Community Health Exam #3

What is the following community resource: WIC (Women, Infants and Children)

Aims to safeguard the health of low-income women, infants, and children up to age 5 who are at nutrition risk by providing nutritious foods to supplement diets, information on healthy eating, and referrals to health care.

What is a method to prevent and treat HIV?

Preexposure prophylaxis (PrEP)

Describe the following change model: Transtheoretical model

Has 6 stages: - pre-contemplation - contemplation - preparation - action - maintenance - the person terminates the change process b/c they are able to continue the behavior assesses an individual's readiness to act on a new healthier behavior. My role is to assess what stage my client is at and provide strategies or education to nudge them into the next level

Why is surveillance done?

Helps us track: - chronic disease - injuries - communicable diseases - animal diseases Help us identify trends, set priorities, develop and evaluate programs. As well as monitor changes and estimate magnitude of issues and guide the public.

When teaching remember: - the easiest thing to change is knowledge - changing attitude is the next step - the most difficult thing to change is __________________

behavior

Diacytel is a chemical found in flavored vapes what can it do to the lungs?

can effect lung capacity and eventually lead to a disease called 'popcorn lung'

carrier state

colonization without apparent disease but can often spread disease

Alcohol, tobacco, and other drugs (ATOD):

current phrase that is a reminder that the leading drug problems involve alcohol and tobacco.

Psychoactive drugs are drugs that affect mood, perception, and thought. How are these drugs categorized?

divided into categories according to their effect on the CNS and the general feelings or experiences the drugs may induce.

What isolation is needed for the following: Influenza

droplet precautions (vaccine available)

What isolation is needed for the following: Pertussis (Whooping cough)

droplet precautions (violent coughing, can break ribs, vaccine avalible)

What are the effects and concerns or the following drug/ drug category: Stimulants

effects: drugs that increase activity of the CNS causing wakefulness

What are the effects and concerns or the following drug/ drug category: Depressants

effects: reduce the activity of the CNS concerns: higher doses can lead to come and potential death

motivational interviewing

encouraging people to get over their ambivalence about changing behavior ("hard working twin sister of therapeutic communication")

The epidemiologic triad contains: - Agent - Host - _________________

environment

define the following magnitude term: pandemic

epidemic spread over several countries or continents

define the following pattern of occurrence: intermittent source / continuous source

exposed over periods of days or weeks (EX- well water, continuously bad restaurant)

T or F: by definition human trafficking is the same as illegal immigration

false

The substance abuser is not only at risk for personal health problems but also may be a threat to the health and safety of ____________, coworkers, and other members of the community.

family members

Passive immunity (both natural and artifical)

given antibodies (immune goblins (while developing acquired immunity from vaccine) or vertical from mother to infant does not last long, weeks to months

virulence

he ability of an infectious agent to cause severe disease

Families with strengths, functional families, and balanced families are terms often used to refer to ___________ families that are doing well.

healthy

Routine voluntary HIV testing recommends for adults ages 13 to 64 at least once, more often for those in ___________groups

high-risk (HIV antibody test - offered in many locations)

define the following magnitude term: holoendemic

highly prevalent problem commonly acquired early in life. Prevalence decreases as age increases

Indirect contact transmission is accomplished by fomites, what are fomites?

inanimate (non-living) objects that I can touch and then someone else can touch

Zoonoses diseases

infection that is transmitted from vertebrate animal to human

How do we interview patients we suspect are struggling with intimate partner violence?

interview them ALONE

Family health risk reduction involves building a relationship, empowering the families and use of contracts. What is contracting with families?

involves a shift in responsibility and control toward a shared effort by client and professional, rather than by the professional alone.

define the following magnitude term: sporadic

irregular pattern with occasional cases found at irregular intervals (ie. Rocky Mountain Spotted Fever in Colorado, Hantavirus in Colorado)

isolation vs. quarantine

isolation: separation if ILL people from those whoa re healthy quarantine: separation of currently healthy people who have been exposed and may become infections (separated from everyone who wasn't also exposed)

Cocaine interacts with dopamine which seems to be the addictive factor. What population is the biggest users?

males 18 - 25 years old (life expectancy is 44 years)

colonization

means that the pathogen is present in the host

The anthro-pod vector born disease zika can cause fever, malaise, pain and rash occurring within several days to a week. What is the concern with pregnant women who contract zika?

microcephaly

What is a main concern when a pregnancy woman contracts Zika?

microcephaly

define the following magnitude term: epidemic (outbreak)

occurrence within an area is clearly in excess of expected levels (endemic) (ie. RSV, measles)

define the following pattern of occurrence: common source

one in which a group of persons are all exposed to an infectious agent or a toxin from the same source.

