Exam 2 Flashcards
(111 cards)
1
Q
What is epidemiology?
A
“The study of the distribution and determinants of health and disease in human populations.”
2
Q
Who is the father of Epidemiology and what disease did he study?
A
Jon snow and cholera
3
Q
What are the 6 chains in the epidemiology circle?
A
- ) infectious agent
- ) reservoir
- ) portal of exit
- ) mode of transmission
- ) portal of entry
- ) susceptible host
4
Q
What is disease surveillance?
A
“the ongoing systematic collection, analysis, interpretation and dissemination of specific health data for use in public health.”
5
Q
What is the purposes of disease surveillance?
A
- Helps public health departments:
- Identify trends and unusual disease patterns.
- Set priorities for using scarce resources.
- Develop and evaluate programs for commonly occurring and universally occurring diseases or events.
6
Q
Public health surveillance can be used to facilitate the following:
A
- Estimate the magnitude of a problem (disease or event).
- Determine geographic distribution of an illness or symptoms.
- Portray the natural history of a disease.
- Detect epidemics; define a problem.
- Generate hypotheses; stimulate research.
- Evaluate control measures.
- Monitor changes in infectious agents.
- Detect changes in health practices.
- Facilitate planning.
7
Q
What are the data sources for disease surveillance?
A
- Cases reported by clinicians, health care agencies and labs to state health department
- Death certificates
- Billing
- Sentinel surveillance system
8
Q
What are the 5 types of surveillance systems?
A
- Passive system
- Active system
- Sentinel system
- Special systems
- Syndromic surveillance systems
9
Q
What is a disaster?
A
“Any event that causes a level of destruction, death, or injury that affects the abilities of the community to respond to the incident using available resources.”
10
Q
Types of disaster
A
- Natural: weather events
- Man-made: terrorist attacks- could set off a natural disaster- combination
- Na tech disaster: combination of weather and technology- these are increasing
11
Q
-Key terms for disaster-
What is Mass Casualty Event (or incident)?
A
more than 100 people involved
12
Q
-Key terms for disaster-
What is Multiple Casualty Event?
A
more than 2 but fewer than 100
13
Q
-Key terms for disaster-
Weapon of Mass Destruction (WMD)?
A
any weapon that is intended to cause death or bodily injury- could be disease organism, radiation, etc.
14
Q
-Key terms for disaster-
Direct Victim?
A
immediately affected by the even
15
Q
-Key terms for disaster-
Indirect Victim?
A
family member, friend or first responder
16
Q
-Key terms for disaster-
Displaced Persons?
A
those who have to leave homes, schools, businesses
17
Q
-Key terms for disaster-
Refugees?
A
group of people who fled their country
18
Q
-Characteristics of disasters-
Frequency?
A
how often a disaster occurs
19
Q
-Characteristics of disasters-
Predictability?
A
ability to determine when or if a disaster will occur
20
Q
-Characteristics of disasters-
Preventability/Mitigation?
A
refers to action taken to reduce the loss of life and property
21
Q
-Characteristics of disasters-
Imminence?
A
speed of onset
22
Q
-Characteristics of disasters-
Intensity?
A
level of destruction- measured on scales
23
Q
-Prevention of Disaster-
Primary Prevention?
A
mitigation planning- we do it before something ever happens- identify possible threats
24
Q
-Prevention of Disaster-
Secondary Prevention?
A
implemented once a disaster occurs
25
-Prevention of Disaster-
| Tertiary Prevention?
focuses on the recovery of the community
26
What do nurses need to know during a disaster situation?
- Likely disaster threats for their community
- Not common but pose a big threat
- What injuries to expect from different disaster scenarios
- Evacuation routes
- Locations of shelters
- Warning systems
27
-Government response during a disaster-
| Local level?
- local EMS (first responders) agency, local government is responsible for safety and wellbeing of the residents. 911 is the main source of communication.
- Contingency planning: basically practicing for an emergency.
- Emergency management agency (county): varies based on county.
28
-Government response during a disaster-
| State level?
- activated when local government is overwhelmed, governor can call a state of emergency
- National Guard: will come in
- May transfer resources from within the state- if a county doesn't have enough EMS, they can look at surrounding counties and divert resources to the county in need
- Emergency Management agency (state): in TN is TEMA
29
-Government response during a disaster-
| Federal level?
