Community Exam 3 Flashcards
What are health disparities linked to?
- gender
- ethnicity
- race
- education
- income differences
What are racial and ethnic minority barriers linked to?
- reduced access to care
- decreased use of preventative care
- poorer health outcomes
What is homicide often related to?
Substance use
Who is homicide usually committed by, and when?
- someone known to the victim
- during an argument
What often precedes homicide in families?
Violence
In what age group is homicide increasing?
adolescents
Who is more likely to be assaulted?
males
Who is at increased risk for assault?
youth
What are the most common types of rape?
- spousal (marital)
- acquaintance (date)
Who is more likely to be raped?
females
When is there an increased risk for rape to occur?
- cities
- between 8pm and 2 am
- weekends
- summer months
What age group has the highest suicide rates?
45-65
Who is more likely to ATTEMPT suicide?
females
Who is more likely to COMPLETE suicide?
males
What are the 4 types of physical violence?
- infant/child
- spouse/partner
- older adult
- non-spouse/partner
What are the 4 types of neglect?
- physical
- emotional
- educational
- health/dental care
What could unexplained or unmentioned injury/wounds be a sign of?
potential abuse/neglect
For violence primary prevention, it is important to teach alternative methods of what?
- conflict resolution
- anger management
- coping strategies
How can you reduce the stress that leads to violence? What level of prevention is this?
- respite services
- finding employment
- social support network
- PRIMARY PREVENTION
What should safeguarding be encouraged for? What type of prevention is this?
- funds
- property
- PRIMARY PREVENTION
How do you safeguard funds and property?
- representative trust
- durable power of attorney
- representative payee
- joint tenancy
What level of prevention is screening?
SECONDARY PREVENTION
What indicates dependence?
- manifestations of tolerance and withdrawal
- denial
How does recovery occur?
- over years
- involves relapses
- with support system and 12-step program
Can tolerance develop with alcohol?
yes
What happens to excess alcohol that is not metabolized?
It circulates in the blood and affects the CNS and the brain
When does alcohol withdrawal start?
Within 4-12 hours of last drink
What should you determine with alcohol withdrawal?
The time of the last drink
How does carbonation affect the blood alcohol level?
It increases absoption
Can you develop a tolerance to tobacco?
Yes and quickly
What are the risks of tobacco use?
- cancer
- cardio disease
- respiratory disease
When do tolerance and dependence develop with marijuana?
With long-term use
What are examples of stimulants?
- tobacco
- caffeine
- amphetamines
- methamphetamines
- cocaine
What are examples of depressants?
- alcohol
- barbituates
- benzos
- chloral hydrate
- GHB
What are examples of opiates?
- morphine
- heroin
- codeine
- fentanyl
What are examples of hallucinogens?
- LSD
- PCP
- MDMA (ecstacy)
How can inhalants cause death?
- dysrhythmias
- asphyxiation
How should you ask questions to those with substance use disorder?
- in a matter-of-fact tone
- explain that the purpose is because of the effects that different substances can have on health
When questioning someone with substance use disorder, what information should you seek?
- info about specific substances
- methods
- quantity
- frequency
How do vitals present in substance use disorder?
Vary based on substance
How does appearance present in substance use disorder?
- disheveled
- unsteady gait
How do eyes present in substance use disorder?
- pupils dilated/pinpoint
- red
- poor eye contact
How does skin present in substance use disorder?
- diaphoretic
- cold/clammy
- needle track marks
- spider angiomas
How does the nose present with substance use disorder?
- runny
- congested
- red
- cauliflower-shaped
How do tremors present in substance use disorder?
fine or coarse
What does the National Alliance for the Mentally Ill (NAMI) do?
- advocacy group
- reduce stigma
- provide services
What are those with mental illness at an increased risk for?
- substance use disorder
- suicide
- chronic illness
Why are incidence and prevalence counts often inaccurate?
Many homeless people are transient, staying with friends, or residing in difficult to access locations
When do impoverished and homeless people usually seek health care?
In times of acute exacerbation or crisis
What is the population of a rural area?
< 20,000 residents
What is the population of a frontier area?
< or equal to 6 persons per square mile
What is the population of an urban area?
20,000 to 49,999 residents
What is the population of larger central cities?
1 million + residents
What can cause injury for those living rurally?
- lightning
- drowning
- boating
- farm machinery
- snowmobile
- all-terrain vehicles
- motorcycle crashes
What are occupational risks for those living rurally?
- agriculture
- mining
- fishing
- construction
What challenges do nurses face when working rurally?
- limited resources
- isolation from other providers
- broad age range and range of conditions
What are barriers to care for those living rurally?
- distance
- transportation
- weather/travel conditions
- insurance/paying for care
- shortage of hospitals and providers
How are migrant workers usually employed?
In farming during the time of caring for and harvesting crops
Are ag workers covered by common labor laws?
No
Are minors 12 y/o and under covered by the child labor act?
No
What does the migrant health act do?
Provides funding for migrant health centers
What does the department of labor do?
Has regulations regarding standards for migrant/seasonal ag workers
Why might undocumented workers not seek services?
Fear of deportation
How can you decrease exposure to pesticides?
- hand washing
- washing food
- changing clothes after work
What is the VHA responsible for?
- purchasing coverage
- delivering health care
What does the americans with disabilities act do?
promotes rights
What does the individuals with disabilities education act do?
promotes rights of children
- ensures free education and assists with funding
- accommodations to prepare child for independent living
- evaluates effectiveness of education
What care are immigrants eligible for?
