1
Q

Health

A

a state of complete physical, mental and social well-being and/or the absence of disease or illness.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Top 10 Causes of death

A
o	Heart disease
o	Cancer
o	Chronic lower respiratory disease
o	CVA
o	Accidents
o	Alzheimer’s disease
o	DM
o	Influenza and pneumonia
o	Kidney disease
o	Suicide
*8 can be prevented by healthier life styles
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Determinants of health

A
o	Age
o	Sex
o	Heredity 
o	Lifestyle
o	Social and community networks
o	Environment
o	Socioeconomic
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Levels of Prevention

A

o Primary Prevention
o Secondary Prevention
o Tertiary Prevention

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Tertiary Prevention

A
restoration and maximizing potential 
•	Restoration and rehabilitation
•	Rehab following CVA
•	Surgical procedure
•	Optimum control of chronic conditions
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Secondary Prevention

A
early identification and treatment.  
•	Early diagnosis and prompt treatment
•	Disability prevention
•	Individual or mass screenings
•	Selective examinations
•	Routine physical exam 
•	Cholesterol screening
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Primary Prevention

A
promoting optimum health before the onset of problems.  Precedes disuse or dysfunction.  
•	Health promoting
•	Specific protection
•	Diet
•	Exercise
•	Immunizations
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Health people 2020

A

o 42 topic areas & 600 objectives

o Focus on the Determinants of Health

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Health people 2020, 12 Leading Health Indicator topics

A
o	Access to health services
o	Clinical preventative services
o	Environmental quality
o	Injury and violence
o	Maternal, infant and child health
o	Mental health
o	Nutrition, physical activity and obesity
o	Oral health
o	Reproductive and sexual health
o	Social determinants
o	Substance abuse
o	Tobacco use
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Ethical principles

A
o	Autonomy 
o	Beneficence
o	Non-maleficence 
o	Justice 
o	Veracity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Autonomy

A

– rights of individuals and their right to determine their lives
• Reason and the ability to make rational choices, to understand one’s environment
• Right to information
• Right to privacy and confidentiality
• Right to appropriate care and treatment
• Difficulties
• Tendency to give advice instead of information
• Persuade clients to change their behavior
• Dismiss the client’s ideas without providing an adequate explanation
• Challenge is accept role of partner and enabler rather than expert and controller
o Beneficence – doing good
• Screening
• Based on economic considerations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Beneficence

A

– doing good
• Screening
• Based on economic considerations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Non-maleficence

A

– does no harm

• Screening may foster anxiety or be painful

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Justice

A

– being fair and equitable

• What is the fair distribution of scarce resources

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Veracity

A

– tell the truth
• Unbiased information based on evidence
• Some cultures do not bale truth in cases of terminal illness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

At risk adults are those who are:

A
o	Depressed
o	Job changes
o	Unemployed
o	Chronic illness
o	Martial crisis
o	LGBTIQ
o	Incarcerated
Other minorities
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Maslow’s hierarchy

A
o	Basic physiologic needs
o	Safety needs
o	Belongingness/love needs
o	Esteem needs 
o	Self actualization
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Self actualization

A

To find self-fulfillment and realize one’s potential

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Esteem needs

A

To achieve, be competent and gain approval and recognition

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Belongingness and love needs

A

To affiliate with others, to be accepted

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Safety needs

A

To feel secure and safe, out of danger

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Basic physiologic needs

A

Hunger, theist and related needs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Immunity

A

Adaptive immunity
Innate immunity
Inflammatory process

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Adaptive immunity

A
Natural
•	Passive – maternal
•	Active – infection 
Artificial
•	Passive – antibody transfer
•	Active – immunization
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Validity

A

a test that is able to classify a large portion of diseased and non-diseased individuals correctly.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Sensitivity

A

The number of diseased divided by the total number of individuals
Proportion of correctly classified diseased individuals.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Specificity

A

The number of correctly classified non-diseased divided by the total number of non-diseased individuals.
Proportion of correctly classified non-diseased individuals.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Immunizations at birth

A

Hep B, 1st dose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Immunizations at 2 Months

A
Hep B, 2nd dose
RV1 (Rotavirus)
DTaP, 1st dose
Hib, 1st dose
PCV, 1st dose
IPV, 1st dose
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Immunizations at 4 Months

