Caring for Diverse & Vulnerable Populations Exam 3 Review

What is the central focus of practice for a faith community nurse?

1. The spiritual dimension is central to the practice. Nursing embodies the physical, psychological, social, and spiritual dimensions of clients into professional practice. Although parish nursing includes all four, it focuses on intentional and compassionate care, which stems from the spiritual dimension of all humankind. 2. The roots of the role balance both knowledge and skills of nursing, using nursing sciences, the humanities, and theology. The nurse combines nursing functions with pastoral care functions. Visits in the office, home, hospital, or nursing home often involve prayer and may include a reference to scripture, symbols, sacraments, and liturgy of the faith community represented by the nurse. The values and beliefs of the faith community are integral to the supportive care given. Nurses also assist with worship services as appropriate within the faith community. 3. The focus of the specialty is the faith community and its ministry. The faith community is the source of health and healing partnerships, which result in creative responses to health and health-related concerns. Partnerships may be among individuals, groups, and health care professionals within the congregation. They may also be among various congregations or community agencies, institutions, or individuals. Partnerships also evolve as the congregation visualizes its health-related mission beyond the walls, stones, and steeples of its own place of worship. 4. Parish nurse services emphasize the strengths of individuals, families, and communities. Parish nurses endorse this fourth characteristic in their practice. As congregations realize the need for care and care for one another, their individual and corporate relationship with their Creator is often enhanced. This provides additional coping strength for future crisis situations within the family and community. 5. Health, spiritual health, and healing are considered an ongoing, dynamic process. Because spiritual health is central to well-being, influences are evident in the total individual and noted in a healthy congregation. Well-being and illness may occur simultaneously; spiritual healing or well-being can exist in the absence of cure.

What is a do not resuscitate order?

A do-not-resuscitate order (DNR) is a specific order from a physician not to use cardiopulmonary resuscitation.

What is a family crisis?

A family crisis occurs when the family is not able to cope with an event or multiple events and becomes disorganized or dysfunctional. When the demands of the situation exceed the resources of the family, a family crisis exists.

Stanhope Chapter 30 What is a disability?

A physical, mental, cognitive, or developmental condition that impairs, interferes with, or limits a person's ability to engage in certain tasks or actions or participate in typical daily activities and interactions; impaired function or ability; an impairment (such as a chronic medical condition or injury) that prevents someone from engaging in gainful employment; an impairment (such as spina bifida) that results in serious functional limitations for a minor; a program providing financial support to a person affected by a disability; the financial support provided by such a program; a disqualification, restriction, or disadvantage; lack of legal qualification to do something.

Stanhope Chapter 34 What is the difference between a migrant and a seasonal farmworker?

According to the U.S. Department of Labor (2016a), a migrant farmworker is a seasonal farmworker who must travel to do farmwork and is unable to return to a permanent residence within the same day. A seasonal farmworker returns to his or her permanent residence, works in agriculture seasonally, and does not work year-round exclusively in agriculture. The term MSFW also includes migrant food-processing workers, who are defined in the same way as seasonal farmworkers but work in food processing and are unable to return to a permanent residence on the same day.

What is adjudication?

Adjudication refers to a judicial decision or a sentence.

What is more likely to occur with babies of teen moms?

Adolescent parents often have unrealistic expectations about their children and may not know how to stimulate emotional, social, and cognitive development. The children born to adolescents are at risk for academic and behavioral problems as they become older. Teens who receive education on normal development and childcare are more likely to avert these problems with their children.

Stanhope Chapter 31 Key Point #1

All countries have population subgroups that are more vulnerable to health threats than the general population.

What is the definition of suburbs?

Area adjacent to a highly populated city.

What are the barriers to rural health care?

Barriers to rural health care include the lack of availability, affordability, accessibility, and acceptability of services.

Who can change the healthcare system to provide accessible, quality, evidence-based care to individuals and populations?

By working with policy makers, government leaders at all levels, and advocacy organizations, nurse leaders have the power to change the health care system to provide accessible, quality, evidence-based care to individuals and populations.