Acquired immunity

our immune system has to do the work of developing antibodies. happens through exposure or immunization long-lasting and sometimes life-long

define the following magnitude term: Endemic

persistent usual presence with low to moderate number of cases (ie. STDs, Botulism in Alaska)

define the following magnitude term: hyperendemic

persistently high number (ie. cholera in pacific islanders, influenza in the United States)

Drug dependence:

physiological change in the central nervous system as a result of chronic drug use.

Why does abuse/violence happen?

power and control

Case definitions

provides understanding of the data that are being collected and reduces the likelihood that different criteria will be used for reporting similar cases of a disease. (each disease has its own unique set of criteria: symptoms, lab values, etc).

Traffickers do not usually use physical restraints to retain their victims. The "chains" they use are often _________________.

psychological.

Depending on the dose of the inhalant, the user may feel a slight stimulation, less inhibition, or even lose consciousness. The user can get high several times in a short period due inhalants being short-acting with _______________________-.

rapid onset

What is a harm reduction approach?

refers to policies, programs, and practices that aim to minimize negative health, social, and legal impacts associated with drug use, drug policies, and drug laws - focuses on non-judgement and is grounded in justice and human rights

protective isolation

reverse isolation used for immunocompromised patients gloves, gown and mask, and hand washing

What is the antigenic drift with the influenza?

small mutations and changes in the surface proteins of influenza viruses This is why we have to redo the influenza vaccine each year. If it changes quickly, it can result in a poor match-the vaccine, by the time the virus gets to the US

Vaping is widely popular and is marketed as ______________.

smoking cessation devices

Natural immunity

species-specific resistance to diseases of other species ie. can't get a cat disease because I am not a cat - Some diseases can cross species, meaning that we do not have natural immunity for every disease.

define the following pattern of occurrence: propagated outbreak

spreads person to person over more than 1 incubation period (EX Measles- but spread to family)

Nicotine, cocaine. caffeine (including energy drinks) and amphetamines are considered what category of drugs?

stimulants

What is an example of self-directed violence?

suicide

When a nurse is a teacher they combine the roles or teacher and motivator. What actions fo nurses take in these roles?

teacher: Provide knowledge and demonstrate needed skills motivator: having a positive attitude, listening to patient needs, encouraging, rewarding, and giving of their TIME. When we show others that we value the information that we are giving, it frequently increases their motivation factor.

viral load

the amount of virus in an infected person's blood

index case

the first case identified in a population

Since caregiver stress is a major risk for abuse, what should the nurse do?

the nurse should address this issue with caregivers on a regular basis as a way to prevent abuse from occurring

herd immunity

the resistance of a community or population to the invasion and spread of an infectious agent, based on high proportions of immunity in people in the community Some people, such as infants, those with allergies to vaccines and the immunocompromised rely on herd immunity to keep them safe 85-95% of the population needs to be immune to prevent the majority of diseases from spreading

Why do we use "intimate partner violence" instead of "spouse abuse, wife abuse or domestic violence"?

the term is more inclusive

Incubation period of communicable disease

time delay between exposure to a pathogen and the onset of signs and symptoms of the disease

lyme disease

transmitted by ixodid ticks that are associated with the white-tailed deer and the white-footed mouse. This disease typically occurs in summer during tick season

T or F: Chronic use of hallucinogens can lead to psychological effects and impaired judgment which can then lead to dangerous decisions or accidents.

true

T or F: Every culture has beliefs and attitudes toward ATOD. These attitudes are influenced by the way society categorizes drugs as either "good" or "bad."

true

T or F: Family is seen as one of many institutions in society

true

T or F: Nicotine acts both as a depressant and a stimulant.

true

T or F: Substance abuse is the number-one national health problem, causing more deaths, illnesses, and disabilities than any other health condition.

true

T or F: any drug can be abused

true

T or F: rubella is a preventable disease by vaccination

true

T or F: their is no cure for Herpes (HSV-2)

true

t or f: smallpox vaccine is effective even after exposure

true

t or f: some vapes contain formaldehyde

true

t or f: suceptibility to small pox is 100% if unvaccinated

true

HIV is confirmed with what type of test?

