Community Based Nursing

In a community, there is a high incidence of hypertension due to an unhealthy lifestyle. What interventions by the community-based nurse are helpful in reducing blood pressure in this community? Select all that apply.

1 Discourage increased activity levels. 2 Correct Promote lifestyle changes. 3 Use mechanical appliances. 4 Emphasize a sedentary lifestyle. 5 Correct Recommend diet modification. The nurse may use various nonpharmacological approaches to reduce the incidence of hypertension in the community. These include assessing lifestyles and promoting lifestyle changes, if required, such as modifying diet and increasing exercise participation. A food journal can be used as a tool to keep track of and monitor dietary habits. Mechanical appliances will not help reduce hypertension. A sedentary lifestyle is a risk factor for hypertension. The nurse should emphasize the importance of exercise in reducing the risk of hypertension.

What are the objectives of performing community surveillance? Select all that apply.

1 Promote religious and ethical values. 2 Correct Maintain the level of health care in the community. 3 Enhance collaboration among the community members. 4 Correct Develop sensitivity to changes in health status. 5 Correct Identify the factors that are responsible for changes in health status. Community surveillance helps the nurse to maintain the level of health care in the community. It also helps to determine changes in the health trends of the community. This information can be used to plan health education programs. The nurse may also identify various factors that are responsible for changes in the health status of the community. Community surveillance does not promote religious or ethical values, nor does it enhance collaboration among the community members.

The nurse works in a community with a high prevalence of cancer. What nursing interventions would be helpful in reducing cancer-related morbidity at the community level? Select all that apply.

1 Provide emotional support to the community. 2 Perform yearly breast self-examinations. 3 Correct Help people quit smoking. 4 Correct Motivate the women to go for annual Pap smears. 5 Encourage mammograms in sexually active women. Though people who have cancer often suffer emotionally, and the nurse should provide emotional support to such patients, this will not reduce cancer-related morbidity. The nurse should encourage patients to quit smoking because smoking is a risk factor for developing cancer. Annual screenings for cervical cancer are performed by taking a Pap smear. The Pap smear helps to detect cancer early and ensures timely treatment. Women should be encouraged to perform a breast self-examination every month, rather than every year. Mammograms should be recommended to the entire community, not just sexually active women.

A 54-year-old woman is poor and suffering from tuberculosis. Other people with tuberculosis live in her area. What care should the nurse take when collecting information about the patient's medical history? Select all that apply.

1 Take a brief history to avoid unnecessary stress to the patient. 2 Avoid questions about financial status of the patient. 3 Correct Include questions on current medications. 4 Correct Determine whether the illness is acute or chronic. 5 Correct Collect data on a comprehensive form that focuses on the specific needs of the vulnerable population with whom you work. Asking questions about current medications will help the health care provider plan other treatments for the patient. It is important to determine whether the illness is in the acute or chronic stage so that caregivers can take necessary precautions and strategize the treatment plan. Making use of the assessment form designed for vulnerable groups helps the caregivers understand their special needs. Assessment of these needs is more important than treating the illness. Often these special needs are the underlying cause of their illness. It is important to take a complete and detailed history that provides all the necessary information about the patient and his or her family to serve the patient better. Questions about financial status also should be asked to understand the patient's situation better.

A community health nurse visits a patient with chronic diabetic ulcers. The nurse cleans the ulcer and applies a dressing. The next day, the nurse takes the patient to a diabetologist for expert care. What are the roles that the nurse played here? Select all that apply.

1 Correct Caregiver 2 Educator 3 Change agent 4 Epidemiologist 5 Correct Client advocate The role of a caregiver in the community setting is to manage and care for the health of the community. A caregiver also ensures that appropriate, individualized nursing care is given to specific patients and their families. Here, the nurse is giving specific care by managing diabetic ulcers for patients and is thus playing the role of a caregiver. As a patient advocate, the nurse needs to help patients with identifying resources and guide the community people members in reaching the appropriate authority. The nurse should also advise patients on service requests, and the process to follow through with the information the patients receive. As an educator, the nurse should arrange for health education programs. A change agent identifies and implements new approaches to a current problem, which is not true in this case. As an epidemiologist, the nurse may be involved in case finding, health teaching, and tracking incident rates of an illness.

What are the key aspects of community-based health care? Select all that apply.

