Exam 2 Flashcards
What is the definition of violence?
an intentional act committed by a person(s) against another person(s) in which there is a conscious choice to act violently
What are the 1st and 2nd leading cause of death in the US?
MVA and Firearms
What are factors that contribute to gun related homicides?
- low income
- discrimination
- lack of education
- lack of employment opportunities
What is a nurses role in gun safety?
they should be vigilant in assessing for gun possession in the home and whether it is safely stored away from children
How does IPV (intimate partner violence) differ?
differs based on culture, dicipline, theoretical framework and philosophical perspectives
What are risk factors of IPV?
- less than 45 years old
- low income
- lack of employment
- recent seperation/divorce
- low education level
- having young children
What are health consequences in children who witness abuse?
- adjustment problems, agression and risky adult behaviors
Women affected by IPV are more likely to engange in ____
high risk behaviors such as tobacco use, substance abuse, and sexual risk taking
How should a nurse screen for IPV?
- nurses need to make questioning sound normal and routine
- know what resources are available and know how to respond to the needs of the patient
- screening should include physical, sexual, emotional and financial abuse
- avoid blame
- build a relationship with the patient - empower the pt
What is the definition of elder abuse?
intentional actions that cause harm (intended or not) or create a serious risk of harm to a vulneable elder by a caregiver or other person whom the elder person trusts
- harm includes failure to satisfy the elder’s basic needs or protect from harm
What is the definition of child maltreatment?
any recent act or failure to act on the part of a parent or caretaker which results in death, serious physical or emotional harm, sexual abuse, or exploitation or any act/failure to act which presents an imminent risk of serious harm
What offers the best hope for reducing abuse/neglet?
prevention strategies
What are possible interventions to prevent/decrease violence?
- prevent exposure
- proving information regarding the cycle of violence
- risk factors associated with increased risk of homicide
- safety planning
- IVP resources specific to them
- national hotline numbers
What is human trafficking?
recruitment, harboring, transportation, provision, or obtaining of a person for the purpose of a commercial sex act, labor or services
What are some potential indicators for human trafficking?
- person doesnt speak english/someone speaks for them
- person doesnt seem to know where they are
- they do not have ID or money
- signs of abuse, neglet, malnutrition, exposure to chemicals
- person has a tattoo representing branding
What are some reasons trafficked people do not ask for help?
- threats of violence to themselves or family
- fear of arrest or deportation
- language barrier
- lack of knoeledge for help/shame/being tested to see if they are trust worthy
What is a SANE nurse?
sexual assault nurse examiner
What is the focus of forensic nursing?
- taking a history of the assult
- collecting evidence
- provding treatment and follow up
What is abstinence?
no use of an illicit substance or alcohol in the preceding 12 months
What are examples of global health policies to minimize harms from substance abuse?
- national awareness campaigns
- minimum drinking age
- license restrictions
- marketing restrictions
- increased pricing through taxes (cigs)
In the US, rates of substance abuse are higher among ____ population than the ____ population
native borne, immigrants
What are high risk populations?
- pregnant women
- substance abuse at an early age
- college students and binge drinking
- older adults
- persons who inject drugs
- methamphetamine users
What is the leadingcause of preventable developmental disability in the world?
fetal alcohol syndrome (FAS)
Infants born to mothers who inject drugs are at an increased of what diseases?
HIV and Hep C
What factors contribute to early substance abuse?
- poor impulse control
- attention deficits
- conduct disorders
- general psychological dysregulation
What is the definition of binge drinking?
alcohol consumption that brings the BAC to above 0.08% (4 drinks for women and 5 drinks for men)
What is the methamphetamine anit-proliferation act?
put restrictions on how much pseydophedrine that can be purchased OTC
What are drugs that assist the tx of alcohol dependence?
- naltrexone (vivitrol)
- acamprosate (campral)
- disulfiram (antabuse)
What are medication that assists the tx of opioid use?
- methadone
- buprenorphine
- naloxone (narcan)
What are some risks to inmates, their families and healthcare workers?
- security issues
- desparining attitudes
- overcrowding
- increases in TB/HIV/STDS
What are some social injustices or economic problems felt by inmates after release?