Western Blot test

Describe the following change model: Health Belief Model

What it basically says is that adults are motivated to change their BEHAVIOR by evaluating the following BELIEFS: - Perceived Susceptibility-"Will something happen to me?" - Perceived Severity-"If something does happen to me, will it be a big problem?" - Perceived Benefits-"If I do what is suggested, will it really help me?" - Perceived Barriers- " Will the barriers be costly or unpleasant?" - Cues to Action-"What might motivate me to actually do something?" - Self-efficacy-"Can I really do this?"

T or F: Hepatitis B and C can lead to liver cancer

true (Hep A does not, however Hep A and B have a vaccine, Hep C doesn't)

T or F: infectious disease can be used as a means of terrorism.

true (future concern)

T or F: 60% of human infections are zoonoses

true (ie. HIV, SARS, COVID19)

T or f: amphetamines are similar to cocaine but the effects last longer and drugs are cheaper

true (methamphetamines are easy to make) (similar chemical structure to adrenaline)

T or F: Side-stream smoke has higher concentrations of nicotine and cancer-causing agents (carcinogens) than mainstream smoke

true (side-stream is second-hand smoke)

T or F: worldwide concern about infectious diseases has increased with the growth of migration.

true As people move from one place to another they bring their diseases, levels of immunity and resistance to diseases, and the viruses or bacteria they may harbor that have not emerged as diseases in them.

T or F: Om the 1900s communicable diseases were the leading causes of death in the United States.

true By 2000, improved nutrition, sanitation, vaccines, and antibiotics had put an end to the epidemics that once ravaged entire populations.

T or F: TANF benefit levels are low and do not enable families to meet their basic needs.

true In almost every state, they leave a family of three below half the poverty line.

T or F: 30% of abused children will abuse their own children

true abuse is a cycle - may associate love with abuse

T or F: Antibiotics can cure bacterial STDs but cannot reverse the long-term damage.

true chlamydia gonorrhea syphilis trichomoniasis

T or F: inhalants are often the first drug used by young children.

true common household chemicals

T or F: all families have strengths and difficulties

true families are neither all good nor all bad, nurses need to view family behavior on a continuum of need for intervention

T or F: smoking is the foremost preventable cause of death in the US.

true leads to CV and Resp disease

T or F: vaccination is important even if the patient is HPV+

true probably not exposed to all strains covered by vaccine

T or F: Hepatitis C is the most common chronic blood-borne infection in the US

true spread through blood or bodily fluids

T or F: Motivational Interviewing is not about advice, but about partnering with a client to find out why they are ambivalent about change

true the nurse acts as a change agent and gives information and support

T or F: the fatality rate for inhalation anthrax is 80%

true treatment is 60 days of antibiotics if infected)

Substance abuse:

use of any substance that threatens a person's health or impairs his or her social or economic functioning.

define the following pattern of occurrence: mixed outbreak

victim of common source spreads disease further propagating the health problem (EX- Salmonella from lettuce- spreads to kid)

Evaluation is fluid and on-going, it requires us to compare what actually happened to ________________________-.

what we hoped would happen

When and how to investigate (surveillance)?

when: unusual increase how: - Confirm the existence of outbreak - Verify diagnosis - Estimate number of cases - Orient the data - person, place & time - Develop a hypothesis - Institute control measures

Describe the following occurrence of disease in populations: pandemic disease

worldwide epidemic Pandemics happen when epidemics occur at various places around the world at the same time.

Marijuana is the most widely used illicit drug in the U.S. Can psychological dependence occur?

yes (little quality control and little known about potential physical dependence)

explain the following type of child neglect: psychological or emotional neglect

Withholding affection, or extreme indifference or inattention for long periods of time.

What are some social and community factors that increase the likelihood of an individual becoming a victim or perpetrator of violence?

Work Education Income Substance use Mental Health History of abuse (including witnessing)

active vs passive immunity Active= activating the immune system (sick or vaccine) Passive=__________________________________

a gift of antibodies (breastmilk or IVIG)

Drug addiction:

a pattern of abuse characterized by an overwhelming preoccupation with the use (compulsive use) of a drug, securing its supply, and a high tendency for relapse if the drug is removed.

what is workplace violence?

any physical assault, threatening behavior, or verbal abuse occurring in the work setting

What is the top risk factor for homicide in intimate partner violence?

attempts to leave by the victim

What is the order we don PPE?

1. gown 2. mask 3. goggles 4. gloves

1 out of ______ rape victims are male

10

A bull's-eye lesion with fever, malaise, aches and enlarged lymph nodes is seen in stage 1 of which vector-borne disease?

Lyme disease (ticks = carrier)

child neglect

failure to meet a child's basic needs

T or F: For some diseases the latent period is less than the incubation, and infected persons can be contagious before we have symptoms to use as a clue.

true

What is an example of interpersonal violence?

