Midterm Flashcards

Question

Proportionate Universalism

Answer 1

Recognizes that to level up the gradient, programs and policies must include a range of responses for different levels of disadvantage experienced within the population. A Focus solely on most disadvantaged will not reduce health inequalities. To reduce the steepness of the social gradient in health, actions must be universal, but with a scale and intensity that is proportionate to the level of disadvantage.

Answer 2

*Improving the health of everyone in the population *Additional attention placed on specific populations that are socially or economically disadvantaged. *Intentionally designed, targeted universalism interventions aim to reduce health inequities

Answer 3

*Population focused nursing aim is to improve the health of the entire population (including, population sub-groups) and to reduce health inequities among priority population groups

Answer 4

– Provides treatment to those with an illness – The individual is the focus.

Answer 5

Assessment, diagnoses, planning, interventions, and evaluation are carried out at individual client level

Answer 6

Uses a defined population and/ or aggregates as the organizing unit of care –Assessment, diagnoses, planning, interventions, and evaluation are carried out for population or subpopulation –Levels of prevention (primary, secondary, tertiary) –Population-level decision making is different –Concerned with more than one subpopulation

Answer 7

*Who : Focus on population *What: All determinants of health *How: More emphasis on the strategies other than individual skill development *Evidence : What have we learned regarding what works in health promotion with populations from research, experiential learning and evaluation

Answer 8

An umbrella term—includes community health nursing in a variety of practice areas, for example: Public health nursing Home health nursing Occupational health nursing Primary health care nursing practice Mental Health Community Nurse Travel nursing Nurses working in health promotion in the community (NHPs)

Answer 9

Nursing practice that focuses on working together to enhance the health of all people and communities particularly those who are structurally disadvantaged – contributing to healthier and more equitable communities.

Answer 10

Working with the people, not just for the people, in assessment, planning, intervention, and evaluation. Community health nurse (CHN) works –In the community (providing health care to individuals and families) –With the community (because the CHN views the community itself as the client)

Answer 11

one area of focus = disease prevention

Answer 12

*Primary prevention (seeks to prevent disease from the beginning) *Secondary prevention (seeks to detect disease early in its progression in order to make early diagnosis and begin treatment) *Tertiary prevention (begins once a disease has become obvious; aims to interrupt the course of the disease)

Answer 13

– Physicians – Social workers – Nutritionists – Physiotherapists – Occupational therapists – Other health care professionals – The client

Answer 14

Community Health Nurses who interact with clients* to promote, protect, and preserve health by using population health determinants based on sound knowledge that includes nursing science, public health science, and social sciences.

Answer 15

In the last 100 years, the emphasis in public health has shifted from management of communicable diseases to the prevention and management of chronic diseases

Answer 16

1. Health protection 2. Health promotion 3. Population health assessment 4. Public health surveillance 5. Injury and disease prevention 6. Emergency preparedness and response

Answer 17

Population focused Community context Health and preventive focus – 1, 2, 3 (disease prevention) Interventions made at the community or population level Concern for the health of all members of the population/ community, particularly vulnerable subpopulations

Answer 18

PHNs are very much involved in providing clinic services, such as: *Influenza prevention *Family planning *Travel health *Immunization *Sexual health *Breastfeeding *Well babies

Answer 19

* Advocate: – e.g., works with patients to obtain necessary resources * Manager: – e.g., works with specific aggregate groups, such as conducting well-baby home visits; identifies the services needed most for the least cost * Leader or consultant: – e.g., builds and maintains partnerships with community leaders and key stakeholders to identify community needs

Answer 20

* Referral resource: – e.g., referring patients to health and social services available within the community * Assessor of patient literacy: – illiteracy has medical, social, and legal implications * Educator: – e.g., provides information to patients or staff * Primary caregiver: – e.g., may provideprenatal services, or free immunization services for targeted populations * Multiple roles in emergency preparedness and planning: – e.g., education, establishing mass dispensing clinics,communicable disease surveillance * Multiple roles in communicable disease control: – e.g., finding infected individuals, notifying contacts, administering treatments

Answer 21

addresses immediate healthcare needs

Answer 22

addresses material circumstances such as housing and employment

Answer 23

advocate for greater fairness in power structures and income

Answer 24

A process of empowering people to increase control over and improve their health

Answer 25

– Means actively engaging the client to gain greater control. – Involves political efficacy, improved quality of community life, and social justice. – Not something that can be done “to” or “for” people; it involves people discovering and using their own strengths.

