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N322: Client System of Nursing > Module 14 > Flashcards

Module 14 Flashcards

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1
Q

Healthy environments are …

A

essential for optimal health and health care

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2
Q

ANA Scope and Standards for Environmental Health

A

Environmental health is essential knowledge for nurses

Nurses should avoid products or practices that harm health or the environment

Nurses have a right to work in a safe and healthy place and have the right to timely information regarding any hazardous exposures

Multidisciplinary collaboration sustain healthy environments

Best practice should govern choice of materials, products, technology and practices in the environment that affect nurses

Nurses should respect the diversity of the people whom they serve

Nurses should focus on the quality of the environment in which they and their clients work and live

Nurses, other health care workers, families, patients and communities have the right to know timely information about potentially harmful products

Nurses should participate in research related to promoting a safe and healthy environment

Nurses should participate in advocacy related to promoting a safe and healthy environment

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3
Q

HP2020 Objectives involve what topicsq

A

Outdoor air quality

Water quality

toxics and waste

Healthy homes and healthy communities

infrastructure and surveillance

global environmental health

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4
Q

T and F: ANA considers environmental health an essential part of a nurse’s practice

A

True

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5
Q

Important Nurses in regard to Environmental Health

A

Florence N

Lillian Wald and Mary Brewster (Henry Street Settlement)

focus on environmental contamination and poverty and exposure to environmental hazards

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6
Q

Institute of Medicine recommendations for nurses

A

to have basic understanding of environmental health principles and integrate them into all aspects of practice, education, advocacy, policies, and research

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7
Q

Toxicology

A

study of negative effects of chemical exposure

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8
Q

Epidemiology

A

science of association between exposures and human health effects

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9
Q

Epidemiology Triangle

A

Agent, host, and environment

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10
Q

Geographic Information Systems (GIS)

A

code data related spatially to place

a way to take data and map it to a place on earth - can look at a specific pop there and housing, diseases, family things etc

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11
Q

When approaching environmental health, you must use a ___ approach

A

multidisciplinary (geologies meteorologists, politicians, chemists, nurses, etc)

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12
Q

Point Source

A

a fixed identifiable site and source for where a contaminant is coming from

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13
Q

What are examples of point source?

A

Air - like with smoke stacks

Water - discharges into water from industry

Land - chemicals added to soil, animal waste

Food - bacteria pesticides, etc

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14
Q

Non Point Source

A

Diffuse sources without a very determined sources

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15
Q

What are examples of point source?

A

Air - smog

Land - acidity of soil, run off

Water - run off, contamination

Food - fishing, low o2 in water, mercury - large quantities

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16
Q

What sort of source is motor vehicle traffic emission on Vestal Parkway

A

non point source (cannot be traced to a certain vehicle)

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17
Q

What sort of source is lourdes hospital pipe draining into the susquehanna river?

A

point source - particular spot of pollution

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18
Q

What sort of source is run off from city streets after a rain storm into the sewers?

A

non - point source - general in origin

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19
Q

What does IPREPARE mean for a windshield survey for an environmental health assessment ?

A

Windshield Survery first then …

Investigate potential exposures

Present work

Residential exposures

Environmental concerns

Past work exposures

Activites

Referrals and resources

Educate (follow up)

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20
Q

Right to Know Laws

A

the public hawse a right to know about hazardous chemicals in the environment

EPA provides envirofacts, CCR is a consumer confidence report on what pollutants are found in drinking water, and MSDS sheets are OSHA initiated stickers for dangers

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21
Q

MSDS

A

Material Safety Data Sheet

Blue - health hazard rating; red - fire hazard rating; white - specific hazard; yellow - reactivity rating

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22
Q

Environmental laws are contentious for what reasons

A

not only because of public or ecological health concerns, but also because of economic interests

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23
Q

Risk Assessment

A

process to determine the probability of a health threat associated with an exposure

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24
Q

What sort of things are done/needed for a risk assessment?

A

Access toxicological or epidemiological data, and determine if chemical associated with negative health effects.

Has a chemical been released into the environment (water, air, food)? How?
Multiple sources?

Estimate how much chemical might enter the body.