- resources in a state overwhelmed (think hurricane Katrina- LA was devastated)- when a governor calls a state of emergency for the entire state- it will open it up to receive more federal resources.
- Department of homeland security:
- Federal Emergency Management Agency (FEMA): cover natural disaster- involved if there is ever a terrorist attack
- CDC: epidemics and pandemics
30
What are the 4 stages of a disaster?
1. ) mitigation
2. ) preparedness
3. ) response
4. ) recovery
31
What is mitigation stage?
NON DISASTER STAGE: identify risk, educate the public and be knowledgeable
-Educate HCPs and first responders
32
What is the preparedness stage?
(emergency response plan) - critical for implementation
- Identify hazards that are happening or about to happen
- We know there is things we can do to reduce damage: board windows, evacuate, hospitals have emergency generators
- Helps people know that their role is during the disaster and the chain of command
- Plan for what happens with the care of the dead
33
What is the response stage?
- Begins immediately after the disaster occurs
- Life safety actions are activated to *hopefully* reduce death
- Search and rescue
- Staging area
- Disaster Triage- nurses may be asked to help out.
34
What does a disaster triage assessment look like? And the mnemonic that goes with it.
Start assessment :
- People who can walk, go to a safe area and then start where you stand.
- RPM: respiration (most critical assessment), perfusion (cap refill), mental status (to measure for brain injury- if it is abnormal tag them as immediate)
35
What is the recovery stage?
- Begins when danger has passed
| - Revise the disaster plan on lessons learned- will happen when COVID is over
36
What is a Veteran?
- “A person who has served in the active military, naval, or air service and who was discharged or released under conditions other than dishonorable.”
- You have to be for at least 180 days.
37
Military at a glance- only ___% of young people qualify- this is due to the obesity aspect- only 0.5% of the population serve.
21%
38
What does Veterans Health Administration do?
provides all types of healthcare in every setting for veterans
39
What does Veterans benefits administration do?
helps with unemployment, pension payment, home loans
40
What are the 2 requirements for VA Benefits?
- Service: must have served in active duty for 24 consecutive months.
- Separation: under any condition EXCEPT dishonorable discharge.
41
VA hospitals and clinics are not a type of health insurance, they are a ______ of service
benefit
42
What is TRICARE?
active duty military and survivors- if they qualify for this, they don't get the other
43
What are some Veteran health risks?
- Traumatic Brain Injury
- noise
- radiation
- cold injuries
- amputations
- occupational hazard exposures
- posttraumatic stress disorder
- military sexual trauma
- polytraumatic injuries
- chronic pain
- substance use disorders
- veteran suicide
- transition to civilian life
44
What is a communicable disease?
An infectious disease transmissible (as from person to person) by direct contact with an affected individual or the individual's discharges or by indirect means (as by a vector)
45
What are the parts of epidemiology triangle?
Host, agent and environment
46
Endemic?
diseases that occur at a consistent and expected level in an area
47
Outbreak?
unexpected occurrence of infectious disease of something in a limited area during a limited time period
48
Epidemic?
unexpected increase of an infectious disease in an extended period of time
49
Pandemic?
steady occurrence of a disease or epidemic that is worldwide or a large geographical area
50
Control of a communicable disease? and what is the most common way to control a disease?
reduction of incidence (new cases) or prevalence (existing cases) of a given disease to a locally acceptable level as a result of deliberate efforts
--vaccines
51
Elimination of a communicable disease?
occurs when it is controlled within a specified geographic area such as a single country, an island, or a continent and the prevalence & incidence of the disease is reduced to near zero. Results from deliberate efforts. So monitoring for a disease after an aggressive immunization campaign and no new cases developed the next year.
52
Eradication
reducing the worldwide incidence of a disease to zero as a function of deliberate efforts without a need for further control measures
53
What is the only disease that has ever been eradicated?
Smallpox (1977)
54
What are some Vaccine Preventable Diseases?
- Diphtheria
- Haemophilus influenza (Hib)
- Measles
- Mumps
- Pertussis
- Rubella
- Polio
- Tetanus
- Varicella
- Influenza
- Pneumococcal Pneumonia
- Hepatitis B
55
What are vaccine information statements (VIS)?