What are the 3 types of child abuse?

Child abuse can be physical, emotional, or sexual. Incest is a common and particularly destructive form of child abuse.

Key Point #6

Child poverty rates are twice as high as those for adults. Children who live in single-parent homes are twice as likely to be poor than those who live with both parents.

How are children of migrant farmworkers affected?

Children of migrant farmworkers may need to work for the family's economic survival. They are most affected by the disruptive and challenging lifestyle.

What are low-income children at increased risk for?

Children who are low income or live in poverty are at increased risk for violence, injuries, and environmental hazards.

What are the three roles of community mental health nurses?

Clinician: Objectives of the practitioner role are to help the client maintain or regain coping abilities that promote functioning. Educator: The educator role uses teaching/learning principles to increase understanding about mental illness and mental health. The educator role is foundational to health maintenance, health promotion, and community action. Coordinator: Coordination of care is a basic principle of the multidisciplinary team approach in community mental health services. Yet there is often a lack of coordination as well as limited services in many communities. Therefore, at a minimum, the role of coordinator must include case finding, referral, and follow-up to evaluate system breakdown and deficits.

Stanhope Chapter 32 What is the definition of rural?

Communities having fewer than 20,000 residents or fewer than 99 persons per square mile.

How can nurses impact the teen pregnancy rate of a community?

Community coalitions, which include nurses, can have a significant impact on teen pregnancy. These coalitions generally have diverse representation from the community, and therefore their activities meet with more community support.

What are the seven basic phases of consultation?

Consultation involves seven basic phases: - Initial contact - Definition of the relationship - Selection of setting and approach - Data collection and problem diagnosis - Intervention - Reduction of involvement and evaluation - Termination

What is the purpose of consumer advocacy for mental health?

Consumer advocacy movements for people with mental illness, like those for other illnesses, came about to fulfill unmet needs and to attempt to decrease the stigma associated with mental illness.

Why do nurses use contracting?

Contracting, which is making an agreement between two or more parties, involves a shift in responsibility and control, from the professional alone to a shared effort by client and professional.

What are food deserts?

Defined as areas having limited access to affordable and nutritious foods.

What is deinstitutionalization?

Deinstitutionalization involved transitioning large numbers of people from state psychiatric hospitals to communities.

What is drug dependence?

Drug dependence is a state of neuroadaptation (a physiological change in the central nervous system [CNS]) caused by the chronic, regular administration of a drug; in drug dependence, continued use of the drug becomes necessary to prevent withdrawal symptoms.

What is multigenerational poverty?

Multigenerational poverty is common among African Americans in the South, Hispanics along the border of Mexico, and American Indians who live in states with multiple reservations.

What are the factors contributing to homelessness?

Factors contributing to homelessness include insufficient availability of low-cost housing; poor health; mental illness; substance abuse and in particular, opioid use; lack of consistent, longitudinal treatment for mentally ill persons; intimate partner violence; and family dynamics which cause children and youth to leave home.

Stanhope Chapter 38 What are the factors influencing social and community violence?

Factors influencing social and community violence include changing social conditions, economic conditions, population density, community facilities, and institutions within a community, such as organized religion, education, the mass communication media, and work.

Key Point #4

Factors leading to the growing number of poor people in the United States include reduced earnings, decreased availability of low-cost housing, more households headed by women, inadequate education, lack of marketable skills, welfare reform, and reduced Social Security payments to children.

Does intimate partner violence factor into teen pregnancy?

Factors that can influence whether a young woman becomes pregnant include a history of sexual victimization, family dysfunction, substance use, and failure to use birth control. Several factors may overlap.

What factors impact the prevalence of poor persons in the U.S.?

Factors which impact the prevalence of poor persons in the United States include race and ethnicity; education level; increased substance abuse, including opioids; the number of households headed by women, who also face lower wages than their male counterparts; wage stagnation; reduced Social Security payments; and political reluctance to further advance such anti-poverty initiatives as increasing the minimum wage to a "living wage."

