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477- Public Health > Exam 1 > Flashcards

Exam 1 Flashcards

1
Q

public health def

A

social enterprise, work to fill gap w/ services, population centered nursing care

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2
Q

contract w/ society

A

est. standard of care
nursing as a profession is awarded society’s trust in exchange for work on the behalf of society’s well being

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3
Q

pre 1800’s public health

A

religiosity
sick because you angered god

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4
Q

1850-1949

A

sanitary reform, germ theory, antiseptic technique, start to dev theories about exposure and transmission

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5
Q

Lillian wald

A

coined term “public health”
est 1st clinic for poor in NY

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6
Q

late 20th century public health

A

antib resistance dev

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7
Q

2000’s public health

A

researching about chronic diseases
ex. Heart disease, cancer

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8
Q

21st century public health

A

genomics
recurrence of infectious disease and antib resistance
dev risk management techniques

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9
Q

public health mandate purpose

A

effects individ and populations
works to mitigate risk and control outbreaks

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10
Q

mandate examples

A

communicable dis
environmental issues
prevent injuries
health beh
disaster and recovery
quality and accessiblity

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11
Q

health impact pyramid
-main point

A

policy and infrastructure changes will have a greater and longer impact on PH than education

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12
Q

factors that affect large populations

A

socioeconomic and social determinants of health

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13
Q

social determin. of health and PH takeaway

A

social determinants affect QOL and length of life more than access to care

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14
Q

3 essential services*****

A

assessment (assess needs)
policy dev
assurance (assure resources are available)

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15
Q

population impact strategies- local

A

local health depart. ( maternal health, immunizations, communicable dis etc)

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16
Q

population impact strategies- state

A

dev policy and codes that are enforced at local lvl
ex. dis outbreaks, hazards

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17
Q

population impact strategies- federal

A

collect tax dollars
dev health standards/practices
assessment of overall public health
coordinate report cards

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18
Q

core functions of public health *****

A

assessment
policy dev
assurance

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19
Q

public health assessement

A

ex. beh risk factor surveillance system
gauges how ppl in specific age groups and geographical areas sleep, mood, work etc

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20
Q

PH policy dev

A

CMS
Medicare

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21
Q

PH assurance

A

ex. annual review of PH agency
annual school immuniz records

ppl need EB care that meets minim. standards

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22
Q

plans that support indivi. and PH

A

systematic planning
tracking measurable objectives (needed for funding)
dev regulations, policy’s and codes

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23
Q

gap filling

A

form of hands-on direct care

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24
Q

health promotion characteristics in PH

A

confidentiality (social contract)
privacy
autonomy
ethics
resilience (despite outside factors)

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25
Q

community def

A

social grp determined by geographical place or shared values (ex. norms, beliefs etc)

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26
Q

function of community

A

indiv work together to est. social control, adaptation, mutual aid and socialization

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27
Q

geographical examples of community

A

town
county
geopolitical«

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28
Q

community care characteristics

A

population centered
health promotion
*can wrk w/ families and indivi but interventions are intended to affect entire pop

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29
Q

examples of indivi interventions that affect entire population

A

infectious dis, tobacco cessation, immunizations, water quality

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30
Q

what helps guide community interventions

A

data analysis

status, structure, process and survey findings
ex. what resources are available and how are ppl utilizing those resources

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31
Q

healthy people def

A

multi-disciplinary approach to achieving
health
equity
reducing disparities

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32
Q

types of home visits

A

skilled care
PH visits
case management

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33
Q

skilled care def

A

reimbursable by medicare
short term
directs nursing care

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34
Q

PH visits def

A

health promotion
help family work towards health-related goals

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35
Q

case management visit

A

private funding or medicaid
focus on chronic health
goal is to keep client in home via prevention and referral services

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36
Q

advantages of home health

A

access to debilitated (gap filling)
awareness of quality of family life
family less anxious, inc readiness to learn

