Community Health Week 5

What are the six major air pollutants

Ozone - most common pollutant and is the primary component of smog Carbon monoxide Nitrogen dioxides Sulfur dioxide Particular matter Lead

A critical theory approach to environment

A critical theory approach uses "thinking upstream" framework. It raises questions about oppressive situations and involves community members in the definition and solution of problems. It also facilitates interventions that reduce health-damaging effects of environments. Before implementing those interventions, you first must identify the strengths and needs with an environmental health history. Here are the benefits of an environmental health history: Increases awareness of environmental health concerns. Improves timeliness and accuracy of diagnosis. Prevents disease and aggravation of conditions. Identifies potential environmental hazards.

Healthy School environment

A healthy school environment is one in which distractions are minimized and that is free of physical hazards and psychological health risks. Please visit the "CDC's Healthy Schools" website for information on the national program to promote healthy schools. Per the National Association of School Nurses, all students and staff have an inherent right to learn and work in a healthy school environment, and that the school nurse can "assess the learning environment for risk factors, educate the community on the impact of environmental exposure, and advocate for the need to address environmental pollution issues." Violence is a major health problem because it threatens the health and well-being, both physical and psychological of children and adolescents. Be aware of risk factors and signs that could indicate a tendency to violence. There are violence prevention programs (stress management, conflict and anger resolution, personal and self-esteem development) that can help schools deal with this issue.

What is a risk factor?

A risk factor is an exposure that is associated with a disease. The criteria for establishing risk factors are: The frequency of disease - varies by category, or amount of the factor The risk factor must precede the onset of the disease The association of concern must not be due to any source of error

Which is an example of a modifiable risk factor? Select all that apply A. Diet B. Air pollution C. Heredity D. Sexual practices E. Cigarette smoking

A. Diet D. Sexual Practices E. Cigarette Smoking

A community health nurse would include which in her assessment of environmental health? Select all that apply A. Food safety B. Water quality C. Families D. Job availability E. Waster management

A. Food safety B. Water quality E. Waster management

An emergency department nurse assesses a 25-year-old patient with tachycardia, headache, and nausea. The patient denies drug use, heart problems, and smoking. She works from her house and states that everyone in her house has had the "flu" but that she is the only one who has not been feeling better. The nurse notices that the patient lives in the historic section of the town. What environmental hazard should the nurse be primarily concerned about? A. Housing quality B. Food quality C. Water quality D. Occupational risks

A. Housing quality

Tobacco Use

Adolescent smoking has been closely correlated with alcohol use and other drugs. Smoking is the single leading preventable cause of death in the United States. Cigarette smoking has declined significantly, but the usage of other forms of tobacco has emerged. Prevention should be a priority in youth because 9 out of 10 cigarette smokers first tried smoking by 18 years of age. More than 25% of high school students in 2015 used some form of tobacco.

Eating Disorders

Anorexia, bulimia, and binge eating

Emerging Issues in Environmental Health

As the United States continues to make advances, it becomes clear that is just as susceptible to environmental issues that are seen more frequently around the world. Some of these issues include: Environmental public health infrastructure Natural disasters Global climate change Ozone depletion Fossil fuel burning Marine dumping Active land mine abandonment in war-torn areas Destruction of tropical rain forests Natural disasters Global climate change Ozone depletion Fossil fuel burning Marine dumping Active land mine abandonment in war-torn areas Destruction of tropical rain forests

Which "determinants of health" would include a predisposition to prostate cancer and a history of depression? A. Physical environment B. Biology C. Social environment D. Behaviors

B. Biology

While verifying compliance with immunization requirements, a school nurse notices that three students from the same family have not completed their immunizations. How should the nurse address this problem? A. Pull the students from class and immunize them B. Contact the parents and educate them about the immunization requirements C. Discuss with the principal the lack of immunizations D. Expel the children from school

B. Contact the parents and educate them about the immunization requirements

Receiving immunizations, regular health screenings, and physical examinations are an example of A. Health maintenance B. Health protection C. Health promotion D. Secondary Prevention

B. Health protection

According to the CDC, which high-risk behaviors need to be targeted in health education courses? Select all that apply A. Poor organizational skills B. Lack of physical activity C. Poor nutrition D. Injury and violence E. Alcohol and drug use

