CH Final exam Flashcards
Goals of Home Health Care
Maximize the client’s level of independence
Minimize the effects of existing disabilities
Decrease rehospitalization
Prevent or delay institutionalization
Types of Home Health Agencies
Voluntary nonprofit agencies, Hospital-based agencies, For-profit proprietary agencies
Medicare Home Health Eligibility
- The type of services and frequency provided must be reasonable and necessary
- The client must be homebound (must be confined to home except for visits to the physician, outpatient dialysis, adult day center, or outpatient chemotherapy and radiation therapy)
- The plan of care must be entered onto specific Medicare forms
- The client must be in need of a skilled service (restrictively defined and include select aspects of nursing, physical therapy, or speech therapy)
- Services must be intermittent and part-time
Home Health Nursing Practice
Locating the client
First step in making a home visit is finding where the client lives
Directions in rural areas may be unclear
Clients may not be staying in households designated in nurse’s paperwork
Always remember that you are a guest in the home
Respect and attentive listening are the foundation for establishing trust
Nurse must take into account the spiritual, cultural, developmental, environmental realms of the client
The client is the driver of care
nurse challenges in the home
infection control, medication safety, risk of falling, technology at home, nurse safety
advantages to home health nursing
Lower cost comparted to inpatient care Quality of life Self-care and independence, easier access to loved ones Restoration of family control of care Provide the nurse with information Improve access Positive outcomes
disadvantages to home health nursing
Nurse safety, travel time, less efficient
Family’s privacy
Distractions
Clients may be resistant or fearful of the intimacy of home visits
Out-of-pocket expenses
Negative impacts on family members
Components of a Home Visit
pre-visit, home visit, conclusion of visit, documentation
disaster
An event that causes human suffering and demands more resources than are available in the community
Can be naturally occurring, man-made, or a combination of both, such as a natural disaster causing technical failures
types of disasters
human made and natural made
examples of human made
Structural collapse, fire, or explosions
Terrorist attacks such as bombing, riots, and bioterrorism
Mass transportation accidents
example of natural disasters
Avalanches Blizzards Communicable disease epidemics Cyclones Droughts Earthquakes Floods Forest fires
level 1 of disaster
Massive disaster that involves significant damage and results in a presidential disaster declaration, with major federal involvement and full engagement of federal, regional, and national resources
level 2 of disaster
Moderate disaster that is likely to result in a presidential declaration of an emergency, with moderate federal assistance
level 3 of disaster
Minor disaster that involves a minimal level of damage, but could result in a presidential declaration of emergency
phases of disaster management
disaster prevention (mitigation), Disaster Preparedness, Disaster Response, and disaster recovery
Disaster Prevention (Mitigation)
Actions or measures that can prevent the occurrence of a disaster or reduce the damaging effects of a disaster
Disaster Preparedness
Disaster preparedness occurs at the national, state, and local levels.
Personal and family preparedness are crucial components of disaster preparedness, as is professional preparedness for individuals employed in civil service and health care.
This level of management includes preparedness for natural or man-made disasters.
Role of the Nurse: Disaster Planning
Develop a disaster response plan based on the most probable disaster threats
Identify the community disaster warning system, and communication center, and learning how to access it
Identify the community’s first responders’ disaster plan
Make a list of agencies that are available for the varying levels of disaster management at the local, state and national levels
Define the nursing roles in first-, second-, and third-level triage
Identify the specific roles of personnel involved in disaster response and the chain of command
Locate all equipment and supplies needed for disaster management, including hazmat suits, infectious control items, medical supplies, food, and potable (drinkable) water. Detail a plan to replenish this regularly.
