Exam 2 Flashcards
ethics
branch of philosophy concerned with determining right and wrong in relation to people’s decisions and actions
ethics questions
- how should I behave?
- what actions should I perform?
- what kind of person should I be?
- what are my obligations to myself and others?
beneficence and non-maleficence
- doing good and doing no harm
- traced back to Hippocratic oath, provides framework for pt-provider relationship
autonomy
- freedom of choice, dignity, self-determination
- ex: advance directives, refusal of care
distributive justice
- fair allocation of benefits + burdens in society based on needs + contribution of members
- aka social justice
egalitarian
- everyone entitled to equal rights + treatment
- ex: vax
libertarian
- advocates for social and economic liberty
- emphasizes contributions of individual
utilitarianism
- moral value of action determined by overall benefit
- end justifies means
- greatest good for greatest number of people
deontology
- action is right or wrong in itself
- moral rules of duty vs. consequences
virtue
- practical reasoning applied to character development
care of ethics
- Jean Watson’s Caring Theory
- morality of responsibility in relationships, care as moral imperative
- people have varying degrees dependence and interdependence
- individuals affected by consequences of another’s choices deserve consideration in proportion to their vulnerability
- situational!
epidemiology def
study of distribution (patterns of health events) + determinants (diff factors influencing) of health related events in pops and the application of knowledge to improve health in communities
inductive research
- specific info–> gen. conclusion
epidemiological triangle
- agent: has to be present for disease/condition to develop (virus, bacteria, fungus, parasite)
- host: anything harboring inf agent
- environment: can be internal (comorbidities, immunity) or external (social, physical, cultural)
- COMMUNICABLE DISEASES
- if you change one part, you can me more susceptible
web of causation
- used for c non-inf diseases, non-communicable diseases, non-disease health related
- ex: CAD, DM, obesity, gun violence, opioid epidemic
types of applied epidemiology
- descriptive: personal characteristics, place, time
- analytical: origins, associations, causal factors
- experimental: intervention aimed at influencing event
epidemiological process vs. nursing process
similarities: problem solving based on scientific process/inductive/observation
differences: nursing looks at individuals and groups, epi looks at aggregates and pop
epidemiological investigation steps
- confirm + verify dx
- establish criteria to ID
- investigate and track cases
- establish existence of outbreak
- ID person, time, place
- surveillance- monitoring for changes beyond expected
epidemiological investigation questions
- who has been affected?
- common between all affected?
- when/where
- risk factors
- transmission
theory of multiple causation
- no single force produces disease
- looks for causal relationship
- investigates relationship between risk factors and environmental factors
endemic
baseline incidence (ex: malaria)
epidemic
cases exceed usual number over certain geographical area
outbreak
higher than endemic
pandemic
across world
vertical vs. horizontal mode of transmission
- vertical: mother to baby
- horizontal: person to person
routes of transmission
- direct: contact (touching c.diff stool)
- indirect: touch object (that has c.diff)
- common vehicle: food, water, air, bodily, fluids
- vector: tick, mosquito
- airborne: flu, RSV, TB, chickenpox
specificity of association
- event can only occur in presence of particular agent
biostats
- predictor for healthcare delivery
- limited by reporting mechanisms/barriers
- basis for ass health needs and planning public programs
- demographics, vital stats
- from CDC, census, coroner, state reporting laws
rates
- measures freq in def pop during specific time
- indicates severity of event
- numerator and denominator from same pop
risk
- probability a disease or health event will occur to given person/group within specific time period
ratio
- stat measure describing a relationship
- numerator not included in denominator
prevalence vs. incidence
- prevalence: existing disease
- incidence: new cases
morbidity
- levels of disease, rate of development, risk of disease occuring
chain of infection
- infectious agent: bacteria, virus, fungus
- reservoir: soil, water
- portal of exit: how it gets out of reservoir- cough, sneeze, saliva
- mode of transmission- how it travels- direct/in/horizontal/vertical
- portal of entry: mucosal, dermal
- susceptible host: age, gender, genetics, comorbidities
what stage of chain of infection can you prevent spread?
mode of transmission
infectivity
ability to enter host and multiply
pathogenicity
ability to produce clinical s
virulence
severity of clinical s
toxicity
poisonous s
invasiveness
penetrate and spread thru out tissue
antigenicity
stimulate immune response
resistance (host factor)
ability to withstand inf
immunity
natural (species determined) or acquired
herd immunity
immunity of group based on resistance of & of group
infectiousness
potential ability of inf host to inf others
factors influencing transmission
physical, biological, social, cultural
father of modern epidemiology
John Snow- plotted where sick people were, traced source of cholera to water pump, had cops remove and spread stopped
incubation period
- organism multiplying
- exposed, can’t pass disease along
- between exposure and onset of symptoms
communicable period
- contagious
- between exposure to stage of clinical disease
when we want levels of prevention
- primary- before susceptibility
- secondary- before exposure
- tertiary- during clinical disease
steps in process???
- prevention: masks, handwashing, vax
- intervention: iso, tracing, medical treatment
- control: reduce cases, dec spread
- eradicate
case
incidence of known disease
contact
exposed person
carrier
has disease and can transmit it, but may/may not be symptomatic
TB (etiology, s, dx, screened?)
- et: mycobacterium tuberculosis spore
- s: hemoptysis, fever, chills, cough, night sweat
- dx: 23 sputum samples
- screened: HCP, law enforcement, teachers
DOT
- direct observation treatment
- someone brings meds, educates, and watches pt take pills- then documents
parasitic diseases
roundworm, tapeworm, flukes, protozoa (pinworms)
waterborne disease
Hep A, cholera, typhoid, cryptosporidiosis
vector borne diseases
Lyme, Rocky Mountain Spotted Fever, Zika
salmonella
- inf meat, poultry, eggs
- fever, HA, abd pain, d/n/v
E.Coli
- meats, unpasteurized milk, cheese and juices, sprouts, water
- s 2-5 days post, sudden onset, cramps, watery/bloody diarrhea
clostridium perfringens
- raw/undercooked meat, poultry
- cramp, fever, d/v
staph aureus
- sliced meat, puddings (foods not cooked post handling)
- s within hours of ingestion, n/v/d, cramps
- abx not helpful
botulism
- neurotoxic protein
- home canned products
- n/v, fatigue, dizzy, double vision, diff swallowing, paralysis
- tx: antitoxin if dx + tx early
norovirus
- v/d
- contact w person, contaminated food/water, touching contaminated surfaces and putting hands in mouth
foodborne illness safe temps
fridge under 40, heat over 140
