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Exam 2 Flashcards

1
Q

What is epidemiology?

A

“The study of the distribution and determinants of health and disease in human populations.”

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2
Q

Who is the father of Epidemiology and what disease did he study?

A

Jon snow and cholera

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3
Q

What are the 6 chains in the epidemiology circle?

A
  1. ) infectious agent
  2. ) reservoir
  3. ) portal of exit
  4. ) mode of transmission
  5. ) portal of entry
  6. ) susceptible host
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4
Q

What is disease surveillance?

A

“the ongoing systematic collection, analysis, interpretation and dissemination of specific health data for use in public health.”

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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.
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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.
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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
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8
Q

What are the 5 types of surveillance systems?

A
  • Passive system
  • Active system
  • Sentinel system
  • Special systems
  • Syndromic surveillance systems
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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.”

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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
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11
Q

-Key terms for disaster-

What is Mass Casualty Event (or incident)?

A

more than 100 people involved

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12
Q

-Key terms for disaster-

What is Multiple Casualty Event?

A

more than 2 but fewer than 100

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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.

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14
Q

-Key terms for disaster-

Direct Victim?

A

immediately affected by the even

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15
Q

-Key terms for disaster-

Indirect Victim?

A

family member, friend or first responder

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16
Q

-Key terms for disaster-

Displaced Persons?

A

those who have to leave homes, schools, businesses

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17
Q

-Key terms for disaster-

Refugees?

A

group of people who fled their country

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18
Q

-Characteristics of disasters-

Frequency?

A

how often a disaster occurs

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19
Q

-Characteristics of disasters-

Predictability?

A

ability to determine when or if a disaster will occur

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20
Q

-Characteristics of disasters-

Preventability/Mitigation?

A

refers to action taken to reduce the loss of life and property

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21
Q

-Characteristics of disasters-

Imminence?

A

speed of onset

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22
Q

-Characteristics of disasters-

Intensity?

A

level of destruction- measured on scales

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23
Q

-Prevention of Disaster-

Primary Prevention?

A

mitigation planning- we do it before something ever happens- identify possible threats

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24
Q

-Prevention of Disaster-

Secondary Prevention?

A

implemented once a disaster occurs

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25
Q

-Prevention of Disaster-

Tertiary Prevention?

A

focuses on the recovery of the community

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26
Q

What do nurses need to know during a disaster situation?

A
  • 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
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27
Q

-Government response during a disaster-

Local level?

A
  • 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.
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28
Q

-Government response during a disaster-

State level?

A
  • 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
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29
Q

-Government response during a disaster-

Federal level?

A
  • 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
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30
Q

What are the 4 stages of a disaster?

A
  1. ) mitigation
  2. ) preparedness
  3. ) response
  4. ) recovery
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31
Q

What is mitigation stage?

A

NON DISASTER STAGE: identify risk, educate the public and be knowledgeable
-Educate HCPs and first responders

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32
Q

What is the preparedness stage?

A

(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
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33
Q

What is the response stage?

A
  • 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.
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34
Q

What does a disaster triage assessment look like? And the mnemonic that goes with it.

A

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)
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35
Q

What is the recovery stage?

A
  • Begins when danger has passed

- Revise the disaster plan on lessons learned- will happen when COVID is over

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36
Q

What is a Veteran?

A
  • “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.
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37
Q

Military at a glance- only ___% of young people qualify- this is due to the obesity aspect- only 0.5% of the population serve.

A

21%

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38
Q

What does Veterans Health Administration do?

A

provides all types of healthcare in every setting for veterans

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39
Q

What does Veterans benefits administration do?

A

helps with unemployment, pension payment, home loans

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40
Q

What are the 2 requirements for VA Benefits?

A
  • Service: must have served in active duty for 24 consecutive months.
  • Separation: under any condition EXCEPT dishonorable discharge.
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41
Q

VA hospitals and clinics are not a type of health insurance, they are a ______ of service

A

benefit

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42
Q

What is TRICARE?

A

active duty military and survivors- if they qualify for this, they don’t get the other

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43
Q

What are some Veteran health risks?

