Community Health Exam 1

Identify the conditions that may contribute to disability

-Arthritis is the most common cause of disability -obesity, injuries (head/spine trauma), burns, near drowning, amputations, repetitive movement trauma -developmental disabilities (congenital/chromosomal defects), mental retardation with poverty, learning disabilities, perinatal complications -chronic diseases (cardiovascular disease, DM, end stage renal disease) -juvenile rheumatic arthritis, tuberculosis, AIDS, cystic fibrosis, asthma, cancer, arthritis, emphysema, lupus -childhood disability may be the result of prenatal damage, perinatal factors, acquired neonatal factors, or early childhood factors (genetic factors, prematurity, infections, traumatic or toxic exposure, nutritional factors)

effects of being disabled on the family

-mothers of children with special health needs report higher levels of stress, anxiety, depression, and feelings of isolation compared to other mothers -siblings of children with disabilities are at higher risk for developing emotional and psychological problems compared with their unaffected peers (more psychosomatic illnesses, anxiety disorders, aggressive behaviors); however, these siblings also tend to be more mature, altruistic, responsible, and independent than their peers -highly affects the "sandwich generation"-- those left to care for their parents AND their own children

Mary brechernrich

-nurse midwife -home visits -school of nurse midwifery

discuss the historical development of the role of public health nurses

-nursing began with the women of the family caring for them then became the work of the nuns. -hospitals emerged -dark period closed hospitals and schools; nuns were no longer allowed to care for the sick -prostitutes began caring for the sick -nightinglae began as war nurse observing sanitation and environmental concerns to health. she used EBP to show her observations and developed nursing schools -wald began home visits -school nurses emerged -Clara barton founded American Red Cross (not an actual nurse)

recognize quality performance standards programs in public health

-By using self-administered survey, public health administrators will be able to show the extent to which public health services are performed within a community regardless of who offers the services. -Client-centered care (recognizes an individual's values and beliefs and allowing them to make their own decisions), teamwork and collaboration (open communication and respect among interprofessional team), evidence-based practice (research, personal experience, and family beliefs to best take care of patient), quality improvement (monitoring interventions to provide the best outcome and change things as necessary), safety (minimize risks), and informatics (using technology and information to improve care)

list the leading causes of death in americans

-Chronic disease is the leading cause of preventable deaths, disability, and decreased quality of life. -The leading cause of death for blacks, american Indians or alaska natives, hispanics, and whites in the US is heart disease. -Cancer is the second leading cause of death in the US, surpassed only by heart disease

Name barriers to acceptance of population focused practice.

-mindset of many nurses that the only role for a nurse is at the bedside or at the client's side -the structures within which nurses work and the process of role socialization within those structures EX: if a position does not exist in an institution, then it is undesirable and is not needed -few nurses receive graduate-level preparation in the conceptions and strategies of the disciplines basic to public health

Describe the implications of being disabled for selected (low-income) populations.

-persons with low income have less access to health care throughout their lives and are less likely to participate in all levels of prevention. Therefore, they are at greater risk for the onset of disabling conditions and for more rapid progression of disease processes -those in poverty could be at greater risk for disabling conditions such as injuries, tobacco/alcohol/drug abuse, and inadequate nutrition -employers may be reluctant to hire people with disabilities due to the possible increased employer-provided health insurance costs (a major barrier to adequate health insurance and access to health care for the disabled population)

Dorothea dix

-reform of mental health care services -recruited army nurses

Lilian wald

-termed public health nursing -worked towards the first insurance payment for nursing services -secured initial donations to support American red cross -realized that babies health and a lot to do with mom's health

what is the relationship between vulnerability and health disparities

-vulnerable populations are more likely than the general population to suffer from health disparities -health disparities refer to the wide variations in health services and health status among certain population groups

Florence Nightingale

-war nurse -started for us on environmental health and universal precautions -established formal trading school for nurses

Core Functions of Public Health

1. Assessment -systematically collecting data on the population, monitoring the populations health and making information about the health available to the community 2. Policy Development -the need to provide leadership in developing policies that support the health of the population including the use of scientific knowledge in making decisions about policy 3. Assurance -role of public health in ensuring that essential community oriented health services are available, providing essential personal health services, also making sure a competent public health and personal health care workforce is available -enforces laws and regulations that protect health and safety

Explain the foundational and historical origin of school nursing

Began in the late 1800s in England where they provided medical exams for children in schools of London. By 1892 nurses in London were responsible for checking the nutrition of the children in the schools. These ideas spread to the US and in 1897 nurses in NYC began to identify ill children. Many states had laws in the late 1800s mandating that nurses teach within the schools about the abuse of alcohol and narcotics. In the early 1900s in the US, the spread of infectious diseases were the biggest problem in the community. Therefore public health nurses went into homes and schools to assess children (Lilian Wald's settlement). After that, school nurses bloomed as there was a high demand.