- affodable housing
- social support
- reconnecting families
- literacy
- job training
What is recidivisim?
the potential for a convicted criminal to reoffen
(norway)
What is a trimorbidity?
substance addiction, mental illness and chronic health problems
What is the definition of environment?
anything outside of ourselves whether human-made or natrual
What is environmental health?
the branch of public health science that focuses on how the environment influences human health
What is exposure?
contact between people and environmental contaminant
- can happen at any time
What is the environemental protection agency (EPA)? When was it established?
- established in 1970, in response to growing public demand for cleaner water, air and land
What is the precautionary principle?
if something has the potential to the enviornment or humans, precautionary measures should be taken if there is a lack of scientific evidence concerning cause and effect
i.e.: e-cigs
Exposure to radon and smoking leads to…
lung disease/cancer
What is a risk assessment of enviornmental contaminants?
a process to determine the likelihood that adverse effects such as illness or disease will occur because of exposure to an enviornmental contaminant
What is exposure pathway?
process of exposure to a contaminate that originates from a specific source
What are the 5 parts of exposure pathway?
- source of contamination
- environmental media and transport
- point of exposure
- route of exposure
- receptor population
What is source of contamination?
what the contaminants are and where they are coming from
What is point source vs nonpoint source?
point source: specfific identified source (very direct)
nonpoint sources: diffuse sources
What is the definition of environemental media?
where the contraminant is; whats contaminanted
(i.e.: groundwater, surface water, air, surface soil, subsurface oil, sediment, plants and animals)
What are the transport mechanisms?
how the contaminant moves from the sources to the point of exposure to people
What is the point of exposure?
where people come in contact with a contaminated medium
What are routes of exposure?
- ingestion
- injection
- skin contact
- inhalation
Who is the receptor population?
the people who are liekly to be exposed
What is proximity in environmental health?
closeness to contaminant
For a contaminant to pose a risk there must be a completed
exposure pathway
What is toxicology?
is the study of the adverse effects of chemical, physical, or biologic agents on people, animals, and the environment
What is bioavailability?
is the amount of contaminant that actually ends up in the systemic circulation
What is biomonitoring?
is the process of using medical test such as blood or urine collection to determine if a person has been exposed to a contaminant and how much exposure he or she has recieved
What are the steps in taking an exposure history?
- identify current or past exposure
- Eliminate exposure
- try to mitigate or reduce a patients afverse health effects from exposures
What is the healthy homes approach?
to prevent disease, and injuries that result from housing related hazards and deficies
What is the focus of healthy homes?
to identify health, safety, and quality of life issues in the home environement
- reduce lead paint, improve air quality, mold/mildew mitigation and control
Who is the most vulnearable population?
children
Why are children vulnearble?
- body systems are still rapidly developing
- eating, drinking and breathing more in propportion to their body size than adults do
- breathing zone is closer to the ground
- bodies less able to breakdown and excrete contaminants
- Behaviors can expose them to more contaminants
- spending time outside home
What is the definition of environment justice?
is the belief that no group of people should bear a disporportionate share of negative environmental health consequences regardless of the race, culture and income
What are global environemental health challenges?
- clean water and sanitation
- air quality
- chemical and contaminant exposure
- climate change
What is the defition of mass casualty incident (MCI)?
an event that overwhelmes the local health care system, where the number of casulties vastly exceeds the local resources and capabilities in a short period of time
What is biological terrorism?
the deliberate relsese of viruses, bacteria, or other germ agents used to cause illness/death in people, animals or plants
What is chemical terrorism?
the intentional release of hazardous chemicals into the environment to harm/kill
How do disasters vary?
- the type of onset
- the duration of the immediate crisis
- the magnitude or scope of the incident
- the extent to which the event affects the community
What are three types of disasters?
- natural
- accidental
- terrorism
What is the first goal after a disaster within a community?
provide basic needs
What to do after a disaster?
- provide basic needs
- monitor for infectious disease outbreaks
- consider special populations (elderly, children, developmentally disables)
- monitor stress reaction in victims AND first responders and public health workers
What is the purpose of disaster planning?
to effectively manage the response to disasters
When does disaster planning start?
before the diaster happens
What is included in disaster plans?
frequent drills to evaluate their effectiveness, identify weaknesses and address gaps - evaluation after drill is key
What is the disaster management cycle?