A
  • 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
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44
Q

What is a communicable disease?

A

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)

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45
Q

What are the parts of epidemiology triangle?

A

Host, agent and environment

46
Q

Endemic?

A

diseases that occur at a consistent and expected level in an area

47
Q

Outbreak?

A

unexpected occurrence of infectious disease of something in a limited area during a limited time period

48
Q

Epidemic?

A

unexpected increase of an infectious disease in an extended period of time

49
Q

Pandemic?

A

steady occurrence of a disease or epidemic that is worldwide or a large geographical area

50
Q

Control of a communicable disease? and what is the most common way to control a disease?

A

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
Q

Elimination of a communicable disease?

A

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
Q

Eradication

A

reducing the worldwide incidence of a disease to zero as a function of deliberate efforts without a need for further control measures

53
Q

What is the only disease that has ever been eradicated?

A

Smallpox (1977)

54
Q

What are some Vaccine Preventable Diseases?

A
  • Diphtheria
  • Haemophilus influenza (Hib)
  • Measles
  • Mumps
  • Pertussis
  • Rubella
  • Polio
  • Tetanus
  • Varicella
  • Influenza
  • Pneumococcal Pneumonia
  • Hepatitis B
55
Q

What are vaccine information statements (VIS)?

A
  • patients need to be provided with information about the vaccine
  • it’s a violation of the federal law to withhold this information
56
Q

-General Vaccine information-

Cold Chain of vaccines?

A

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
Q

-General Vaccine information-

Timing & Spacing?

A

all children should be age appropriately administered

58
Q

-General Vaccine information-

Administration?

A
  • 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
Q

-General Vaccine information-

Hypersensitivity & Contraindications?

A
  • 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
Q

-General Vaccine information-

Vaccine Safety?

A
  • Reporting adverse events to VAERS

- Related injuries

61
Q

-General Vaccine information-

Primary Vaccine Failure?

A
  • failure of the vaccine to stimulate an immune response

- Improper storage, administration route, exposure to light

62
Q

-Control of Communicable disease-

Primary Prevention?

A

Immunization

63
Q

-Control of Communicable disease-

Secondary Prevention?

A

Testing, Reporting, Investigating, Notifying, finding new cases & isolating cases

64
Q

-Control of Communicable disease-

Tertiary Prevention?

A

Caring for persons with the disease to cure or maintain quality of life

65
Q

What is HIV?

A

The virus that causes AIDs- first known case was in 1959- first US 1980

66
Q

What is Stage 1 of HIV?

A
  • 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
Q

What is Stage 2 of HIV (about 3 months later)?

A
  • 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
Q

What is Stage 3 of HIV?

A
  • A final stage of symptomatic disease- AIDs
  • CD4+ t-lymphocyte count of less than 200/mL
  • Opportunistic infections: often fatal
69
Q

What is Pre-exposure Prophylaxis (PREP) used for?

A

When taken consistently, reduces the rate of HIV by 92%

70
Q

What is Mycobacterium TB?

A
  • Ancient disease; 9,000 years ago is the earliest trace
  • The goal is to eliminate the disease
  • National notifiable disease
71
Q

What are some common symptoms of Mycobacterium TB?

A

Hemoptysis (bloody sputum), fever, night sweats, unexplained weight loss, failure to thrive and SOB

72
Q

What are the 2 types of TB?

A

-Latent TB:
Bacteria is present in the body, in a dormant state with no symptoms
-Active TB:
TB bacteria is actively causing symptoms

73
Q

How is TB detected?

A

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
Q

How is a TB patient taken off of airborne precautions?

A

3 negative sputum cultures in a row

75
Q

TB can be eliminated from the body with what treatment?

A

antibiotics

76
Q

What are the 4 first line antibiotics that are required to treat active TB?

A
  1. ) Isoniazid (INH)
  2. ) Rifampin (RIF)
  3. ) Ethambutol (EMB)
  4. ) Pyrazinamide (PZA)
77
Q

It may take a ____ or more to complete treatment for Active TB?