Who are the most likely population to become homeless in the US?

Single Adult African American Men

determine how public health policy is developed and implemented

Statement of the healthcare problem. Statement of policy options to address the health problem. Adoption of a particular policy product. Implementation of the policy product. Evaluation of the policy

List the major chronic conditions affecting adults

The most common and costly chronic diseases are heart disease, diabetes, stroke, cancer, and arthritis

cultural imposition

belief in one's own superiority, or ethnocentrism, and is the act of imposing one's cultural beliefs, values, and practices on individuals from another culture

race

biological variation within populations groups based on physical markers derived from ancestry such as skin color, physical features, and hair texture

effects of being disabled on the community

children who are chronically ill or disabled entering school require additional educational support from public school system such as ST, OT,play therapy, and behavioral therapy -this can all add to the cost of educating children

understand the meaning of cultural competence and rationale for including cultural competence as a BSN education essential

cultural competence entails a combination of culturally congruent behaviors, practice attitudes and policies that allow nurses to use interpersonal communication, relationship skills and behavioral flexibility to work effectively in cross-cultural situations -culturally competent nurses respect individuals from different cultures, value diversity and function effectively when caring for clients from other cultures

prejudice

emotional manifestation of deeply held beliefs (stereotypes) about a group

cultural desire

fifth element in at the process of developing cultural competence -refers to the nurses intrinsic motivation to want to engage in the previous four elements necessary to provide culturally competent care

lina rogers

first School nurse

what are the major emphasis of public health nursing

focuses on health promotion and disease/injury prevention -they also focus on intervening and the population level rather than individual level

Isabell Hampton robb

founded ANA

Margaret sander

founded planned parenthood

cultural encounter

fourth element to becoming culturally competent -refers to the process that permits nurses to seek opportunities to directly engage in cross-cultural interactions with clients of divers cultures to modify existing beliefs about a specific cultural group and possibly avoid stereotyping

educator

health education with nursing framework -groups that are identified to be at risk in a community and the nurse will implement the health education programs -nurses can educate about disease process and treatment

researcher

help improve the nursing practice through developing knowledge -NPs and advanced public health nurses can conduct their own research and apply it to their nursing practice -they play a key role in ensuring Evidenced based research is shared and used in practice

define terms related to disability

-Disability: a condition such as an illness or injury that damages or limits a person's physical or mental abilities; the condition of being disabled; limitation in the ability to pursue an occupation because of a physical or mental impairment; or a program providing financial support to one affected by a disability; lack of legal qualification to do something or a disqualification, restriction or disadvantage -No one specific definition -top 10 most common causes of disabilities: Arthritis or rheumatism Back or spine problems Heart trouble Mental or emotional problem Lung or respiratory problem Diabetes Deafness or hearing problem Stiffness or deformity of limbs Blindness or vision problems Stroke -social security administration: ultimately determines the individual's status for disability benefits (definition for SSA on page 696) -americans with disabilities act: definition on page 696 in book; -functional disability definition pg 696 -additional definitions on page 697

describe how nurses can address health disparities in a variety

-Disparities: inequity (lack of fairness or justice) in social structures based on particular characteristics such as ethnicity, race, gender, age, and sexual orientation. Can be expressed in differences in morbidity and mortality rates among population groups. -Healthy People 2020 has objectives that can eliminate health disparities among different populations: --Increase the proportion of persons with health insurance --Increase the proportion of insured persons with clinical preventive services coverage --Increase the number of persons with usual primary care provide --Increase the proportion of persons who have a specific source of ongoing care --Reduce the proportion of individuals who are unable to obtain necessary medical care, dental care, or prescription medicine -Who can address these? --Public health nurse --Floor Nurse --Nurse Practitioner in a primary care setting

Discuss the implication of increasing incidence of chronic conditions on mortality, morbidity rates