Check equipment (including evacuation vehicles) regularly to ensure proper operation
Evaluate the efficiency, response time, and safety of disaster drills, mass casualty drills, and disaster plans
Role of the Nurse: Disaster Response
In the health care agency setting, if a disaster occurs, the agency disaster preparedness plan (emergency response plan) is activated immediately, and the nurse responds by following the directions identified in the plan
In the community setting, if the nurse is the first responder to a disaster, the nurse cares for the victims by attending to the victims with life-threatening problems first; when rescue workers arrive at the scene, immediate plans for triage should begin
Perform triage and direct those affected, coordinating evacuation, quarantine, and opening of shelters
Triaging involves identifying those who have serious verses minor injuries, prioritizing care of victims, and transferring those requiring immediate attention to medical facilities
Triage color
Red: (Emergent) Priority 1 (Highest)
Victims with life-threatening injures and need for immediate attention and continuous evaluation; high probability for survival when stabilized
Yellow: (Urgent) Priority 2
Victims who require treatment and whose injuries have complications that are not life-threatening, provided they are treated within 30 minutes to 2 hours
Green (Nonurgent) Priority 3
Victims with local injuries who do not have immediate complications and who can wait at least 2 hours for medical treatment
Black:
Expired or soon will be deceased; would not benefit from any care because of the severity of injuries
Role of the Nurse: Disaster Recovery
Make home visits and reassess the health care needs of the affected population.
Provide and coordinate are in shelters.
Provide stress counseling and assessing for PTSD or delayed stress reactions, and making referrals for psychological treatment.
Category A Biological Agents
High priority agents include organisms that pose a risk to national security because they:
Can be easily disseminated or transmitted from person to person
Result in high mortality rates and have the potential for major public health impact
Might cause public panic or social disruption
Require special action for public health preparedness
Category A Biological Agents examples
Anthrax Botulism Plague Smallpox Tularemia Viral hemorrhagic fevers (e.g., Ebola)
Category B Biological Agents
Second highest priority agents include those that:
Are moderately easy to disseminate
Result in moderate morbidity rates and low mortality rates
Require specific enhancements of CDC’s diagnostic capacity and enhanced disease surveillance
Category B Biological Agents examples
Brucellosis
Clostridium perfringens toxin
Food safety threats (Salmonella, E. coli O157:H7)
Q fever
Ricin toxin
Typhus fever
Viral encephalitis (Eastern Equine Encephalitis, Western Equine Encephalitis)
Water safety threats (Vibrio cholera, Cryptosporidium parvum)
Category C Biological Agents
Third highest priority agents include emerging pathogens that could be engineered for mass dissemination in the future because of:
Availability
Ease of production and dissemination
Potential for high morbidity and mortality rates and major health impact
Category C Biological Agents examples
Nipah virus
Hantavirus
________ - __________ ____________ is the setting that provides the necessary care allowing the greatest personal freedom.
Least-restrictive environment
The nurse’s role in acute mental health and community-based mental health care settings are similar in that the nurse provides client education and administers medications in both settings.
true
Benefits of group therapy include
Sharing common feelings and concerns
Sharing stories and experiences
Diminishing feelings of isolation
Creating a community of healing and restoration
Providing a more cost-effective environment than that of individual therapy
termination phase of group development
Marks the end of the group sessions; group members discuss termination issues; group leader summarizes work of the group and individual contributions.
orientation phase of group development
Focus is to define the purpose and goals of the group; group leader sets a tone of respect, trust, and confidentiality among members; members get to know one another and the group leader; discussion about termination to prepare group members.
working phase of group development
Focus is to promote problem-solving skills to facilitate behavior change; group leader uses therapeutic communication to encourage group work toward meeting goals; group members may take informal roles within the group.
Assisting the client with cessation of smoking is an example of what type of mental health therapeutic strategy?
health promotion and health maintenance
Providing incentives to promote client self-care is an example of what type of mental health therapeutic strategy?
promotion of self care activities
Administering prescribed medications; monitoring for adverse effects of medications is an example of what type of mental health therapeutic strategy?
psychobiological interventions
Coordinating holistic care to include medical, mental health, and social services is an example of what type of mental health therapeutic strategy?
case management
___________ - ___________ ___________ is care consisting of:
- dignity and respect
- information sharing
- patient and family participation and
- collaboration in policy and program development
patient centered care
_________ _________ is a small version of the larger society; provides an opportunity for the patient to test new behaviors and increases the patient’s ability to interact adaptively when discharged to the community.
milieu therapy
goals of acute mental health treatment?