- patients need to be provided with information about the vaccine
- it's a violation of the federal law to withhold this information
56
-General Vaccine information-
| Cold Chain of vaccines?
very important; in order for vaccines to be effective it needs to be sorted at certain temperatures from the time they are manufactured to the time they are administered
57
-General Vaccine information-
| Timing & Spacing?
all children should be age appropriately administered
58
-General Vaccine information-
| Administration?
- all vaccines can be administered simultaneously except for yellow fever and cholera: they need to be separated by 3 weeks.
- Live vaccines need to be separated by 4 weeks if NOT given at the same time.
59
-General Vaccine information-
| Hypersensitivity & Contraindications?
- Patient allergies should be concerned at each vaccine.
- Mild illness with or without low grade fever is NOT a contraindication
- Pregnancy is not a contraindication for inactivated vaccines, but yes for live vaccines- unless the risk for infection is very likely
- MMR can be administered to HIV infected people
60
-General Vaccine information-
| Vaccine Safety?
- Reporting adverse events to VAERS
| - Related injuries
61
-General Vaccine information-
| Primary Vaccine Failure?
- failure of the vaccine to stimulate an immune response
| - Improper storage, administration route, exposure to light
62
-Control of Communicable disease-
| Primary Prevention?
Immunization
63
-Control of Communicable disease-
| Secondary Prevention?
Testing, Reporting, Investigating, Notifying, finding new cases & isolating cases
64
-Control of Communicable disease-
| Tertiary Prevention?
Caring for persons with the disease to cure or maintain quality of life
65
What is HIV?
The virus that causes AIDs- first known case was in 1959- first US 1980
66
What is Stage 1 of HIV?
- The primary infection (within about 1 month of contracting the virus)
- Lymphadenopathy, Myalgia, Sore throat, Lethargy, Rash, and Fever
- Antibody tests at this point are usually negative
67
What is Stage 2 of HIV (about 3 months later)?
- Clinical latency, a period with no obvious symptoms
- Gradual deterioration of the immune system and can transmit the virus to others.
- Now antibody tests are now positive
- Highly active antiretroviral therapy (HAART) increase survival rate
68
What is Stage 3 of HIV?
- A final stage of symptomatic disease- AIDs
- CD4+ t-lymphocyte count of less than 200/mL
- Opportunistic infections: often fatal
69
What is Pre-exposure Prophylaxis (PREP) used for?
When taken consistently, reduces the rate of HIV by 92%
70
What is Mycobacterium TB?
- Ancient disease; 9,000 years ago is the earliest trace
- The goal is to eliminate the disease
- National notifiable disease
71
What are some common symptoms of Mycobacterium TB?
Hemoptysis (bloody sputum), fever, night sweats, unexplained weight loss, failure to thrive and SOB
72
What are the 2 types of TB?
-Latent TB:
Bacteria is present in the body, in a dormant state with no symptoms
-Active TB:
TB bacteria is actively causing symptoms
73
How is TB detected?
TB Skin test (TST)
-PPD aka Mantoux Test
-Reading a skin test: palpate for induration, measure only the induration- redness SHOULD NOT be measured
-In vitro gamma release interferon assay (IVGRA)
QuantiFERON-TB blood test
-Sputum smears
Detects acid-fast bacilli
74
How is a TB patient taken off of airborne precautions?
3 negative sputum cultures in a row
75
TB can be eliminated from the body with what treatment?
antibiotics
76
What are the 4 first line antibiotics that are required to treat active TB?
1. ) Isoniazid (INH)
2. ) Rifampin (RIF)
3. ) Ethambutol (EMB)
4. ) Pyrazinamide (PZA)
77
It may take a ____ or more to complete treatment for Active TB?
year
78
Latent TB may be treated in as little as ___ weeks
12
79
What is Directly Observed Therapy (DOT)?
the nurse watches the patient take the medication every time
80
What 2 things can happen when antibiotic treatment is not completed by HIV patients.
- Multidrug Resistant TB (MDR-TB)
| - Extensively Drug Resistant TB (XDR-TB)
81
What is Extensively Drug Resistant TB (XDR-TB)?