-Health status indicators are the quantitative or qualitative measures used to describe the level of well-being or illness present in a defined population or to describe related attributes or risk factors -They can be represented in the form of rates, such as mortality and morbidity, or proportions such as percentages of a given population that receive immunizations -While health status indicators in the US show persistent health disparities among ethnic and racial groups, the awareness of these disparities remains low among the general public -Persons with low SES are more likely to be affected by chronic illness such as diabetes, hypertension, and HIV and are less likely to be screened for colorectal cancer or vaccinated against influenza -Mortality: life expectancy is a measure that is often used to gauge the overall health of a population ---Years of life lost (YLL) rates increased for Alzheimer disease, drug use disorders, chronic kidney disease, and falls ---Ischemic heart disease, lung cancer, stroke, COPD, and road injury were diseases and injuries with the largest number of YLLs in 2010 -Morbidity: the prevalence of diabetes, serious heart condition and hypertension among adults 45-64 years of age is strongly associated with poverty status ---Increasing prevalence of chronic diseases and other conditions associated with aging can increase functional limitations and affect the quality of life

primary prevention

-Promotes health and protects against threats of health. -It keeps problems from occurring in the first place! -Implemented before a problem even develops. EX- immunizations, building developmental assets in young persons to promote health (like sex education) Targets= essential well populations

understand how the nursing scope of practice and ethical codes inform nursing

-Scope of practice describes the services that a qualified health professional is deemed competent to perform, and permitted to undertake - in keeping with the terms of their professional license. -Nursing ethical codes: A system of principles that deals with the conduct of the nurse, the relationship between the nurse and the patient, the patient's family, fellow health care team members, and the society at large. (altruism means doing good, autonomy means the patient has rights to make their own decisions, integrity, social justice, etc.) -Cultural competence: a combination of culturally congruent behavior, practice attitudes, and policies that allow nurses to use interpersonal communication, relationship skills, and behavioral flexibility to work effectively in cross cultural situations. -The nursing scope of practice and ethical codes guide the nurse in performing culturally competent care by establishing what the nurse can do and how the nurse should treat the patient. For example, it would be against ethical codes for the nurse to not try and understand the patient's culture and integrate their culture into the care she provides.

Understand how the of the Patient Protection and Affordable Care Act (ACA) has informed the implementation of community health assessments

-The ACA (passed in 2010) mandates that non-profit hospitals complete a community assessment every three years in order to identify and address areas of public health concern. -These assessments help pinpoint where community health can get better. -The goal of the assessments is to move hospitals away from just treating the sick, and toward addressing population health and prevention. -Hospitals need to work closely with public health and get buy-in from people and organizations not typically represented at the health care table.

tertiary prevention

-limits further negative effects from a problem -keeps existing problems from getting worse -alleviates the effects of disease and injury and restores individuals to optimal health -implemented after a disease or injury has occured EX- directly observed therapy to someone with active TB to ensure compliance with medication Targets= populations who have experiences disease or injury

Describe the importance of evaluating the educational product

-The educational product is the outcome of the educational process (did the audience learn what was intended for them to learn?) -Quality of the product is measured by improvement and increase in the learner's knowledge, skills, and abilities related to the content ---The educational product is assessed as a measurable change in the health or behavior of the client -Evaluation of educator provides an opportunity to modify the teaching process and enables the educator to better meet the learner's needs -Short term evaluation - have the learner perform a return demonstration to see if teaching was effective; if unable to, then more teaching needed -Long term evaluation - assessing the learner over time to see if behavioral changes are lasting so that health can be improved

Understand how the nursing process informs the implementation of the community health assessment process

-When performing a community health assessment, it is important to gather information from multiple resources. For example, info on the health status of children could be obtained from: public health nurses who worked with families located in clinics, schools, and homes. Community partners who worked with families (healthcare providers, mental health workers, social workers, school personnel). Preschool screening data on young children. -PHNs would then participate in a meeting to that prioritized the issues located in the assessment listed above. They would make diagnosis based on the data gathered. For example, a child is at increased risk delayed development, injury and disease because inadequate parenting by a primary parent. -The PHNs would then develop a list of goals based upon the issues/diagnosis. They will then develop a plan as to how they will solve these issues. -The PHNs will implement the plan and then evaluate their effectivenes

state key opportunities for population-focused practice

-an opportunity for population practice is to establish new roles for nurse leaders who are prepared to think in populations terms -due to reorganizing our healthcare system to be more population-focused, new jobs will be created such as director of client care services and program designers for preventive services

