pop OBJECTIVES EXAM 2 +ATIS + QUESTIONS
rural communities: nurse roles
Advocate: assist families and communities in obtaining quality care Coordinate/case management: connect clients to modes of transportation Referral agent: make connections between rural clients and urban services areas Mentor: guide nurses to community Change agent/researcher: suggest new approaches to solving community problems Collaborator: work with other healthcare providers Activist: take risks to improve community health
Use the levels of prevention to describe the role of the C/PHN
Primary Prevention (preventing a disaster from occurring; acting to eliminate its occurrence; or minimizing damage. Secondary Prevention (Disaster has occurred) Tertiary Prevention (reducing degree of disability)
Health Policy 1. A group of community health workers is working with their senator to develop a new policy to lower the prices of insulin; however, passing the policy has been a struggle. Which factor is most likely to be the source of the opposition? A) Opposition from pharmaceutical special interest groups. B) Lack of support from constituents. C) The policy is redundant. D) Similar policies have failed to pass
A) Opposition from pharmaceutical special interest groups.
Health Policy 2. An instructor is teaching a group of nurses the various types of policies. The instructor recognizes the class understands the information when they identify which result as an example of a distributive health policy? A) Licensure of health professionals B) Federal subsidies for nursing education C) Accreditation of hospitals D) Establishing the age to buy alcohol
B) Federal subsidies for nursing education
PRACTICE QUESTIONS GLOBAL HEALTH AND DISASTER 8. How can the nurse help their local community prepare for emerging health threats such asEbola and COVID-19? A) Offering mental health counseling for affected individuals .B) Administering vaccines to all individuals in affected regions. C) Developing and implementing emergency response plans .D) Training community health workers to combat non-communicable diseaseS
D) Training community health workers to combat non-communicable diseaseS
Explain how a focus on primary health care provides the basis for health promotion anddisease prevention.
Essential health care based on practical, scientific & socially acceptable methods that is accessible to individuals, families & communities at a cost that the community/country can maintain
urban health
Influences by interactions of citizens where they reside, work, gather for daily life events
Triage Categories
Knowing the principles and practices of triage allows the responding C/PHN to provide the most effective nursing care Sorting multiple causality, GREATEST GOOD FOR THE GREATEST NUMBER Categories: Walking wounded/minor (green tag) Delayed (yellow) - not emergent Immediate (red) - right away or serve adverse outcomes Imminent or deceased (black)
urban health- social determinants of health
Poverty Slums Poor air quality Child labor Health concerns Transportation Substance use and abuse
Health Policy 4. A public health nurse is concerned about some specific issues that are occurring in the localcommunity and would like to see positive changes occur to improve the situation. Which is the best wayfor any nurse to advocate for change and exert power? A) Pursuing an advanced degree B) Running for state congressional seat C) Actively participating in a professional nursing organization D) Becoming a member of a local not-for-profit agency board of directors
A) Pursuing an advanced degree
strategies - adaptation PREPARING FOR IMPACT
Building more resilient infrastructure
Social Justice
Foundation of public health nursing Health equity: ensuring that individuals have an equal opportunity to maximize their health
Seasonal farm workers
live in one geographic location and labor in the fields of that particular area - a day in the life of a migrant farm workers; Don't have a lot of time to seek medical care, moire concerned with work
environmental concern- food contamination
more allergies, pesticides, proper food storage, cooked right -Unhealthy or contaminated food Educate people about proper food storage
prevention measures used in environmental health Secondary Prevention -
survey for health condition or environmental disparities, looking at chemical exposure, screening children 6mo-5 years for lead poisoning, surgery for health conditions relating to exposures, assess neighborhoods for acute environmental hazards
PRACTICE QUESTIONS GLOBAL HEALTH AND DISASTER 6. When does disaster management begin? A) Before a disaster occursB) Immediately after the disasterC) Throughout the disaster periodD) When the disaster begins
A) Before a disaster occurs
strategies - mitigation PREVENTION
Aims to prevent the planet from warming beyond critical thresholds. Reduce impact and how bad going to get Improving energy proficiency, protect wildlife, transportation PARIS AGREEMENT: restrict increase in global temps to <2 degree
agencies - American Red Cross/Red Crescent Societies AFTER
American Red Cross founded in 1881 by Clara Barton authorized to provide disaster assistance free of charge & Duties provide shelter, food, basic health and mental health services, and distribution of emergency supplies
PRACTICE QUESTIONS GLOBAL HEALTH AND DISASTER 4. The global health nurse understands that which of the following explains the significance ofDisability-Adjusted Life Years (DALYs)? A) DALYs aid in assessing the economic consequences of healthcare interventions.B) DALYs offer valuable insights into the burden of diseases on populations.C) DALYs provide the life expectancy of individuals living with disabilities.D) DALYs serve as a measure of the total healthcare expenditure on diseases
B) DALYs offer valuable insights into the burden of diseases on populations.