Answer 26

₋ Self regulated ₋ Autonomous ₋ Collaboration ₋ Direct service

Answer 27

₋ Civic engagement ₋ Community partnerships ₋ Political activism ₋ Service

Answer 28

– A macroscopic, “big picture,” population health approach – Includes a primary prevention perspective – Considers determinants of health and other economic, political, and environmental factors

Answer 29

Takes a microscopic, individual, curative focus to population health. Considers individual health concerns and treatments, but does not consider the sociopolitical, economic, and environmental variables

Answer 30

The study of the distribution or ‘patterns’ of health events in populations (or population subgroups) and the determinants that influence those patterns Health events can be many things: ₋ Infectious disease, ₋ Chronic disease (CA, CVD) ₋ Mental health events/ SUD ₋ Environmental exposure/ contaminant, ₋ Shared risk factor – (MVA, injury violence etc.) ₋ Positive health states

Answer 31

Improve the health status/ outcomes of entire population – using health equity lens

Answer 32

What is a health profile? A health profile is a collection of statistics that provide an overview of the health of a population. A health profile typically includes both determinants of health (the things that make us healthy or unhealthy) and health status (how healthy or unhealthy we are) indicators.

Answer 33

Studying the distribution of disease or health event ‘Describes’ disease or health event in terms of person, place and time Seeks examine health outcomes in terms of what, who, where, and when

Answer 34

Heavy drinking rates remain harmfully high Sexually transmitted and blood-borne infections are on the rise Current vaccination rates are not reaching national targets Antimicrobial resistance and unnecessary antibiotic use is an emerging threat Climate change is impacting health and well-being Cannabis use rises in adults 25+ Vaping increases among youth High rates of opioid-related deaths continue Poor mental health continues to impact Canadians Chronic diseases continue to be the major disease burden Life expectancy is changing

Answer 35

The study of the origins and causal factors (etiology) of the disease (how and why) Deals with determinants of health and disease How does the disease occur? Why are some people/groups affected more than others? DoH – individual, relational, communal, social, or environmental

Answer 36

Data for epidemiological studies commonly come from three categories: Routinely collected data such as census data, vital records, and surveillance data Data collected for other purposes, such as medical, health department, and insurance records Original data collected for specific epidemiological studies

Answer 37

A type of ratio that shows the relationship between the total number and the frequency of occurrence in the case of a particular health event It is an expression of a comparative part or share of the total of a particular health event during a specified period of time The denominator must include the numerator

Answer 38

The basic measure in epidemiological studies and deals with change A measure of how quickly something is happening (How rapidly a disease is developing in a population or How rapidly people are dying) Incidence and prevalence are expressed in mathematical measures called rates A rate is a ratio, but it is not a proportion

Answer 39

Used to calculate an approximation of risk Measure of relationship between two numbers expressed as one divided by the other

Answer 40

The formula for calculating a rate is: Events/ condition X (1000, 10,000 or 100,000) Population at risk for experiencing condition

Answer 41

Risk: The probability that an event will occur within a specified period High-risk population: Those persons for whom there exists a greater probability of the event occurring

Answer 42

Identifies the number of persons in a population that have a disease or have experienced an event at a specific period or a particular moment in time Old and new cases included Prevalence rate calculated as: # population with the disease # population at risk *usually X 100

Answer 43

Reflects the number of new cases developing in a population at risk during a specified time Knowing the number of new events of a specific disease during a specified period of time, gives a sense of how quickly a disease is spreading – a estimate of ‘risk’ Incidence rate is calculated as: # new cases in a specified period # of population at risk *usually, X 1000

Answer 44

A mortality rate is a measure of the frequency of occurrence of death in a defined population during a specified interval. We often hear about morbidity rates and mortality rates. These measures are often the same mathematically; it's just a matter of what you choose to measure, illness (morbidity) or death (mortality).

Answer 45

Commonly used mortality rates include: Crude mortality rate Age-specific rate Cause-specific rate Proportionate mortality ratio Case fatality rate Infant mortality rates

Answer 46

Infant Mortality rate: is calculated as the number of deaths of infants less than 1 year of age per 1000 live births. The infant mortality rate is used all over the world as an indicator of overall health and availability of health care services.