10 essential public health services

-assessment -diagnose and investigate -inform/educate -identify and solve health problems -develops policies -enforce laws -link people to needed personal health services -assure competent public and personal health care workforce -evaluate effectiveness -research

examine the links between cultural competency and health disparities

-care that is not culturally competent may increase the gap in racial and health disparities between minority and majority populations -failure to effectively respond to the health care needs of culturally and linguistically diverse individuals may: --increase barriers to equitable access to care --inhibit effective communication between the client and nurse --create obstacles in gathering assessment data, thus limiting the development and implementation of effective treatment plans

effects of being disabled on the individual

-children with disabilities tend to be less physically active and at greater risk of obesity than their healthy peers, along with higher risk of psychological problems (depression, anxiety) -difficulty accurately interpreting social cues (cognitive disabilities) -adolescents with disabilities are often viewed as asexual by their peers along with suffering with prejudice, discrimination, and social isolation more so than their healthy peers -adults with disabilities are at increased risk of being placed in a nursing home or long term care facility-- decreasing community participation and limiting social integration

three domains of learning

-cognitive: gaining knowledge and understanding about a topic; being able to recall information learned -affective: enabling the learner to relate to or evoking some sort of feeling/response from the learner; changing the attitude or values of the learner -psychomotor: physically performing or demonstrating what they learned

secondary prevention

-detects and treats problems in their early stages. -it keeps problems from causing serious or long-term effects, or from affecting others -implemented after a problem has begun, but before signs and symptoms appear. -identifies risks or hazards and modifies, removes, or treats them before it's serious. EX- programs that screen for HTN, hyperglycemia, hypercholesterolemia, etc, mammograms Targets= populations that have risk factors in common

Clara barton

-founded American red cross -founded army nurse corps -not a nurse

state the relationships between nursing practice, health policy and politics

-health policy is a set course of action to obtain a desired health outcome for an individual, family, group, community or society; policies are made notably by governments, but also by such institutions as a health department or other health care agency, a family, a community or a professional organization -politics plays a role in the development of such policies; politics is found in families, professional and emptying agencies, and governments; politics determines who gets what and when and how they get it; it is the art of influencing others to accept a specific course of action -Through political action, a policy may become a law, a regulation, a judicial ruling, a decision, or an order. After the law is established, regulations further define the course of action (policy) to be taken by organizations or individuals in reaching an outcome -Nurses must be aware of policies that are currently in place and nurses should advocate for the patient by changing or creating new policies to fit the needs of the community. Nurses also are in charge of enforcing policies and informing the public about policies

what factors contribute to vulnerability

-limitations in physical and environmental resources such as poverty, limited social support, and working in a hazardous environment -people with pre-existing illness have less ability to cope with stress

culture brokering

Advocating, mediating, negotiating, and intervening between the client's culture and the biomedical health care culture on behalf of clients.

Explain how the Coordinated School Health Program (CSHP) impacts the practice of school health nurses

A coordinated school health program is an integrated set of planned, sequential, school-affiliated strategies, activities, and services designed to promote the optimal physical, emotional, social, and educational development of students. The program involves and is supportive of families and is determined by the local community based on community needs, resources, standards, and requirements. It is coordinated by a multidisciplinary team and accountable to the community for program quality and effectiveness. This program teaches children prevention of common chronic illnesses. Funding from the CDC pays for the staff to be trained over certain policies and guidelines. This impacts the nurse because they will assist children in problem solving, communication and other life skills to reduce their risk factors for chronic disease.

Home Healthcare Nurse role

A home nurse is a Registered Nurse (RN) who specializes in providing home healthcare to sick individuals or those recovering from an illness or injury. The duties of a home nurse involve a wide range of services such as IV therapy, wound care, help controlling disease, or drug monitoring. Additionally, the home health nurse consults with doctors on the status of the patient's condition and, based off of the patient's response to treatments, makes recommendations to the doctor about any potential changes to the home care plan. In many situations, a home health nurse will also supervise the certified home health aides and any other non-licensed caregivers for the agency.