B. Lack of physical activity C. Poor nutrition D. Injury and violence E. Alcohol and drug use

A comprehensive school health program should include which components? Select all that apply A. Comprehensive physical examinations B. Physical education C. Nutrition services D. Health services E. Health education

B. Physical education C. Nutrition services D. Health services E. Health education

A week before finals, a school nurse assesses a 15-year-old girl complaining of vague symptoms. Which symptoms or behaviors should result in a request for a parent or guardian conference and referral to a physician for further evaluation? Select all that apply A. Frequent costs to the school nurse B. Unable to sleep C. Difficulty dealing with daily life D. Inability to concentrate on even the most basic tasks

B. Unable to sleep C. Difficulty dealing with daily life D. Inability to concentrate on even the most basic tasks

Behaviors

Behaviors are an individual's responses to internal stimuli and external conditions. They are the result of desires or thoughts of the individual (internal) and the actions of the individual impacted by opportunity, experiences, and surroundings (external). Behaviors interact with biology in a common relationship, as one may influence the other. Examples of lifestyle behaviors include regular exercise, cigarette smoking, alcohol, diet. Etc.

Biology

Biology is an individual's genetic makeup, family history, and any physical and mental problems developed in the course of a life. Illnesses or disabilities that change an individual's biology can be caused by aging, diet, physical activity, smoking, stress, alcohol, drug abuse, injury, violence, or a toxic or infectious agent.

Physical Education

Children today are less physically active. Children are becoming more sedentary as a result of increased use of computers and television and decreasing requirements for physical education. A sedentary lifestyle is associated with obesity, hypertension, heart disease, and diabetes. Studies show that people who are active have a better quality of life and outlive those who are inactive. Habits in childhood are likely to continue into adulthood. Children and adolescents who are physically active have increased self-confidence and self-esteem and decreased anxiety, stress, and depression

Health Promotion and Risk Reduction

Community health requires a significant focus on health promotion and risk reduction. This is the foundation of a practice for a community health nurse. Not only should illness be treated, but health should be promoted through education, access to resources, and reduction of risks.

What are the national health education standards?

Comprehend concepts related to health promotion and disease prevention to enhance health. Analyze the influence of family, peers, culture, media, technology, and other factors on health behaviors. Demonstrate the ability to access valid information, products, and services to enhance health. Demonstrate the ability to use interpersonal communication skills to enhance health and avoid or reduce health risks. Demonstrate the ability to use decision-making skills to enhance health. Demonstrate the ability to use goal-setting skills to enhance health. Demonstrate the ability to practice health-enhancing behaviors and avoid or reduce health risks. Demonstrate the ability to advocate for personal, family, and community health.

A primary role of the community health nurse in facilitating community participation and partnership in environmental health is _______. A. Implementing solutions to environmental racism B. Altering individual behaviors C. Solving environmental health problems D. Educating about environmental health hazards

D. Educating about environmental health hazards

Which "determinants of health" refers to factors that are experienced with the senses-things that can be seen, touched, heard, and smelled? A. Social environment B. Biology C. Behaviors D. Physical environment

D. Physical environment

A 6-year-old child fails a routine vision screening on a Snellen chart at a school-based health center. The appropriate action by the nurse is to ________. A. Re screen the child in the following year B. Use a Rosenbaum chart instead of a Snellen chart C. Do an internal ophthalmologic examination D. Refer the child to an eye specialist

D. Refer the child to an eye specialist

How does medical care impact school health?

Decreased or inferior medical care has been linked to serious health problems resulting in an increase in absenteeism that may be correlated with failure in school. Poor academic performance is strongly correlated with uninsured status of youth; acquisition of health insurance leads to an increase in school performance.

Environmental Changes

Environmental changes in the past few decades have profoundly influenced the status of public health. Globally, environmental risk factors, including air, water, and soil pollutants, exposure to chemicals, radiation, and climate change contribute to nearly 25% of all deaths by increasing diseases. Environmental health can be more challenging to improve because it requires social, economic, and political factors to change for improvement to be made.

What is environmental health?

Environmental health is composed of external factors that relate to behavior. This includes physical, chemical, and biological factors. Environmental health puts an emphasis on reducing environmental exposures, such as chemical or other pollutants in the air, water, soil, and/or food to promote healthy communities.

Areas of Environmental Health

Environmental health is composed of the built environment, work-related exposures, outdoor air quality, healthy homes, water quality, food safety, and waste management.