Is the chemical toxic? What is the source and amount of exposure? What is the route and duration?

The goal of assessment is to try to predict the potential for harm on the basis of the estimated exposure.

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25
Q

What are high risk vulnerable populations for environmental health?

A

Pregnant women

children

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26
Q

Why are children and pregnant women more at risk with environmental populations?

A

Size and immaturity of systems.

Greater respiration rate = great exposure to air pollutants

Short stature so closer to biological and chemical agents on floors and carpeting. Higher risk during disasters

Bodies work differently than adults: blood-brain barrier, kidneys, growing bodies

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27
Q

How can nurses reduce environmental health risks?

A

Apply basic principles of disease prevention (since its less costly)

reduce reuse recycle

risk communication (provide right info, to the right people, and at the right time)

ethics

governmental environmental protection

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28
Q

Ethics and environmental health

A

essential for making ethical decisions regarding environmental health.

asking people to sacrifice some of their self interests to benefit the greater good of more people (fracking)

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29
Q

Environmental Justice

A

equal protection from environmental hazards for individuals, groups, or communities regardless of race, ethnicity, or economic status

(ex: env justice act, executive order 12898, 2012 environmental justice strategy and implementation plan )

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30
Q

Nursing Skills: Advocacy

A

Nurses have responsibilities to be informed consumers and to be advocates for citizens in their community regarding environmental health issues

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31
Q

Nursing Roles in environmental health

A

Individual and Population Risk Assessment

Referral

Community involvement and public participation

Risk communication

Epidemiologic investigations

Policy development

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32
Q

Examples of Environmental Hazards

A

lead pain

quality of your water and air

has your home been checked for radon

do you have CO2 and smoke in the home

do you or your neighbors use pesticides

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33
Q

No workplace is …

A

completely risk free (and people spend half their time at work!!)

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34
Q

Occupational health Nursing

A

specialty practice that focuses on the preventive healthcare, health promotion, and health restoration within the context of a safe and healthy environment (at work)

it includes prevention of adverse health effects from occupational and environmental hazards, and health promotion in general

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35
Q

Scope of practice is determined by __ ___

A

state law

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36
Q

What are some things in the scope of practice for occupational health nurses?

A

Worker/workplace assessment and surveillance
Primary care
Case management
Consulting
Counseling
Health promotion/protection
Administration and management
Research
Legal-ethical monitoring
Community orientation

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37
Q

Ada Mayo Stewart

A

First “industrial nurse” (occupational health nurse)

worked in vermont marble company

visited sick employees homes and provided emergency care, taught mothers to care for kids, and taught health living habits

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38
Q

Betty Moulder

A

hired coal miners in 1888 to take care of ailing workers and their families

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39
Q

Evolution of Occupational health nursing

A

workers comp (1911)

American association of occupational health nurses (1942)

occupational safety and health act (1970) –> OHSA and NIOSH

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40
Q

Roles of occupational health nurses

A

Clinician; case manager; coordinator; manager; nurse practitioner; corporate director; health promotion specialist; educator; consultant; researcher

41
Q

What is academic education for occupational health nursing usually?

A

graduate level (but assoc and bach work in here too)

42
Q

Workers act as a ___ ___

A

population aggregate

43
Q

jobs are shifting from __ to ___ to ___

A

agrarian to manufacturing to service

44
Q

3 Levels of Responsibility for Accidents and Accountability

A
  1. Individual
  2. Management
  3. Organization and Policies
45
Q

Individual level of responsibiity

A

individual responsibility to make decisions with safety in mind

46
Q

Management level of responsibility

A

responsibility of management to assure safe environment and equipment

47
Q

Organization and Policy levels of responsibility

A

responsibility of organization to create policies for safety standards and compliance

48
Q

Host

A

any susceptible human being; assume that all employed individuals are at risk of being exposed to occupational hazards

49
Q

Agent

A

factors associated with illness and injury; classified as biological, chemical, environmental and mechanical, physical, or psychosocial

50
Q

Environment

A

includes all external conditions that influence the interaction of the host and agents

51
Q

How is the epidemiologic model use in occupational health nursing?

A

Used to plan interventions to restore and promote the health of workers.

