NU 302 Exam 4 Flashcards
Define people who are displaced
People who are forced to leave their homes escape the effects of a disaster
Define a refugee
Reserved for people who are forced to leave their homeland because of war or persecution
Define casualties
Number of human beings injured or killed by or as a direct result of an incident
Define a multiple casualty incident
> 2 but <100
Define a mass casualty incident
> 100 people
Define the scope of a disaster
Range of its effect, either geographically or in terms of the number of victims
Define the intensity of a disaster
The level of destruction and devastation it causes
What is a man-made disaster?
A disaster caused by human activity
What is a natural disaster?
A disaster caused by natural events
What are the 3 stages of disaster management?
Preparedness, response, recovery
Describe preparedness
Plans for communication, evacuation, rescue, and recovery.
Disaster drills
Adequate supplies
Prevention
Train individuals
Response
What is the response phase of a disaster?
Immediate triage, stabilization, transportation, rescue and recovery. Caring for and identifying bodies support for survivors
define Recovery of a disaster
Rebuilding and restoration
Psychological support
What is bioterrorism category A?
Highest priority- easily transmitted and high mortality rates (smallpox, botulism, anthrax, Ebola)
What is bioterroism category B?
Second-highest priority: Moderately easy to transfer + high morbidity/ low mortality rates (ricin toxin, food and water borne illnesses)
What is bioterrorism category C?
Third priority- easy to produce and has high morbidity and high mortality rates (TB, flu, rabies, SARS, and MERS)
What is triage green?
Minor (walking wounded)
What is Triage yellow?
Delayed
What a is triage red?
Immediate
What is triage black?
Deceased/morgue/unable to assist
What is an emergency preparedness kit?
-Water (1 gallon per person per day- 3 day supply)
-Non-perishable food (3 day supply for evacuation, 2 weeks for home)
Flashlight
Battery powered radio
First aid kit
7 day supply of meds
Multi purpose tools
Hygiene items
Copies of personal documents (birth certificates, passports, insurance policies)
Cell phone with charger
Emergency contact info
Emergency blanket
What is an incidence command center/ system?
Can grow or shrink to meet the needs of the incident
Provides meeting and collaboration of various agencies
Cost effective by decreasing duplication of services
What is FEMA?
Federal Emergency Management Agency; est 1979; provides oveeeresight of National Incident Managemeent Systems
What are disaster host factors from the epidemiological triad?
factors of the host that can affect them during a disaster
Age, general health, mobility, psychological/ socioeconomic factors
What are disaster agent factors from the epidemiological triad?
Natural or technological element that causes the disaster
What are disaster environmental factors from the epidemiological triade?
Those that could potentially contribute or mitigate a disaster
i.e. level of preparedness of the community, presence of industries that produce harmful chemicals, presence of flood-prone rivers.
What is ecology?
The study of the interactions and relationships between living organisms and their environments
What the does public health ecological model or perspective do?
Recognize the determinants of health include the environment and effect health of individuals
What is environmental epidemiology?
Focus on environmental exposures and the health effects
What is toxicology?
The study of adverse effects of chemical, physical, or biological agents on living organisms
What is upstream focus?
Recognizing factors which contribute to a problem
Can help determine if environmental factors contribute to illness.
What is the upstream focus framework in order?
- assess for environmental exposures
- Establish health goals
- Determine interventions
- Align community
- Measure effectiveness
What is the precautionary principle?
-In the absence of clear date that indicate the safety of an action, chemical, or material that poses a threat to human health, it should not be used.
-The principle states, “when an activity raises threats of harm to human health of the environment, precautionary measures should be taken if some cause and effect relationships are not fully established scientifically.
Who are some vulnerable populations?
-Pregnant women
-Those with compromised immune systems
-Children
what is the I PREPARE method?
Investigate potential exposures
Present work
Residence
Environmental concerns
Past work
Activities
Referrals and resources
Educate
What are some air quality concerns?
-Pollutants may include: aerosols, carbon monoxide, lead etc.
_Adveres effects include irritation of respiratory system, exacerbation of asthmas, chronic lung disease
-Indoor exposures such as oil or kerosene, second hand smoke, carpeting and adhesives, asbestos in insulation
What are Water and food quality concerns?
