaginitis, PID, toxic shock syndrome)
types of aquired immunity
active- production of antibodies by the body in response to infection or immunization passive- transfer of anitbodies from mother to baby or transfusions (temporary)
tertiary preventions for substance abuse
acute treatment and relapse prevention
ACE
adverse child events
modes of transmission
airborne foodborne waterborne vector-borne direct contact
epidemiological triangle
an organized method of inquiry to derive an explanation of disease, which analyzes three elements. 1. agent 2. host 3. environment
what are the 7 diseases that require special public health preparedness and response.
anthrax botulism plague smallpox tularemia viral hemorrhagic fevers pandemic influenza the first six are category A bioterrorism disesases
IPV prevention
awareness green dot PACT menswork
what are some sample screening tools for IPV?
behavioral focused (IJS) the other is geared towards physical violence and is designed to identify people who are at the highest risk of being killed by a partner
Reporting requirements for suspected abuse and neglect of a dependent or vulnerable person
child abuse- KY and IN spousal abuse- KY abuse of a dependent adult- KY and IN homicidal/suicidal
waterborne diseases
cholera typhoid fever bacillary dysentery giardia lamblia
11 vaccine preventable childhood diseases
diphtheria pertussis tetanus polio measles mumps rubella varicella (chicken pox) rotavirus haemophilus influenzae type B pneumococal
contact diseases
disease with lesions: -smallpox and chickenpox diseases that can contaminate the environment: -SARS -pandemic influenza -multidrug resistant organism (CDIFF, MRSA, CRE)