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37
Q

barriers/challenges of home health

A

privacy w/ client
focused/prepared material by nurse

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38
Q

disadvantages of home health

A

increased distractions from others
hard to reach client by phone, hearing loss
have to problem solve independently

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39
Q

phases of home visit (5)

A

initiation phase
pre visit- initiate contact w/ family
in home- build trust (focus on interventions clients are most passionate about)
termination- summarize and set next app.
post visit- charting/documentation

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40
Q

types of home health agencies

A

private, non-profit
proprietary (For profit)
official (riverstone)
hospital-based
combo

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41
Q

current issues- home health
indigent care

A

no health insurance

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42
Q

current issues- home health
discharge planning

A

SNF, swing bed, etc

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43
Q

current issues- home health
use of tech. in home

A

ex. DM care

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44
Q

current issues- home health
family and nurse stressors

A

ex. cost of care, parental duty, heavy pt load, transportation

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45
Q

current issues- home health
lack adeq funding and fraud

A

ex. families charged by insurance for services they never received
solution- inc documentation to demonstrate need and ensure service was preformed

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46
Q

influenza transmission

A

respir tract infection
airborne, direct contact with infected droplets

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47
Q

type A influenza

A

large epidemics
most virulent
found in animals (aquatic birds, domestic chickens, pigs) saliva, intestines and respir tract

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48
Q

type B influenza

A

regional epidemics

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49
Q

type C influenza

A

sporadic, mild illness
not targeted w/ annual flu vaccine

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50
Q

influenza-like illness

A

fever > 100 F and cough w/ sore throat

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51
Q

minor antigenic changes

A

lead to antigenic DRIFT
responsible for yearly regional outbreaks
d/t point mutation during viral replication

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52
Q

indication for annual flu vaccines

A

antigenic changes cause antigenic drift and point mutation

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53
Q

major antigenic changes

A

antigenic SHIFT
only apparent w/ type A influenza

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54
Q

influenza categorization

A

surface proteins/antigens
hemoglutinan (18)
neuraminidase (11)

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55
Q

influenza genetic material

A

lipid envelopes w/ capsid
RNA

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56
Q

avian flu transmission

A

direct contact w/ infected droplets from birds
wild birds can infect poultry

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57
Q

avian flu prevention

A

avoid infected areas
bird poop
animal barns at fairs

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58
Q

mixing vessel

A

two + separate viruses infected same animal
replicate and create new “novel virus”
ex. h7n9 virus in China from birds

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59
Q

naming of influenza

A

type / place 1st id / lab ID# / yr of discovery / protein surface type
ex.
A/hong Kong/156/97 (H2N1)

if non-human infection include host species

ex. A/Chicken/Hong Kong/156/97 (H2N1

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60
Q

influenza complications

A

viral or bac pneumonia
death

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61
Q

influenza high risk populations

A

children <2yr
elderly
ppl w/ chronic cond
neuro conditions
preg wmn (very common to be hospitalized)
immunocomp

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62
Q

factors that affect pandemic flu fatality

A

access to healthcare
living conditions
comorbid
age (commonly affects younger populations)

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63
Q

R0 of seasonal flu v pandemic flu

A

1.2 to 1.8+

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64
Q

avian flu concerns w/ seasonal flu

A

hinders vaccine efforts (need eggs for flu shot)

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65
Q

5 categories of surveillance

A

viral surv.
surveill for NOVel type A
out pt illness surv (id influenza by age grp)
mortality surv
hospitalization surv
summary of geographic spread of influenza (from monitoring labs)

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66
Q

5 categories of surveillance

A

viral
surv for novel type A
out pt illness (id by age grp)
mortality
hospitalization
summary of geographic spread (done by labs)

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67
Q

purpose of influenza surveillance

A

predict virus in next flu vaccine

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68
Q

types of influenza vaccine

A

egg based
cell recombiant
trivalent and quadrivalent

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69
Q

flu vaccine contraindicated pop

A

<6 mo
anaphylaxis (gelitin, antib)
*still can get if allergic to egg, just must be supervised