- Community violence - Intimate partner violence - Sexual violence

What is the (step-by-step) public health approach to violence prevention?

1. Identify the problem: Collect data to determine the "who", "what", where", 'when,' and "how". This is an epidemiological approach. 2. Identify the risk factors. Why do one person or one community experience violence, and another does not? 3. Develop and test prevention strategies and share this information with others. 4. Disseminate and implement the strategies in step 3.

What are some concerns we have for intimate partner violence during pregnancy?

For mother: - STDs (condom refusal) - spontaneous abortion or premature delivery - depression - substance abuse For infant: - spontaneous abortion - premature - low birth weight - SGA - drug exposure in utero

By 2000, improved nutrition, sanitation, vaccines, and antibiotics had put an end to the epidemics that once ravaged entire populations. What replaced communicable diseases as the leading cause of death in the United States?

chronic disease

Is the following droplet or airborne transmission: - travel < 5 feet through the air - droplets produced during coughing, sneezing, talking, exchanging spit - droplets NOT suspended in the air - land on mucous membranes of eyes, nose, mouth or hands that put to mucous membrane - examples: influenza, pertussis, meningococcal meningitis

droplet transmission

Is the following droplet or airborne transmission: influenza, pertussis, meningococcal meningitis

droplet transmission

Elder abuse can be similar to other types of abuse: physical, sexual, emotional, and neglect. What is another type of abuse no listed above that can be a major problem for the elder population?

financial abuse (money, stocks/bonds, assets) (by force, threat, fraud or coercion)

Intimate partner violence is driven by power, control and _____________.

jealousy

explain the following type of child neglect: physical neglect

lack of adequate nutrition or housing, abandonment or being left unsupervised

explain the following type of child neglect: medical neglect

not providing appropriate medical care

Violence is the leading cause of death and disability that disproportionally affects youth, low-income populations, and ________________________.

people of color.

There are several societal factors that influence rates of violence, these include factors that: - contribute to a culture that accepts violence - those that reduce inhibitions against violence - ______________________________________________________

those that both create and perpetuate disparities between different segments of society

Latent period of communicable disease

time delay between one being exposed and the onset of contagiousness (when they are able to spread the pathogen to others)

T or F: Adolescents are more likely to engage in violent behavior when their peers accept this behavior.

true

T or F: HIV/AIDS have become on of the world's greatest public health challenges.

true

T or F: Risk for violence is increased when a woman and one or more children live with an abuser.

true

T or F: Significant mortality and morbidity result from violence.

true

T or F: adolescents are 3.5x more likely to experiences rape

true

T or F: anyone can become a victim of human trafficking given the right situation and power dynamics.

true

T or F: as violence escalates the abuser's remorse lessens

true

T or F: being abused or seeing abuse causes profound changes in the nervous and immune systems

true

T or F: children view violence as a way to solve problems

true

T or F: over half of rape victims know their perpetrator

true

T or F: rabies is almost universally fatal

true

T or F: suicide is the second leading cause of death in 10 - 34 year olds

true

T or F: west nile virus in children is often asymptomatic

true

T or F: 1 in 6 women have been been the victim of an attempted or completed rape in her lifetime.

true (1 in 7 hispanic women)

to prevent lyme disease you should prevent exposure to ticks and use DEET. What age group should not use DEET products?

under 2 years

explain the following type of child neglect: educational neglect

unexcused absences missing too much school (skipping or not enrolled). Controversial case by case basis-not providing special help to a child that needs it, if it is available and affordable

What is the following type of surveillance system: international surveillance

- At the international level the WHO maintains surveillance of important diseases - Gives timely warning to national governments - Works across borders

Health risks are any factors that increase the chance of disease or injury. Health risks for families can be:

- Biological or age-related-can impact a family by costs, caregiving strain, parenting concerns or unmet needs - Environmental-housing, neighborhood, occupational risks - Behavioral- nutrition, exercise, safe sex practice - Genetics - Life events (illness, birth of a new baby)

Infection vs. intoxication (foodborne disease)

- Infection: occurs when live bacterial cells are ingested. These bacterial cells can then grow in the digestive tract and cause symptoms. An example of a bacterial infection is Salmonella infection. - Intoxication: occurs from eating a food that contains a toxin produced by bacteria.

What are the goals for harm reduction?