Resistant to isoniazid and rifampin, plus any fluoroquinolone and at least one of three injectable second-line drugs (i.e., amikacin, kanamycin, or capreomycin)
82
What is Multidrug Resistant TB (MDR-TB)?
Resistant to at least isoniazid and rifampin
83
"Healthy People" focus on what 4 infectious diseases?
- STDs
- HIV/AIDs
- TB
84
_______ is the 2nd most commonly reported infectious disease?
Gonorrhea
85
How does Gonorrhea affect men?
typically men are asymptomatic; however,
when men do have symptoms: dysuria, purulent clear discharge and epididymitis (inflammation of the tube at the back of the testicle that stores and carries sperm)
86
How does Gonorrhea affect women?
-Often confused with bladder or vaginal infection
-PID: pelvic inflammatory disease
Major cause for ectopic pregnancy and infertility
87
True/False:
| Gonorrhea can be passed from mothers to newborns.
true
88
What is the cause for syphilis and how is it spread?
- Causes by treponema pallidum (bacteria)
| - Spread by first contact with sore- usually on external genitals or inside the vagina, anus, rectum or throat
89
True/ False:
| Gonorrhea cannot be passed between pregnant women and their fetus.
False
| This CAN be passed on
90
Primary Stage of Syphilis?
-Bacteria produces a chancre at the site of entry
-Chance is usually firm, round and painless
-Lasts 3-6 weeks then disappears
If not treated; will progress to the next stage
91
Secondary stage of syphilis?
Bacteria enters the lymph system and spreads
92
What are some S&S that can be seen in the secondary stage of syphilis?
Skin rash, fever, swollen nodes, sore throat, patchy hair loss, headaches, weight loss, muscle aches and fatigue
93
Tertiary stage of syphilis can lead to what things?
Damage to internal organs, lesions of the bone, skin and mucous membranes, difficulty coordinating muscle movements, paralysis, numbness, gradual blindness, dementia, ultimately can lead to death
94
What is the treatment for syphilis?
Penicillin G: IM injection- very thick and needs a large needle
95
What is chlamydia trachomatis also known as?
"silent disease"
96
What is the most reported infectious disease in the US?
Chlamydia Trachomatis
97
Since Chlamydia Trachomatis is transmitted by discharge it greatly affects what body parts?
genitourinary tract and rectum
98
Since Chlamydia Trachomatis is transmitted by discharge, it is possible that newborns can contract this disease and it can cause what 2 things?
Conjunctivitis and pneumonia
99
What are some S&S of Chlamydia Trachomatis?
```
Typically appear within 1 to 3 weeks of exposure
May lead to Pelvic Inflammatory Disease (PID)
Dysuria
Purulent vaginal discharge
Lower abdominal pain
Low back pain
Nausea
Fever
Pain during intercourse
```
100
What are the treatment options for Chlamydia Trachomatis (2)?
1. ) Azithromycin 1g orally in a single dose
| 2. ) Doxycycline 100mg orally twice a day for 7 days
101
What type of Hepatitis does not have a vaccine?
Hep C
102
What is the method of transmission for Hep A?
fecal-oral route
103
What is the method of transmission for Hep B?
blood and body fluids
104
What is the method of transmission for Hep C?
bloodborne
105
Who are the persons most at risk to get Hep A?
- Travelers (to areas with high rates)
- Children (living in areas with high rates)
- IV drug users
- Men who have sex with men (MSM)
- Persons with clotting disorders or chronic liver disease
106
What are some S&S of Hep A?
- Fever
- Nausea
- Lack of appetite
- Malaise
- Abdominal discomfort
- Jaundice (after several days)
107
Who are the persons most at risk to get Hep B?
- IV drug users
- Persons with STDs or multiple sex partners
- Immigrants, refugees, and their descendants from areas with high endemic rates
108
What are some S&S of Hep B?
Mild flu-like symptoms
- Jaundice
- Extreme lethargy
- Nausea
- Fever
- Joint pain
109
Who are the persons most at risk to get Hep C?
- IV drug users
- Health care workers
- Emergency Personnel
- Prisoners/Inmates
- Those on hemodialysis
110
What are some S&S of Hep C?
Mild, non-specific
| Possible Fatigue
111
Which forms of Hepatitis could be acute or chronic and which one is only acute?
Hep B & C= both
| Hep A= only acute