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70
Q

effectiveness of influenza in older pop

A

less effective
have weaker immune systems

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71
Q

ages approved to receive live, attenuated influenza vaccine

A

2-49yrs
nasal mist

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72
Q

high dose inactived influenza vaccine (HD-IIV4)

A

ppl >65

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73
Q

antiviral meds and influenza

A

option for those who can’t get vaccine
ex. <6mo, allergy
starting at 2 wks infant can get antiviral and at 6 mo can get flu shot

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74
Q

infant protection during influenza spread

A

preg mom get tdap at 36 wks
herd immunity
antiviral at 2wks
flu shot at 6mo

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75
Q

conflict btw pandemic and minority populations

A

pandemics dispropor affect
highlight pre-existing health disparities
higher infection rate
higher death rate
often chose not to stay home when sick- inc community spread

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76
Q

epidemiology def

A

study of what happens to people, factors, and patterns of distribution
ex. consequences of hurricanes (inc communicable dis)

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77
Q

father of epidem.

A

john snow
pump handle
cholera in london

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78
Q

descriptive v analytic epidemiology

A

descrip- id dis entity according to person, place and time (foodborne outbrks)
analytic- id etiology of dis
ex. scientific studies

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79
Q

types of analytic epidem (4)

A

1- cross sectional
2- retrospective (id risk f)
3- prospective, cohort, longitudinal
(determine incidence of health condition w/ exposed v unexposed (attack table))
4- clinical/experimental
(control v experiem grps)

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80
Q

pre-pathogenesis

A

what happened before dis

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81
Q

pathogenesis

A

what needs to happen for condition to occur

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82
Q

discernable early lesions

A

first s/s

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83
Q

natural history epidemiology components

A

pre pathogenesis
pathogen
discernable early lesions
advanced dis

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84
Q

infectivity v virulence

A

infectivity- ability to enter host
virulence- ability to produce illness (severity lvl)

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85
Q

validity v reliability

A

reliability (consistency or ability to be repeated)
validity- accuracy

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86
Q

rate v risk

A

rate- ratio
frequency of a health event

risk-probability that event will occur in specified time

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87
Q

secular pattern

A

long term, can reflect changes in social beh or health practices

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88
Q

cyclic pattern

A

dis occurrence or event r/t time patterns

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89
Q

point epidemic

A

certain point in time/space w/ large concentration of cases

used to chart an outbreak
helps to id incubation period

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90
Q

epidemic v pandemic

A

epidemic- regional
pandemic- worldwide

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91
Q

agent

A

cause of health issue
bacterial, toxin, etc

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92
Q

host

A

who is experiencing health condition
ex. animals or humans

factors
genetic susceptibility
immutable characteristics (age, race)
lifestyle (diet, tobacco, exercise)

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93
Q

infectivity v pathogenicity

A

ability to enter host and mulitply
capacity to cause dis in infected host

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94
Q

virulence v invasiveness

A

virul- ability to produce illness (lvl of severity)

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95
Q

types of agents

A

chemical
biological
psychosocial (war, suicide, economic downturn)

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96
Q

relationships btw variables in epidem

A

est. weak or strong assoc.
cannot prove

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97
Q

ex. web of causation

A

factors assoc. w/ htn
ex. genetics, lifestyle, physiological changes w/ aging

have to address all factors to improve dis

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98
Q

prevalence rate

A

measure of existing dis in pop at given time
inc rate= inc risk

ex. chronic conditions
DM, obesity, HTN

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99
Q

incidence

A

proportion of pop at risk for NEW health even
used only in conditions that have not been dx in person or are time limited
ex. influenza, pertussis (not conditions that are chronic)

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100
Q

crude mortality

A

propor death from any cause

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101
Q

case fatality

A

d/t specific cause

102
Q

infant mortality

A

reflects countries ability to provide for most vul pop= gauges quality and infrastructure of healthcare system