Understanding the definition of school nursing

A specialized practice of professional nursing that advances the well-being, academic success and lifelong achievement and health of students". They give comprehensive nursing care to the children and the staff at the school, as well as coordinate the health education, consult with school officials to identify and care for other persons in the school community, and provide leadership in promoting health and safety

School health nurse

A student's health status is directly related to his or her ability to learn. Children with unmet health needs have a difficult time engaging in the educational process. The school nurse supports student success by providing health care through assessment, intervention, and follow‐ up for all children within the school setting. School nurses addresses the physical, mental, emotional, and social health needs of students and supports their achievement in the learning processes. The school nurse not only provides for the safety and care of students and staff but also addresses the need for integrating health solutions into the education setting.

Occupational Health Nurse

According to AAOHN (2012), occupational health nurses collaborate with workers, employers, members of the occupational health and safety team, and other professionals to identify health and safety needs. The occupational health nurse is the center of coordinated care for individual employee needs and has the responsibility for delivering comprehensive and qualified service and programs that meet or exceed OSHA requirements and reduce medical benefits from a company's bottom line. These workplace activities include health and wellness, case management, ergonomics, workplace safety, infection control, disaster preparedness and others such as travel health.

identify several public health policies and their implications at the national, state and local levels

National: CDC, NIH, USDA State: DNR and DPS Local: boards and agencies that have taxing authority in the community *STATES HAVE THE PRIMARY AUTHORITY IN PUBLIC HEALTH*

stereotyping

ascribing certain beliefs and behaviors about a given racial ethnic group to an individual without assessing for individual differences

cultural preservation

assistive, supportive, facilitative or enabling nurse actions and decisions that help the clients of a particular culture to retain and preserve traditional values, so they can maintain, promote, and restore health

cultural accomodation

assistive, supportive, facilitative, or enabling nurse actions and decisions that help clients of a particular culture accept nursing strategies, or negotiate with nurses to achieve satisfying health care outcomes

clinician

Assessing, diagnosing, planning, implementing, evaluating, and documenting treatment for prevention, intervention advanced public health nurses do these thins in the community and look at entire populations -nurse practitioners do this moe on an individual basis and in terms of health risk and illness status

Compare the gender difference in incidence of certain chronic conditions

Being male or female leads to different socialization, expectations, and lifestyles that affect and interact with health in complex ways. Of particular concern is the high prevalence of adults with risk factors such as tobacco use, high cholesterol, obesity, and insufficient exercise habits, which are all associated with chronic disease. Women live longer than men by about 5 years; women are more likely to use health services and report greater rates of disabilities. The lifetime risk for stroke is higher in women than men & more women tend to die from strokes compared to men (since women live longer and strokes increases with age). Gender makes a difference on environmental impact on health. Gender also influences how a person responds to stress, presents with symptoms, experiences the course of illness, and accesses/uses mental health services. Hazardous environmental exposures has a greater negative impact on women vs men Women tend to suffer more from anxiety/depression; yet, men have a higher suicide rate. The suicide rate is 4x greater for men, although women are dx 2x as often with major depression. Females are at a greater risk for STDs as a result of biological differences and other factors. Men's health is often overlooked and factors exist that prevent men from reaching their full health potential. Factors such as SES, access to health care, male acculturation to health issues, harmful perceptions to masculinity, and lack of understanding of male health behaviors contribute to poor health outcomes for men. There are a wide range for poorer overall health status and health outcomes for men in the US that results in a 5-year shorter life span. Ex: more men than women smoke, more men are overweight, and men are less likely to receive routine care or seek out care early in the disease process than women. Men do not participate in health care to the same level as women, apparently because of the traditional masculine gender role learned through socialization. Men are socialized to ignore pain, be self-reliant, and be achievement oriented. Large numbers of men do not receive health screenings intended to prevent and identify disease. These behaviors limit the opportunity to prevent disease, but also manage/treat once diagnosed

how do nurses intervene with vulnerable populations

Create a trusting environment - follow through and do what you say you will, if you don't know say, "I don't know but ill find out" Show respect, compassion, and concern - listening is a form of respect. Do not assume Coordinate services with providers- people often don't know where to get services- find it for them. Collaborate to meet their needs. Advocate for accessible health care services - vulnerable people have trouble getting access to services.Using mobile vans or home visits may help. Arrange to have as many services as possible in a single location Focus on prevention - immunizations, safe sex, footcare, nutrtion - providing prophylactic antiTB drug therapy to those with HIV Know when to walk beside them and when to encourage them to walk a head - this helps them learn to do things by themselves but also helps make sure they get what they need Know what resources are available Develop your own support network - working with vulnerable populations can be challenging and exhausting so have support Interentions Minimize hassle for client bc they dont have extra energy, time or money. Be culturally sensitive Teach them skills Teach them how to be effective healthcare consumers (ex-role play and have them practice asking questions in a physician office). They may not come back for follow ups so teach self care strategies (ex - teach homeless to read on TB skin test)