Prevention of client harming self or others
Stabilizing mental health crises
Return of clients to community care settings
transference
Feelings that the client has developed toward the therapist in relation to similar feelings toward significant persons in the client’s early childhood
Countertransference
when the nurse displaces onto the patient feelings that are a response to people in the nurse’s past. Strong positive or strong negative reactions to a patient may be indicative of countertransference
Cognitive-Behavioral Therapy (CBT)
Based on the underlying theoretical principle that feelings and behaviors are largely determined by the way people think about the world and their place in it
Dialectical Behavioral Therapy (DBT)
A cognitive-behavioral therapy for clients who have a personality disorder and exhibit self-injurious behavior
Focuses on gradual behavior changes and provides acceptance and validation for these clients
A nursing student new to psychiatric mental health nursing asks a peer what resource he can use to determine which symptoms are present in a specific psychiatric disorder. The best answer would be:
A. Nursing Interventions Classification (NIC)
B. DSM-5
C. Nursing Outcomes Classification (NOC)
D. NANDA-I Nursing Diagnoses
B
Providing a safe environment for patients, orienting the patient to the physical setting, and assisting the patient to participate in appropriate activities are all part of: A. Milieu therapy B. Cognitive-behavioral therapy C. Behavior therapy D. Interpersonal psychotherapy
A
A nurse is planning care for a client who has a mental health disorder. Which of the following actions should the nurse include as a psychobiological intervention?
A. Assist the client with systemic desensitization therapy.
B. Teach the client appropriate coping mechanisms.
C. Assess the client or comorbid health conditions.
D. Monitor the client for adverse effects of medications.
D
persecution
Feels singled out for harm by others (e.g., being hunted down by the FBI)
Grandeur
Believes that he/she is all powerful and important, like a god
somatic delusions
Believes that his/her body is changing in an unusual way, such as growing a third arm
religiosity
Is obsessed with religious beliefs
magical thinking
Believes his/her actions or thoughts are able to control a situation or affect others, such as wearing a certain hat makes him/her invisible to others
thought withdrawal
Believes that her thoughts have been removed from her mind by an outside agency
thought insertion
Believes that others’ thoughts are being inserted into his mind
thought broadcasting
Believes that her thoughts are heard by others
ideas of reference
Misconstrues trivial events and attaches personal significance to them, such as believing that others, who are discussing the next meal, are talking about him
antipsychotics appropriate for positive symptoms
First-Generation (Conventional, Typical) Antipsychotics
antipsychotics appropriate for positive and negative symptoms
Second-Generation/Atypical Antipsychotics
antipsychotics appropriate for positive, negative, and cognitive symptoms
Third-Generation Antipsychotics
medication examples for second generation/atypical antipsychotics
risperidone, clozapine, quetiapine, olanzapine, ziprasidone
medication examples for first generation (Conventional, Typical) Antipsychotics
haloperidol, chlorpromazine, loxapine, fluphenazine
medication examples for Third-Generation Antipsychotics
aripiprazole
A nurse is caring for a patient who has schizoaffective disorder. What type of statement indicates the client is experiencing depersonalization?
“I am no one, and everyone is me”
Signs and symptoms that precede the acute, fully manifested signs and symptoms of disease; occurs in 80-90% of persons with schizophrenia before the emergence of frank psychosis
prodromal phase of schizophrenia
Periods of florid positive symptoms (hallucinations, delusions) as well as negative symptoms (apathy, withdrawal, lack of motivation) and cognitive symptoms
acute phase of schizophrenia
Period in which acute symptoms, particularly the positive symptoms, decrease in severity
stabilization phase of schizophrenia
Period in which symptoms are in remission, although their might be milder persistent symptoms (residual symptoms)
maintenance phase of schizophrenia
Period in which symptoms are in remission, although their might be milder persistent symptoms (residual symptoms)
maintenance phase of schizophrenia
flight of ideas
Associative looseness - A flight of ideas occurs when a person rapidly shifts between conversation topics, making his or her speech challenging or even impossible to follow
neologisms
Made-up words that have meaning only to the client
echolalia
Client repeats the words spoken to him
clang association
meaningless rhyming of works, often in a forceful manner
word salad
Words jumbled together with little meaning or significance to the listener
positive symptoms of schizophrenia
hallucinations, delusions, disorganized speech (associative looseness), bizarre behavior
flat affect, poverty of thought or speech (alogia), lack of motivation (avolition), inability to experience pleasure or joy (anhedonia)
negative symptoms of schizophrenia
inattention, impaired memory, poor problem-solving skills, poor decision-making skills
cognitive symptoms of schizophrenia
depression, anxiety, demoralization, suicidality, hopelessness
affective/mood symptoms of schizophrenia
true or false: Prevention of relapse with schizophrenia can be more important than the risk of side effects from medications because most side effects are reversible, while the consequences of relapse may be irreversible.