Could be contaminated with chemicals or microbes
Water contamination and availability becoming a significant issue
Pharmaceutical waste disposal major concern
What are core public health functions?
Assessment; monitoring health status, the diagnosis and investigation of health hazards into the community
Assurance: the enforcement of policy
Policy development: provides guidance through the essential community services, engages scientists to analyzes an develop Olivier to ensure health based upon sound evidence.
What is the lead poisoning home checklist?
- Was your home built before 1978?
- Do you see walls, furniture, or window sill in your home with chipping or peeling paint?
- Do your children play in lead-contaminated soil near your home?
- Do you store food in imported pottery that contains lead?
- Do you work with lead in your job?
What is an MSDS?
Material Safety Data Sheet: Instructions for when you are exposed to a certain chemical
What is a rural population?
All territory, population, and housing units located outside urbanized areas and urban clusters. Fewer than 2500 residents and are classified as “completely rural”.
What is an urban population?
Areas that encompass at least 2500 people at least 1500 of which reside outside institutional group quarters
What is a frontier population?
Area with six or fewer persons per square mile, but others include not only population density but distance and travel time to market service areas.
What is a migrant population?
A transit population, usually immigrants, that moves regularly to follow work opportunities usaually founds as far workers.
What are the 3 most common health problems of rural residents?
-CV disease
-Diabetees
-COPD
What are health problems for children of migrant families?
High BP
Obesity
Earache
Poor nutrition
anemia
Vitamin A deficiency
Lead poisoning
Dental problems
Intestinal parasites
Skin infections
TB
Developmental delays
Pesticide poisoning
s/s of pesticide poisoning
Sore throat,
runny nose,
headache,
fatigue,
drowsiness,
itchy skin,
abdominal pain,
N&V.
Severe symptoms include
sweating,
blurred vision,
pinpoint pupils,
muscle twitching,
weakness,
respiratory depression
What are some Occupationals hazards for migrant and rural workers?
tractor accidents and rollovers
Machine and equipment accidents
Heat stroke
Animal injuries
What are characteristics of urban populations?
-Those within large cities
-Often high unemployment, low incomes, substance abuse
-Urban planning “improving the welfare of individuals and communities b creating a more healthful, efficient, attractive, and equitable places”.
What are health disparities of urban populations?
negative health contributors
-Poverty
-Environmental exposures (air pollution, fast food, tobacco)
-Poor housing quality
-higher sound levels
-Violence
-Lack of access to healthy foods
-Increassed incidence of alcohol and drug abuse
What is a developmental crisis?
Periods of disruption that occur at transition points during normal growth and development
What is a situational crisis?
Is a stressful, disruptive event arise it from external circumstances that occur sudddenly, often without warning, to a person, group, aggregate, or community due to where they are in time or space.
What are multiple crises?
Different kinds of crises can overlap in actual experience, compounding the stress felt by the persons involved.
What are the different types of child abuse?
-Neglect
-Physical
-Sexual abuse
-Sexual exploitation
-Emotional
S/s of physical child abuse?
-unexplained injuries like bruises, bite marks, abrasions, lacerations, head or internal injuries, or fractures.
-bruising from defensive injuries to forearms
-Burns from cigarettes, ropes, or hot water/ grid
-Traumatic slope is with potential hematoma area and is tender to touch.
-Trauma to ear
-appears depressed, withdrawn, anxious, or aggressive
-Appears scared of parent/does not want to go home.
Who are those directly impacted by disasters?
Includes survivors and deceased. May include displaced or refugees.
Who are those indirectly impacted by disasters?
Relatives or friends of direct victims.
Which would be considered a mass-casualty incident?
A. 26 victims
B. 54 victims
C. 78 victims
D. 110 victims
D. 110 victims
A mass casualty incident is one in which are are more than 100 victims.
What is the individual experiencing the disaster?
Host
What is the cause of the disaster?
The agent
What are the factors that may contribute to the disaster?
The environment
What are some agent factors of the epidemiological triad and disasters?
Natural or technological element that causes the disaster
What are some environment factors of the epidemiological triad of disasters?