understand the process of becoming culturally competent

Cultural competence entails a combination of culturally congruent behaviors, practice attitudes, and policies that allow nurses to use interpersonal communication, relationship skills, and behavioral flexibility to work effectively in cross-cultural situations. Allows nurses to partner with the client to deliver health promotion, disease prevention, and health restoration. Respects individuals from different cultures, value diversity, and function effectively when caring for clients from other cultures Care must be client centered, that is, designed for the specific client, family or community Care must be based on the uniqueness of the client's culture and incorporate the cultural norms and values of the client in the management of care plan Self-empowerment strategies of the client are identified and viewed as strengths to facilitate client decision making and self-care management in health and illness situations

Discuss implications of developmental disability, physical disability, or chronic illness

Developmental disability-- a chronic impairment that occurs during development and up to age 22 and lasts throughout the person's lifetime. This type of disability limits the functioning of an individual in at least three of the following areas: self-help, language, learning, mobility, self-direction, independent living, and economic self-sufficiency Physical disability-- requires the use of an assistive device due to difficulty with tasks such as climbing stairs, or having a disease such as arthritis or osteoporosis, etc. Chronic illness-- any long lasting condition or illness. Disease processes (DM, cancer, heart disease) and congenital or acquired conditions (down syndrome, severe burns, amputation) are examples

identify the governmental authority base for public health

Executive Branch: president, governor, mayor, staff, cabinet, and various administrative and regulatory departments and agencies such as the USDHHS. (this branch suggest, administers, and regulates policies) Legislative: Senate and HOR. (identifies problems and purposes debates and passes laws) Judicial: Courts. The executive branch suggests, administers, and regulates policy. The role of the legislative branch is to identify problems and to propose, debate, pass, and modify laws to address those problems. The judicial branch interprets laws and their meaning, as in its ongoing interpretation of states' rights to define access to reproductive health services to citizens of the states. Police policy: act to protect the health and safety of the citizens

Faith based nurse

Faith community nursing is the specialized practice of professional nursing that focuses on the intentional care of the spirit as part of the process of promoting holistic health and preventing or minimizing illness in a faith community. Nurses intentionally focus on spiritual health, and primarily uses the nursing interventions of education, counseling, advocacy, referral, utilizing resources available to the faith community.

Understand the variety of services offered in school-based clinics

Federal School Health Programs: teaches children how to prevent chronic illnesses School-based Health Centers: family-centered, community based clinic run within the schools; provide mental health, dental care, etc School-Linked Program: coordinated by school, but has community ties (ex: nurses employed at hospital provide healthcare for children K-5th grade)

jessie sleet

First African American public health nurse -advocated to reduce the excess burden of TB morbidity and mortality among African-americans

forensic nurse role

Forensic nursing was first recognized as a specialty by the American Nurses Association in 1995. Forensic nursing as defined by the International Association of Forensic Nurses (IAFN) is: the application of forensic science combined with biological and psychological, education of the registered nurse - in the scientific investigation, evidence collection and preservation, analysis, prevention, and treatment of trauma and death-related medical issues.

Why is one's personal attitude about poverty an important affective domain for nurses to be concerned about?

It is important for nurses to respect the individuality of all clients, including those who are . Those clients can be faceless, nameless, and invisible. There is no set reason for homelessness because it occurs for so many different reasons, but that does not mean they do not deserve healthcare

compare and contrast race-specific chronic conditions

Four modifiable health behaviors preventing chronic disease: Lack of physical activity, poor nutrition, tobacco use, and excessive alcohol use. Cardiovascular disease- leading cause of death for African Americans, American Indians, Hispanics, and whites. Leading cause for both men and women. Primary prevention- collaborate with organizations such as American Heart Association to design and implement interventions aimed at reducing women's risk Secondary Prevention- Establish screening clinics in community settings Tertiary prevention- Develop a community-based exercise program for women who have heart disease Hypertension- Occurs in 1 in 3 Americans. Uncontrolled HTN leads to heart attack, stroke, kidney damage, etc. 44% of African Americans have HTN. Stroke- Risk is higher in women (1 in 5) and less in men (1 in 6). More women are more likely to die from it.African Americans have twice the risk of first time strokes as whites. MexicanAmericans have increased incidence of stroke on non hispanic whites. Diabetes- Increases in obesity, decreases in PE, and aging population are associated with increase in T2DM. For every three people who have it,l there is another who does not know they have it. Higher prevalence in American American Indians. Complications include heart disease, stroke, hypertension, retinopathy, kidney disease, neuropathies, amputations, and dental disease. Mental Health- Gender differences. Women have anxiety and depression more often,, men have higher suicide rate. Cancer- Second leading cause of death in the U.S. STDs- Females at greater risk. High risk populations- pregnant women, adolescents, lesbians