PRACTICE QUESTIONS GLOBAL HEALTH AND DISASTER 1. A nurse is educating the community about mitigation strategies to address climate change.Which strategy would the nurse include? A) Implementing early warning systems for extreme temperaturesB) Improving public transportationC) Changing building codes to withstand hurricanesD) Distributing masks for high pollution days
B) Improving public transportation
PRACTICE QUESTIONS GLOBAL HEALTH AND DISASTER 2. Which of the following is considered a key role for the population health nurse working inglobal health?A) Researching vaccines needed in the community B) Leading community health promotion programsC) Conducting cultural competence trainingD) Advocating for healthcare policy changes at the WHO
B) Leading community health promotion programs
rural communities: health problems
Cardiovascular problems:leading cause of death in US, particularly in the south Diabetes:greater in rural areas among hispanic and black population; rise in obesity due to the lack of walking; access of care may be limited so they may not be seeking preventable measures COPD: twice higher in rural areas; environmental exposures we will see are coil mining; can cause black lung; bring the residue from home which affected their whole family -Farming: bringing home pesticides and working with them that leads to health problems
Describe a variety of disasters, including their causation, number of casualties, scope, andintensity
Causation - natural or human made Casualties - number of human beings injured or killed by or as a direct result of an incident Multiple-casualty incident: >2 but <100 Mass-casualty incident: less than 100 Scope - Range of effect, either geographically or in terms of the number of persons affected Intensity - The level of destruction and devastation + Varies based on a number of factors
Describe the major health care trends currently affecting the world's populations includingthe impact of climate change
Climate change is a major threat to human health (main cause also causes air pollution) Affecting air and water availability, quality and safety Exacerbating existing medical conditions Straining critical public health infrastructure and healthcare systems Disrupting food production, chains, and supply Climate crisis will be the greatest threat to public health in the coming decades
PRACTICE QUESTIONS GLOBAL HEALTH AND DISASTER 5. The nurse knows that which public health initiative will most likely result from understandingthe DALY values for a specific region? A) Implementing a cultural competence training program for healthcare workers.B) Advocating for policies to increase the number of hospitals and urgent care centers.C) Administering vaccines to the entire population to prevent infectious diseases.D) Developing a targeted health education campaign to reduce the burden of disease
D) Developing a targeted health education campaign to reduce the burden of disease
Health Policy 3.. The population health nurse identifies which of the following as an international level health policy? A) Medicare B) The Chester County Anti-Discrimination Act. C) The Nurse Practice Act D) Sustainable Development Goals
D) Sustainable Development Goals
The Patient Protection and Affordable Care Act (ACA) improved access to care
Expanded Medicaid in many states, extending coverage to low-income individuals & families Requires insurance companies to cover preventative health care visits without copay Requires insurance companies to cover those with preexisting conditions Percentage of uninsured dropped to 10.9% from 18%
nursing role in global health
Health education & promotion to reduce disease burden Educate on importance of vax, administer, monitor Interventions to reduce maternal & newborn mortality Develop & lead community health programs Educate to reduce disease transmission Advocate for policies and resources to improve healthcare access & reduce disparities Capacity Building: Train other healthcare workers (community health workers, auxiliary personnel) Cultural Competence: Provide culturally responsive care in diverse and multicultural environments. Advocate for justice and equality Partner with communities and leaders to implement a strengths-based approach Collaborate and coordinate with informal and formal community leaders
public Health Agencies: Local Health Departments typical services
Immunizations Family planning Primary preventive programs Regulatory inspections: food service, schools/day care, drinking water
environmental concern- water pollution
Lack of access to clean water and sanitation -Surface water(lakes and streams); underground sources *** nurse role: examine household and and city drinking water; identify incidences of drinking water diseases
Explain the role of the occupational and environmental health nurse and other members of the occupational health team in protecting and promoting workers' health and safety
Learn about possible environmental health threats. Assess clients' environment and detect health hazards. Plan collaboratively with citizens and other professionals to devise protective and preventive strategies. Assist with the implementation of programs Take action to correct situations in which health hazards exist Educate consumers and assist them to practice preventive measures. Take action to promote the development of policies and legislation that enhance consumer protection and promote a healthier environment. Assist with and promote program evaluation to determine the effectiveness of environmental health efforts. Apply environmentally related research findings and participate in nursing research