103
Q

attack table

A

used to determine offending source of food in outbreak

104
Q

attack table- odd ratio

A

odds of getting sick if eat food
1=baseline
<1= not likely
>2= likely

105
Q

major contributors to chronic dis

A

lifestyle factors
lack physical act.
tobacco
poor nutrition- access whole foods
excessive etoh use
SDOH
health literacy
environm/living conditions

106
Q

high risk DM groups

A

native americans 2x
family hx (genes, obesity/eating habits)
sedentary job

107
Q

carbs/meal

A

45-60
avoid sugary drinks

108
Q

exercise/ day

A

30 min 5 days wk, 20 min 7 days/wk or 150 min /wk

109
Q

target weight loss goal

A

5-7% (dec insulin resistance)

110
Q

s/s of type 2 dm

A

polyuria
polydipsia
polyphagia
blurry vision
obesity

111
Q

A1C DM pts v normal

A

DM= > 6.5%
pre dm= > 5.7%
normal <5.7%

112
Q

dm dx- fasting/ non fasting

A

2 readings on seperate occasions
>100 mg/dl= pre d
>126 mg/dl= dm

113
Q

DPP

A

dm prevention
more effective than meds
ex. exercise and dietary group for pre-dm

114
Q

risk factors for dm

A

obesity
not physically active
baby >9lbs
polycystic ovary syndrome
family hx
gestational dm

115
Q

risk factors for dm- non modifiable

A

inc age
men>wmn
inc BMI
african american, latin a, hispanic and native a

116
Q

A1C goals NO DM

A

a1c <5.7
150 min exercise / wk
5-7% wt loss recc.

117
Q

A1C goals for DM

A

6.9 or under
(>6.5= dm)
DPP, dm ed support services

118
Q

prevention lvls for dm

A

primary- playground for kids
secondary- walking group for pre-dm pts
45+ need yrly screening
tertiary- A1C control, prevent MODS, BP control

119
Q

ae of dm

A

retinopathy, nephropathy, neuropathy (autonomic and gastroparesis)
vascular damage (cerebral, cardiac, carotid)
Hispanics 50% more likely to die of dm than white

120
Q

vascular disease prevention lvl examples

A

primary- diet, exercise, lifestyle
secondary- bp mgmt, meds
tertiary- cardiac rehab

121
Q

downstream vascular dis outcomes

A

stroke
MI
CHF
Dementia (sclerotic cereb arteries)

122
Q

risk factors for vascular dis

A

uncontrolled bp
high sodium intake
dm
obesity
physical inactivity
excessive etoh

123
Q

htn s/s

A

blurry vision
HA
fatigue
chest pain

124
Q

htn risk factors

A

obesity
family hx
sedentary lifestyle
dietary habits (high Na and not enough whole grains)
comorbidities (DM)

125
Q

HTN supplemental treatments

A

wt loss
DASH diet
Na reduction
inc K (4-5 servings fruits/veg)
exercise program
reduce etoh (wmn 1/day; men 2/day)

126
Q

BP goal

A

130/80
post stroke/TIA- 140/90

127
Q

LDL goal

A

<129 mg/dL
<100 is ideal

128
Q

CHF and ethnicity

A

blacks 2x likely to die
Hispanic paradox-
25% less likely than whites despite inc health dispa. (access, safety, quality health care etc)

129
Q

CHF readmission

A

medicare will not pay for readmit w/in 20 days of 1st DC

could be d/t poor pt ed
lack out pt/community resources
illness progression

130
Q

main risk factors for CKD

A

DM and HTN= CKD= ESKD

131
Q

end stage kidney dis and ethnicity

A

blacks 3x more likely than whites

132
Q

prevention lvl exaples ESKD

A

primary- exercise, diet, smoking cessation
secondary- education, BP control, monitor creatinine,manage dm, awareness of nephrotoxic meds
tertiary- prevent infection, inc QOL on dialysis

133
Q

Healthy BMI
waist circum

A

18-24.9 BMI
men < 40 in
wmn < 35 in

134
Q

primary prevention policy ex

A

school lunch
monitoring advertisements to children
bike paths
workplace wellness
tax on soda
*target SDOH