Describe the different roles of school nurses according to the National Association of School Nurses (NASN)

Give and evaluate appropriate up to date nursing care Collaborate well with other health providers and school staff Maintain school health office policies, including privacy and safety of health records Teach health promotion and maintenance to children, families, and communities Develop school health policies and procedures Evaluate their own nursing practice Keep up with nursing knowledge Interact with the interprofessional healthcare team Ensure confidentiality in providing health care Consult with others to give complete care Use research findings in practice Ensure the safety of children, including when delegating care to other school personnel Have good communication skills Manage a school health program effectively Teach others about wellness

Describe how nurses can work with groups to promote the health of individuals and communities

Groups are an effective and powerful medium to initiate and implement changes for individuals, families, organizations, and the community

Palliative and Hospice Nurse

Hospice and palliative care nurses work in collaboration with other health providers (such as physicians, social workers, or chaplains) within the context of an interdisciplinary team. Composed of highly qualified, specially trained professionals and volunteers, the team blends their strengths together to anticipate and meet the needs of the patient and family facing terminal illness and bereavement. Hospice and palliative nurses distinguish themselves from their colleagues in other nursing specialty practices by their unwavering focus on end-of-life care. Hospice and palliative care includes 24-hour nursing availability, management of pain and other symptoms, and family support. By providing expert management of pain and other symptoms combined with compassionate listening and counseling skills, hospice and palliative nurse promote the highest quality of life for the patient and family.

List the five steps of the educational process

Identify educational needs Establish educational goals and objectives Select appropriate educational methods Implement the educational plan Evaluate the educational process

How does poverty directly affect the health and well-being of patients?

Poverty directly affects the health and well-being, leading to the following: Higher rates of chronic illness Higher infant morbidity and mortality Shorter life expectancy More complex health problems More significant complications and physical limitations from chronic diseases such as asthma, diabetes, and HTN. Higher hospitalization rates

how can nurses accommodate the cultural practices of patients and families

Provide client centered care that is designed for the specific client and family Care should be based on the uniqueness of the client's culture and incorporate their cultural norms into the care plan Self-empowerment strategies of the client are identified and viewed as strengths to facilitate client decision making When in doubt, always ask the patient what they prefer, and are seeking for in their care

What are the most common health problems of homeless persons?

Psychological - Depression, Mental/Psychiatric illness, alcohol/substance abuse Infection - HIV/AIDS,TB Other - Trauma, Preterm birth, COPD, low birth weight, foot problems, malnutriton, decreased access to care/increased ED use

Public Health Nurse role

Public health nursing is a specialty practice within nursing and public health. It focuses on improving population health by emphasizing prevention, and attending to multiple determinants of health. Often used interchangeably with community health nursing, this nursing practice includes advocacy, policy development, and planning, which addresses issues of social justice. Key characteristics of practice include: 1) a focus on the health needs of an entire population, including inequities and the unique needs of sub-populations; 2) assessment of population health using a comprehensive, systematic approach; 3) attention to multiple determinants of health; 4) an emphasis on primary prevention; and 5) application of interventions at all levels—individuals, families, communities, and the systems that impact their health.

specialization of public health nursing and community health nursing

SOS HELP

how is poverty defined socially and culturally?