Public Health Agencies: Local Health Departments •Primary responsibilities and functions
Legal responsibility for health of its citizens Assess the local population's health status and needs Determine how well those needs are being met Take action toward satisfying unmet needs Develop policy Advocate for equitable distribution of resources and services Keep the community informed
environmental concern- climate change
Ozone depletion, global warming and climate change -Effects increased for skin cancer and cataracts; indirectly damaging food chain, increasing exposure to vector borne diseases, raising of ocean levels and negative impact on crop production -Government's role: clean air legislation
Nurse Role in reforming Health Care
Practice to the full extent of their education and training Achieve higher levels of education and training that promote seamless academic progression Be full partners in redesigning health care Be part of health care policy and planning using data collection to inform decision-making
Describe the role of the community/public health nurse (C/PHN) in preventing, preparing for,responding to, and supporting recovery from disasters
Prevent disasters (primary, secondary, tertiary) Prepare for disasters (personal prep, warning/evacuation, assess risk factors) Respond to disasters (triage, rescue) Support recovery (long-term treatment & support)
Identify the four phases of disaster management.
Prevention - No disaster expected or anticipated Identify community risk factors, develop & implement programs to prevent disasters Preparedness - Improve community & individual reaction/response to minimize effects of disaster Response - Rescue, triage, stabilize, transport, & treat at local hospitals/clinics Recovery - Repair, rebuild, or relocate while restoring health, social, & economic vitality to the community
Primary Prevention (preventing a disaster from occurring; acting to eliminate its occurrence; or minimizing damage.
Providing and participating in training sessions on prevention Knowing high-risk groups and vulnerable populations Completing a community assessment Educating the community about prevention and preparedness Anticipatory guidance: Disaster drills and other exercises help the community and responders experience some of the feelings of chaos and stress before a disaster occurs
agencies - Public health response requires coordination with national, state and local authorities & nongovernmental agencies
Public health is a critical part of planning, preparedness, and response.
Types of Policy
Public: issued by national, state, or local government Health: involves health and health care Framework for health services, rules, regulations, legislation, and funding that we invest in providing, regulating, and researching health care for Americans Distributive: allocation of services or benefits Regulatory: puts limits on activities or behaviors
urban health- Disparities that affect access to health care:
Race Ethnicity Socioeconomic status Age, sex Disability status Sexual orientation Gender identity Residential location
Tertiary Prevention (reducing degree of disability)
Rehabilitative work to help a community recover and reduce the risk of further disasters + Long term support
Characteristics
Rural areas: Chester county, open land and areas Urban areas:city type areas(Philly and Delco) Frontier areas:6 or fewer people per square mile; more land Health professional shortage area:facilities can have shortages of medical, dental or mental health professionals Medically underserved area:residents such as frontier area have shortages of healthcare services Medically underserved population: looking at those with economic or environmental disparities to healthcare services; have difficulty accessing; could be culturally; don't allow them to have preventative care
Types of Advocacy
Self-advocacy - Advocating for oneself Individual advocacy - Advocating for an individual or group Community health advocacy - Advocating for a community Legislative advocacy - Advocating for a change/modification to local, state, or federal laws Professional Advocacy - membership in professional organizations, lobbying
Explain the Global Burden of Disease
The calculation of health disparities among global populations Factors: social, economic, and environmental GBD = population's disability-adjusted life years (DALY)
agencies - National Incident Management System (NIMS)
Unified approach to incident management, incorporates standard command and management structures, and emphasizes preparedness, mutual aid, and resource management
Migrant farm workers
move to find agriculture work throughout the year, state to state, establishing temporary residences - sunrise to sunset nurses role: IPREPARE Improving existing services Advocating and networking Utilizing unique methods of health care delivery Improved health data information systems Practicing cultural sensitivity Using lay personnel for community outreach
environmental concern- toxic waste
plastics, solvent wastes, dioxins, waste from electroplating and similar operations, wastes from oil refineries, pesticides, explosives
prevention measures used in environmental health tertiary Prevention -
refer owners, removing lead out of homes, educating patients with asthma, supporting clean up and being involved with organizations
agencies - Federal response first became coordinated in 1979 with establishment of the Federal Emergency Management Agency (FEMA)
responsible for assessing and responding to disaster events in the United States & Provides training and guidance in all phases of disaster management.