A
RV1, 2nd dose
DTap, 2nd dose
Hib, 2nd dose
PCV13, 2nd dose
IPV, 2nd dose
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Immunizations at 6 Months

A
Hep B, 3rd dose
DTap, 3rd dose
PCV, 3 rd dose
IVP, 3rd dose
Flu, and every year following
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Immunizations at 12 Months

A
Hib, 3rd dose
PCV, 4th dose
IPV, 3rd dose
MMR, 1st dose
VAR, 1st dose
Hep A, 1st dose
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Immunizations at 18 Months

A

DTaP, 4th dose

Hep A, 2nd dose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Immunizations at 4 - 6 Years

A

DTap, 5th dose
IVP, 4th dose
MMR, 2nd dose
VAR, 2nd dose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Immunizations at 11 - 12 Years

A

Meningococcal, 1st dose
Tdap
HPV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Immunizations at 16 Years

A

Meningococcal, 2nd dose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Birth to 5 Years Screening

A

Height, weight, B/P
Vision Start at age 3-4
At birth: Hemoglobinopathy, phenylalanine, T4 TSH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Birth to 5 Years Counseling

A

Car seat safety or lap belts, bicycle helmets, smoke detectors, flame retardant sleepwear, hot water heater temperature, window/stair guard, safe storage of harmful substances, poison control number, CPR training for caregivers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Child 5 - 10 Years Screening

A

Height, weight, B/P

Assess for nutritional, learning, developmental problem

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Child 5 - 10 Years Counseling

A

Injury prevention: lap belts, helmets, smoke detectors, safe storage of firearms
Substance Abuse: Avoid tobacco, underage drinking, illicit drugs, drinking and driving
Sexual behavior: good touch/bad touch

41
Q

11 - 24 Years Screening

A

Height, weight, B/P
PAP, Chlamydia screen, Rubella (Females)
Assess for drinking problem

42
Q

11 - 24 Years Counseling

A

Injury prevention: lap belts, helmets, smoke detectors, safe storage of firearms
Substance Abuse: Avoid tobacco, underage drinking, illicit drugs, drinking and driving
Sexual behavior: STD prevention, abstinence, avoid high risk behavior

43
Q

25 - 64 Years Screening

A

Height, weight, B/P
Total cholesterol
PAP/ Pelvic
FOB and/or sigmoidoscopy/ colonscopy > age 50
Mammogram + clinical breast exam (50-69)
Assess for substance abuse
Rubella for childbearing women + MVI with folic acid

44
Q

25 - 64 Years Counseling

A

Injury Prevention
Lap belts, helmets, smoke detectors, safe storage of firearms
Tobacco cessation, safe use of ETOH, diet and exercise
Limit fat and cholesterol, maintain caloric balance
Emphasize grains, fruits and vegetables
Adequate Calcium for women
Regular physical activity
Sexual Behavior
STD prevention, abstinence, avoid high risk behaviors
Dental Health
Regular visits to dentists
Brush, floss and use fluoride toothpaste

45
Q

65+ Years Screening

A
Height, Weight, B/P
FOB, colonscopy or sigmoidoscopy
Mammogram + CBE Stop age 70
Pelvic exam  test
Vision and Hearing Screening
Substance Abuse
46
Q

65+ Years Counseling

A
Tobacco cessation, safe use of ETOH
Diet and Exercise
Limit fat and cholesterol, maintain caloric balance
Emphasize fruit, grains and vegetables
Adequate CA for women
Regular physical activity
Injury prevention
Lap belts, helmets, smoke detectors
Fall prevention, safe storage of firearms
Hot water heater temperature
CPR for household members
47
Q

Immunizations at 65+ Years

A

Pneumococcal
Influenza
TD booster
Shingles

48
Q

Bradshaw Taxonomy of Need

A

Normative: square feet in homes for foster children/ BP

Felt needs: what someone internally thinks and feels that they need May not express it/ difficult to ascertain