- Keeping people alive and encouraging positive change in their lives - Reducing the harms of drug laws and policy - Offering alternatives to approaches that seek to prevent or end drug use - Preventing diseases such as HIV and hepatitis among users - "Meeting people where they are" - Have a strong positive impact on community health

What is the following type of surveillance system: active system

- Local or state health departments, or hospitals, actively search for cases - involve regular outreach to potential reporters to stimulate the reporting of specific diseases or injuries.. Many disease investigations require active surveillance - ie. STI tracking, food borne outbreaks, TB contacts

What is the following type of surveillance system: special system

- May be a combination of active, passive, or sentinel systems - ie. Syndromic surveillance systems (used to detect bioterrorism). (Syndromic surveillance focuses on the signs and symptoms of an illness rather than physician-diagnosed or laboratory-confirmed illnesses.) - collecting particular types of data

What is the following community resource: SSI (Supplemental Security Income)

- Minimum basic financial assistance to older adults and persons with disabilities (regardless of age or work history) with very limited income - Pays Benefits based on financial need

At al levels of prevention the nurse functions are what roles?

- counselor - educator (safe sex and drug use) - advocate - case manager - community outreach

Anthrax incubation can be up to a week (spores stay alive for 60 days), what are some s/s of anthrax exposure?

- cutaneous, GI and respiratory changes - fever - shortness of breath - cough

Examples of anthropod-borne viral infections:

- dengue - west nile - chikungunya - zika

Tertiary intervention strategies for drugs and alcohol

- detox - addiction treatment - smoking cessation programs - support groups (AA< NA, gambling anonymous, etc)

When it comes to disease prevention what are the nurses roles?

- education - vaccination - investigation

Examples of how motivational interviewing and therapeutic communication differ:

- explore ambivalence to change - use scaling questions and readiness to change rulers - develop a discrepancy between where they are now and where they would be if they made a change

Family demographics can be analyzed by looking at data about the families and household structures and the events that alter these structures. Nurses draw on family demographic data to forecast and predict family community needs, such as:

- family developmental changes - stresses - ethnic issues affecting family health

What is the following community resource: SNAP (Food Stamps)

- federal nutrition program based on financial need - cannot buy beer, wine, tobacco, vitamins, non-food items (ie. pet food)

Caffeine is one of the most widely used psychoactive drugs in the world found in coffee, tea, soft drinks and various medications. High doses can lead to what?

- health effects - withdrawal symptoms

What are some principles of disease prevention?

- immunization - health education - sanitation - notification - diagnosis - investigation - lock transmission - treatment - isolation - quarantine

How is anthrax spread?

- in soil - handling infected animals NOT spread human to human

What factors place youth at risk for STIs?

- insufficient screening - confidentiality concerns - biology - lack of access to healthcare - multiple sex partners

Nurses role in ATOD care?

- know resources - help create programs

Contributing factors that contribute to the substance abuse problem include:

- lack of knowledge about the use of drugs; - the labeling of certain drugs (alcohol, nicotine, and caffeine) as non-drugs; - lack of quality control of illegal drugs; - drug laws that label certain drug users as criminals.

What is the following community resource: Temporary Assistance to Needy Families (TANF)

- limit 5 years - helps families with rent, education, transportation - work requirement - employment and training services - case management support - managed by federal funds but differs by state

Describe the following change model: Health Promotion Model

- looks at prior related behavior (such as perceived barriers, self-efficacy) as well as personal factors (such as interpersonal influences and situational influences) in hopes to lead to health promoting behavior

How is TB diagnosed?

- medical history - physical exam - chest x-ray - acid-fast bacilli in sputum

strengths of motivational interviewing

- non-confrontational - supported by research - successful in brief sessions and with high-risk populations - anyone can learn and use it

Continuous stress has negative effects on what (when talking about families):

- physical and mental health - family communication - positive growth (tendency to get "stuck") - potential for abuse - child development and education

Primary intervention strategies for drugs and alcohol

- promote healthy lifestyle and resilience factors (decision making, etc.) - drug education (no drug is completely safe, any drug can be abused, lead to informed decisions to minimize potential harm).

what needs to be assessed for in order to develop an appropriate education session for the patient?

- readiness to learn - motivators - cultural considerations - barriers

What is the following type of surveillance system: passive system

- relies on passive reporting (simple and inexpensive) - Case reports are sent to local health departments - Local health departments analyze the data and then pass it on the state health department, and it eventually gets to the CDC - The majority of surveillance systems are passive

examples of reflective listening

- repeating - rephrasing - reframing - amplified reflection NOT assuming you know what was said

s/s of smallpox

- sudden onset fever - rash starts as small red spots on the tongue and in mouth and spreads to all body parts in 24 hours - lesion ae all at the same stage in all areas

Rabies is a zoonoses disease that is 100% fatal if untreated. When should treatment begin and how many doses does the patient receive?