true
agranulocytosis
Serious blood-dyscrasia; can be fatal; most often seen with clozapine; requires frequent monitoring of WBC
extrapyramidal symptoms
Acute dystonia, pseudoparkinsonism, akathisia, tardive dyskinesia
neuroleptic malignant syndrome
Life-threatening medical emergency; sudden high fever, blood pressure fluctuations, diaphoresis, tachycardia, muscle rigidity, drooling, decreased LOC, tachypnea, coma
nurses role in milieu Therapy
Orienting the client to the physical setting
Identifying rules and boundaries of the setting
Ensuring a safe environment for the client
Assisting the client to participate in appropriate activities
psychoanalysis
Therapeutic process of assessing unconscious thoughts and feelings, and resolving conflict by talking to a psychoanalyst
Clients attend many sessions over the course of months to years
non pharmacological therapeutic therapies
free association, dream analysis and interpretation, transference, and defense mechanism
Psychodynamic psychotherapy
Employs same tools as psychoanalysis, but focuses more on the client’s present state, rather than on his early life
Interpersonal psychotherapy
Assists clients in addressing specific problems
Can improve interpersonal relationships, communication, role-relationship, and bereavement
psychotherapy
Involves more verbal therapist-to-client interaction than classic psychoanalysis
depersonalization
positive sign of schizophrenia- A feeling that one is somehow different or unreal or has lost his identity
May feel that body parts do not belong to them or may sense that their body has drastically changed
Derealization
positive sign of schizophrenia- A false perception that the environment has changed (e.g., everything seems bigger or smaller, or familiar surroundings seem somehow strange and unfamiliar)
Extreme motor agitation
positive sign of schizophrenia- Excited physical behavior, including pacing and rocking; can be harmful to self or others
Stereotyped behaviors
positive sign of schizophrenia- Motor patterns that originally head meaning to client such as sweeping the floor or washing windows, but now are mechanical and lack purpose
Automatic obedience
positive sign of schizophrenia- Responding in a robot-like manner
Waxy flexibility
positive sign of schizophrenia- Maintaining a specific position for an extended period of time
Stupor
positive sign of schizophrenia- Motionless for long periods of time; may even appear to be in a coma
Negativism
positive sign of schizophrenia- Doing the opposite of what is requested
Echopraxia
positive sign of schizophrenia- Purposeful imitation of movements made by others
affect
negative sign of schizophrenia - Usually blunted (narrow range of expression) or flat (facial expression never changes)
Severe reduction in the expression of emotions on the face, lack of eye contact, bland intonation of speech
alogia
negative sign of schizophrenia -Poverty of thought or speech
The client might sit with a visitor but only mumble or respond vaguely to questions
anergia
negative sign of schizophrenia - Lack of energy, passivity, lack of persistence at work or school
anhedonia
negative sign of schizophrenia - Lack of pleasure or joy
The client is indifferent to things that often make others happy, such as looking at beautiful scenery
Avolition
negative sign of schizophrenia - Lack of motivation in activities and hygiene; inability to initiate tasks, such as social contacts, grooming, and other aspects of activities of daily living
Cognitive symptoms include
Disordered thinking
Inability to make decisions
Poor-problem solving ability
Difficulty concentrating to perform tasks
Memory deficits
Working memory, such as inability to follow directions to find an address
First-generation (conventional) antipsychotics potential side effects
Extrapyramidal Symptoms (EPS) Acute dystonia Pseudoparkinsonism Akathisia Tardive Dyskinesia (TD Anticholinergic Symptoms Neuroleptic Malignant Syndrome Cardiovascular Effects Hypotension Tachycardia Severe dysrhythmias (prolonged QT interval)
Second-generation/atypical antipsychotics potential side effects
Extrapyramidal Symptoms (EPS)
Anticholinergic Side Effects
Sedation
Adverse effects of agitation, dizziness, sedation, and sleep disruption can occur
Instruct client to report these symptoms as the prescriber might need to change the medication
Orthostatic Hypotension
Monitor BP and HR for orthostatic changes
Weight Gain/Diabetes
To minimize weight gain, advise client to follow a healthy, low-calorie diet, engage in regular exercise, and monitor weight
Metabolic Syndrome: weight gain, dyslipidemia, altered glucose metabolism
Agranulocytosis (in particular with clozapine)
Inform client of the need for blood tests to monitor
Third-generation antipsychotics nursing considerations
Produces little risk of EPSs or tardive dyskinesia
Unlikely to cause significant metabolic effects, hypotension, or prolactin release
Produces little anticholinergic effect
Does not seem to cause dysrhythmias
dopamine relationship to mental health disorder
Increased in schizophrenia and mania.