Answer 47

CIHI is promoting the measurement of health inequalities through the reporting of health indicator results by socio-economic status and demographic factors. CIHI has developed several resources to help you analyze and report on health inequalities through equity stratification. – Equity stratification is the process of dividing data into population subgroups for analysis, based on demographic, social, economic or geographic descriptors (also known as stratifiers).

Answer 48

Agent, Host, and Environment

Answer 49

complex interrelationships of factors, to increase (or decrease) the risk of disease.

Answer 50

how social determinants of health influence development across the lifespan in relation to immediate as well as long-term health and illness status.

Answer 51

An animate or inanimate factor that must be present or lacking for a disease or condition to develop

Answer 52

A living species capable of being infected or affected by an agent

Answer 53

Everything internal or external to a given host or agent and that is influenced by and influences the host and/or agent. Also includes social and physical factors.

Answer 54

- The testing of groups of individuals who are at risk for a certain condition but do not manifest any symptoms, in order to determine the likelihood that these individuals will develop the disease - The aim of screening is early detection and treatment when these are likely to result in a more favorable prognosis. - Screening is a key component of many secondary prevention interventions. Not diagnostic – most times further testing is required to determine or rule out a diagnosis

Answer 55

CHNs are involved in surveillance and monitoring of disease trends. CHNs can identify patterns of disease in a group. Nursing documentation on patient records is an important source of data for epidemiological reviews (e.g., patient demographics, health histories).

Answer 56

Sensitivity - TP True Positive: the person has the disease and the test is positive. False Negative: the person has the disease and the test is negative. Specificity - TN True Negative: the person does not have the disease and the test is negative. False Positive: the person does not have the disease and the test is positive.

Answer 57

Quantifies how accurately the test identifies those with the condition or trait and represents the proportion of persons with the disease whom the test correctly identifies as positive (true positives) High sensitivity is needed when early treatment is crucial and when identification of all cases is important

Answer 58

Indicates how accurately the test identifies those without the condition or trait, i.e., the proportion of persons whom the test correctly identifies as negative for the disease (true negatives) High specificity is needed when re-screening is impractical and when reducing false positives is important

Answer 59

A branch of philosophy that includes both a body of knowledge about the moral life and a process of reflection for determining what persons ought to do or be, regarding this life.

Answer 60

▪ 1. To not harm others ▪ 2. To respect others ▪ 3. To tell the truth ▪ 4. To keep promises

Answer 61

Shared and generational societal norms about what constitutes right and wrong conduct.

Answer 62

Beliefs about the shared worth or importance of what is desired or esteemed within a society.

Answer 63

framework that nurses use to guide their ethical obligations and actions within the profession

Answer 64

1. provision of care 2. Health 3. Informed decision making 4. Dignity 5. Privacy 6. Justice 7. Accountability

Answer 65

1. Assess the ethics of the situation, including the relationships, goals, beliefs and values. 2. Reflect on and review potential actions *. 3. Select an ethical action. 4. Engage in the ethical action. 5. Reflect on and review the action.

Answer 66

That component of ethics which focuses on the process of how ethical decisions are made

Answer 67

Moral challenges facing the nursing profession

Answer 68

Puzzling moral problems in which morally justified reasons for both taking and not taking a certain course of action are envisioned

Answer 69

For community health nursing: ➢Advocacy is the application of information and resources to effect systemic changes that shape the way people in a community live. For public health nursing: ➢Advocacy is intended to benefit aggregates, e.g., to reduce death or disability in groups of people, and uses information and resources to reduce the occurrence or severity of public health problems.

Answer 70

promoting health and well-being promoting and respecting informed decision-making preserving dignity maintaining privacy and confidentiality promoting justice

Answer 71

refer to basic needs, including material and social goods, liberties, rights, and entitlements. [Wealth, Education, Public Services]

Answer 72

to be shared [Taxes, Military service, Location of incinerators and power plants]

Answer 73

The right action is the one that produces the greatest amount of good or the least amount of harm in a given situation.

Answer 74

is a well-known consequentialist theory that appeals exclusively to outcomes or consequences in determining which choice to make.