- immunizations
- school lunch
- tx for communicable disease
- emergency care
What does the federal bureau of prisons do?
promotes rights of inmates
How can nurses help decrease the risk of future violent behavior in inmates?
By providing transitional care
What public health processes should be strengthened during disaster prevention?
- immunizations
- isolations
- quarantine
What should you determine about a community during disaster prevention?
- threats
- vulnerabilities
- capabilities
- demographics
What should be used to prepare for a disaster?
the threats and vulnerabilities identified during prevention
What is the goal of the National Incident Management System?
effective communication and a clear chain of command to manage disasters
How are disasters classified?
- type
- level
- scope
When is the National Response Framework activated?
if a federal emergency is declared
When does disaster recovery begin?
when danger no longer exists and needed representatives/agencies can assist with rebuilding
When does disaster recovery last until?
until the economic and civil life of the community are restored
What is the heroic phase of emotional reaction during a disaster?
intense excitement/concern for survival
What is the honeymoon phase of emotional reaction during a disaster?
affected individuals begin to bond and relive their experiences
What is the disillusionment phase of emotional reaction during a disaster?
responders may experience depression and exhaustion, causing delays in receiving aid
What is the reconstruction phase of emotional reaction during a disaster?
involves adjusting to a new reality and continued rebuilding of the area, counseling, looking ahead
What should a disaster kit consist of?
- at least 3 days’ supply of food
- water
- medication
- clothing
- hygiene items
- copies of personal documents
- first aid supplies
Why are category A agents the highest priority?
They are easily transmitted and have high mortality rates
What category does smallpox fall under?
A
What category does botulism fall under?
A
What category does anthrax fall under?
A
What category does tularemia fall under?
A
What category does ebola fall under?
A
What category does plague fall under?
A
What category does typhus fever fall under?
B
What category does ricin toxin fall under?
B
What category does E. Coli fall under?
B
What category does west nile virus fall under?
B
What category does hantavirus fall under?
C
What category does influenza fall under?
C
What category does TB fall under?
C
What category does rabies fall under?
C
What are the characteristics of category B agents?
- moderately easy to disseminate
- high morbidity rates, low mortality rates
What are the characteristics of category C agents?
- can be engineered for mass dissemination
- easy to produce
- potential for high morbidity and mortality rates
How can you prevent inhalational anthrax?
- vaccine (if at high risk for exposure)
- ciprofloxacin, doxycycline (following exposure)
How can you treat inhalational anthrax?
- antitoxin
- IV antibiotics
- antimicrobial agents
Is there a vaccine for botulism?
no
How can you treat botulism?
- airway management
- antitoxin
How can you eliminate botulism toxins?
- vomiting
- enema
- surgical excision of wound tissue
Is there a vaccine for ebola?
no
What PPE should you wear for Ebola?
- gown
- two pairs of gloves
- boot covers
- apron
- N95 mask
What precautions are used for Ebola?
droplet and contact
How can you prevent smallpox?
vaccine within 3 days of exposure
What precautions are used for smallpox?
contact and airborne
Is there a cure for smallpox?
no
Is there a vaccine for the plague?
not available in the US
What precautions should be used for the plague?
- contact until decontaminated
- droplet until 72 hours of finishing antibiotics
How can you treat the plague?
gentamicin, fluoroquinolones
Is there a vaccine for tularemia?
yes but it is under review by the FDA and not available
How can you treat tularemia?
- streptomycin, gentamicin
- in mass casualty, doxycycline, ciprofloxacin
Who should nurses report bioterrorism activity to?
the local health department
How should you prepare for bioterrorism?
- drills
- vaccines
- ensuring the availability of antibiotics
- have a bioterrorism response plan`
What are infection control and containment measures?
- disinfection
- decontamination
- PPE
- education/notification
- quarantine
What are referrals based on in acute care?
medical diagnosis or other clinical information
Is rehab a health care service or specialty service agency?
health care service
Are PT and OT health care services or specialty service agencies?
health care services
Are transportation services health care services, or specialty service agencies?
specialty service agencies
Are home care services health care services or specialty service agencies?
health care services
Are support groups health care services or specialty service agencies?
specialty service agencies
When does discharge planning start?
on admission
Why should nurses have good communication skills?
- saves time
- promotes successful outcomes
Case managers are at risk for liability. What is this related to?
- care management
- referrals
- experimental tx
- confidentiality
- fraud/abuse
Why must case managers be proactive?
to balance the effect of illness against cost of care
How does the use of community agencies contain costs?
Monitoring of clients leads to better disease management
What does some technology assist with?
cost control
How can nurses use technology?
- increase awareness
- provide education
- collect data
What are examples of how nurses can use technology?
- social media campaigns
- electronic surveys
- health literature databases
What are some examples of informatics?
- EHR, EMR, databases, billing
- computers, smartphones, geographic information systems, internet
How is informatics used?
- meetings, chat rooms, asynchronous discussion
- education, support groups, peer collaboration, staff orientation/training
What situation is telehealth useful in?
rural areas
Who is using telehealth more increasingly?
Home health
What types of data can telecommunication transmit?
physical, audio, visual
What do laws related to healthcare regulate?
licensing
What do laws related to healthcare define?
scope of practice/negligent care
What do laws related to healthcare outline?
responsibilities in specific settings
How can nurses influence those who develop policies?
- professional communication
- presenting evidence-based solutions
How can nurses act as change agents?
advocate for change at local, state, or federal level
How can nurses act as lobbyists?
by persuading or influencing legislators
How can nurses act as coalitions?
by facilitation of goal achievement through collaboration of 2+ groups
How can nurses act as public office?
by serving society and advocating for change by influencing policy development
