CH 3 Community-Based Nursing Practice: Public Health Nursing
What is epidemiology?
-the study of incidence and prevalence (pervasiveness or extent) of disease within a population. -factors that influence the frequency and distribution of disease, injury, and other health-related events and their causes within a population. -The purpose of their work is to establish programs to measure and prevent disease and control its spread.
What are the 5 steps in the Nursing Process?
1)Assessment: Assessments of a community or target population are done using community health assessment instruments, community health assessment questions, and/or vital statistics records. 2)Diagnosis: Nursing diagnoses are population-centered and identify greatest problems or needs within the population 3)Planning: Goals are population-centered. Interventions are planned on the primary, secondary, and tertiary levels of prevention. 4)Intervention: Interventions are implemented in the target population. 5)Evaluation: Effectiveness of an intervention is evaluated for the target population using the population-centered goal as the evaluation criteria.
What are extrinsic factors?
AKA environmental factor; relate to the immediate physical environment, the biologic environment (including food sources and vectors of disease, such as animals and insects), and socioeconomic influences, such as workplace conditions, residence in an urban versus a rural setting, and the potential impact of social unrest or disaster on a community.
What are intrinsic factors?
AKA host factors; include genetics, age, gender, ethnic group, immunization status, and human behavior.
Information about which aspect of a community could best be obtained by walking or driving through a neighborhood? Likelihood of violence Bus routes servicing the hospital Emergency medical response speed Accessibility of grocery stores to senior housing
Accessibility of grocery stores to senior housing
Which nursing diagnosis is definitively related to a public health problem? Compromised Family Coping related to temporary family role changes as evidenced by the significant person withdrawing from the client. Altered Health Seeking Behaviors related to discontinuation of senior bus services as evidenced by canceled clinic visits related to lack of transportation. Frail Elderly Syndrome related to chronic illness as evidenced by social isolation. Caregiver Role Strain related to family member with significant care needs as evidenced by disturbed sleep and difficulty performing required tasks.
Altered Health Seeking Behaviors related to discontinuation of senior bus services as evidenced by canceled clinic visits related to lack of transportation.
What is a public health nurse doing during a Windshield Survey? Promoting compliance with safety standards Ensuring street safety Evaluating population demographics Assessing the community
Assessing the community
Which scenario is an example of primary prevention? Conducting a lead screening program targeted at pre-school age children Providing directly observed drug therapy for clients with active tuberculosis Collaborating in the development of a citizen emergency preparedness plan Asking about abuse as part of routine health assessment
Collaborating in the development of a citizen emergency preparedness plan
According to the American Nurses Association (ANA, 2013), public health nurses use the nursing process to perform which specific role functions? Select all that apply Coordinate services Staff publicly funded clinics Consult with government officials Promote healthy lifestyles Provide health education Participate in regulatory activities
Coordinate services Consult with government officials Promote healthy lifestyles Provide health education Participate in regulatory activities
What is descriptive epidemiology? Descriptive epidemiology is concerned with the causes of disease. Descriptive epidemiology is the study of the "who, when, and where" of disease occurrence. Descriptive epidemiology determines how to limit disease in a specific population. Descriptive epidemiology is concerned with hypotheses about why a disease is occurring in a population.
Descriptive epidemiology is the study of the "who, when, and where" of disease occurrence.