Expressed needs” what people say they need/ may or maynot be an actual need

Comparative needs- comparing one group to another

49
Q

Healthy People 2020 Infant & Children Objectives

A

Newborn screening
Reduce the number of children living in homes with lead paint
Timely follow-ups
early developmental and autism screening
increase the number of infants put to sleep on their back
increase the number of infant that are breast fed
increase car seats and bike helmets
increase use of protective gear in sports
decrease child abuse

50
Q

Healthy People 2020 Adult Objectives

A

increase screening for Chlamydia infections
screen for STIs and BV during prenatal visits
increase number of women getting Pap tests
increase glacoma screening
increase colorectal screening
increase mammogram screening
decrease the number of people living in homes w/ lead paint
increase cholesterol screening
increase HTN screening
increase TB screening in those infected w/ HIV

51
Q

Screenings ADOLESCENTS

A

Yearly Wellness Visits

Height/Weight/BMI/Blood Pressure

Lipid Screening age 17-21 years

Hearing Screening 11 to 14 years, 15-17 years and 18 to 21 years

Vision Annually

Depression Screening at 12 yrs

Alcohol, Tobacco and Drug Use Screening

HIV, Hep B, Hep C and STI Screening for At Risk

Diabetes Screening if At Risk

52
Q

Screenings 5-12

A
Yearly Wellness Visits
Height/Weight/BMI yearly
Blood Pressure yearly
Lipid Screening age 9 to 11 years
Dental Visits 
Hearing and Vision Screening yearly
TB testing if At Risk
Hgb/Crit if At Risk
Diabetes Screening if At Risk
Drug/Alcohol Screening for At Risk
STI’s if at High Risk
53
Q

Screenings Under 5

A

Well Child Visits: 12, 15, 18, 24, 30 months, 3, 4 and 5 years
Developmental and Behavioral Screening at 9, 18, 24 or 30 months and each routine visits/wellness
Anemia Screening at 9-12 months routinely; and 1-5 years if at risk. Highest risk between 1 and 2 years(AAP)
Autism Screening 18 and 24 months
Lead Testing if indicated age 1 and 2 years old
Height/Weight/BMI: Every visit
Blood Pressure, Vision, Hearing: Around 3 years old

54
Q

Screenings NEWBORN

A

Hypothyroidism
PKU (phenylketonuria)– People with PKU can’t process certain foods. They must avoid certain foods and drink a special formula. PKU can cause intellectual disability (mental skills that are below average) if it’s not treated early.
Sickle cell disease– This is a blood disorder that can cause problems like serious pain, infection, or stroke. If it’s found early, sickle cell disease can be watched and treated.
Hemoglobin Electrophoresis
Bilirubin
Hearing - within first month
Developmental Milestones especially under age 3
Wellness Visits: 1,2, 4, 6, 9 months

55
Q

Hypothyroidism

A

– The thyroid is a gland in the neck that makes the thyroid hormone. Hypothyroidism (low thyroid hormone) can cause problems with growth and development, but it can be treated if it’s found early.

56
Q

Formative Evaluation

A

evaluation of the process

57
Q

Summative Evaluation

A

evaluation of the outcomes

58
Q

Local Perspective

A

how the community defines their success

59
Q

Important Factors in Community Process

A
  • establish rapport
  • easier if a member of the community
  • community member competence
  • mutually agreed upon outcomes
60
Q

Community Partnership

A
  • initiated by community

- needs questionnaire to ascertain need

61
Q

The Ways Individuals Process Information is Determined By:

A
  • genetics
  • environment
  • Societal Influences
  • Developmental level
62
Q

Short Term Strategies

A
  • get their attention
  • chunk information
  • get to the point quickly
63
Q

Long term Strategies

A
  • connect key information with what the person already knows
  • engage the person in interaction with the information
  • repeat or restate
64
Q

Patient Goal Setting

A
  • assess pt goals
  • mutual goal setting
  • realistic goals
65
Q

Addressing Health Behaviors

A

ensure the pt understands your reasons for addressing the issue

66
Q

Partnership Strategies

A
  • consultant

- investigator

67
Q

Identify Pt Risk

A

Normative Permission

Neutral Language

68
Q

Normative Permission

A

normalize a health behavior to make behavior more acceptable to pt and therefor, easier to address