What do families have to do with healthcare decisions?

Families are the context within which health care decisions are made. Nurses are responsible for assisting families in meeting health care needs.

What are family demographics?

Family demographics is the study of structures of families and households as well as events that alter the family, such as marriage, divorce, births, and cohabitation. Demographic trends affect the family.

Stanhope Chapter 26 What is the definition of family?

Family, as defined and implemented in the health care system, continues to be based on the legal notions of relationships such as biological/genetic blood ties and contractual relationships such as adoption, guardianship, or marriage. However, the family system and family nurses use the following broader definition of family: "Family refers to two or more individuals who depend on one another for emotional, physical, and/or financial support. The members of the family are self-defined"

Stanhope Chapter 44 What does forensic mean?

Forensic means pertaining to the law.

How can forensic nurses promote primary prevention?

Forensic nurses work in cooperation with public health professionals, including nurses, in developing programs of prevention such as automobile safety and intimate partner violence prevention.

What is forensic nursing?

Forensic nursing is a community-oriented specialty that addresses the prevention and treatment of accidental injury and violent crimes. Forensic nursing synthesizes the biopsychosocial and spiritual aspects of nursing care with an expert understanding of forensic science and the criminal justice process.

When do we need to utilize a forensic nurse?

Forensic nursing is needed whenever injury has legal implications.

What is a functional limitation?

Functional limitations occur when individuals experience difficulty performing basic activities of daily living because of their disability. Examples of functional limitations include difficulty standing, walking, climbing, grasping, and reading.

What is the definition of urban?

Geographic areas described as non-rural and having a higher population density; more than 99 persons per square mile; cities with a population of at least 20,000 but less than 50,000.

Stanhope Chapter 28 Why do we need good nutrition?

Good nutrition is essential for healthy growth and development, and it influences disease prevention in later life.

Stanhope Chapter 33 What are federal poverty levels (FPL) used for?

Guides eligibility for federal assistance such as the Supplemental Nutrition Assistance Program (SNAP) and the Children's Health Insurance Program (CHIP)

Do HIPAA privacy rules apply to school nurses?

HIPAA privacy rules regarding the health information of children apply in schools.

What are the links to health problems of migrant health workers?

Health problems of migrant farmworkers are linked to their work and housing environments, limited access to health services and education, and lack of economic opportunities.

Stanhope Chapter 27 What is a health risk appraisal?

Health risk appraisal refers to the process of assessing for the presence of specific factors in each of the categories that have been identified as being associated with an increased likelihood of an illness, such as cancer, or an unhealthy event, such as an automobile accident.

Stanhope Chapter 41 What do home health nurses do?

Home health nursing is "a specialty area of nursing practice that promotes optimal health and well-being for patients, their families, and caregivers within their homes and communities.

Why are home visits important?

Home visits afford the opportunity to gain a more accurate assessment of the family structure and behavior in the natural environment. Home visits also provide opportunities to make observations of the home environment and to identify both barriers and supports to reducing health risks and reaching family health goals.

What intervention is successful in preventing selected diseases?

Immunizations are successful in prevention of selected diseases. Barriers to immunizing children are parental concerns, cost, vaccine shortages, and changes in recommended vaccine scheduling.

Stanhope Chapter 29 What is the Americans with Disabilities Act?

In 1990, the Americans with Disabilities Act (ADA) was passed, providing protection against discrimination to millions of Americans with disabilities. A disability is generally defined by the ADA as a physical or mental impairment that substantially limits one or more major life activities, having a record of such an impairment, or being regarded as having such an impairment. The ADA legislation requires government and businesses to provide disabled individuals with equal opportunities for jobs, education, access to transportation and public buildings, and other accommodations for both physical and mental limitations.

What are factors are major stressors for APN roles?

Major stressors for APHNs and NPs include professional isolation, liability, collaborative practice, conflicting expectations, and professional responsibilities.