Which examples are public health nursing interventions? Select all that apply. Developing a water safety guide for distribution at local water recreational areas Organizing a "Dispose of Unused Medications Safely Day" Distributing informational materials on proper preparation and storage of foods at a local health fair Arranging for home delivery of a patient's medications Speaking at the senior citizens' center about the benefits of the pneumonia vaccine
Developing a water safety guide for distribution at local water recreational areas Organizing a "Dispose of Unused Medications Safely Day" Distributing informational materials on proper preparation and storage of foods at a local health fair Speaking at the senior citizens' center about the benefits of the pneumonia vaccine
Which essential functions of public health nursing are directly or indirectly involved when a public health nurse speaks to members of the city council about the need for, and benefits of having parks and playgrounds within the city limits? Select all that apply. Education Promotion of healthy lifestyles Coordination of services Consultation with public entities Participation in regulation
Education Promotion of healthy lifestyles Consultation with public entities
Which standards of practice requirements are identified by the ANA as similar for public health nurses and nurses in other practice areas? Select all that apply. Ethical behavior Participation in research Commitment to healthy behavior Advocacy Leadership Responsible resource utilization
Ethical behavior Participation in research Advocacy Leadership Responsible resource utilization
Which is a defining characteristic of public health nursing that distinguishes it from community-based nursing? Focus on populations Concern with disability as well as acute disease Importance of collaboration Commitment to patient-centered care
Focus on populations
Which descriptive phrases apply to public health nursing practice? Select all that apply. Focuses on threats to health as well as disease Develops plans of care for groups of people Examines the community as a whole Employs collaborative and interdisciplinary strategies Advocates for individual patients from special interest groups
Focuses on threats to health as well as disease Develops plans of care for groups of people Examines the community as a whole Employs collaborative and interdisciplinary strategies
Which facts must the public health nurse consider when determining any public health goal? Select all that apply. Progress reports need to be scheduled monthly Goals need to be population focused Community leaders need to review goal Goals need to be measurable Stakeholders need to have input
Goals need to be population focused Goals need to be measurable Stakeholders need to have input
Committee work advocating for which groups would be an appropriate public health nursing intervention? Select all that apply. Homeless Domestic violence victims Cardiac care unit patients Hearing impaired adults Sexually abused children Migrant workers
Homeless Domestic violence victims Hearing impaired adults Sexually abused children Migrant workers
Which is an example of a community health care service focused on tertiary prevention? Initiating an occupational therapy referral for a patient recovering from a stroke Counseling new mothers on the use of infant car safety seats Screening adolescent girls for scoliosis Contacting persons exposed to tuberculosis
Initiating an occupational therapy referral for a patient recovering from a stroke
What is the public health nurse primarily accomplishing when he or she invites two representatives from the local senior citizens center to participate in meetings to plan a nutritional fair for the over 65 population? Gaining community trust Involving stakeholders Promoting participation Ensuring volunteers
Involving stakeholders
Which term describes the establishment of a support group for patients following hospitalization for heart failure? Early intervention Primary prevention Secondary prevention Tertiary prevention
Tertiary prevention
What are the ANA's Standards of Practice in Public Health Nursing?
Participation in research Responsible resource utilization Ethical behavior Leadership Advocacy
While manning a booth at a community health fair, a public health nurse is asked what is meant by primary prevention. Which would be a correct response? Primary prevention focuses on restoration of health and rehabilitation. Primary prevention is concerned with early identification and treatment of an illness to limit its effect. Primary prevention consists of strategies whose goal is to avoid recurrence of disease. Primary prevention refers to interventions designed to prevent disease or disability.
Primary prevention refers to interventions designed to prevent disease or disability.
Which is an example of a public health oriented nursing diagnosis? Risk for Ineffective Childbearing Process related to domestic violence Risk for Ineffective Relationship related to substance abuse Risk for Contamination related to elevated lead levels in the public water supply Risk for Ineffective Activity planning related to insufficient social support
Risk for Contamination related to elevated lead levels in the public water supply
When a public health nurse screens for hearing loss, which level of prevention is being addressed? Primary Primary transitional Secondary Tertiary
Secondary
What is a windshield survey?
a community health assessment instrument; a visual assessment of a community done by walking or driving through a community. -This process begins the initial needs assessment by collecting data through observation of the community's geography, population, environment, industry, education, recreation, communication, transportation, and public services. EXAMPLES: Whether people are walking or are engaged in physical activity Availability of single- or multiple-family private and public housing units Availability of health, safety, and social services agencies, located along a bus route or other public transportation line Presence of spiritual or religious places of worship, educational institutions, and news and media services, as well as types of open and closed businesses and industries Availability of grocery stores General appearance and condition of neighborhoods
What is most essential for the public health nurse when planning interventions for a community with multiple nursing diagnoses? Review community demographics Consult with colleagues Reassess the problems Set priorities
Set priorities
Because of the number of accidents involving cyclists and motor vehicles, a public health nurse initiates a safety education program in her town. Which term can most appropriately be used to describe cyclists in this scenario? Target population Interest group At-risk individuals Client population
Target population
What is a target population in Public Health Nursing?
a defined group of people within a community -important in order to study the population and customize services to best meet that population's needs!!!