A

year

78
Q

Latent TB may be treated in as little as ___ weeks

A

12

79
Q

What is Directly Observed Therapy (DOT)?

A

the nurse watches the patient take the medication every time

80
Q

What 2 things can happen when antibiotic treatment is not completed by HIV patients.

A
  • Multidrug Resistant TB (MDR-TB)

- Extensively Drug Resistant TB (XDR-TB)

81
Q

What is Extensively Drug Resistant TB (XDR-TB)?

A

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
Q

What is Multidrug Resistant TB (MDR-TB)?

A

Resistant to at least isoniazid and rifampin

83
Q

“Healthy People” focus on what 4 infectious diseases?

A
  • STDs
  • HIV/AIDs
  • TB
84
Q

_______ is the 2nd most commonly reported infectious disease?

A

Gonorrhea

85
Q

How does Gonorrhea affect men?

A

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
Q

How does Gonorrhea affect women?

A

-Often confused with bladder or vaginal infection
-PID: pelvic inflammatory disease
Major cause for ectopic pregnancy and infertility

87
Q

True/False:

Gonorrhea can be passed from mothers to newborns.

A

true

88
Q

What is the cause for syphilis and how is it spread?

A
  • Causes by treponema pallidum (bacteria)

- Spread by first contact with sore- usually on external genitals or inside the vagina, anus, rectum or throat

89
Q

True/ False:

Gonorrhea cannot be passed between pregnant women and their fetus.

A

False

This CAN be passed on

90
Q

Primary Stage of Syphilis?

A

-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
Q

Secondary stage of syphilis?

A

Bacteria enters the lymph system and spreads

92
Q

What are some S&S that can be seen in the secondary stage of syphilis?

A

Skin rash, fever, swollen nodes, sore throat, patchy hair loss, headaches, weight loss, muscle aches and fatigue

93
Q

Tertiary stage of syphilis can lead to what things?

A

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
Q

What is the treatment for syphilis?

A

Penicillin G: IM injection- very thick and needs a large needle

95
Q

What is chlamydia trachomatis also known as?

A

“silent disease”

96
Q

What is the most reported infectious disease in the US?

A

Chlamydia Trachomatis

97
Q

Since Chlamydia Trachomatis is transmitted by discharge it greatly affects what body parts?

A

genitourinary tract and rectum

98
Q

Since Chlamydia Trachomatis is transmitted by discharge, it is possible that newborns can contract this disease and it can cause what 2 things?

A

Conjunctivitis and pneumonia

99
Q

What are some S&S of Chlamydia Trachomatis?

A 
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
Q

What are the treatment options for Chlamydia Trachomatis (2)?

A
  1. ) Azithromycin 1g orally in a single dose

2. ) Doxycycline 100mg orally twice a day for 7 days

101
Q

What type of Hepatitis does not have a vaccine?

A

Hep C

102
Q

What is the method of transmission for Hep A?

A

fecal-oral route

103
Q

What is the method of transmission for Hep B?

A

blood and body fluids

104
Q

What is the method of transmission for Hep C?

A

bloodborne

105
Q

Who are the persons most at risk to get Hep A?

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
Q

What are some S&S of Hep A?

A
  • Fever
  • Nausea
  • Lack of appetite
  • Malaise
  • Abdominal discomfort
  • Jaundice (after several days)
107
Q

Who are the persons most at risk to get Hep B?

A
  • IV drug users
  • Persons with STDs or multiple sex partners
  • Immigrants, refugees, and their descendants from areas with high endemic rates
108
Q

What are some S&S of Hep B?

A

Mild flu-like symptoms

  • Jaundice
  • Extreme lethargy
  • Nausea
  • Fever
  • Joint pain
109
Q

Who are the persons most at risk to get Hep C?

A
  • IV drug users
  • Health care workers
  • Emergency Personnel
  • Prisoners/Inmates
  • Those on hemodialysis
110
Q

What are some S&S of Hep C?

A

Mild, non-specific

Possible Fatigue

111
Q

Which forms of Hepatitis could be acute or chronic and which one is only acute?

A

Hep B & C= both

Hep A= only acute

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