The official poverty measure in the U.S. is a specific dollar amount that varies by family size but is consistent across the country, excluding Alaska and Hawaii. The poverty guidelines are used to determine whether a family is eligible for public programs. Families actually need about twice the amount of the poverty levels to meet their basic needs. Although income continues to be the measurement of choice, poverty is not adequately defined solely by income level. Understanding the social and cultural dimensions of poverty helps to broaden our view of the concept. Poverty refers to having insufficient financial resources to meet basic living expenses. Meanings and perceptions of poverty differ across cultures. Most Western cultures view poverty negatively, whereas other cultures respect the poor

Identify the six health-risk behaviors monitored with the Youth Risk Behavior Surveillance Survey (YRBSS)

Unintentional injury & violence Sexual behaviors that contribute to unintended pregnancy & STI's, including HIV Alcohol & other drug use Tobacco use Unhealthy dietary behaviors Inadequate physical activity

Describe how group purpose, member interaction, cohesion, conflict, and leadership affect group effectiveness

When a group is cohesive, they work toward common goals, endure frustration for the sake of the group, and defend the group against outside criticism. A group is cohesive when members are compatible with one another and they share the same goals. -Traits that increase group cohesion and group productivity: Compatible personal and group goals Attraction to group goals Attraction to some members of the group A mix of leading and following skills Good problem-solving skills Traits that decrease cohesion and group productivity: A sense of conflict between personal and group goals Lack of interest in group goals and activities Poor problem solving and communication abilities Lack of both leadership and supporter skills Disagreement about types of leadership Aversion to other members Behaviors and attributes that others do not understand

ethnocentrism/cultural prejudice

a belief that one's own cultural group determines the standards by which another groups behavior is judged

culture shock

a feeling of helplessness, discomfort and disorientation experienced by an individual attempting to understand or effectively adapt to a cultural group, whose beliefs and values are radically different from the individual's culture

racsism

a form of prejudice that occurs through the exercise of power by individuals and institutions against people who are judged to be inferior on the basis of intelligence, morals, beauty, inheritance and self worth

cultural conflict

a perceived threat that may arise from a misunderstanding of expectations when nurses are unable to respond appropriately to another individual's cultural practice because of unfamiliarity with the practice

culture

a set of beliefs, values and assumptions about life that are widely held among a group of people and is transmitted intergenerationally

understand the definition of a community health assessment

a systematic examination of the health status indicators for a given population that is used to identify key problems and assets in a community. The ultimate goals of a community health assessment is to develop strategies to address the community's health needs and identified issues

consultant

problem solves with an individual or family the steps of consulting include: assessing, determining, the availability and feasibility of resources, proposing solutions and assisting with implementing a solution -nurses can consult to other nurses or other healthcare workers to inform them to help improve care -nurses can consult for schools or health departments to help with health promotion

describe what population focused practice means

problems are defined by assessments or diagnoses, and solutions/interventions are implemented for or with a defined population or subpopulation

identify the interaction between the practice of public health and that of nursing

public health directly impacts nursing care. public health targets environmental conditions, sanitation, control of communicable diseases, health education, prevention of disease and disability. Education and prevention can prevent patients form becoming sic k and coming to the hospital. can also prevent diseases and illnesses such as diabetes, heart disease, etc. public health nurses care for elders or the sick in their homes praciting nursing care in the public/community setting

cultural repatterning

refers to assistive, supportive, facilitative, or enabling nurse actions and decisions that help clients of a particular culture to change or modify a cultural practice for new or different health care patterns that are meaningful, satisfying, and beneficial

cultural awareness

self-examination and in depth exploration of one's own biases, stereotypes and prejudices as they influence behavior toward other cultural groups

administrator

supervises an organization's staff and client care -decision makers and problem solvers -look at business and management aspects such as supporting and managing personnel, budgeting, establishing quality control and making policies

what is vulnerability

susceptibility to actual or potential stressors that may lead to an adverse effect -those at risk are those with poor health status and poor access to healthcare

cultural diversity

the degrees of variation that is represented among populations based on lifestyle, ethnicity, race, interest, across place and place of origin across time

cultural knowledge

the process of searching for and obtaining a sound educational understanding about culturally diverse groups ex: middle eastern women might not attend prenatal classes without encouragement and support from the nurse

ethnicity

the shared feeling of peoplehood among a group of individuals and relates to cultural factors such as nationality, geographic region, culture, ancestry, language, beliefs and traditions

cultural skill

third element of cultural competence -refers to the ability of nurses to effectively integrate cultural awareness and cultural knowledge when conducting a cultural assessment as well as culturally based physical assessment and to use the data to meet the specific client's needs

Mission of Public Health

to generate organized community effort to address the public interest in health by applying scientific and technical knowledge to prevent disease and promote health

Mary brewster

works with Lilian wald and began visiting the poor and later became the first visit nursing services