5. When describing the philosophy of hospice care to a group of students, which of the followingstatements made by a student indicates their understanding? A) "The philosophy of hospice includes euthanasia."B) "The philosophy of hospice includes caring for clients in their last year of life."C) "The philosophy of hospice includes providing holistic care to terminally ill clients."D) "The philosophy of hospice includes symptom management with curative treatment."
C) "The philosophy of hospice includes providing holistic care to terminally ill clients."
assessment method: genogram
purpose is to look at genetics traits of illness example: who had heart disease in the family; high risk of diabetes if parents/grandparents had it - used to know risk factors
Identify the stages of the family life cycle and the developmental tasks of a family
Forming a Partnership- establishing a mutually satisfying relationship Childbearing- adjusting to pregnancy/parenthood/fitting into kin network Preschool-age Children- adapting to critical needs of preschool children School-age Children- fitting into the community Teenage Children- balancing freedom w/ responsibility Launching Children- releasing young adults into work Middle Aged Parents- rebuilding relationships Aging Family Members- adjusting to retirement
ATI at-risk and vulnerable populations and related effects on health A nurse is assisting with a community group presentation about the needs of vulnerable groups. Which of the following statements by the nurse indicates an understanding of the unique needs of vulnerable groups?
I include the client's cultural traditions as i complete my assessment
Family characteristics
common emotional bond sense of affection and belonging small social system moves through stages in its life cycle own cultural values and rules has structure certain basic function
a chn is reviewing disaster preparedness. which of the following actions should the nurse plan to take when providing care during a disaster?
preform on going data collection as the disaster situation evolves
a chn is teaching a group of new nurses about their role in the recovery phase of the disaster management cycle. which of the following actions should the nurse should the nurse include in teaching?
refer community members to mental health status
a chn is at the site of a mass casuailty incident and is triaging victims. the nurse is evaluating an adult victim who is unconscious and not breathing spontaneously. which of the following actions should the nurse take first?
reposition the victims airway
EPIDEMIOLOGIC TRANSITIONS: Era of social health conditions
"Where you live determines your health" Neighborhood wealth/poverty, housing, crime, drugs
PRACTICE QUESTIONS GLOBAL HEALTH AND DISASTER 7. Which best describes how a community will know if its disaster plan is adequate?A. After a disaster occurs and reports of deaths and injuries are fairly accurateB. By following practice drills involving various feasible scenariosC. When federal experts have reviewed and approved the planD. When state officials have reviewed and approved the plan
B. By following practice drills involving various feasible scenarios
PRACTICE QUESTIONS GLOBAL HEALTH AND DISASTER 3. What is the Global Burden of Disease (GBD)? A) A measure of the overall economic impact of healthcare systems.B) An annual report on the number of healthcare workers needed globally.C) A comprehensive assessment of health challenges faced by populations.D) The number of individuals living with a specific disease worldwide
C) A comprehensive assessment of health challenges faced by populations
Secondary Prevention (Disaster has occurred)
C/PHNs work with the American Red Cross to coordinate and provide emergency assistance. Identification of patients who may be reluctant to evacuate Providing psychological first aid Triaging
rural communities: occupational hazards
Dirty, Dangerous, Demanding EX: occupations are dirty-Pesticide exposure, poor sanitation, poor nutrition, overweight, obesity -Fever, chills, running nose-substandard housing, crowding-risks to social, emotional, and behavioral health-intimate partner violence
EPIDEMIOLOGIC TRANSITIONS: Era of infectious diseases
Most died from infectious disease (plague, TB) High death rate and birth rate; short life expectancy
prevention measures used in environmental health Primary prevention -
educate individuals to reduce environmental hazards, educate groups about hazards, advocating for clean air and water, looking at programs to reduce waste, advocating for recycling and advocate for water reduction
environmental concern- radiation
ionizing (radon gas, cosmic radiation) and nonionizing (microwave, radiowave) -PUT YOU AT RISK FOR LUNG CANCER
environmental concern- waste disposal
issues involving disposal of human waste, garbage, and hazardous waste
strategies for global include
mitigation adaptation Green infrastructure American Climate Corps CDC climate and health task force
EPIDEMIOLOGIC TRANSITIONS: Era of chronic, long-term health conditions
Advent of antibiotics: increased life expectancy Increase in chronic illness (heart disease, cancer)
. A nurse is visiting a family in their home for the first time. The nurse knows whichinformation is critical to consider? A) The family has engaged in pre-visit preparation.B) The family is happy to have the nurse in their home.C) The nurse is a guest in the family's home.D) The nurse knows what's best for the family
C) The nurse is a guest in the family's home
US Public health System
Entire system is underfunded, undertreat, unable to protect our health System has been starved for funding and resources
rural communities: ways to improve
Healthy People 2030 School-based clinics-help children become provided with care; will include dental services Telehealth
IPEPARE ACRONYM
I investigating exposure P present exposure R residences E environmental concerns P past work exposure A activities they do R resources E educate - ways to reduce risk
Advocacy -
Pleading the case of another Championing a cause Influencing outcomes for people, communities, and systems
Sources of Health Care financing
Private insurance companies Government health programs Medicare, Medicaid Children's Health Insurance Plan VA, Tricare, etc.