135
Q

SDOH

A

economic stability
neighborhood/physical environm
education
food
community and social context
health care system

136
Q

dis surveillance

A

systematic collection and analysis
used to monitor and improve health, eval interventions and plan programs

137
Q

dis surveillance examples

A

geographic distribution
detect epidemics
changes in infectious agents
evaluate control measures (hand washing, respir precautions)

138
Q

role of PHN

A

reporting
id factors that contrib to outbreaks
educate

139
Q

population lvl intervention examples

A

contact tracing
partner notification

140
Q

common causes of foodborne illness

A

campylobacter (poultry)
salmonella (eggs/poultry)
cyclosporine (produce)
e coli

141
Q

bacterial foodborne illnesses

A

salmonella
(carried by poultry/reptiles)
campylobacter

142
Q

bac. foodborne s/s

A

sudden HA, abd pain, diarrhea (bloody if campylobacter), nausea, fever

143
Q

dx and tx for campylobacter

A

stool cul
antib

144
Q

clostridium perfingens

A

spore forming bac
raw meat and poultry
dx stool cul
tx- NO antib

145
Q

botulism causes

A

canned foods (esp. veget), wound, infant, adult intestinal, iatrogenic

146
Q

botulism s/s

A

musc weakness, respir paralysis, blurred vision, slurred speech

147
Q

botulism dx and tx

A

dx- hx, ct, xray
tx- supportive, mech ventilation, antitoxin

148
Q

honey in babies

A

contraindicated if < 12 mo

149
Q

waterborne illnesses

A

cryptosporidiosis
giardia

150
Q

prevention lvl examples for waterborne illn.

A

primary- well checks, filters
secondary- screening
tertiary- antib for diarrh.

151
Q

high risk pop for waterborne dis

A

elderly
kids < 5yrs old (higher body water percentage)

152
Q

giardia dx and tx

A

HAS to be treated w/ antiprotozoal antib
dx- 3 stool samples on diff days, fecal immunoa.

153
Q

giarda s/s

A

greasy stools that float
diarrh
abd cramping

154
Q

5 keys to safe food

A

keep clean
keep raw and cooked separate
cook thoroughly
food at safe temps
use safe water and raw materials
no cross contamination

155
Q

vector prevention- 4 D’s

A

deet
drain standing water
avoid dusk and dawn
dress long sleeves

156
Q

malaria onset, prevention

A

onset 10-15 days after exposure
mosq. nets

157
Q

zoonotic examples

A

rabis, toxoplasmosis (cats), brucellosis, hanta virus

158
Q

zoonotic prevention

A

education
vaccination
policy

159
Q

parasites- 3

A

protozoa
helminths
ectoparasites

160
Q

TB transmission

A

airborne
droplet

161
Q

areas of body affected by TB

A

lungs
brain
spine
bone
kidney
lymph nodes

162
Q

latent TB tests

A

detectable 2-8wks after infection
TST (skin)
interferon-gamma release assay (IGRA) (blood)
*NOT used to dx TB, need other supporting data

163
Q

latent tb v active tb

A

latent- infected by NOT infectious
active- infected and INFECTIOUS, onset can be yrs later

164
Q

tb s/s

A

prolonged cough (3+ wks)
hemoptysis
chest pain
night sweats
fever
fatigue

165
Q

high risk pop for TB

A

ppl w/ close contact
ppl who have visited TB prev. countries

166
Q

environmental risk factors for TB

A

small spaces
poor ventilation
positive air pressure

167
Q

TST reading

A

48-72hrs
measure area of induration (not redness)
if no induration record 0 mm

168
Q

TST > 5mm

A

positive in
HIV
contact w/ infectious tb
abnormal chest x-ray
immunosuppressed

169
Q

TST >10mm

A

positive in
iv drug users
high risk employees
children < 5yrs
arrival from notorious countries
general pop

170
Q

TB DX criteria

A

abnormal chest xr
3 sputum cul

171
Q

false positive TST ex.

A

BCG vaccine

172
Q

false negative TST ex.

