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NRSG 477 > Exam I > Flashcards

Exam I Flashcards

1
Q

How was health/illness perceived pre 1800s?

A

It was perceived as religious/moral forces

  • Epidemics
  • Did not understand the causes of disease
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2
Q

Lillian Wald

A

Coined “public health nurse:

  • Henry street settlement
  • First school nurse and after school program
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3
Q

Late 20th century public health focused on what?

A

Chronic illness/disease and increasing life expectancy

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4
Q

2000+ public health efforts

A

Emergency preparedness

Growth in public health and policy

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5
Q

Public health mandates

A
  • Communicable diseases
  • Environmental issues
  • Prevalent illnesses
  • Health behaviors
  • Disaster and recovery
  • Quality and accessibility
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6
Q

Health impact pyramid

A

Going up: Increasing individual effort needed
Going down: Increasing population impact
- Utilization of the social determinants of health

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7
Q

What are essential services of the public health wheel?

A

Assurance ( evaluate ), assessment and policy development ( mobilize )

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8
Q

How is public health achieved?

A

Via local health departments

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9
Q

State health department functions

A
  • Funding oversight
  • Health codes regulations
  • Creating partnerships assistance to local health departments.
  • Not as much direct care
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10
Q

Federal public health

A
  • Money
  • Assessment
  • Standards/practices
  • Coordinate report cards
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11
Q

What are the three CORE FUNCTIONS of public health***

A

Assurance
Policy development
Assurance

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12
Q

Social marketing in public health

A

Inform, educate, and empower about health issues

-providing accessible health information resources at community levels

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13
Q

Community collaboration in public health

A

Mobilize partnerships t ID and solve health problems

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14
Q

Principles of partnership

A

Mission
Trust and respect
Strengths, assets and areas of improvement
Open communication

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15
Q

Policies and plans that support individual and community health

A
  • Systematic planning
  • Tracking measurable outcomes
  • Developing codes, regulations and legislation
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16
Q

T/F: Link people to services and provide health care only when available

A

False: Link people to services and provide health care when unavailable

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17
Q

T/F: Enforce laws and regulations that protect health and ensure safety

A

True

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18
Q

Public health worker characteristics

A
  • Ability to deal with complex problems
  • Tolerating ambiguity
  • Focusing on big picture
  • Commitment to the work
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19
Q

Important themes in PHN

A 
Confidentiality
Privacy
Autonomy
Ethics-available to all
Resilience
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20
Q

Home visits: Skilled Care

A

Reimbursable by Medicare
-Short term/acute-care focused; usually direct nursing care.
-

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21
Q

Is skilled care reimbursable by Medicare?

A

Yes

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22
Q

Home visits: Care Management

A

Funded privately or through Medicaid

  • Services of nurse/social worker/case manager
  • Focus is on chronic health problems including mental
  • Focus on maintaining client in home via prevention and referral to services
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23
Q

T/F The nursing student must always communicate with care manger before offering new services or appliances

A

True

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24
Q

The focus on chronic health problems and maintaining the client within the home via prevention and referrals is characteristic of which type of home visiting service?