69
Q

neutral language

A

non-judgemental words and tone to address a health behavior

70
Q

Strategies for Teaching Young Teens

A
  • simple, concrete, today & tomorrow focus
  • use physical advantages when listing Pros & Cons
  • use peer situations
    identify confidentiality boundaries
71
Q

Strategies for Teaching Middle Teen

A
  • don’t challenge
  • work w/ what they know and add to that
  • guided peer education
  • use Pro’s & Con’s
  • expect slow behavior change
  • give structured choices if possible
72
Q

Strategies for Teaching Late Teen

A
  • open discussions
  • weigh Pros & Cons
  • plan for future
  • use reasoning and discuss value
  • work with desire to know
73
Q

PEEK

A

P - physical readiness
E - emotional readiness
E - experiential readiness
K - knowledge readiness

74
Q

Motivational Strategies

A
  • positivity
  • decrease the likelihood of failure
  • enhance learners self esteem
  • acknowledge the learner’s responsibility in completing the task
  • provide positive closure
75
Q

Strategies for Teaching Adults

A
  • active discussion and role play
  • present smaller amount of new material
  • help w/ synthesis, analysis and application
  • validate that they can learn
  • provide an environment that allows for sensory changes
  • provide visual information as well
76
Q

Prioritizing Learning Needs

A
  • mandatory
  • desirable
  • possible
77
Q

Mandatory

A

needs that must be learned for the survival or situation s in which the learner’s life or safety is threatened

78
Q

Desirable

A

need that are not life threatening but are related to well-being

79
Q

Possible

A

Needs for information that is “nice to know” but not essential or required to know

80
Q

Cultural Competency

A
  • develop a strategy for continuous education about the predominant cultures you treat
  • consider integrating the appropriate use of indigenous medicines and practices
  • use co-professionals from other cultures or members of the family or social network that can consult and mediate on specific pt problems
81
Q

Strategies for Teaching Children

A
  • get them interested
  • simplify the task
  • maintain the pursuit of the goal
    -control frustration and risk through achievable goals
    demonstrate an idealized version on the act to be performed
82
Q

Strategies for Teaching the Elderly

A
  • visual changes
  • memory changes
  • slow response time
83
Q

Learning Strategies to Remember

A
  • motivation (self)
  • reinforcement
  • retention
  • transference (a habit has formed)
84
Q

Family

A

a system, affected by culture, environment, religious-spiritual dimension and other variables which affect the person and society.

85
Q

Correlation of Healthy People 2020 to the Family

A
  • increase the proportion of people who have a source of ongoing care
  • reduce adult obesity
  • reduce child/teen obesity
  • decrease teen and adult drug and alcohol abuse
86
Q

Family Teaching

A
  • more effective
  • resource for the individuals
  • strong interrelationship between family & health of it’s member
87
Q

Calgary Family Assessment Model

A
  • cognitive
  • affective
  • behavioral
88
Q

Nuclear Family

A

male, female, kids, dog

89
Q

Extended Family

A

including grandparents

90
Q

Cohabitating Family

A

unmarried couple

91
Q

Augmented Family

A

part of the family that are of no relation

92
Q

unmarried Family

A

roommates

93
Q

Framingham Study

A

linked cardiovascular disease with smoking, obesity and high b/p

94
Q

CVD

A
  • # 1 killer in the nation, across the board
  • > 90 milion americans have some form of CVD
  • cost of CVD is >$1 billion by 2030
95
Q

CVD and B/P

A
  • HTN is most common primary dx in US

- most unaware of HTN

96
Q

Benefits of lowering b/p

A
  • decreases incidence of CVA by 35 - 40%
  • …of MI by 20 - 25%
  • …HF by 50%
97
Q

For HTN in pt >60 yr

A

initiate rx tx for:

  • systolic b/p >150
  • diastolic of >90
  • tx goal <150/90
98
Q

For HTN in pt <60 yr

A

initiate rx tx for:

  • systolic b/p >140
  • diastolic of >90
  • tx goal <140/90
99
Q

Initiating Tx for HTN

A

In the general nonblack population, including those with diabetes, initial drug therapy should include a thiazide type diuretic, CCB, ACE-I, or ARB, general black population including those with diabetes, initial drug therapy should include a thiazide type diuretic or CCB