Critical Community Health Nursing Practice

Environmental nurses have an important role, but rather than intervening at the community level, they intervene at the population level. Here are some nursing interventions to address some of the environmental issues listed above: Take a stand; advocate for change Ask critical questions Facilitate community involvement Form coalitions Using collective strategies

Obesity

Fastest-rising public health concern; will likely overtake tobacco use as the single leading preventable cause of death Has more than doubled in children and tripled in adolescents over the past three decades One in five school-aged children (ages 6-19) are considered obese

Food Safety

Food safety is the availability, accessibility, and relative costs of healthy food that is free from contamination or harmful substances, such as pesticides or bacteria. When any of these aspects of food safety are interrupted, it will negatively impact the health of those in the community. Here are examples of some of the problems inadequate food safety can have on health: Malnutrition Bacterial food poisoning Food adulteration Disruption of food chains by ecosystem destruction Carcinogenic chemical food additives

What are some examples of problems with outdoor air quality?

Gaseous pollutants Greenhouse effect Destruction of the ozone layer Aerial spraying of herbicides and pesticides Acid rain Nuclear facility emissions

Access to quality health care

Health care access is essential to decreasing health disparities and improving the general community's quality of life and average healthy lifespan.

Health Promotion

Health promotion includes a variety of experiences that are designed to improve and maintain health. This can include health education and access to resources, such as economical, social, mental, and organizational support. Some examples of health promotion in the community are: Veggie fair: education about healthy nutrition and improving access to food Promoting ongoing health or illness prevention

Health Protection

Health protection includes actions that are specifically intended to prevent disease and illness as well as detect disease in the early stages. Health protection could also include maximizing one's health with a diagnosis of an illness This is focused on risk reduction, such as immunizations, mammograms, and cancer screening

Healthy Home

Healthy home is definition as the availability, safety, structural strength, cleanliness, and location of shelter, including public facilities and family dwellings. It also includes indoor air quality. Here are some examples of the problems: Homelessness Rodent and insect infestation Presence of lead-based paint Sick building syndrome Unsafe neighborhoods Radon gas seepage in homes and schools - radon is the second leading cause of lung cancer, after active smoking, and the leading cause among nonsmokers

Injury Prevention

Injury prevention should be taught early and be age appropriate. Bicycle safety and helmets Proper use of backpacks Schoolyard and playground safety Motor vehicle safety for adolescents (cell phone texting, seat belts) Sports safety Use of proper equipment Regular hydration and frequent rest periods Effective warm-up, and cool-down activities Pool safety

What does a built environment affect?

It directly and indirectly affects health outcomes and disease rates. If there is infrastructure and areas in the environment that make the neighborhood more walkable, there tends to be more activity and less depression and alcohol abuse. Here are examples of some of the problems: Drunk driving Second-hand smoke Noise exposure Urban crowding Technological hazards

Nutrition Concerns

Junk food and school vending machines Skipping meals, especially breakfast Unhealthy snacks The nurse should identify nutritional problems, counsel, and make appropriate referrals

Immunizations

Many communicable diseases have been reduced by more than 99% as a result All States now require proof of current immunization status or evidence of immunity before a child can enter school; certain exceptions may apply

Sex Education

Many teens become sexually active at an early age. Despite recent declines, pregnancy rates continue to be high. Teen mothers are less likely to complete high school and are more likely to be single parents. Teen mothers are also likely to live in poverty. Sex education in the school setting is a controversial topic. Opponents of sex education believe that the parents have the responsibility for teaching this content to their children - laws in certain states prohibit or dramatically limit sex education in public schools. 24 states and the District of Columbia mandate that public schools teach sex education. No research concludes that sex education in schools increases sexual activity.

Modifiable Risks

Modifiable risks are the ones that the individual has control over them. About 50% of US death are a result of modifiable risk factors. Those that adopt healthy lifestyle behaviors, such as diet, exercise, and healthy weight have a 66% lower risk of death versus those without those behaviors. Examples of modifiable risks are smoking, sedentary versus active lifestyle, eating habits, and type of activity.

Non-modifiable Risks

Nonmodifiable risks are the ones that the individual has little or no control over them. Examples of nonmodifiable risks are genetic makeup, age, and environmental exposure.