- treatment must begin immediately post-exposure - receives 4 doses post-exposure - (dogs and cats should be vaccinated, recieve medical care after all bites)

Heroin is the most often recreationally used opioid. Serious complications can results due to:

- unsanitary administration of the drug - complications due to overdose - intoxication it can cause (tolerance and physical dependance develops quickly - 37 year life expectancy)

What is an example of a vector borne transmission?

- west nile virus - malaria - zika virus - rocky mountain spotted fever - lyme disease

What is a family crisis?

- when a family lacks or loses the ability to cope with a specific event or multiple events and becomes disorganized or dysfunctional - when the demands of the situation exceed the resources of the family

What populations are at higher risk of acquiring an STD?

- young people (15-24) - gay and bisexual men - pregnant women

What is the order we doff PPE?

1. Gloves 2. Goggles 3. Gown 4. Mask (Alphabetical order)

An HIV antibody test may not be a true negative because it takes 6 - ___ weeks before evidence of HIV antibody.

12

examples of motivational statements:

4 types: - Cognitive Recognition of the problem (e.g., "I guess this is more serious than I thought.") - Affective Expression of concern about the perceived problem (e.g., "I'm really worried about what is happening to me.") - A Direct or Implicit Intention to change behavior (e.g., "I've got to do something about this.") - Optimism about one's ability to change (e.g., "I know that if I try, I can really do it.")

What are some examples of harm reduction services and practices?

- Needle and syringe exchange programs - Drug consumption rooms -Non-abstinence-based housing and employment opportunities - Drug checking - Overdose prevention and reversal - Psychosocial support - Provision of education and information on safer drug use

Reporting to the WHO is required for internationally notifiable diseases such as:

- Smallpox - Poliomyelitis (wild type) - Human influenza caused by any new subtype - Severe acute respiratory syndrome (SARS) - Ebola

What is the following community resource: SSD (Social Security Disability)

- Social Security Disability Insurance (SSDI) supports individuals who are disabled and have a qualifying work history - Pays benefits if you worked long enough and paid social security taxes

What is the following type of surveillance system: sentinel system

- Surveillance in those populations that will get sick the soonest or have the highest possible exposure - Allows for earliest detection of disease - Selected institutions or individuals provide regular reports or are encouraged to obtain more testing - Sentinels can be either a location, institution or a group of people (or animals)

What is surveillance and who does it?

- Surveillance is the ongoing systematic collection, analysis, interpretation and dissemination of specific health data for public use - Hospitals and clinics can perform surveillance to improve their quality of care and health outcomes It is important for nurses to be prepared to lead and be a team member if an unusual occurrence or event strikes a community. - State and local "police powers" make this possible.

What is the following community resource: FMLA (policy)

- This act allows covered employees to take up to 12 weeks of leave each year for certain family and medical reasons. - Many states have added more leave time and benefits for employees in their state. - Under the FMLA, employees may take an unpaid leave of absence for many reasons: for their own serious illness; for the illness of their child, parent, or spouse; and for the birth or adoption of a child. - Keeps medical benefits while off.

For which diseases or health conditions should we design a surveillance system?

- Those that cause severe health consequences - Those that cause a lot of health consequences - Those where action can be taken to improve health - Those where data is easily available

What are some problems with electronic nicotine delivery systems?

- Unregulated - Appeal to youth - Changing social norms - making smoking more acceptable - Can cause nicotine addiction - Lack data re: health effects long term

rocky mountain spotted fever

- a serious tickborne illness which can be deadly if not treated early. It is spread by several species of ticks in the United States - seldom seen in the rocky mountiains

Explain the following learning domain: psychomotor learning

- acquiring a new physical skill - neuromuscular coordination and motor skills - first demonstrate, then practice

Explain the following learning domain: cognitive learning

- acquiring new knowledge - includes: memory, recognition, reasoning, understanding, application and problem solving - first step: assess cognitive abilities

Secondary intervention strategies for drugs and alcohol

- assess for ATOD problem (truthfulness may be an issue) - drug testing

What is some of the HIV test counseling RN's do?