Decreased in depression.
norepinephrine relationship to mental health disorder
Decreased in depression.
Increased in schizophrenia, mania, and anxiety.
serotonin relationship to mental health disorder
Thought to play a role in thought disorders of schizophrenia.
Decreased in depression.
Possibly decreased in anxiety and obsessive compulsive disorder.
GABA relationship to mental health disorder
Decreased in anxiety and schizophrenia.
Dopamine
Sleep/wake cycle. Signals muscles to become active.
norepinephrine
Affects attention, learning, memory, and regulation of mood, sleep, and wakefulness.
serotonin
Affects sleep and wakefulness, especially falling asleep. Affects mood and thought processes.
GABA
Amino acid that modulates other neurotransmitters.
anticholinergic effects
Can’t see- blurred vision
Can’t pee- urinary retention
Can’t spit- dry mouth
Can’t s***- constipation
pseudoparkinsonism
stooped posture, shuffling gait, rigidity, bradykinesia, tremors, pill rolling
acute dystonia
facial grimacing, involuntary upward eye movement, muscle spams to tongue/face
akathisia
restless, trouble standing still, pacing, feet inconstant motion
tardive dyskinesia
protrusion and rolling of the tongue, sucking and smacking movements of lips, chewing motion, facial dyskinesia, involuntary movements
antidepressants have an effect on what neurotransmitter?
norepinephrine and serotonin
Selective Serotonin Reuptake Inhibitors (SSRIs)
block the reuptake of serotonin which increase the availability of that neurotransmitter for use in the synapse.
Tricyclic Antidepressants (TCAs) side effects
sedation, orthostatic hypotension, anticholinergic effects, cardiac dysrhythmias.
overdose can be deadly
Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs)
Increase the levels of both serotonin and norepinephrine by inhibiting their reuptake into cells in the brain
Selective Serotonin Reuptake Inhibitors (SSRIs) side effect
Serotonin syndrome is a potentially life-threatening condition resulting from excess serotonin agonist activity
Monoamine Oxidase Inhibitors (MAOIs)
MAOIs block monoamine oxidase by binding to the enzyme and permanently inactivating it
restrictions when taking MAOIs
Tyramine-free diet - if not followed can lead to hypertensive crisis
initial drugs of choice for many patients with depression
SSRIs
Withdrawal Emergent Syndrome from SSRI’s
caused by abrupt cessation of SSRIs causes cholinergic rebound: dizziness, flu-like, paresthesias, myalgia, insomnia, chills, tearfulness, sensory-perceptual
anti-anxiety medications
benzodiazepines
anti-anxiety medications neurotransmitter
increases the receptor responsiveness to GABA
risks of anti-anxiety medications
Risk of dependence
Caution when driving
Do not use with alcohol
Do not stop abruptly
full therapeutic effect of Antipsychotic Drugs
Takes time to have a full therapeutic effect however the antipsychotics may be used for rapid sedation.
intrapersonal communication
Communication that occurs within an individual.