Categories based on ambulation, respirations, perfusion and mental status
Support recovery (long-term treatment & support, self care) Directly effected: people experiencing the event Dead and survivors, forced to leave homes Indirectly affected: relatives or friends of those affected Extreme anguish trying to locate love ones
phases of disaster in correct order -->
heroic honeymoon disillusionment reconstruction
concepts and frameworks for environmental health: SUSTAINABILITY
humans beings and natural environment must coexist harmoniously for human survival Long term range goals and consideration of present and future needs Food and fuel limitations of the natural environment Attendance to conservation through balancing of present and future needs Prevention of the consequences of environmental abuse
a chn is helping community memebrs with their disaster planning. which of the following objectives of healthy people 2030 regarding disasters preparedness?
increase awareness of local evacuation plans increase the number of evacuation routes and shelters increase the number of individuals who are prepared for a disease outbreak
a chn is reviewing the acts and initivites that have been adopted to improve disaster preparedness and response. the nurse should identify that which of the following describe the national health security strategy?
is is a collective effort of governments and includes national, state, territorial, and local agencies
a chn identifies clients who have potentially been exposed to a communicable disease during a disaster. which of the following actions should the nurse take first?
isolate the clients away from others who have no been exposed
development framework
life cycle perspective examination of members changing roles and tasks in each progressive cycle stage
a nurse is working in a community clinic and observes that numerous clients have come to the clinic reporting nausea, vomitings, and blisters on their skin. which of the following actions should the nurse suspect?
radiation exposure
stages of the dying process: depression
Reality of the dying process sinks in; Often a silent depression Nursing care and interventions: Be with the individual Facilitate clergy-client relationship Help family understand client's withdrawal
pallative care
Relief of suffering without curing underlying disease Symptom management at any time
Identify unique challenges of hospice nurses.
Respect or disregard for client autonomy Relief or disregard for client suffering Avoidance of killing at very end of life
Describe essential characteristics of home health nursing practice.
locating and getting through the door, promoting self-management, detecting problems, collaborating, mobilizing, strengthening, teaching and solving problems
assessment method: ecomap
look at relationship between family members and how they interact in a community looks at connections, relationships, activities and roles
a phn is discussing the principle of utilitarianism when responding to a disaster with a group of nurses. which of the following actions should the nursei s an example of ultitarianism?
using resources on victims who are more likely to survive
environmental concern- land use
using up all the spaces, industries and their toxic releases
ATI Environmental Influences: Terms to describe environmental influences with a client. The nurse should include which of the following terms describes an environmental influences that occur prior to an agent reaching a host
Upstream
List the five basic principles the public health nurse should follow when assessing family health.
Focus on family as total unit Ask goal directed questions Collect data over time Combine quantitative and qualitative data Exercise professional judgment
ATI Environmental Influences: Which of the following immunizations should the nurse include in teh review as recommended by the CDC due to these exposures
Hep B, MMR, influenza
four major approaches in end of life care
Holistic care that attends to the body, mind, and spirit. Death must not be a taboo topic. Medical technology should be used with discretion. Clients should be actively involved in treatment decisions
ATI at-risk and vulnerable populations and related effects on health A nurse is reinforcing the importance of adhering to their medication regimen with a vulnerable group of clients who have been diagnosed with a mental illness. The nurse should identify that this is an example of Which of the following phases of the nursing process?