- assess risk - discuss risk behavior and how to avoid - develop risk-reduction plan with patient - establish follow-up appointment and posttest counseling - educate on partner notification and contact tracing

Explain the following learning domain: Affective learning

- attitude changes and development of values - focus on emotions and values ( nurses values and attitudes may differ), difficult to change because deeply rooted

E. coli

- bacteria normally live in the intestines of healthy people and animals, and most types are harmless or cause brief diarrhea. - can cause severe stomach cramps, bloody diarrhea, and vomiting. It is most often caused by contaminated water or food such as raw vegetables, undercooked ground beef, unpasteurized milk, and some fresh produce such as spinach. - There is often person-to-person transmission in daycare centers, homes, and institutions. - Outbreaks also have been associated with petting zoos

Salmonellosis

- bacterial disease that affects the intestinal tract - Humans are most often infected through contaminated water or food such as that which is eaten raw or is undercooked

What are some sources of data for health surveillance?

- cases reported by clinicians, healthcare agencies and laboratories to state health departments. - mortality data - morbidity data

For all people over 4 years old with no risk factors for TB a TB test is positive if he induration is equal to or more than ____mm.

15 mm (10mm if under 4 or inject drugs, 5mm if an organ recipient, immunosuppressed or close contact with positive TB patient)

About 1/3 of the world's population are affected with TB, about ____% of those exposed get active TB within 2 years of exposure.

50 (this is why we focus on close contacts)

A TB skin test (Mantoux test) is read 48 - ____ hours after injection.

72

what is the following mode of transmission and what are some examples: vertical transmission

= parent to offspring - example: birth canal, placenta, milk

What are some high-risk groups for drug and alcohol problems?

Adolescents Older adults Injection drug users Drug use during pregnancy Use of illicit drugs

Which of the following have a vaccine? a. HSV-2 b. HPV c. Hepatitis A d. Hepatitis B e. Hepatitis C

B, C, D

What is the following community resource: Voluntary programs

Examples: - American cancer society - American heart association - American lung association - muscular dystrophy association

T or F: HIV can be transmitted by casual hugging, touching, and through healthy, unbroken skin.

FALSE this is misinformation

T or F: Stimulants give the person more energy.

FALSE make the body expend its own energy sooner and in greater quantities

Treatment can improve the lives of many people living with viral STDS (but there is no cure). What are the viral STDS?

HIV Herpes HPV Hepatitis B

Are antiviral drugs a good substitute for influenza vaccination?

No

Hallucinogens are drugs that stimulate the nervous system and produce varied changes in perception and mood. What controls the patients response to these drugs?

Response to these drugs is related to the user's mood, basic emotional makeup and expectations, including the ability to cope with perceptual distortions, expectations and the immediate surroundings.

secondary case

Someone who is infected by a primary case

T or F: Only 9% of traffickers are strangers to the persons they traffic.

TRUE Family or friends of the family compose approximately 50% of traffickers.

ambivalence vs. resistance

ambivalence - wanting both of two opposite things (ie. wanting to do something and not do something simultaneously) resistance - avoidance, arguing, etc.

primary case

The person that brings the infection into a population

define the following pattern of occurrence: point source

all people became ill at one time during one incubation period - does not spread it though

when teaching different age groups how can we adapt to different ages: a. children b. adolescents c. adults

a. children: learn through play and experience b. adolescents: include view of peers, take into account development c. adults: internally motivated, must believe they need to learn before willing to, they want things to be relevant and useful immediately

When caring for clients with AIDS in the community what is important to educate managers about?

about how to deal with ill or infected workers to reduce the risk of breaching confidentiality or wrongful actions such as termination

What isolation is needed for the following: Measles

airborne )highly contagious, Koplik spots, vaccine available)

What is the oldest and most widely used psychoactive drug in the world?

alcohol

What are some signs and symptoms of child abuse?

- changes in physical appearance - difficulty in school - emotional neglect -etc.

Is the following droplet or airborne transmission: measles, chicken pox, TB, smallpox

Airborne transmission

Physical abuse

Any forceful or violent physical behavior.

tertiary case

Someone who is infected by a secondary case

What are some examples of direct contact transmission?

(all horizontal in pattern; person to person) - bite - kissing - touch - intercourse

common vehicle transmission

- Transmission via contaminated items ie. Food, water, blood, saliva, plasma - inanimate contaminated vehicle is taken into the body as opposed to fomites

what are some red flags that point towards financial abuse of an elder?

- changes in banking practices - "cashing in" on insurance policies or bank accounts - sudden failure to pay bills - unusual changes in wills and other legal documents - valuables missing from the home

Mandatory reporting may vary by state. What populations are we mandated to report in Colorado?

- children - seniors - developmentally disabled

What are reservoirs of infection?

