Exam 3 Flashcards
medical tourism
going to different countries for certain medical care
malnutrition (3 types)
undernutrition, micronutrient-related malnutrition, overweight
undernutrition
wasting (low weight for height), stunting (low height for age), underweight (low weight for age)
micronutrient-related malnutrition
micronutrient deficiencies or excess
overweight
obesity + diet related noncommunicable diseases- heart disease, stroke, DM, cancers
malnutrition factors
economic, education, social, personal
pellagra
deficient in niacin (B3)
scurvy
deficient in vit C
rickets
deficient in vit D
Kwashiorkor
- protein deficient, may be getting enough cal.
- edema, enlarged liver, fluid shift
marasmus
- protein and cal. malnutrition
- shrunken body, no muscle mass, no SQ tissue
vitamin A def can lead to what deficits
vision
primary determinant of health is
environment
environmental media
air, water, soil, food
toxicology
studying negative health effects of chemical exposure
dose effect/reponse
amount of exposure directly related to the impact
types of exposure
lead (houses pre 1978), asbestos, radon, pesticides
environment protection prevention
- education, waste minimization, proper land use
- controls + standards for gov. structures
solution to pollution is
dilution (ex: air diffuses pollution)
environmental role for nurses
mitigation, response, advocate for public policy
vulnerable pops
peds, pregnant/postpartum/lactating women (esp. teens), disabilities, geri, c medical disorders, mental illness, prisons, detention centers, limited English, American Indian + Alaska Native, racial, low income, single parent, public housing, homeless, LGBTQIA+, veterans
social determinants of health
economic, education, physical environment, social support, access to healthcare
vulnerable pops risk factors
- underdeveloped/deteriorating infrastructure
- lack of employment opportunities
- inadequate medical/social/educational services
- lack transportation/communication services
- high crime + victimization
- environmental conditions
- outmigration of young + better educated
resiliency
- ability to bounce back to normal functioning post adversity
- vp may lack due to inadequate resources/coping skills
vulnerability aspects
social determinants, disempowerment, victim blaming, disenfranchisement, disadvantaged status
vulnerability outcomes
increased stress, inc hopelessness, poor health outcomes, vulnerability cycle
homelessness categories
- episodic: moving in and out of homelessness
- temp/transitional: lay offs, divorce, violence (catastrophic event)
- chronic: mental/physical illness, addiction, c unemployment
homelessness causes
- intrinsic: substance abuse, disability (phys + mental), lack of education
- extrinsic: no income, no access to employment, displacement, no access to resources, lack of affordable housing, DV, incarceration, return from military services, discrimination
poverty threshold
specific $ amount that varies by fam size used to determine if fam/individual can meet basic needs/qualify for certain programs
near poor
income just above fed guidelines, can affect eligibility
persistent poverty
multigenerational poverty
neighborhood poor
geographic areas w poor housing, poor health outcomes, high unemployment
3 leading deaths in US for ages 15-34
unintentional, suicide, homicide
5 principles trauma informed care
safety, humility + responsiveness, collab, trustworthiness + transparency, empowerment
violence factors
previous exposure, lack of communication + problem solving skills, easy access to firearms, inc stress, living conditions
victim factors
learned/acquired helplessness, acquired/congenital disability, inability to meet expectations of others, poor self esteem, social isolation
perpetrator factors
low self esteem, fear + distrust of others, poor self control, isolated/inadequate social skills, immature motivation for marriage/childbearing, weak coping skills
primary vs. secondary malnutrition
- primary: not taking in enough nutrients
- secondary: malabsorption, GI illness (Crohns, celiac, UC)
primary prevention (abuse)
- encourage community to take stand against violence
- actively support legislation
- reduce vulnerability by improving physical security
- teach coping skills
secondary prevention (abuse)
- initiate measures to reduce/terminate further abuse
- crisis intervention for fam violence
tertiary prevention (abuse)
- no further violence tolerated
- empower fam
- capitalize on strengths
disasters
- natural or man-made event that causes destruction that requires assistance
first stage- prevention (disaster)
mitigation, protection
second stage- preparedness (disaster)
personal, professional, community
role of CH nurse in disaster
- teach preparedness: >3 day supply food + waqter, communication plan, first aid kit
- consider needs of elderly
third stage- response (disaster)
- EMS, CERT, MRC, USDHHS, FEMA, ARC
- triage
triage
- separating casualties, allocating resource for best survival
- red: most urgent, life threatening (shock, hypoxia) if given immediate care will most likely survive
- yellow: systemic but not life threatening, can most likely wait 45-60 min without immediate risk
- green: injury localized, unlikely to deteriorate for several hours
- black: unresponsiveness w no ventilation/circulation…dead
fourth stage- recovery (disaster)
- fed response, emergency support functions, delayed stress reaction
bioterrorism
intentional release of biological agent
surveillance
active, 24H, multi-system involvement/communication, observe for syndromes
local/area response plan
-triage, treatment
- stockpiling and distribution
- communication, evacuation, morgue needs
agency/fed response plan
- incorporate w disaster planning
- coordinate w area response team
- train staff
- maintain communication w area response team
-prep for communication w media
anthrax
- spore forming bacteria found in soil
- infects animals
- cutaneous (itcy, dark black), GI (fever, chills, SOB), resp
- mailed letters in 2000s, used in WW1+2
anthrax prognosis
- cutaneous: mild + v treatable
- resp + GI: fatal even w treatment
- abx: PCN, doxycycline, fluroquinolones
smallpox hx
- considered biggest achievement of international public health
- no longer immunizing for
- 100% susceptibility in unvax, fatality rate 20-40%
- Dr. Jenner observed milkmaids immunity r/t frequent exposure to cowpox–> vax developed, 1960-70s- WHO campaign
- WHO announced eradication May 8, 1980
smallpox
- transmits person to person; droplet
- fluid filled vesicle
- treatment: anti-virals
- vax not for gen pop but high risk (military, lab workers)
varicella v smallpox
- varicella: rash present @ onset w fever, lesions more on torso, develop in diff stages
- smallpox: feel sick pre rash, sores in mouth–> spreads to face, limbs, soles, palms; lesions develop all at once (deep w pitting center)
tularemia
- francisella tularensis: aka rabbit fever
- infected thru tick and deer fly bites, skin contact w inf animals, drinking contaminated water, inhaling contaminated aerosols or agricultural dust
- s depend on exposure route: skin/ocular ulcer, swollen glands, resp involvement
- dx diff: lab tests + cultures
- tx: abx, prognosis good w tx
plague bacterium
- yersinia pestis
- transmitted by bacteria found in rodents and their fleas
- people inf by bites, touching/skinning inf animals, inhalin g droplets of inf person/animal
plague types
bubonic, septicemic, pneumonic
plague dx + tx
-dx: hx, s/s, cultures
- tx: IV gentamicin, fluroquinolones…good prognosis w prompt tx