- preparedness
- mitigation
- response
- recovery
- evaluation
Community disaster plans should identify:
- roles of personnel in disaster reponse and chain of command
- call up system
- local, state, federal agency contacts
- equipment and supplies - plans for 72 hrs until SNS can be deployed
What is the national response framework? Who was it established by?
established by the homeland security, guides the conduct and coordination of all hazards incident reponses
What is the national incident management system?
framework that guides all levels of government, nongovernmental organizations that the private sector to work together to prevent, protect against, mitigate, respond t and recover from incidents
What are point of distribution (POD) or emergency dispensing site (EDS)?
it is a centralized location to pickup emergency supplies, food, water, and medications following a disaster
What are table top exercises (TTX)?
involves key personale discussing simulated scenarious in an informal setting
What are ways to mitigate a disease?
PPE (gloves, N95, masks, goggles, pens/paper, large trashbags)
Who is at the first level of response during a disaster?
local first reponsders (fire, police)
What is the responsibility of feild triage?
- identifies and assesses those people who need medical care and priorities their needs
- victims are assessed by their presenting condition and they then are color coded as to the severity of the case
What is antigenic drift vs shift?
the antigenic drift is the slow and progressive genetic changes that take place in DNA and RNA as organisms replicate in multiple hoss.
The antigenic shift is a sudden change in the molecular structure of DNA and RNA in microorganisms, resulting in a new strain of the microorganisms.
What is antibiotic stewardship?
a set of coordinated strategies to improve the use of antimicrobial medications with the goal of enhancing patient outcomes, reducing resistance to antibiotics, and decreasing unnecessary cost
What is the convergence model?
it is the model illistrating the interaction of 13 factors that contribute to the emergence and reemergence of infectious diseases
What is directly observed therapy?
it is observation of clients to ensure that they ingest each dose of anti TB medication to maimize the likelihood of completion of therapy
What is an ecosystem?
it is a natural unit consisting of all iving things (plants, animals, bacteria, viruses) interacting with, and dependent on, one another for survival within their nonliving environment
What is the definition of emerging infectious disease?
newly identified, clinically distinct (novel) infectious disease
What is herd immunity?
type of immunity in which a large proportion of people in a population are not suseptible to a communicable disease and the few people who are susceptible will not liekly be exposed and contract the illness
What is microbial adaptation?
process by which prganisms adjust and change to their environment
What is the definition of reemerging infectious disease?
it is the reappearance of a known infectious disease after its decline with an incidence that is increasing in a certain geographic area or among a specific population
What is a vaccine preventable disease?
dangerous or deadly diseases that are preventable by vaccination
What is the definition of femicide?
it is a term used to describe a homicide of a female person that occurs in the context of Intimate partner violence
What is gender based violence?
it is a term used to distinguish violvence which targets people, or groups of people, on the basis of their gender from other forms of violence. It includes any act that results in or is likely to result in, physical, sexual, or psychological harm such as rape, torture, mutilation, sexual slavery, forced impregnation and murder
What is intimate partner violence?
a pattern of assaultive and coercive behaviors which may include inflicted physical injury, psychological abuse, sexual assualt, progressive social isolation, deprivation, intimidation and threats. These behaviors are perpetrated by someone who is, was or wished to be involved in an intimate or dating relationship with an adult or adolescent and they are aimed at establishing control by one partner over the other
What is the lethality assessment?
an assessment that identifies high-risk factors for IPV
What is the definition of perpetrate?
to be responsible for;commit a crime
What is defintion of violence?
framed in the context of intentional violence state another way that which is carried out by a person or persons against another person(s) when there is a conscious choice to act in a violent manner
Addiction is also called
substance dependece
What is the defintion of a craving?
a very strong urge or desire to seek the euphoric feeling achieved by using substances
What is the definition of intoxication?
a reversible syndrome that appears after injestion of a specific substance that results in clinically significant problematic behavioral or psychological changes (belligerence, mood lability, impaired judgement, disturbances of perception, psychomotor behavior and interpersonal behavior)
What is the defintion of early vs sustained remission?
early remission occurs when a person has previously met criteria for a substance use disorder by has not met the criteria for 3-12 months.
sustained remission occurs when a person no longer meets the criteria for a substance use disorder for 12 months or more
What is the defintion for substance use? What is included in this?
it is the use of alcohol, illicit drugs and no medical use of prescription medications.