Also referred to as “self talk”
interpersonal communication
Communication that occurs one-on-one with another individual
Small-group communication
Communication that occurs between two or more people in a small group
Public communication
Communication that occurs with large groups of people
Transpersonal communication
Communication that addresses an individual’s spiritual needs and provides interventions to meet those needs
true or false: Asking excessive questions and using “why” questions are examples of effective communication techniques.
false
true or false: Intrapersonal communication is communication that occurs within an individual, while interpersonal communication is communication that occurs one-on-one with another individual.
true
phases of therapeutic relationship
pre-orientation, orientation, working, termination
orientation phase
Introduce self to the client and state purpose
Set the contract: meeting time, place, frequency, duration, and date of termination
Discuss confidentiality
Build trust by establishing expectations and boundaries
Set goals with the client
Explore the client’s ideas, issues, and needs
Explore the meaning of testing behaviors
Enforce limits on testing or other inappropriate behaviors
working phase
Maintain relationship according to the contract
Perform ongoing assessment to plan and evaluate therapeutic measures
Facilitate the client’s expression of needs and issues
Encourage the client to problem-solve
Promote the client’s self-esteem
Foster positive behavioral change
Explore and deal with resistance and other defense mechanisms
Recognize transference and countertransference issues
Reassess the client’s problems and goals, and revise plan as necessary
Support the client’s adaptive alternatives and use of new coping skills
Remind the client about the date of termination
termination phase
Provide opportunity for the client to discuss thoughts and feelings about termination and loss
Discuss the client’s previous experience with separations and loss
Elicit the client’s feelings about the therapeutic work in the nurse-client relationship
Summarize goals and achievements
Review memories of work in the sessions
Express own feelings about sessions to validate the experience with the client
Discuss ways for the client to incorporate new healthy behaviors into life
Maintain limits of final termination
which terms are used in Nevada to refer to a temporary emergency admission for mental health care?
legal 2000 and 72 hour hold
Psychiatric Advance Directives (PAD)
Allows patients concerned they may be subject to involuntary psychiatric hospitalization to prepare a Psychiatric Advance Directive that expresses their treatment choices.
Can clarify the patient’s choice of a surrogate decision maker and instructions about hospital choices, medications, treatment options, and emergency interventions.
Identifies individuals who are to be notified of the patient’s hospitalization and who may have visitation rights.
true or false: The use of the least restrictive means of restraint for the shortest duration is always the general rule and even the law.
true
Beneficence
The quality of doing good, can be described as charity
Autonomy
The client’s right to make their own decisions. However, the client must accept the consequences of those decisions. The client must also respect the decisions of others
Justice
Fair and equal treatment for all
Fidelity (nonmaleficence)
Loyalty and faithfulness to the client and to one’s duty
Veracity
Honesty when dealing with a client
Documentation of seclusion and restraint must include which of the following:
Precipitating events and behavior of the client prior to seclusion or restraint
Alternative actions taken to avoid seclusion or restraint
Time treatment began
Time released from restraints
types of admission to mental health facility
1. Voluntary admission;
2. Emergency admission; and
3. Involuntary court-ordered admission.
epidemiological triangle
Classic model used in epidemiology to explain the occurrence of disease - has a host, agent, and environment that explains the occurrence of disease
epidemiological constants
person, place, and time
web of causation
helps to understand the multiple factors that contribute to the development of disease
ecological model
Used to design health promotion efforts and understand health behavior
health promotion
includes interventions that can be done to help maintain health
health behaviors
include behaviors that contribute either positively or negatively to overall health
determinants
Any factor that brings about change in a health condition or other defined characteristic
distribution
Involves the analysis of disease patterns according to the characteristics of person, place and time
environment
All of the external factors that can influence the host’s vulnerability to a disease
Biologicial, chemical, physical or nutritional; responsible for the disease
agent
Susceptible human or animal
host
Epidemiology is defined as “the study of the ____________ and ____________ of health-related states or events in specified ___________ and the application of this study to the control of health problems.”
distribution, determinants, populations
The neonatal nurse is providing anticipatory guidance to the mother of a newborn infant. When discussing immunization schedules, the nurse explains that the first dose of inactivated poliovirus vaccine (IPV) is given at what age?
2 months
At what age can children begin getting yearly flu shots?