Stanhope Chapter 36 Who is affected by mental health issues?

Mental disorders are indiscriminate. They occur across the life span and affect persons of all races, cultures, genders, and educational and socioeconomic groups.

Why are migrant workers considered a vulnerable population?

Migrant farmworkers are considered a vulnerable population because of their lifestyle and lack of resources.

Who is in an excellent position to identify potential victims of family abuse?

Nurses are in an excellent position to identify potential victims of family abuse because they see clients in a variety of settings, such as schools, businesses, homes, and clinics. Treatment of family abuse includes primary, secondary, and tertiary prevention and therapeutic intervention.

Who is in an ideal role to assist with the tertiary prevention of addicts and their families?

Nurses are in ideal roles to assist with tertiary prevention for both the addicted person and the family.

Why should nurses know the federal and state disability laws?

Nurses must know both federal and state laws pertaining to disabilities to most effectively assist clients and their families.

What nursing interventions for physically compromised clients require?

Nursing interventions for physically compromised clients require attention to their health as well as to the environment in which they live.

What is codependence?

People in a close relationship with the addicted person often develop unhealthy coping mechanisms to continue the relationship. This behavior is known as codependency—a stress-induced preoccupation with the addicted person's life, leading to extreme dependence and excessive concern with the addicted person.

Why do physically compromised clients need to participate in health promotion? (examples?)

Physically compromised individuals need to participate in health promotion to prevent the onset of a new health disruption, to strengthen their well-functioning aspects, and to prevent further deterioration of their health.

What are political skills?

Political skills are those used in negotiation and conflict management and managing power dynamics among health care teams and within the community.

Key Point #5

Poverty has a direct effect on health and well-being across the life span. Poor people have higher rates of chronic illness and infant morbidity and mortality, shorter life expectancy, and more complex health problems.

Who develops plans for emergency care in the schools?

The school nurse must have an emergency plan in place so that a routine can be followed when emergencies occur.

Stanhope Chapter 46 What is public health nursing?

Public health nursing is the practice of promoting and protecting the health of populations using knowledge from nursing and social and public health sciences.

What is meant by frontier?

Regions having fewer than six persons per square mile.

What is relapse management?

Relapse management and promotion of recovery are major goals of intervention in community mental health nursing. Assessment of the frequency, intensity, and duration of symptoms for the purpose of identifying biological, environmental, and behavioral triggers that may lead to illness relapse helps the consumer manage the illness and promotes recovery. Examples of triggers are poor nutrition, poor social skills, hopelessness, and poor symptom management. Once triggers are identified, interventions aimed at fostering effective coping skills can be introduced to offset relapse of symptoms. For example, an intervention that may promote effective coping to offset social isolation is to guide the client to organized consumer group activities available in the community. Another is to promote consumer and family efforts at job training through community vocational agencies. Still another is to promote competency in family members by coordinating services that enhance their understanding of the illness, provide social support, and include respite care when needed. Finally, an alliance with the client to manage medication and side effects is an important component of relapse prevention and recovery promotion.

What should a school nurse do if she suspects child abuse or neglect?

School health nurses are mandated reporters of suspected cases of child abuse and/or neglect.

Stanhope Chapter 42 What type of nursing skills are performed at schools?

School nurses carry out catheterizations, suctioning, gastrostomy feedings, and other complex clinical skills in schools.

What roles do public health nurses fill?

Some of the roles public health nurses function in are advocate, case manager, referral source, counselor, educator, outreach worker, disease surveillance expert, community mobilizer, and disaster responder.

Stanhope Chapter 45 Is spiritual care the same as religious care?

Spiritual care is different from religious care and is an expected and welcomed component of faith community nursing care.

What risk does spousal abuse present?

Spouse abuse is usually wife abuse. It involves physical, emotional, and, frequently, sexual abuse within a context of coercive control. It usually increases in severity and frequency and can escalate to homicide of either partner.

Stanhope Chapter 35 What is coercive sex?