A

low protein
very young or advanced age
recent TB infection
renal or lymphoid dis

173
Q

latent v active dx differences

A

latent- positive tst but negative cxr and smears
active- everything positive
requires isolation and respir precautions

174
Q

TB and DOT

A

directly observed therapy
ex. staff watches pt swallow e dose
can reduce drug resistance, trtmnt failure and relapse

175
Q

latent TB tx

A

6-9 mo isoniazid monotherapy (INH)
or
3-4 mo rifamycin based (RIF)

176
Q

things to monitor w/ isoniazid monotherapy

A

periph neuropathy
hepatitis if preg/postpartum
liver enzymes

177
Q

drug resistant TB v regular TB

A

DR-TB is NOT more infectious

178
Q

general summary of rural health pop

A

sicker
older
less educated
dec income
not insured
inc health costs

179
Q

rural def

A

all population, housing, and territory not incl in urban

can be determined at county lvl, by zipe code or census data (ppl/square mile)

180
Q

rural pop- finance

A

more likely to be widowed
lower income
less likely to have private insurance (usually public or uninsured)

181
Q

rural health disparities

A

education
distance
child care
less anonymity
poor internet access
less resources (school nurse, specialist)

182
Q

rural health- higher rates

A

trauma
cancer
allergies
resp conditions
mvc
death d/t opioid OD
infant/maternal morbid rates

183
Q

rural pop- preven. care

A

less likely to participate
(bp, leisure physical act, seat belts)

more likely to chose radical treatment

184
Q

rural pop- chronic conditions

A

more likely
heart dis
copd
htn
arthritis
Cardiovasc dis
cancer (cervical)

185
Q

telemed barriers

A

billing
wifi
low literacy levels
“digital divide”

186
Q

rural pop- CAM

A

complementary/alt meds
popular w/ older rural ppl

187
Q

CAM reasons for use

A

desire for control
concerns abt ae o/ meds
ineffectiveness of allopathic trtmnts

188
Q

CAM- possible complications

A

med interactions
side effects
polypharmacy (coumadin)
seeking care

189
Q

rural- response to illness (SLP)

A

self care (watch and wait)
lay resource (friends advice)
professional resource (for emergencies)

190
Q

approaches to inc rural health

A

screenings (cancer, htn)
dec obesity
(healthy eating, encourage leisure time physical act)
mental health support
(MV safety (seat belt, car seat), safer opioid prescribing, smoking cessation))

191
Q

ecological public health model strategies (5)

A

address health determinants-
build healthy policy
creat supportive environm
strengthen community action
dev personal skills
reorient health services

192
Q

rural access to care model principles (5)

A

health of indiv is paramount
health is an individ capacity to pursue needs
all indiv must have same opport
local capacities for health services
public policy should facil. navigation of the system

193
Q

5 P’s of STD screening

A

partners
practices
prvention of preg
protection from STI
past hx of STI

194
Q

gen pop at inc risk for STI

A

partner has hx of STI
multiple partners
not using condom
pre-existing STI- usually get multiple STI at same time
gay
MSM
younger 15-24

195
Q

ae of STI

A

sterility or infertility
birth defects if preg

196
Q

bacterial STI

A

chlamydia
gonorrhea
syhpillis
bac vaginitis

197
Q

viral STI

A

hiv
hsv2
hpv
hep a-c

198
Q

fungal STI

A

yeast infection (candida)

199
Q

parasitic STI

A

trichomonas vaginalis
pubic lice
scabies

200
Q

bacterial STI s/s

A

genital lesions (syphil, hpv, hsv)
lymphadenopathy
perineal itching, erythema
pain w/ urination
foul discharge (change in amnt, color or smell can indic infection)

201
Q

chlamydia

A

most reported STI
many asympt- goes untreated
effects men, wmn, babies
can infect throat, rectum and eyes
trtmnt- 1 gm azithromycin PO
or doxycycline 100 mg PO BID x7 (contraind in preg)