1 Correct Focus on primary care 2 Correct Emphasis on health promotion 3 Correct Health education about diseases 4 Emphasis on diagnosis and treatment 5 Care is subsidiary to various hospitals. Community-based health care focuses on providing primary care to individuals and families in the community. It emphasizes health promotion and provides basic knowledge to the community about various health-related problems. Diagnosis and treatment is managed in hospitals rather than community centers. Community-based health care occurs outside traditional health care institutions such as hospitals

On the basis of an assessment, the nurse identifies an increase in the immigrant population group in the community. How would the nurse determine some of the health needs of this population? Select all that apply.

1 Correct Identify which two health needs the immigrant population views as most important. 2 Correct Apply information from Healthy People 2020. 3 Correct Determine how the population uses available health care resources. 4 Correct Identify perceived barriers to health care. 5 Implement an exercise program to help with weight loss. The first four options assess the health care needs of this population. It is necessary to identify their priorities and try to meet them, applying information from reliable guidelines such as Healthy People 2020. How or if a population uses available health care resources and the perceived barriers to health care are all important. These elements help identify factors that promote or impede health care for this group. Implementing an exercise program would be making an assumption before a complete assessment of needs has been performed.

A community health nurse is interviewing a patient who is diagnosed with tuberculosis. The patient is unemployed and has no source of income. The patient's spouse is bedridden and needs constant care. The patient chews tobacco and drinks alcohol in moderation. Which factors should the nurse identify as reasons for the patient's poor health? Select all that apply.

1 Correct Stress 2 Correct Poverty 3 Correct Malnourishment 4 Substance abuse 5 Decreased self-esteem The patient is obviously stressed both physically and mentally, which could make the individual susceptible to diseases. Poverty, malnourishment, and unhygienic surroundings could lead to infections. The patient does not give any history of substance abuse. The patient does not seem to have decreased self-esteem.

A schizophrenic patient has been discharged from the hospital to community-based health service assistance. What is true of community-based assistance for someone with a mental disorder? Select all that apply.

1 Correct There are fewer services offered. 2 Correct The services are limited and fragmented. 3 The services assume patients have enhanced survival skills. 4 Correct These service a vulnerable population. 5 Correct Increased collaboration with community resources is essential for treatment. The constraints of community-based assistance to someone with a mental disorder include fewer services offered, and the services offered are more limited and fragmented. People with severe mental illness are a vulnerable population. During community-based treatment of mental illness, increased collaboration regarding community resources is essential. The patient with the mental disorder has fewer higher functioning skills, not enhanced survival skills.

The nurse is placed in a community clinic. The nurse attends to many patients living in poverty. What are the reasons that make these patients vulnerable to various health ailments? Select all that apply.

1 Correct They work at high-risk jobs. 2 Correct They do not eat a well-balanced diet. 3 They do not get enough sleep. 4 Correct They live in a hazardous environment. 5 They do not have stress related to work People living in poverty are vulnerable to various health problems because they may work at high-risk jobs. They may consume food that is not well balanced. The environment in which they live may be is hazardous and thus predisposes them to various disease conditions. Sleep and poverty are not directly related, and lack of sleep is not a reason for the vulnerability of poor people. People living in poverty have multiple stressors.

A 54-year-old woman is poor and suffering from tuberculosis. Other people with tuberculosis live in her area. What should the nurse include in her assessment of the community? Select all that apply.

1 Correct Water and sanitation facilities 2 Correct Economic status 3 Correct Transportation 4 Communication skills 5 Number of schools in the vicinity The nurse should assess the available water and sanitation facilities to check the level of hygiene among the people. This will help curb the spread of diseases. Assessing economic status helps determine the standard of living of the people in the community. It also helps to determine whether they can afford medical services. Transportation needs to be assessed to see if patients can conveniently reach the hospital when necessary. Assessment of communication skills or number of schools does not help improve the health condition of the community.

In an occupational health setting, the nurse determines that a large number of employees smoke and thus designs an employee assistance program for smoking cessation. This is an example of which nursing role?

Counselor To convince a patient to participate in a smoking cessation program or any program that requires changing a behavior requires the nurse to act as a counselor to support the patient in changing said behavior (in this case a smoking habit). It means that the nurse does not educate the patient about the dangers of smoking; first, the nurse must actively counsel the patient to decide to change the behavior. Without support and counseling, the smoking cessation education may not be used effectively by the patient.