Delegation of tasks by the school nurse

Not every school has a full time nurse available on site, a nurse may be assigned to multiple schools The nurse is responsible, but each states nurse practice stipulates what may be delegated -The nurse must provide appropriate education, written procedures, and ongoing supervision and evaluation of caregivers. Responsibility for assessment, diagnosis, goal setting and evaluation may never be delegated

Outdoor Air Quality

Outdoor air quality is definition as the protectiveness of the atmospheric layers, the risks of severe weather, and the purity of the air for breathing purposes. It refers to the purity of the air and the presence of air pollution (13th leading cause of mortality worldwide).

Policies and Interventions

Policies and interventions are usually implemented at local, state, and national levels by many agencies and can have a profound effect on the health of individuals, groups, and communities. Examples of positive effects from policies include smoking in public places, seatbelt and child restraint laws, litter ordinances, and enhanced health care.

What is the leading cause of death?

Remember that the leading cause of death is related to lifestyle factors, like diseases, cancer, stroke, and chronic respiratory disease. Risk reduction is aimed at lowering the risk for these diseases and ultimately lowering the rate of premature death. Health and more specifically good health is the goal of health promotion and health protection. Health is freedom from disease or pain combined with a state of well-being.

Risk Communication

Risk communication is the process through which the public receives information regarding possible or actual threats to health. It is affected by the way individuals and communities perceive, process, and act on their understanding of risk.

What is a risk?

Risk is the likelihood of a specific event (usually a negative event) happening within a given time frame. Such as the likelihood of getting in a car crash, having a stroke, or being exposed to toxic chemicals

Risk Reduction

Risk reduction is a proactive process. It enables individuals to react to actual or potential threats to their health.

School Nursing Practice

School nurse must atleast hold a bachelor's degree or higher and must be educated in areas like growth and development, public health, mental health nursing, case management, program management, family theory, leadership, and cultural sensitivity. The school nurse will fulfill many roles. It is possible that the school nurse may be one of the few stable adults in a child's life who will listen without being judgmental. Some of the most important roles of the school nurse is to act as: Care provider Student advocate Educator Community liaison Case manager Counselor Some additional skills for a school nurse can be the ability to supervise others, to practice relatively independently as a member of an interdisciplinary team, and delegate care.

Family and Community Involvement

School nurses are often asked to provide health education to family, parents, and the community on a variety of topics. Health education in the community consists of programs that are designed to positively influence parents, staff, and others in matters related to health. School nurses also act as a leader, consultant, and advocate. Engaging families to get involved with their children at the school can have positive impacts on their health and learning. Some of those benefits include: Are more successful Experience less emotional distress Eat healthier Are more actively engaged in learning

Counseling, Psychological, and social services

School nurses may act as a counselor - looking beyond the initial complaint to identify underlying problems. In cases of child abuse or neglect, the school nurse may help the child learn problem-solving, coping mechanisms, and steps to build self-esteem. They also help promote mental health and can play a role in addressing the following concerns: Depression Substance abuse Conduct disorders Self-esteem issues Suicidal ideation Eating disorders Underachievement or overachievement Physical or mental abuse Chronic health conditions Pregnancy

Student records

Should include immunization status, pertinent history, result of screenings and examinations, and IHPs Family educational rights and privacy (FERPA)- a strong privacy protection act, that protects student education and health records Health insurance portability and accountability act of 1996 (HIPPA)- ensures the confidentiality of personal health information

Health Education

The CDC identified the following six high-risk behaviors as needing to be targeted in health education courses: Alcohol and drug use Injury and violence (including suicide) Tobacco use Poor nutrition Lack of physical activity Sexual behavior that results in STDs or unwanted pregnancies These problems and behaviors are preventable and often coexist; they also lead to both social and educational problems that contribute to high dropout and unemployment rates and crime statistics.

Work related exposures

Work-related exposures is defined as occupational exposure to environmental hazards that can cause illness or injury. It can happen as a result of poor working conditions and can lead to potential injury or illness. Here are some examples of the problems: Asbestos exposure Agricultural accidents Excessive exposure to x-rays Prevention of work-related health problems requires integrated action to improve job safety and the working environment

School Health Overview

The healthy development of children and adolescents is influenced by many societal institutions, and after the family, the school is the primary institution responsible for the development of young people in the United States. Academic success and healthy children and youth are closely intertwined. It is impossible to achieve success in school without maximizing the health of the students. In the United States, 55.6 million children attend school every day and the school nurse has a unique opportunity to have a positive impact on the nation's youth.