- continual (or potential) sources of infection - human, animals or environmental (non-living) - In public health, we want to know about disease reservoirs because if we can eliminate a reservoir or diminish it's ability to carry infections, we can prevent the spread of disease. (ie. vaccines, spraying for mosquitos or cleaning the water supply).

How is HIV transmitted?

- exposure to blood, semen, vaginal secretions and breast milk - most often transmitted through sexual behaviors and needle or syringe use - rarely transmitted through accidental needle-stick injury, organ transplants and blood transfusions

What are some examples of portals of entry and exit?

- eyes, ears, mouth, nose - skin - digestive tract - fecal/oral - urinary tract - genital organs

What are some nursing interventions done to help abuse patients?

- form trusting relationship (not always easy) - safety is first priority - honesty and empowerment - know available resources - support the victims and their choices - focus on family strengths

What are some red flags to look for that can point to a patient being a human trafficking victim?

- inconsistent history - hesitant to answer questions - delays in care - lack of identification - dressed inappropriately - refusal to let the patient have privacy - evidence of a controlling relationship - not aware of their location, date or time - hostile behavior - avoids eye contact - unable to provide address - fearful or nervous - frequent texting if alone - appears in a hurry - not in control of own money - multiple sexual partners

What are 4 major causes of child abuse?

- intergenerational transmission of violence - social stress - social isolation and low community involvement - family structure (foster home, single parent, parents of parent)

Suicide rates are higher in what populations?

- men - American Indian - Alaskan natives - military - middle-aged men - rural residents

What populations are at high risk for HIV/AIDS?

- minorities - male-to-male sexual contact - transgender women

what is the following mode of transmission and what are some examples: horizontal transmission

- person to person - examples: STDs, lice

What are some signs of abuse in intimate partner violence?

- physical marks - low self-esteem - depression - PTSD

what are some cues that we can look for in the caregiver that may be a red flag for elder abuse?

- refusing to allow the nurse access to client - anger towards client - name calling towards the client

what is human trafficking?

- the severe exploitation of another person by means of force, fraud, or coercion for some kind of labor, including commercial sex.

What is a vector borne disease and who are common vectors?

- transmission through a living object carrier (not people) - common vectors: mosquitos, rodents, ticks

what children are at an increase risk of child abuse?

- under 4 years old - special needs children

Religion generally teaches nonviolent conflict resolution, however, historically a seemingly contradictory relationship exists between abuse and religion. What are some examples?

- victimization of women - male domination in some religions

What are some reasons that elder abuse is frequently underreported?

- victims are reluctant to report it - elders bruise easily (this can be misinterpreted) - elders are frequently socially isolated - many providers do not consider it or report it ( only 1 out of 14 cases come to the attention of authorities)

Factors that increase peoples' and communities' resilience to violence include: • Coordination of resources and support services among community agencies. • _____________________________________________________________________________ • Support and connectedness, including to one's community, family, peers, and school.

Access to mental health and substance abuse treatment services.

Is the following droplet or airborne transmission: - may disperse widely - inhaled into alveoli - small particles (droplet nuclei or dust) remain suspended in air (sometimes for a long time) - examples: measles, chicken pox, TB, smallpox

Airborne transmission (these particles are small enough to be inhaled deeply into the alveoli as opposed to droplet transmission

Sexual abuse

Any non-consenting sexual act or behavior.

Psychological abuse

Any threat to do bodily harm to a partner, a child, a family member, friends, pets, or one's self (suicide).

Why do we worry about infectious disease in community health?

Because Infectious diseases are acquired specifically and directly as a result of our behaviors and lifestyles

Dating violence is a cycle. When does it need to be stopped?

Before it starts in the dating period. (cycle = dating > IPV > child > elder)

Communicable period of communicable disease

CONTAGIOUS TIME - when a person to person transmission is possible

Describe the following occurrence of disease in populations: epidemic disease

Disease beyond normal expected rates in one region or community (Another way to say that is that the amount of disease is above the endemic level. - which is the constant present).

Describe the following occurrence of disease in populations: endemic disease

Disease constantly present in a population (or at least on a seasonal basis)

Describe the following occurrence of disease in populations: sporadic disease

Disease that occurs occasionally in a population

The primary infection (within 2-4 weeks) of HIV presents as flu-like symptoms, lasting days to weeks. Clinical latency (body shows no symptoms) without treatment 10-15 years. Many are unaware they have the infection. What is the final stage of the symptomatic disease and can patients transmit even without symptoms?

Final stage = AIDS If the viral load is detectable HIV can still be transmitted even without symptoms.

Emotional abuse

Includes hurting another person's feelings by saying cruel, unfair comments or by name calling.