Statutory rape

What is the number one national health problem linked to morbidity and mortality?

Substance abuse is the number one national health problem, linked to numerous forms of morbidity and mortality.

Stanhope Chapter 37 What is substance abuse?

Substance abuse is the use of any substance that threatens a person's health or impairs social or economic functioning. This definition is more objective and universal than the government's definition of drug abuse, which is the use of a drug without a prescription or any use of an illegal drug.

Why do pregnant teens not receive adequate prenatal care?

Teens have reported barriers to care, which include denial of the pregnancy, fear of telling parents, transportation, dislike of providers' care, and offensive attitudes among clinic staff toward pregnant teens.

What is the child nutrition act?

The Child Nutrition Act (CNA) was originally passed in 1964 to combat malnutrition and hunger among disadvantaged children and pregnant women. This law funds the National School Lunch Program, breakfast and summer food programs in schools and preschools, and food supplements for pregnant and breastfeeding women and their preschool children (U.S. Congress, 2010). The Act also establishes minimum standards for nutrition content of meals, requires decreased student access to non-nutritious foods on school grounds, and the inclusion of nutrition education, physical activity, and school wellness programs.

What is the Family Medical Leave Act?

The Family and Medical Leave Act (FMLA), initially passed in 1993, provides job protection and continuous health benefits where applicable for eligible employees who need extended leave for their own illness or to care for a family member. Gender equality was expanded with FMLA to offer women the ability to better manage both a career and a family. However, FMLA is limited. It only permits eligible employees to take 12 weeks of unpaid leave during a 12-month period for limited situations such as birth, adoption, or care for a serious illness of self or family members. It also only applies to employees who worked for at least 12 months in companies that have 50 or more employees. The FMLA definition of spouse was revised in 2015 to allow eligible employees in same-sex marriages to take family and medical leave.

What is Medicaid?

The Medicaid program, established by the Social Security Act in 1965, is a state-administered health insurance program financed jointly by the federal and state governments. Children under 18 years of age living in a household with an income level up to 138 percent of the federal poverty level (FPL) or children meeting disability requirements qualify for this program. The program provides health services at no cost to participants and includes outpatient visits, hospitalization, laboratory testing, immunizations, well care/preventive services, and dental care.

What is the National Institute for Occupational Safety and Health?

The National Institute for Occupational Safety and Health is the education and research agency that provides grants to investigate the causes of workplace illness and injuries.

What does the Occupational Safety and Health Administration do?

The Occupational Safety and Health Administration enforces workplace safety and health standards.

What is the Affordable Care Act?

The Patient Protection and Affordable Care Act of 2010 (ACA) helps women, children, and families by increasing access to health care, improving health care quality, lowering health care costs, and instituting new consumer protections. However, as with all policies, health care providers must be diligent in the follow through and continued maintenance of policies that improve the health of our families, including advocating for vulnerable populations with our legislative bodies. Improving access and control over resources such as health care can lead to greater empowerment of families.

Who receives social security benefits ?

The Social Security Administration (SSA), who ultimately determines the individual's status for disability benefits, defines disability as the inability "to engage in any substantial gainful activity (SGA) because of a medically-determinable physical or mental impairment(s): That is expected to result in death, or That has lasted or is expected to last for a continuous period of at least 12 months". An individual's inability to perform any SGA is the criteria used by the Social Security Administration to determine disability. A gainful work activity is "Work performed for pay or profit; or Work of a nature generally performed for pay or profit; or Work intended for profit, whether or not a profit is realized". The Social Security Administration and Worker's Compensation Programs determine the patient's disability based on clinical evidence. Health care providers should consult the office of Disability Determination Services in the Social Security Administration or the Worker's Compensation Programs for guidelines from individual states because requirements may vary.

What is the goal of consultation?

The goal of consultation is to stimulate clients to take responsibility, feel more secure, deal constructively with their feelings and with others in interaction, and internalize skills of a flexible and creative nature.

What is the goal of family nursing?