Substance Use: Illicit Drugs

The most commonly used illicit drug in the United States is marijuana. Use of other illegal drugs in high school students includes cocaine, hallucinogenics, Ecstasy, inhalants, heroin, methamphetamine, steroids, and prescription drugs-opioids (Vicodin or OxyContin), depressants or antianxiety medications (Valium or Xanax) or stimulants (Ritalin or Adderall). Use of illegal anabolic steroids has decreased, but remains a concern because of the number of athletes who abuse the drugs.

Physical Environment

The physical environment is composed of those things that are experienced with the senses—what an individual smells, sees, touches, hears, and tastes. Aspects of the physical environment can impact health negatively or positively. Those living in neighborhoods with high walkability engage in significantly more walking than those living in neighborhoods with low walkability. Living in a walkable neighborhood provides free access to safe areas to exercise, transport to nearby places, and spend time in the neighborhood. Read this article about how walkability can have a significant impact on one's health. Another environmental example is the presence of toxins in a town's water supply can impact community health.

What is the purpose of environmental health?

The purpose is to ensure the conditions of human health and provide healthy environments for people to live, work, and play through risk assessment, prevention, and intervention. Maintaining a healthy environment is vitally important to promote the health of populations. Evidence indicates that a healthy environment increases quality of life and years of healthy living.

Social Environment

The social environment Includes interactions and relationships with family, friends, coworkers, and others in the community. It is affected by the availability of resources in a community, which can manifest as affordable housing, general safety, public transportation systems, and other pools of resources (both tangible and not). Thus, important social institutions, such as law enforcement, faith communities, schools, government agencies, can influence the social environment.

National health education standards

These standards are established to promote positive health behaviors for students in all grades. They give educators, administrators, and policy makers a framework for developing and designing health education programs in schools. Standards are written to promote personal, family, and community health in students, targeting grades 2, 5, 8, and 12.

Built Environment

This is the part of the environment that we physically create and build around us. These are buildings, spaces, and products that are created or modified by people, including homes, schools, workplaces, parks/recreation areas, greenways, business areas, and transportation systems. Built environment consists of the connections among people, communities, and their surrounding environments that affect health behaviors and habits, interpersonal relationships, cultural values, and customs.

Substance Use: Alcohol

Use of alcohol and other drugs is associated with problems in school, injuries, violence, and motor vehicle deaths. The most commonly used and abused drug among children and adolescents is alcohol.

Health Screenings

Vision and hearing Scoliosis or postural screening High blood pressure Height, weight, BMI Dental screenings EPSDT: Early and Periodic screening, diagnosis, and treatment created by Medicaid

Waste Management

Waste management is defined as the management of waste materials resulting from industrial and municipal processes, human consumption, and efforts to minimize waste production. Waste can contaminate areas where humans can eat and live. If these systems are inadequate or malfunctioning, it can result in significant health complications. Here are examples of problems that can occur with waste management: Use of non-biodegradable plastics Poorly designed solid waste dumps Inadequate sewage systems Transport and storage of hazardous waste Illegal industrial dumping Radioactive hazardous wastes

Water Quality

Water quality is definition as the availability of and accessibility to a clean water supply, the mineral content levels, pollution by toxic chemicals, and the presence of pathogenic microorganisms. It consists of the balance between water contaminants and existing capabilities to purify water for human use and plant and wildlife sustenance. Here are examples of the problems: Contamination of drinking supply by human waste Oil spills in the world's waterways Pesticide or herbicide infiltration of groundwater Aquifer contamination by industrial pollutants Heavy metal poisoning of fish

Healthy People 2030

We discussed the goals of Healthy People 2030 in Week 1. This initiative was directed at health promotion and health protection. It works towards its goals with the the following: It created a health promotion initiative for the nation Challenges individuals, communities, and professionals, to take specific steps to ensure that good health, as well as long life, are enjoyed by all (U.S. Department of Health and Human Services, 2012) Leading health indicators, or determinants of health, in each topic area help track progress toward meeting the goals

School nurse provides what nutritional services?

nutritional concerns, eating disorders, obesity, nutrition education programs