Answer 75

Persons should always be treated as ends in themselves, and never as mere means to the ends of others.

Answer 76

➢Telling the truth ➢Veracity promotes trust in the nurse–patient therapeutic relationship. *Challenging – utilitarianism – more harm then good

Answer 77

➢Health care professionals have specific obligations that exist because of the practices and goals of the profession

Answer 78

often emphasized in acute care settings

Answer 79

emphasized more in community health

Answer 80

The allocation of benefits (e.g., basic needs) and burdens to members of society

Answer 81

respect for autonomy beneficence non-maleficence justice *focus is on individual

Answer 82

Public Health Ethics is mostly about what should and shouldn’t be done, collectively, to protect and promote the health and health equity of communities.

Answer 83

➢ It is normative, not descriptive (i.e., it is about what is appropriate or best to do, and not just a description of what people actually do) ➢ It focuses on a collective (public) effort (i.e., an organized societal effort undertaken on behalf of everyone) ➢ It focuses on populations, not individuals (i.e., interventions and their effects are considered at a community-wide or population level) ➢ It focuses on health and health equity (i.e., protecting and promoting the health of the entire population, and the other involves reducing the unfair distribution of health burdens and risks that affect)

Answer 84

the goals apply in every country including canada

Answer 85

achievement of any one goal is linked to achievement of the others

Answer 86

there is a need to move past business as usual and seek transformational solutions

Answer 87

success depends on the inclusion of the poorest and most vulnerable

Answer 88

*Women in developing nations represent almost all pregnancy related deaths globally. Why? o430/100,000 births in low-income countries o13/100,000 births in high-income countries o In 2023 in Canada maternal mortality rate was 9.38/100,000 births *Africa has the highest maternal mortality rates *Impoverished nations have limited access to cervical cancer screening and cervical cancer treatments. *HIV & AIDS impacts more than 12 million women in Sub-Saharan Africa where little treatment is available.

Answer 89

*Encompasses health promotion, health protection and disease prevention, and health maintenance in adult women *In most countries, women live longer than men, but are generally less healthy. *This is related to poverty: *Although women make up half of the world’s population, three-quarters of the world’s poor are women.

Answer 90

*Unequal power relationships between men and women - men having more power /rights ( legal, religious, cultural) and power over women – women are left dependent on others rather than having their own power. *Social norms that limit education for females and limit access to paid employment opportunities - or less pay for equal work. *An exclusive focus on women’s reproductive roles - (the work of women) as opposed to reproduction being a shared family value or experience *Potential or actual experience of physical, sexual and emotional violence. *Many of these factors are rooted in poverty and everywhere in the world poverty is a significant barrier to positive health outcomes for both men and women, poverty tends to yield a higher burden on women and girls’ health.

Answer 91

Miscarriage Induced abortion incomplete abortion intrauterine fetal demise

Answer 92

*Breast milk is recognized as the normal and optimal food for infants. *Exclusive breastfeeding is recommended for the first six months of life for healthy, term infants with nutrient-rich complementary foods, (with particular attention to iron) introduced at six months with continued partial breastfeeding until two years or longer for the nutrition, immunologic protection, growth, and development of infants and toddler

Answer 93

*Lactogenesis is the term the onset of milk secretion *Stage 1 Secretory differentiation – mid-pregnancy until 2-3 days postpartum *Stage 2 Secretory activation – Day 2-3 postpartum until day 8 *Stage 3 Galactopoiesis – Day 9 postparum onwards *Stage 4 Involution – Approximately 40 days after last feed

Answer 94

*Human milk contains immunologically active components. *Provide some protection against broad spectrum of bacterial, viral, and protozoal infections *Secretory immunoglobulin A is the major immune globulin in human milk. *Colostrum, a clear, yellowish fluid *More concentrated than mature milk *Extremely rich in immune globulins *Higher concentration of protein, fat-soluble vitamins, and minerals *Less fat than mature milk *Composition changes during each feeding. *Fat content of breast milk increases.

Answer 95

*Maternal cancer therapy or diagnostic and therapeutic radioactive isotopes *Active tuberculosis not under treatment *HIV *Maternal herpes simplex lesion on a breast *Galactosemia in infant *Maternal substance use *Maternal human T-cell leukemia virus type 1 *Some medications may exert an untoward effect on the breastfeeding infant