The public health nurse assesses the social, cultural, and ethnic traditions of a community for which reason? This information is essential to the provision of patient centered care. This information is necessary to establish a trusting relationship with community members. It facilitates collaboration with community leaders. It is needed to identify vulnerable groups.
This information is essential to the provision of patient centered care.
Which is an example of data a public health nurse would collect during a windshield survey? Life expectancy of target groups Type of housing and transportation Prevalence of STDs Health literacy levels
Type of housing and transportation
Which community assessment questions would the public health nurse answer through online research? Select all that apply. What is the incidence of teen pregnancy in the community? How many cases of tuberculosis occurred in the state in the last five years? What is the number of traffic accident-related deaths in the state last year? What is the average income level of the local population? How often are the community playgrounds being used?
What is the incidence of teen pregnancy in the community? How many cases of tuberculosis occurred in the state in the last five years? What is the number of traffic accident-related deaths in the state last year? What is the average income level of the local population?
What is public health nursing?
a branch of community health nursing that focuses on health promotion and disease prevention in a population.
What is community-based nursing?
a branch of community health nursing that focuses on providing direct nursing care for individuals in a community setting, such as in a home, school, or workplace.
What is community health nursing?
a broad term that encompasses work done in communities to addresses issues of health and disease either within a population or for a specific individual of a community.
What is analytic epidemiology?
analyzes descriptive data, generates a hypothesis of why the disease might be occurring in the community, and then tests the hypothesis.
Which term most accurately describes the primary focus of public health nursing interventions? a) Disenfranchised groups b) Families c) Individuals at risk d) Populations
d) Populations
Which concept best encompasses all areas of nursing practice outside the acute care setting? a) Outpatient Clinic Nursing b) Community-based nursing c) Community health nursing d) Public health nursing
c) Community health nursing
What is the primary goal of health care professionals who specialize in epidemiology? a) Track the incidence and prevalence of communicable disease to identify vulnerable groups b)Improve morbidity and mortality rates by identifying patterns of disease c) Establish programs to prevent the development of disease and control its spread d) Design strategies to monitor the effectiveness of treatment on limiting the prevalence of disease
c) Establish programs to prevent the development of disease and control its spread
What is descriptive epidemiology?
consists of studies that are conducted once a disease is evident. -Data collected describe the time and place of occurrence of the disease and the characteristics of people affected by the disease.
What is Secondary prevention? Give examples
focuses on identifying an illness or phenomenon and limiting its impact or recurrence through specific interventions. Examples include: -blood pressure screening for older adults -toxin screening for migrant workers who may be exposed to pesticides -screening for exposure to domestic violence -training nurses in recognition of signs of child abuse
What is primary prevention? Give examples
interventions designed to prevent disease or disability. Examples include: -food banks offering healthy food options for -low-income populations -employee wellness programs -fitness classes -smoking cessation programs
What is tertiary prevention? Give examples
interventions for those populations already experiencing symptoms of disease or disability. Tertiary care focuses on maintenance or restoration of health, and rehabilitation. Examples include: -cancer patient support groups -pain management counseling -cardiac rehabilitation programs -workplace modifications for disabled workers
What are vulnerable populations?
target populations at high risk for health problems.
What does public health nursing examine?
the greater community as a whole—the city, county, state, nation, continent, world—
What is public health nursing's goal?
to design collaborative and interdisciplinary strategies to keep the population healthy by preventing or controlling disease and threats to human health.