202
Q

gonorrhea

A

women less likely than men to present w/ s/s
thick discharge
can affect joints, blood, eyes, throat, rectum
trtmnt- no sex during trtmnt and for 7 days after (reduces r/f antib resistance surge)
500 mg ceftriaxone IM x1

203
Q

syphilis

A

10-90 incubation period
3 stages
1st- 3wks w/ chancre
2nd- 42-6mo flu like s/s, hair loss, RASH on palms and soles
can get warts on tongue
3rd- w/in 1 yr, s/s absent, serious nervous system damage, mental changes
cannot be spread in latent phase

204
Q

syphilis trtmnt

A

penicillin (benzathine pen G)- 2.4 million units IM x1
test for concurrent HIV
re-exam at 3 and 6mo
can be reinfected

205
Q

syphilis target pop

A

very prominent in MSM

206
Q

congenital syphilis

A

50% mort rate
primary- educating teens
secondary- prenatal screening
tertiary- Pen Ben G im x 1 or x3

207
Q

STI screening

A

13-64 tested at least once for HIV (if injects- annually)
annual chlamydia sexually active <25 yr
syphilis, hiv, chlamydia, hep b and gon for preg
MSM (gay and bisex) q3-6mo

208
Q

STI disparities

A

15-24yr olds
non-hisp blacks
MSM, gay (syphilis and gonorrhea)
*differences reflect access to care and risk of encountering an infected indiv. not sexual practices

209
Q

herpes simplex virus 2 (HSV2)

A

periodic exacerb
buring, flu like s/s, rash,blisters, lymphad

210
Q

herpes types

A

1- oral
2- genital= inc rf cervical ca
if active lesions= c section

211
Q

herpes trtmnt

A

acyclovir 400 mg TID (5x) 7-10days
NO CURE

212
Q

Human papillomavirus (HPV)

A

wmn- warts, cancer, birth defects
men- warts, cancer

prevention- vaccination (Cervarix, Gardasil)
trtmnt- topical, removal

213
Q

HPV prevention

A

vacc age 11-12 (cervical cells changing)
pap screening q3yr >21 yrs
annually if abnormal

214
Q

molluscum contagiosum

A

poxvirus
commonly in children
rash everywhere except palms and soles
umbilicated papule (ulcerated in middle)
trtmnt- removal prn, self limiting

215
Q

trichmoniasis

A

protozoal infection
trtmnt- metronidazole 2 gm PO x 1
men usually no s/s
wmen- frothy green disch w/ stong odor

can be transmitted from men (urethra) or wmn

216
Q

yeast infection

A

causes- recent antib, douching, high sugar diet, can occur w/ HIV
trtmnt- antifungal cream

if pt has burning they need to be assessed. could have UTI or yeast infection

217
Q

pubic lice

A

parastitic mites, feed on blood
trtmnt- mech removal, topicals w/ permethrin, wash clothing/linens in hot water and hot dryer

218
Q

scabies

A

itch mite
direct prolonged skin to skin contact
itching and pimple like rash (burrows) in armpits, belt area and webbing of fingers

cannot get from clothing, pool, animals etc

219
Q

scabies trtmnt

A

scabicides
wash in hot water, dry with hot dryer or seal in plastic bag for at least 72 hr

220
Q

incarceration- rates and consequences

A

inc in areas of poverty and ppl of color live
inc money on corrections= dec funding for education and prevention

221
Q

pre v post arrest diversion programs

A

pre- train officers to id ppl. w/ mental health illness
post- eval for mental h and substance abuse

222
Q

prisoners rights

A

access care, refuse trtmnt
right to informed consent and medical confidentiality

223
Q

population at risk for jail

A

low ses
males
black or hispanic
many have chronic dis or infectious dis

224
Q

nursing care for inmates

A

education
screenings
preventative services
manage chronic conditions
health assessment required w/in 14d of admin

225
Q

who shapes correctional care

A

nurse practice act, code fo ethics, federal and state laws, regulations and supreme court decisions