A

Care management

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25
How is care management paid for?
Privately or via Medicare
26
What are the two types of Home visiting?
Skilled care and Care management.
27
Why home visits?
Not everyone can come in to seek needed care Opportunity to interact with clients in their own environment. More cost-effective Independence in nursing practice
28
Advantages to home visiting
Access to debilitated Awareness of the quality of family life Family less anxious, increased readiness to learn
29
Challenges and barriers of home visiting
Finding privacy
30
T/F: It is not essential that the nurse be focused and prepared when making home visits- not simply a social call
False: It IS essential
31
Disadvantages to home visiting
May have increased distractions from family members Clients may be difficult to reach by phone, may be HOH Often need to problem solve independently
32
Components of home visits
``` Preparation- scheduling when and where Introduction Build trust Interventions Closure- summarize and set next appt Charting & documentation completed per agency policy ```
33
How can a nurse build trust?
Consistency, keeping things private, confidentiality
34
What are the types of home visiting agencies?
``` Private, non-profit Proprietary Official Hospital-based Combination ```
35
Current issues in public health: Home visiting
``` Indigent care Discharge planning Use of technology in the home Family and nurse stressors Lack of adequate funding ```
36
Oasis-C Goal
Goal is to demonstrate cost effectiveness; Measures of clinical outcomes - Diabetic foot care, pain management - Areas foci include nurse specific measures
37
Who is the father of Epidemiology
John Snow; Cholera
38
Reliability
Precision; consistency or repeatability
39
Validity
Accuracy; is it measuring what its supposed to measure
40
Something that measures what is supposed to measure is reliable or valid?
Valid
41
Some that is consistent or repeatable is reliable or valid?
Reliable
42
Infectivity
Ability to cause infection
43
Virulence
Ability to produce illness
44
Secular patterns
Long term patterns of mobility and mortality that reflect LONG TERM PATTERNS of social behavior or health practices. -Changes over time; STI's, HIV, depression
45
Point epidemic
One temporal and spatial pattern of disease distribution | -sharp increase in time from outbreak
46
Cyclical patterns
Cyclical time patterns of disease; seasonal | - Flu season
47
Epidemic
Occurrence of a disease in a community or region in excess of normal expectancy "outbreak"- more than the baseline number
48
Pandemic
An epidemic occurring worldwide and affecting large populations
49
Epidemiology
Study of distribution and determinants health related states or events in specified populations and the application of this study to control health problems.
50
What are the two type of epidemiologic studies?
Descriptive and analytic
51
Descriptive epidemiologic study
Seeks to identify disease entity according to PERSON, PLACE, and TIME; used in food born illness outbreaks
52
Analytic epidemiologic study
Seeks to understand the etiology of disease; may be prospective or cohort study. - What are the causes of disease, ID risk factors - Cross sectional, retrospective, case control study, prospective cohort
53
Food born illness outbreaks are usually descriptive or analytic?
Descriptive
54
What are the three points on the epidemiologic triad?
Agent, host and environment
55
Epi triad: Host characteristics (3)
1. Genetic susceptibility- based on DNA 2. Immune characteristics- Age, race, ethnicity, chromosomal makeup. 3. Life style factors- Diet, education, activity, tobacco use, sexual practices, occupation, where you live
56
Epi triad: Environment
Climate Flora and Fauna Population density Socioeconomic factors
57
Epi triad: Agents
Chemical, biological or psychosocial - Infectivity - Pathogenicity - Virulence - Invasiveness
58
How do we prove relationships among variables?
We can't prove but we can demonstrate a correlation - lung cancer and smoking - HIV and IV drug use
59
Web of causation
All diseases and states of health have multifactor components and dimensions
60
Example of web of causation: HTN why?
HTN can be caused by familial, weight, NA+ intake, stress, decreases physical activity etc.
61
Epidemiologic factors/disease investigation steps (7)
1) Establish that a problem exists 2) Confirm homogenetity of events 3) History 4) Characterize events as epi, factors: person, place, time 5) look for patterns trends 6) formulate hypothesis 7) Test hypothesis
62
Prevalence rates
A measure of existing disease in population at a given time
63
When would you use a prevalence rate?
CHRONIC conditions; HIV, asthma, COPD, HTN, obesity, depression
64
Incidence
Proportion of the population at risk who experience a new health event. - Acute and resolves - Influenza, norovirus, pertussis, teen pregnancy
65
**Crude mortality
proportion of population that died in a given time frame (ALL DEATHS)
66
Case fatality
Number of deaths d/t SPECIFIC cause
67
Infant mortality
Number of deaths before ONE YEAR; in comparison to live births. - A good measure of healthcare
68
T/F An attack table does not allow us to find causation but shows relationships
True
69
Odds ratio values 1 = >1 = < =
``` 1 = equal chance to >1 = greater likelihood <1 = not as associated with ```
70
Attack table
Used in foodborne illnesses to ID offending food source | -List food products and determine percentages of those eating food who became ill.
71
Community concepts
Place People or person Function Each community is unique and the defining characteristics will affect your partnership
72
Data analysis
Status Structure Process Survey findings
73
Data analysis: Status
Vital Statistics of population; literature review, health risk of group
74
Data analysis: Structure
How are they structured
75
Data analysis: Process
How community engages it members; engage around health issues.
76
Data analysis: Survey finding
Creating a short survey | -What do they think issues are
77
What are the first steps of the community assessment project
1) select population 2) probable health issues--> Healthy people 2020 objectives 3) Develop questions that relate to healthy people 2020 objectives
78
CAP: Assessment process
Data collection- using systematic approach with goal to obtain usable information about the community and its health.
79
CAP: What is the first step?
Gaining entrance into your population
80
CAP: Preparation
Familiarize Community observation Volunteer to participate in activities to gain trust
81
CAP: Evaluation
Important to gain input of community Be honest with regard to what could be improved Project evaluation tool included in guidance

NRSG 477 (11 decks)

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