52
Q

Susan, a new nurse on the unit has a coworker that is caustic in her attitude towards Susan. this is an example of what type of agent causing Susan’s distress

A

psychosocial (not biological, physical, or environmental)

53
Q

What is a prominent and important chemical agent in hospitals

A

Latex

54
Q

most chemical agents have some sort of…

A

cancer risk

55
Q

Organizational and public efforts to promote worker health and safety can be …

A

limited or comprehensive

56
Q

Milk With Dignity

A

migrant justice with ben and jerry’s

they do a program to recruit farmers and improve conditions for migrant workers

57
Q

Worker Assessment aspects

A

Traditional history and physical assessment, emphasizing exposure to occupational hazards

Occupational health history

Teach about workplace hazards and preventive measures

58
Q

Workplace Assessment aspects

A

Worksite walk-through

59
Q

HP2020 in relation to occupational health

A

Identifies the national health objectives aimed at reducing the risk of occupational illnesses and promoting safety.

Health education and health protection strategies are proposed to address the needs of large population groups such as the American workforce.

60
Q

Important legislation related to occupational health

A

Occupational safety and health administration (OHSA)

hazard communication standards

material safety data sheets (MSDS)

national institute for occupational safety and health (NIOSH)

61
Q

OSHA

A

Occupational Safety and Health Administration (OSHA): federal agency charged with improving worker health and safety by establishing standards and regulations, educating workers, and enforcing standards.

62
Q

Hazard Communication Standard

A

the “right-to-know” standard that requires all manufacturing firms to inventory toxic agents, label them, develop information sheets, and educate employees about these agents

63
Q

NIOSH

A

National Institute for Occupational Safety and Health (NIOSH): the branch of the U.S. Public Health Service that is responsible for tracking workplace illnesses, accidents, and hazards

64
Q

MSDS

A

inventory toxic agents, make info sheets, label, and educate employees on them

EVEN WINDEX - every company in US must have a way for employees to have chemical sheets for anything

65
Q

Occupational Safety and Health Administration (OSHA) is a federal agency in charge of tracking workplace illnesses, accidents, and hazards

A

False (THIS IS NIOSH)

66
Q

Superfund Amendment and Reauthorization Act (SARA)

A

effective disaster plans designed by those with knowledge of the work processors and materials, the workers and workplace, and the resources of the community

shared with key community agencies

specific steps must be detailed for actions to be put in place by specific individuals in the event of a disaster

nurse is a key person in disaster planning!

67
Q

What is a disaster?

A

A natural or man made incident causing human suffering and creates human needs that victims cannot alleviate without assistance

68
Q

When a disaster occurs, what happens to needs a resources

A

Needs (outnumber) > Resources

69
Q

What is the DISASTER paradigm

A

Detect
Incident command
Scene security and safety
Assess hazards
Support
Triage and treatment
Evacuation
Recovery

70
Q

Why do nurses need to be prepared for disasters

A

most do not get disaster education and have to learn from the experience, so we need to prepare

71
Q

Nurses now have a list of what for disasters

A

core competencies

(core disaster life support, basic disaster life support, advanced disaster life support)

72
Q

Types of Natural Disasters

A

flooding

earthquake

hurricane

tornado

blizzard

communicable disease epidemic

73
Q

Types of Man Made Disasters

A

Train derailment

dam breakage

plane crash

nuclear reactor meltdown

bombing and warfare

hazardous material incident

water supply containment

civil unrest

74
Q

Heavy rains caused flooding of Smithville forcing 50% of the town to evacuate. After seven days, a dam near the town broke, and compounded the flooding of the village causing the rest of the residents to evacuate, and the businesses to close. This disaster could be classified as a:

A

both man made (the dam condition) and natural (heavy rain storm)

75
Q

It is ideal to think in what way for disasters?