6 months
true or false: It is recommended that pregnant women receive one dose of Tdap with each pregnancy, preferably between 27 and 36 weeks gestation.
true
Which of the following is the first anti-cancer vaccine?
hepatitis B vaccine
Which vaccine is given soon after birth?
hepatitis B
Pediarix combines which of the following vaccines:
DTap - Hep B - IPV
Which vaccine is given subcutaneously?
varicella
true or false: If the first dose of hepatitis B vaccine was given more than one year ago, and no subsequent doses were given, you should repeat the first dose.
false
A parent brings her 4-month-old infant to a well-baby clinic for immunizations. The child is up to date with the immunization schedule. The nurse should prepare to administer which immunizations at this 4-month visit?
DTaP, Hib, IPV, PCV, RV
Which of the following vaccines usually aren’t given until a child’s first birthday (12 months of age).
MMR
DTaP stands for:
Diphtheria - Tetanus - acellular Pertussis
Which of the following vaccines helps to prevent bacterial meningitis in children aged 2 months to 2 years?
Hib
Which of the following infectious diseases is NOT considered a vaccine-preventable disease at this time?
hepatitis C
The human-made surroundings created for the daily activities of humans, reflects the range of physical and social elements that make up a community.
built-environment
I PREPARE mnemonic
one method of determining current and past environmental exposures I: investigate P:present work R: Residence E: Environmental concerns P: past work A: activities R: referrals and resources E: educate
Which of the following agencies is the main resource for HIV care In Washoe County?
HOPES
metronidazole 500 mg PO BID x 7 days is recommended for
bacterial vaginosis
ceftriaxone 250 mg IM AND azythromycin 1 G PO OR doxycycline 100 mg PO BID x 7 days is recommended for
gonorrhea
benzathine penicillin G (2.4 million units IM in a single dose) is recommended for
syphilis
azithromycin 1 g PO OR doxycycline 100 mg PO BID x 7 days is recommended for
chlamydia
Which of the following groups is not included in the list of persons who should get tested for sexually transmitted diseases (STDs)?
Persons < 25 years of age who are not sexually active
acronym “CHART” for the key STD motivators
C: complications of untreated disease H: HIV connection A: Asymptomatic infection R: Re-infection T: Transmission
Recognizing the differences between cultures; no one culture is superior to another
ethnorelativism
Includes self-awareness of one’s own cultural background, biases, and differences
cultural awareness
A skill the nurse develops in learning to respect individual dignity and preferences, as well as acknowledging cultural differences
cultural competence
Believing one’s own culture is best; judging another culture by the values and standards of one’s own culture
ethnocentrism
Examples of groups typically viewed as vulnerable:
People living in poverty People of color The uninsured Those experiencing homelessness Older adults Those with disabilities
Vulnerability
The increased susceptibility to poor health of an individual or group stemming from exposure to multiple risk factors
A characteristic of a person or a group of persons that is contrary to those characteristics of the larger group
stigma
A social process through which a person or group is on the periphery of society based on identity, associations, experiences, or environment
marginalization
An exagerated, usually negative belief or image applied to an entire category of people
stereotype
bilateral organization
Represent a single government that gives aid to developing countries
multilateral organizations
Collaborative work and funding come from multiple governments, nongovernmental sources, and is distributed to many different countries
primary care
Refers to personal health care services
primary health care
Refers to the essential care needed to have healthy individuals and a healthy community; concept originated at the 1978 WHO conference
epidemic
Occurrence of a disease clearly in excess of normal expectancy
endemic
The habitual presence of a disease within a given geography
pandemic
An epidemic affecting or attacking the population of an extensive region, country, or continent
When an epidemic occurs in multiple countries or continents
disease defenses
Herd Immunity
- Protection due to the immunity of most community members making exposure unlikely
Natural immunity
- Natural defense mechanisms of the body to resist specific antigens or toxins
Acquired immunity
- Develops through actual exposure to the infectious agent
CDC reference level of blood lead levels
5 uq/dL is elevated
routes fo exposure to lead
Occurs primarily through ingestion; inhalation is the second major pathway of exposure
prevention of lead exposure
Wash your hands before you eat
Take off your shoes at the door
Eat a healthy diet that includes iron and calcium
Regularly check your home for chipping, peeling, or deteriorating paint
Test your home’s drinking water (schools and childcares should also be tested
Healthy People 2020 Environmental Health Objectives (6 themes)
Outdoor air quality Surface and ground water quality Toxic substances and hazardous wastes Homes and communities Infrastructure and surveillance Global environmental health