Illicit drug use includes cannabis, cocaine, heroin, hallucinogens, inhalents and methamphetamines. Prescription medications used nonmedically include pain relievers, tranquilizers, stimulants and sedatives
What is the definition of tolerance?
diminished physical and or psychological response to effects of alcohol or illicit substance. A person develops a tolerance when he or she needs to use higher doses of alchol or illicit substances to achieve the desired euphoric effect
What is the definition of withdrawl?
it is a reduction in prolonged aubstance use that results in problematic behavioral, physiological and cognitive changes. Withdrawl causes significant impairment in social, occupational, and interpersonal functioning and is usually associated with an urge to readminister the substance to reduce the symptoms
What is genomics?
the study of DNA sequencing to analyze the function and struction of complete sets of DNA in a cell of an organism
What is health professional shortage area?
geographic area, population group or medical facility with shortages of healthcare professional that may not allow a full complement of healthcare servicves
What is an inmate?
a person who is held in a jail or prison to protect the public
What is a medically underserved area?
area that is determined through calculation of a ratio of primaru medical care physicians per 1,000 population, infant mortality rate, percentage of the population with incomes below the poverty level, and percentage of the population aged 65 or older
What is a medically underserved population?
a US federal designation for those populations that face economic barriers (low-income or medicaid-eligible populations) or cultural and/or linguistic access barriers to primary medical care services
What is an underserved population?
a subgroup of the population that has a higher risk of developing health problems due to a greater exposure to health risk because of marginalization in sociocultural status, access to economic resources, age or gender
What is veterans health?
care or service that will promote, preserve and restore health of those who have served in the military
What is the definition of environmental epidemiology?
it is the feild of public health science that focuses on the incidence and prevalence and a disease or illness in a population from exposures in their enviornment
What is envrionmental justice?
it is the belief that no group of people should bear a disproportionate share of negative environmental health consequenses regardless of race, culture or income
What is exposure estimate?
estimated amount of contaminant that comes in direct contact with the body from inhalation, ingestion, dermal contact or injection
What is exposure history?
process to help determine whether an individual has been exposed to environmental contaminants
What is the all hazards vulnerability approach?
an integrated approach to emergency preparedness that addresses a wide spectrum of emergencies
What is an after action report?
retrospective analysis used to evaluate emergency response drills
What is decontamination?
the process of cleaningto remove biologic, chemical or radiologic agents
What is evacuation?
moving people from a dangerous place to safety
What is human simulation training?
use of life-like/computerized models for creating increased reality during a practice scenario
What is incident command system goal?
to improve emergency response
What is invacuation?
moving people from one area to another within the same facility
What are strategic national stockpile?
the supply of potentially lifesaving pharmaceuticals and medical supplies maintained by the CDC for use in a public health emergency severe enough to cause lack of local supplies
When do symptoms of schizophrenia typically appear?
- late adolescence or young adulthood
- ## persists throughout a persons life
What is the primary goal of early intervention programs?
- to maintain the individuals current level of educational and vocational functioning through early treatment
What is the secondary goal of Early intervention programs?
identify at risk individuals prior to the onset of hallucinations, delusions and other disorderly thinking
Medication in psychosis shoule be supplemented with…
medication treatment should be supplemented with psychoeducation, cognitive behavioral therapy and family therapy
What is the most common factor associated with relapse of psychotic symtoms?
non-adherence
How does the duration of psychotic symptoms affect the anatomy of the brain?
- the longer and more frequent symtpms the greater the grey matter atrophy, the greater the impairment in cognition
What are nursing interventions for adherence in schizophrenia?
- oral and written reminders
- self monitoring tools
- cues and positive reinforcement by the nurse and the family
What is the rule of thumb for first gen drugs to tx schizophrenia?
- oral meds before injectable meds
Why is med adherence difficult?
because of side effects
What are common side effects of first gen schizophrenia drugs?