226
Q

common inmate health problems

A

mental health
drug abuse
communicable dis
chronic conditions (TBI)

227
Q

inmate pop at risk for suicide

A

female
younger
white
suffer most from mental h problems
inc risk if committed violent crime

228
Q

inmmates- communicable dis

A

tb, mrsa, influenza, hep c, sti, hiv/aids

spreads quickly
most prisons prohibit condom distribution
eval upon admit- look for retinal hemorrh and hepatitis

229
Q

future inmate trends (pop)

A

older, sicker
live and dying in prison
females
more chronic conditions

230
Q

alt/ast range

A

> 35= injury
most commonly inc d/t fatty liver dis, hepatitis (inflamm of liver) or hemochromatosis

231
Q

hepatitis gen s/s

A

fatigue, upper r quadrant pain, jaundice, clayish/white stool, dark urine, fever

232
Q

hep a transmission

A

NOT lead to chronic ilness
fecal/oral (contaminated food/water) (produce)

233
Q

hep a s/s

A

gain natural immunity for life after recover

234
Q

pop at rf hep a

A

poor sanitation, lack safe water
sexual partner w/ someone who has hep a
traveling to areas w/o being immunized
injecting drugs
homeless
gay, MSM
incarcerated
undeveloped countries-
commonly in children

235
Q

hep. a dx, tx and prevention

A

dx- blood test
tx- immunoglobulin for s/s, fluids
prevention- vaccine, sanitary practices
vaccine for children >1, employees at day cares, travelers, MSM, employees in nursing homes

NOT for preg moms

236
Q

hep b transmission

A

blood, semen, body fluids

237
Q

hep b s/s

A

avg 90d incubation
acute phase- non s/s, may be sick for couple days
severe sickness= fulminate hepatitis
most healthy adults can recover completely

238
Q

pop at rf hep b

A

sex w/ infected partner
contact w/ blood (healthcare workers)
mother to child transmission
sharing needles, razors, toothbrushes
tattoo/acupuncture
endemic in china and asia commonly in childhood

239
Q

hep b prevention, tx, dx

A

dx- blood test (antigen will show + before develop s/s)
tx- meds, hydration
prevention- vaccine (1st dose at birth, 2nd before 6mo)

240
Q

hep b antigen v antibody

A

antigen- + if exposed
if persistently += carrier

antibody- + if someone has been vaccinated (passive immunity)
or
+ indicates end of acute infection

  • does not always mean person has had the actual dis
241
Q

hep c transmission

A

bloodborne
asymp
if s/s dev will have cirrhosis
DO NOT dev natural immunity -can be reinfected even after recover

242
Q

hep c acute v chronic phase

A

acute- w/in 6 mo
most often progresses to chronic

chronic- lifelong infection if untreated
ae- cirrhosis, ca, death

243
Q

pop at rf hep c

A

0-19 and 19-29 yr olds
injecting drugs
blood transfusion before july 1992
blood or organ from hep c + person
sharps injury
hep c infected mother
common in egypt

244
Q

hep c dx, prevention

A

dx- blood test, genetic testing (genotype 1 in US0
liver biopsy
prevnetion- NO vaccine
avoid blood products and blood
sexual transm is low among monogamous couples
get vacc for hep a and b

245
Q

hep c trtmnt

A

antiviral
wkly injections (interferon alfa)
ribavirin PO BID
expensive trtmnt 24-48 wks

246
Q

hep d

A

have to have had hep B
prevention- hep b vaccine

247
Q

hep e

A

fecal contaminants
ages 15-40
no vaccine
dx- stool study
treatment- symptomatic
prevention- sanitary practices
hep a vaccine?

248
Q

where to report hep cases

A

state health dept and billings area IHS
federal, state, county, tribal

249
Q

popular areas. for hep dx

A

ER
treatment centers
homeless sites
adult book stores, massage parlors
family planning
institutional settings

250
Q

hep- public health action

A

awareness
mobilize resources
screening
marketing
media campaigns
task forces (tribal)

251
Q
A

477- Public Health (2 decks)

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