Ch. 7 Care of Specific Populations Flashcards
Health Disparities
can be linked to gender, ethnicity, race, education, and income differences
Healthy People has a goal to eliminate disparities to achieve health equity
National Health Goals
goals to address for vulnerable populations include following;
- increasing the number of people who have a routine primary. care provider
- increasing the number of people who have insurance
- reducing number of people who are unable to access, or have a delay in accessing, health care services and prescribed medications
- reducing the number of people who have disabilities who report physical barriers to accessing health and wellness programs in the community
Violence;
Homicide
often r/t substance use
most by someone known to the victim and during arguments
violence often precedes homicide within families
rates are increasing among adolescents than other age groups
Violence;
Assault
- males are more likely than females to be assaulted
- youths are at a significantly increased risk
Violence;
Rape
often unreported
most incidences are spousal or acquaintance (date) rape
females more likely than males to get raped.
risk are increased in cities between 8 p.m. and 2 a.m. on the weekends, and in the summer months
Violence;
Suicide
per CDC- highest among individuals 45 to 64
- females more likely to attempt, males more likely to complete
- caucasians are more likely than other ethnic groups to commit suicide
risk factors include depression/ mental health disorders, substance use, having access to a firearm, partner violence or neglect issues
Violence
physical
sexual
emotional
neglect
neglect
failure to provide the following
- physical care (food, shelter, hygiene)
- emotional care
- education
- needed health or dental care
Social and Community Violence Risk Factors
-work stress
-unemployment
-media exposure to violence
-crowded living conditions
-poverty
-feelings of powerlessness
-social isolation
-lack of community resources (playgrounds, parks, theaters)
individual risk factors for violence
< Hx being abused or exposure to violence
< low self-esteem
< fear and distrust of others
< poor self-control
< inadequate social skills
< minimal social support/ isolation
< immature motivation for marriage or childbearing
< weak coping skills
Secondary Prevention for violence
- identify and screen those at risk
- assess and eval. any unexplained bruises/ injuries
- screen all pregnant women for potential abuse
- refer sexual assault/ rape survivors for assessment by a sexual assault abuse team
- assess and counsel anyone contemplating suicide/ homicide and refer
- support and educate the offender, even though a report must be made
- assess and help offenders address and deal with stressors
- alert all involved about available resources
- advocate for legislation designed to assist older adult independence and to ^ fundings for programs to low-icome/ at-risk
substance dependence
a pattern of pathological, compulsive use of substances and involves physiological psychological dependence
Cardinal indicators of dependence
include manifestations of tolerance and withdrawal
Denial is also a primary indicator;
- defensiveness
- lying about use
- minimizing use
- blaming/ rationalizing use
- intellectualizing
- “going with the flow”
Health problems with substance abuse
alcohol, tobacco, and other substances
- low birth weight
-congenital abnormalities
- accidents
- homicides
- suicides
- chronic diseases
- violence
- disability
Factors influencing the way the body processes alcohol
- size and weight
- sex
- carbonation (increase absorption)
- time elapsed during alcohol consumption
- food in the stomach
- drinker’s emotional state
- type of alcohol
alcohol withdrawal
manifestations appear within 4 to 12 hr
important to know when the last drink was ingested
manifestations of withdrawal
- irritability
- tremors
- nausea
- vomitting
- headaches
- diaphoresis
- anxiety
- sleep disturbances
- tachycardia
- ^ BP
tobacco use
Cigarette smoking results in deep inhalation of smoke, which poses the greatest health risk (cancer, CVD, resp. disease)
Cigars, pipes, and smokeless tobacco increase the risk of cancers of the lips, mouth, and throat
Passive smoking- resp. disease, lung cancer
stimulants
caffeine, amphetamines, methamphetamines, cocaine
depressants
barbiturates, benzos, chloral hydrate, GHB
Opiates
morphine, heroin, codeine, fentanyl
Hallucinogens (psychedelics)
produce anxiety, paranoia, impaired judgment, and hallucinations.
ex. lysergic acid diethylamide (LSD), phencyclidine (PCP), MDMA (ecstasy)
inhalants
acute cardiac dysrhythmias or asphyxiation can occur
Improving mental health
secondary prevention
- screen to detect mental health disorders
- work directly with at-risk individuals, families, and groups through formation of a therapeutic relationship
- conduct crisis intervention
vhealth issues of homeless populations
- URD
- TB
- skin disorders
- substance use disorders
- HIV/AIDS
- trauma
- mental health disorders
- dental caries
- hypothermia and heat-related illnesses from environment
- malnutrition
Health status of rural residents
higher infant and maternal morbidity rates
higher rates of DM
higher rates of obesity
less likely to meet physical activity recommendations
higher rates of suicide
^ trauma/ injuries from lightning: farm machinery; drowning and boating; snowmobile, all terrain vehicle, motorcycle crashes
^ occupational- associated risks (agriculture, fishing, mining, construction are most dangerous)
less likely to seek preventative care
^ risk for skin cancer
higher rates of resp. complications from exposure to pesticides and chemicals
risk for stress-related health problems and poorer mental health
barriers to health care in rural areas
distance from services
lack of personal/ public transportation
unpredictable weather or travel conditions
inability to pay for care
shortage of rural hospitals/ hc providers
priority needs for rural health
- cancer prevention and care
- mental hc
- substance use prevention and tx
- immunization programs
- family planning
health problems of migrant workers
- dental disease
- TB
- chronic conditions
- stress, anxiety, and other mental health concerns
- leukemia
- iron deficiency anemia
- stomach, uterine, and cervical cancers
- lack of prenatal care
- higher infant mortality rates
- STIs, HIV/AIDS
- pesticide exposure!!!
Pesticide exposure
subjective findings
> headache
dizziness
dyspnea
nausea
abd. cramps
poor concentration
eye irritation
Pesticide exposure
objective findings
- confusion
- irritability
- muscle weakness and twitching
- nasopharyngeal irritation
- vomiting
- rash
Pesticide exposure complications
! cancer
! reproductive problems
! Parkinson’s disease
! liver damage
! behavioral issues
secondary exposure from contaminated clothing can affect fetal development in pregnant women
Veteran Health issues
mental health
substance use disorders
suicide
infectious disease
exposures to herbicides, chemicals, radiation
TBI
spinal cord injuries
traumatic amputations
cold injury
military sexual trauma
hearing impairments
visual impairments
American with Disabilities Act
one of the first legislation to promote rights for individuals who have a disability
Individuals with Disabilities Education Act (IDEA)
promotes rights of children with disabilities
ensures free public education and accommodation to prepare child for independent living, assists with funding of education, and evaluates the effectiveness of the education
Immigrants
only eligible for immunizations, school lunch, tx for communicable disease, and emergency care
Refugees
eligible for TANF, Medicaid, and supplemental security income
Federal Bureau of Prisons (Department of Justice)
regulates HC for inmates
National Health Goals
sexual or gender minorities
- ^ survey and monitoring systems that include standardized questions to allow individuals to identify sexual or gender preference
- reduce adolescent bullying
- ^ health insurance coverage
- reduce the proportion of persons who experience major depressive episodes
- reduce adult tobacco and illicit drug use
- ^ the number of individuals who have a routine health care provider
Nursing Actions
sexual or gender minorities
- advocates increasing access to care
- support the development or maintenance of healthy families
- provide opportunities and safe environments for clients to discuss care concerns