- tardive dyskinesia
- akathisia
- dystonia
- blurred vision
- urinary retention
- Neuroleptic malignant syndrome
What is tardive dyskinesia?
irreversible twisting movements of tounge, lips and torso
What is akathisia?
extreme restless limbs
What is dystonia?
serve muscle stiffness
- usually the neck
What are symptoms of second gen schizophrenia drugs?
- less chance of TD
- greater weight gain
- dyslipidemia
- hyperglycemia
How do the rates of mental illness differ in high risk populations?
the unemployed, the poor, and the homeless all report higher levels of depression, anxiety, schizophrenia, and substance abuse
what is a strong predictor for suicide?
past self harm
What shows the greatest promise for lowering the rate of suicide?
population approaches
What strategies does the WHO recommend to reduce suicide?
- restrict access to means of self harm/suicide
- develop policies to reduce harmful use of alcohol as a component of suicide prevention
- encourage the media to provide information about where to seek help and avoid sensationalizing suicide
What are nursing interventions for mood and anxiety disorders?
- patients should be directly asked if they have any thoughts of harming themselves
- if yes ask if they have a specific plan to carry it out
- non-suicidal injury should always be interpreted as a cry for help
How is a diagnosis made for hoarding disorders?
a person must accumulate and not discard, items to such a degree that it impairs their ability to perform basic skills of daily living
what is the treatment for hoarding disorders?
antidepressants, cognitive behavior therapy and family support
How do the symptoms of ADHD differ from bipolar disorder?
ADHD: distracted, unrelenting motor behavior, unable to sit still/finish task
Bipolar: family hx of mood disorder and mood symtoms
What is the nurses role in ADHD and bipolar disorders in children?
- help adolescent understand their diagnosis
- be empathetic
- an active listener and supporter
What is the mental health parity act?
- all health insurance coverage (deductibles, copays, coinsurance, and out of pocket expenses) as well as tx limitations including frequency of treatment number of visits, days of coverage or other similar limits will be the same regardless of health need or diagnosis
What is the patient protection and affordable care act?
assured that behavioral health would be an essential benefit for all insurance plans
What are the 3 stages of psychological first aid?
- protect, connectm and direct (food, clothing, shelter)
- connection with family and loved ones
- nurses act as advoactes and direct survivors to relief agencies
What is the education for all handicapped children act?
- the inclusion of all children with special needs
- amendment to act: required identification of children who have a learning problem due to a medical issue that requires special services
- once identified the child needs an individual edication plan (IEP)
What is the individuals with diabilities education act (IDEA)?
- originally the education for all handicapped children act
- designed to protect the rights of students with diabilities by ensuring that everyone receives a free appropriate public education regardless of ability
What is the every student succeeds act (ESSA)?
- attempts to ensure success by focusing on the best teaching and learning strategies for all students, inclduing gifted and talented students
What is the whole school, whole community and whole child model?
- outlines the 10 recommended components of a comprehensive school health program
What are three types of school health service visits?
- visit for acute illness (vomiting, fever, headache)
- typical screenings (vision, hearing, immunization status)
- counseling (advice and support)
What is the youth risk behavior surveillance survey?
biannual survey of common risk behaviors influencing todays youth
What is the school health index?
an online self-assessment and planning tool that schools can use to improve their health and safety policies and programs
What is the role of the school nurse as a health educator?
- schoo nurses educate students and their families in the classroom, in individual encounters and/or in group meetings
How do you prevent bullying?
- assess, engage parent and youth, set policies and riles, build a safe environment, educate after bullying
What is electronic bullying?
bullying through email, chat rooms, instant messaging, websites or texting
What is the nurses role as an advocate?
- spread knowledge
- networking: working together with parents, teachers, and healthcare workers
What is bioterrorism?
the intentional release of viruses, bacteria, fungi or toxins into the environemtn for the purpose of causing illness or death
What are bioterrorism agents?
- anthrax
- botulism
- plague
- small pox
- tularemia
- viral hemorrhagic fevers
How does a chemical disaster differ from a biologic one?
- does not require an incubation period like biologic agents
- makes its presence known immediately with rapidly emerging symptoms
What are common symptoms of PTSD?
- faulty memory
- inabilitiy to concentrate
- mood swings
- depression
- comatic complaints