A

Both preventative role as well as reactive role

we tend to enter a preventative and single patient care vacuum, but prevention of problems is rare and nursing and medicine are more responsive than preventative in disasters

76
Q

Mitigation

A

reducing risks to people and property from disasters before they occur

77
Q

Examples of Primary Disaster Prevention

A

community wide disaster preparedness education

78
Q

Examples of secondary disaster prevention

A

screening for community level risks

monitoring safety initiatives developed for disaster prevention

efforts to restore community to “normal”

79
Q

Examples of tertiary disaster prevention

A

disaster response

life after the disaster

80
Q

Mission of the US Dept of Homeland Security (via Homeland Security Act)

A

develop and coordinate comprehensive national strategies to secure the US from terrorist threats and attacks - 2002

in 2011 it was updated to include disasters

81
Q

National Incident Management System (NIMS)

A

2004

an all disciplines, all hazards approach for a organized response to any disaster in the U.S. including the Incident Command System (ICS), a multi-agency coordination of systems

82
Q

What things does NIMS discuss and detail

A

Discusses the need for preparedness

Discusses resource management, communications, and information management.

Details command structure to assist you in understanding the response plan and implementation of resources.

83
Q

National Response Frameworks

A

Outlines how the federal government will use all of its agencies to respond to the needs of a community in a disaster.

In the past, response time lagged behind what people needed.

It is problematic to think that disaster response is a federal job.

84
Q

How does disaster response start locally?

A

Start in your home with you and your family.

Moves to the local community response.
Proceeds to the regional response .

Next to the State Office of Emergency Management.

Finally to the state Governor’s office (state of emergency), initiating a request to the U.S. President for assistance.

Stafford Act mandates the President to respond with a Declaration of Disasters for States.

President assigns a Federal Coordinating Officer (FCO) to each disaster.

85
Q

Phases of a Disaster

A

Pre impact phase
Impact phase
Honeymoon phase
Disillusionment and Recovery Phase
Reconstruction Phase

86
Q

Pre Impact Phase

A

this is usually evident in disasters where we have some warnings issued (example: NOAA weather patterns indicate a storm or hurricane are coming).

Predictions provide guidance for preparation (example: snow storm is coming with predicted 3 feet of snow. We prepare the community for the storm).

87
Q

Impact Phase

A

when the disaster has occurred and we are in the mist of emergency response to the disaster.

Initial assessments are needed: how many injured, how many may need rescue, and how many need medical attention.

Also referred to the “heroic phase”

Common to see citizens working to rescue and help each other.

Fire and emergency personnel performing daring rescues .

88
Q

Honeymoon Phase

A

many expressions of joy at being alive and have survived the incident

Outside organizations have brought in help. People from outside of the community feel they can and want to help!!

89
Q

Disillusionment and Recovery Phase

A

people who have survived the ordeal now become frustrated

Realization of how long it may take to rebuild, claim insurance, and redevelop the community

Often many are outspoken and resentful that the government did not do enough

90
Q

Reconstruction Phase

A

occurs anytime between between 3 months to years after the disaster

Rebuilding a community may not happen quickly and rebuilding businesses and other infrastructure may take longer then expected

91
Q

After Puerto Rico was devastated by the recent hurricane, the Mayor severely criticized the Trump administration for its poor response. This is an example of what disaster phase?

A

This is the recovery phase (or disillusionment phase) when people realize how long recovery may take and become vocal about the government’s response

92
Q

Disaster Response includes thinking ..

A

outside the box

do the greatest good for the greatest number involves more than assigned priorities for treatment and transport

it means using available medical resources as efficiently as possible

93
Q

Triage

A

large part of caring for large numbers

the assignment of degrees of urgency to wounds or illnesses to decide the order of treatment of a large number of patients or casualties.

94
Q

ID-ME

A

Triage Basics

degrees of triage CARE:

Immediate (red), Delayed (yellow), Minor (green), Expectant near decreased (black)

95
Q

Immediate Care (red)

A

life threatening with a change for survival in triage

96
Q

Delayed Care (Yellow)

A

they can wait a few hours or days for surgical intervention, given pain medications and splinted fractures in triage

97
Q

Minor Care (green)

A

walking wounded, need minor care, first aid in triage

98
Q

Expectant Near Decreased (Black)

A

impending death, no chance for survival or recovery with the resources on hand

99
Q

T/F: People tagged green in a triage situation will receive immediate care

A

False

green tag can have any care delayed, they only need basic first aid and are ambulatory

N322: Client System of Nursing (13 decks)

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