Implementation
Identify unique challenges of home nurses.
Infection control Med safety Risk for falls Technology at home Nurse safety
ATI at-risk and vulnerable populations and related effects on health A nurse is caring for a client following a suicide attempt. The client has a history of depression, substance use disorder, and anorexia. Which of the following actions should the nurse take first
Initiate suicide precautions
ATI Environmental Influences: A chn is leading a group of nurse volunteers to help with a mass casualty disaster. Which of the following actions is beneficial for the volunteers to take?
Keep individuals safe and remove those in harm's way
ATI Environmental Influences: Africa, name of the disease that is passed from mosquito to humans
Malaria
PRECAUTIONARY PRINCPLE
absence of clear data that indicate the safety of an action, chemical, or material that poses a threat to human life, it should not be used
other assessment methods
questionares, checklists, flowsheets, interview guides, self care assessment
UPSTREAM FOCUS
- move thinking to those factors that are at an institutional/system level rather than looking solely at healthy lifestyles focus to assess, monitor, educate, advocate, and create policies to reduce environmental health risks (deep to the cause)
a nurse is discussing disaster preparedness and response with a newly licensed nurse. which of the following information should the nurse include when discussing schools and places of worship?
- public schools provide disaster preparedness education to students - places of worship can be used as sites for shelters during a disaster - places of worship often provide food and supplies following a disaster
3. When assessing a family, which would lead the nurse to be concerned about the health of afamily? A) Role relationships are inflexible.B) Coping is actively attempted.C) Members regularly communicate via text.D) The family seeks links with the communit
A) Role relationships are inflexible
1. A community health nurse visits an elderly woman newly diagnosed with Type II diabetes.The client lives with her adult daughter and grandchildren. During the visit, the nurse finds theclient depressed over her new diagnosis while the family is trying to console and help her. Thenurse suggests that together they identify positive points about their family system. The nurse isusing: A) StrengtheningB) Data collectionC) Goal-directed questioningD) Measuring family functioning
A) Strengthening
ATI at-risk and vulnerable populations and related effects on health A nurse is caring for a client who is a member of a vulnerable population. Which of the following actions would the nurse take
Advocate for the clients needs
Describe the components of the nursing process as they apply to enhancing family health.
Assessment (pre visit prep) Diagnosis (pre visit prep) Planning (pre visit prep) Implementation (actual visit) Evaluation (documentation and planning for the NEXT visit)
2. During a home visit, a client asks the community health nurse to take them shopping topurchase some food for their new diet. Which response by the nurse would be most appropriate? ]A) "I can't this time, I'm going in a different direction."B) "You need to find some other way to get to the store."C) "I'll help you find a way to get to the store."D) "Use the foods you have now and we will shop next week."
C) "I'll help you find a way to get to the store.
ATI Environmental Influences: A nurse is speaking with a client who wants to know the name of the chemical compound used to kill mice. Which of the following terms should the nurse provide
Rodenticide
ATI Environmental Influences: A nurse is reviewing the harmful effects the environment can have on human health. Which of the folli health conditions should the nurse attribute to environmental factors?
Cancer, asthma, allergies
Describe reimbursement and payment models hospice programs.
Client MUST: Have a prognosis of 6 months or less to live Choose comfort care over curative Acknowledge terminal prognosis Waive regular medicare health services
ATI at-risk and vulnerable populations and related effects on health: A nurse is collecting data from an adolescent who is pregnant. Which of the following findings represents the greatest risk factor for clients?
Client reports being without housing
ATI at-risk and vulnerable populations and related effects on health A nurse is assisting with the case of multiple clients at a community health center. Which of the following clients should the nurse anticipate a referral for a social worker?
Client who has diabetes mellitus and reports inadequate medical supplies at home
Summarize the contemporary circumstances of home health
Clients include the individual, family, significant others Clients are predominantly Over 65 years of age Women Clients tend to: Have chronic health needs Rely on care from family members May exhibit signs of compassion fatigue
ATI at-risk and vulnerable populations and related effects on health A phn is conducting a windshield survey in a new community they will be serving. Which of the following is soul the nurse expect to collect?
Condition of roads and other infrastructure
ATI Environmental Influences: A phn is beginning to work in a new community to improve their environmental health. Which of the following actions should the nurse take first?