The goal of family nursing is to focus care, interventions, and services to optimize the self-care capabilities of families and to achieve the best possible outcomes.

What is the goal of palliative care?

The goal of palliative care is quality of life.

What is hospice care?

The goal of the hospice movement is to humanize the end-of-life experience.

What is the goal of the local health department?

The goal of the local health department is to safeguard the public's health and improve the community's health status.

Stanhope Chapter 40 What are the 4 goals of nursing leadership?

The goals of nursing leadership and management are: (1) to achieve organization and professional goals for client services and clinical outcomes (2) to empower personnel to perform their responsibilities effectively and efficiently (3) to develop new services that will enable the organization to respond to emerging community health needs (4) to work with others for a healthy community.

Where are Advanced Practice Nurses likely to be employed? Why?

The major role functions of the APHN and NP in community health are clinician, consultant, administrator, researcher, and educator; typically, the NP spends a greater amount of time in direct care clinical activities and less time in indirect activities than the APHN. Major arenas for practice for APHNs and NPs in community health include primary care practice, institutional settings, industry, government, public health agencies, schools, home health, correctional health, nursing centers, retail clinics, and health ministry settings.

What is multidimensional poverty?

The multidimensional approach takes a more holistic view, defining poverty by considering deficits across health, standard of living, and monetary domains. Newer adaptations of the multidimensional approach consider the significance of social relational health to poverty.

Is abortion an option for teens?

The provision of reproductive health care services to adolescents requires sensitivity to the special needs of this age group. This includes knowing about state laws regarding confidentiality and services for birth control, pregnancy, abortion, and adoption.

What does forensic nursing include?

The specialty reflects an integration of nursing, forensic science, and the law. The skill set is defined by the scope and standards of practice, which includes skills such as collection, documentation, and preservation of evidence and other findings that may later be used in the prosecution of a crime.

What is included in the functions of a faith community nurse?

The usual functions of the faith community nurse include health counseling and teaching for individuals and groups, facilitating linkages and referrals to congregation and community resources, advocating and encouraging support resources, and providing spiritual care.

What are the four approaches to viewing families?

There are four approaches to viewing families: - Family as context - Family as client - Family as a system - Family as a component of society.

What are Adverse Childhood Experiences (ACEs)?

Traumatic events in childhood that have long-term negative effects on well-being that can last into adulthood.

Stanhope Chapter 39 Where is the shift in nursing going based on society's demands and needs?

Trends such as a shift of health care from institution-based sites to the community, an increase in technology, self-care, cost-containment measures, accountability, third-party reimbursement, and demands for humanizing technical care have influenced the new roles of the APHN and NP.

What are the major causes of morbidity and mortality?

Unintentional injuries are the major cause of morbidity and mortality in the child and adolescent population. Most are preventable. Nurses have a major role in anticipatory guidance and prevention.

Which family member(s) can be victims of violence and abuse?

Violence and abuse of family members can happen to any family member: spouse, older adult, child, or developmentally disabled person.

Key Point #2

Vulnerable populations are more likely to develop health problems as a result of exposure to risk or to have worse outcomes from those health problems than the population as a whole.

Key Point #3

Vulnerable populations are more sensitive to risk factors than those who are more resilient, because they are often exposed to cumulative risk factors. These populations include poor or homeless persons, pregnant adolescents, migrant workers, severely mentally ill individuals, substance abusers, abused individuals, people with communicable diseases, and people with sexually transmitted diseases.

What does an occupational health nurse do with work-related health problems?

Work-related health problems must be investigated and control strategies implemented to reduce exposure. Control strategies include engineering, work practice, administration, and personal protective equipment.

Stanhope Chapter 43 What are workplace hazards?

Workplace hazards include exposure to biological, chemical, enviromechanical, physical, and psychosocial agents.

Where does family nursing take place?

• Family nursing is practiced in all settings. • Family nursing is a specialty area that has a strong theoretical base and is more than just common sense. • Community health nurses must integrate both family theory and public health theory in their practice.