Conduct a windshield survey of the community
Describe reimbursement and payment models for home health care
Corporate: Insurance companies, HMOs, PPOs, and case management programs Government Third Party Payers Medicare, medicaid, veterans administration Clients, families
sign and sym with death is imminent
Decline in blood pressure Rapid, weak pulse Dyspnea and periods of apnea/Cheyne Stokes respirations Slower or no pupil response to light Cold extremities; mottling Bladder and bowel incontinence Increased secretions (death rattle) **Nurses need to identify and recognize approach of death symptoms to keep family informed
Discuss how a family's culture influences its values, behaviors, and roles
Definition - the acquired knowledge that family members use to interpret their experiences and generate behaviors that influence family structure and function Values - fam members share certain values that affect family behavior Roles - certain roles are prescribed and defined for family members Culture - a family's culture determines its distribution and use of power
stages of the dying process: Denial
Deny the reality of the situation → Serves useful purposes Nursing Interventions → Accept their reactions, Keep door open for honest dialogue, Always leave room for hope
safety when traveling to a home
Ensure agency is aware of where will you will be traveling to Arrival at the home Friction between family members Family members under the influence of drugs/alcohol ++++ Strangers!
ATI at-risk and vulnerable populations and related effects on health A nurse at a clinic is assessing a client who is part of a vulnerable population. Which of the following actions should the nurse take?
Ensure the environment is comfortable, discuss client care with other members of the interprofessional team is correct, provide culturally appropriate health care
ATI Environmental Influences: A chn is asking a client about potential lead exposure that could affect children in the community. Which of the following techniques is the nurse using?
Environmental health assessment
ATI at-risk and vulnerable populations and related effects on health A nurse is preparing an inservice about methods to remove barriers to health care. Which of the following information should the nurse include?
Establish a mobile clinic to provide services for clients in rural communities
dying process - symptom management: pain
Nursing interventions → Regularly assess pain Prevention is the goal Pain management interventions Establish schedule for pain medication
Summarize the contemporary circumstances of hospice care
Palliative care Relief of suffering without curing underlying disease Symptom management at any time Hospice Provides for quality end-of-life experience Four major approaches in end-of-life care: - Holistic care that attends to the body, mind, and spirit. - Death must not be a taboo topic. - Medical technology should be used with discretion. - Clients should be actively involved in treatment decisions
Analyze the role of the community health nurse in promoting the health of the family
Prepared to work with ALL types of families and accept them as valid! Address client needs throughout these life changes Identify and develop strengths with families in planning nursing care Involve them in the plan of care as appropriate
stages of the dying process: bargaining
Promises in return for an extension of life Nursing care and interventions → Explore individual's feelings with him or her Provide realistic perspective but allow for hope
ATI at-risk and vulnerable populations and related effects on health A chn is speaking with an older adult client about methods to reduce the risk of depression. Which of the following is a primary intervention the nurse should include in the teaching
Provide stress reduction techniques for the client
hospice
Provides for quality end-of-life experience
Describe the functions of a family
Providing affection Providing safety, security (physical, emotional, mental) Developing identity Affiliation with community Providing socialization Establishing controls
4. Describe essential characteristics of hospice nursing practice.
RN is central to hospice interdisciplinary team, Rotation through 24-hour call 7 days/week to assure continuous availability, relieving physical and emotional suffering of terminally ill people and their families
ATI Environmental Influences: A home care nurse is visiting a client and their family to conduct an environmental assessment of their home. The nurse discovers peeling paint on the walls in the home which is over 50 years old, using the nursing process, which of the following actions should the nurse take next
Review the data and make hypothesis regarding the potential for lead in the home
ATI at-risk and vulnerable populations and related effects on health A nurse understands that social determinants contribute to poor health. Health disparities, and inequities. Which of the following is an example of a social determinant of health?
Socio-economic status
major health care conditions
Some big hazards-asbestos(disease of the lung), carbon monoxide poisoning, tobacco smoke, lead(paint)-children most at risk-cause developmental delays, mold
stages of the dying process: acceptance
Struggling ends and relief ensues; Come to terms with death; find a sense of peace Nursing care and interventions: Assist client with maximizing quality of life Support final wishes Assist loved ones with acceptance
ATI Environmental Influences: A nurse is caring for a client who frequently uses pesticides. The nurse should understand which of the following is true about pesticides
The can cause illness through genetic mutation, enter the air and cause lung irritation, residue seeps into the ground and harm drinking water
home health criteria: medicare
The patient MUST: Be confined to home or homebound Need skilled services (from a nurse or therapist) Be under the care of the provider Receive services under a home health plan of care established and periodically reviewed by a provider!Have had a face to face encounter with a provider Episode of care reviewed q 60 days* Medicare plan of care, documentation
stages of the dying process: anger
Unfilled desires and unfinished business + Feeling of injustice Nursing care and intervention → Do not respond to anger with anger Show acceptance Assist client with processing feelings Assist with unfulfilled desires if possible Involve interdisciplinary team Care for family
ATI Environmental Influences: A phn is working with a group of clients who are concerned about malaria in their town. They ask the nurse about effectives ways to help prevent the spread of malaria. Which of the following strategies should the nurse suggest
Use insecticide- treated mosquito nets
ATI at-risk and vulnerable populations and related effects on health A nurse manager is preparing an inservice about vulnerable populations for nursing staff. Which of the following should the nurse include?
Vulnerable populations experience more adverse health outcomes than the general population
family health practice guidelines
Work with the family collectively Start where the family is Adapt nursing interventions to the family's stage of development Recognize the validity of family structural variations Emphasize family strengths Anticipate needs
a nurse is discussing the domains whitin the core competencies in disaster nursing by the international council of nurses with a group of nurses. which following domains should the nurse include the action of reporting an event that might indicate an emergency?
assessment
Describe environmental conditions to consider when assessing the environment of a community
built environment, land use, climate change, water pollution, food contamination, waste disposal, toxic waste, radiation
a chn is a triaging victims at the site of a mass casualty incident. which of the following actions should the nurse tag with the color red?
child victim who is unconscious and breathing spontaneously victim who is conscious, has a sucking chest wound and is breathing spontaneously
a chn is assisting with disaster proparedness and is following the eight domains of core competencies in disaster nursing by the international council of nurses. which of the following actions should the nurse identify as a part of the domain?
collaborting with disaster response team members to provide surge capacity care
Chapter 14 family
schwartz
concepts and frameworks for environmental health: ECOLOGICAL MODEL OF HEALTH
used to illustrate the determinants of health
ATI at-risk and vulnerable populations and related effects on health A nurse is reviewing the data for the number of new colorectal cancer screenings. This data is for the 6 months following a community campaign stressing the importance of screening for colorectal cancer. The nurse should identify that this is an example of Which of the following phases of the nursing process?
Evaluation
Interactional framework
Family as a unit of interacting personalities emphasis on communication, roles, conflict, coping patterns, and decision-making processes look at areas of communites strengths family system is influenced by these interactions
Describe individual and group characteristics of a healthy family
Family members interact to facilitate and achieve goals. individual member development is supported. Relationships are nurtured Teaching values and behaviors Rituals and traditions Prioritizing the family Spiritual foundation Active attempts are made to cope with problems. A healthy home environment and lifestyle. Physical, emotional, mental Regular links with the broader community
ATI at-risk and vulnerable populations and related effects on health A nurse in the emergency department is assisting with the care for an older adult client who lives with a family member. The client's family members report the client has blood in their urine. Which of the following actions should the nurse take?
Determine the cause of the bleeding while asking about other social family concerns
a chn is discussing with a group of new nurses. which of the following statements should the nurse indicate an understanding of the information?
disasters often overwhelm the availability of local resources
concepts and frame works for environmental health: ECOSYSTEMS
dynamic communities of plant, animal, and microorganisms - Helps regulate water, gasses, waste recycling, nutrients recycling, pollination, infectious disease, climate, biology, and cultural opportunities for human use
which of the following examples should are natural disasers?
earthquake, hurricanes, sinkholes, blizzards
ATI emergency preparedness and management assessment A nurse is working at a local school when a possible gas leak occurs in the building during lunch. which of the following actions should the nurse take?
evacuate everyone from the building
nursing process family as client
nursing process as in community health settings → context and client focus are different Interactional framework Family as a unit of interacting personalities Family system is influenced by these interactions Emphasis on communication, roles, conflict, decision making process Developmental framework Life cycle perspective Examination of members changing roles and tasks in each progressive cycle stage
dying process- management symptoms
pain dyspnea/ resp distress - elevate bed, oxygen, relaxation tech anxiety - interventions constipation increased secretions "death rattle"
ATI Environmental Influences: A community health nurse is giving a presentation to a group of students about collecting data on community environments? What should I include?
physical , social, occupational
environmental concern- built enviroment
physical structures, contribute to social disruption, not natural -All aspects of an environment not naturally occurring