Those that could potentially contribute to or mitigate a disaster
What is FEMA?
Federal Emergency Management Agency- provides over site of National Incident Management System (NIMS)
What is DHS?
The Department of Homeland Security
What is NIMS?
National Incident Management System-Coordinates responders
What happens during the preparedness phase of a disaster?
Plans for communication, evacuation, rescue, and recovery.
Disaster drills
Adequate supplies
Prevention
Train individuals
What happens during the response phase of a disaster?
Immediate
Triage, stabilization, transportation, rescue and recovery
Caring for & identifying bodies
Support for survivors
What happens during the recovery phase of a disaster?
Rebuilding
Psychological support
T or F, rescue and triage occur during the recovery phase of a disaster?
False; rescue and triage occur during the response phase.
Which of the following is a component of disaster prevention?
A. Outlying specific roles of community agencies
B. Identifying community vulnerabilities
C. Prioritizing care of individuals
D. Providing stress counseling
B. This is part of a risk assessment for your community
What is terrorism?
Unlawful use of force and violence against persons or property to intimidate or coerce a government, the civilian population, or any segment thereof, in furtherance of political or social objectives.
Describe anthrax
how its spread, what are tue s/s, how to treat it
Spores found in digestive tracks of herbivores and soil
Itchy skin, lesions, Escher, infection and septicemia
Treat with antitoxin
Describe smallpox
s/s
Fever
Malaise
Abdominal pain
Vomiting
Rash which becomes lesions
No cure
Vaccine
Describe botulism
s/s and how to treat
Double or blurred vision
Slurred speech
Muscle weakness
Difficulty breathing
Antitoxin
Describe Ebola
s/sand treatment
Fever, HA, fatigue, hemorrhage and even shock
Supportive treatment
T or F, anthrax is a chemical agent?
False; anthrax is considered a bio weapon used for terrorism
What are primary levels of prevention for a disaster?
first things you can do before a disaster
Establish disaster plans
Teach community of disaster plans
Report unusually activity
Acquire basic knowledge of skills to respond appropriately
What are secondary levels of disaster prevention?
things you would do during the disaster
quickest response
Provide early evacuations if possible
Crisis intervention
What are some tertiary preventions for disastsers
after the disaster
Assist with recovery
PTSD support
Grief counseling
What is the census definition of a rural community?
All territory, population, and housing units located outside urbanized areas and urban clusters
What is the Department of Agriculture’s definition of a rural community?
Fewer then 2,500 residents and are classified as completely rural
What is the textbook’s definition of a rural community?
Fewer than 10,000 residents and a county population density of >1,000 persons/square mile
What are common race and ethnicity characteristics of rural populations?
There has been a rapid growth in the Hispanic population
What are common education characteristics of rural populations?
Lower education levels compared to urban populations. (Related to poverty)
What are some income characteristics of rural populations?
Lower in rural areas compared to urban populations (Higher unemployment)
What are some values/belief characteristics of rural communities?
Value self-sufficiency, privacy, and autonomy
-hard working-resistant to help from outside services and agencies
-strong social and family support
T or F, rural populations are becoming more male dominated
False; Rural populations have shifted to become more female dominated
What are 3 major health problems for rural communities?
CV disease, diabetes, COPD
What are some barriers to health care in rural communities?
Lack of transportation
Distance from services
Limited choice of providers
Weather
Describe rural communities access to care
Many uninsured or on Medicaid
Use of family practice clinics
Rural health clinics
Lack of core health services
Heavy reliance on public health department services
Describe working characteristics for migrant workers/families
Move from place to place to find agricultural work
Typically only live in one place for 6-8 weeks
Childcare/children help with work
What are the economic characteristics of migrant workers?
Low income
Sometimes wage violations
What are the healthcare characteristics of migrant workers?
Lower life expectancies
May delay treatment
May live in substandard housing
What are some general characteristics of migrant workers?
Median education: 6th grade
Income from agriculture
Mostly male
Mostly speak Spanish
What are some occupational health risks of migrant workers?
Occupational hazards
Communicable diseases
Substandard housing
Poor sanitation
T or F, most migrant workers have at least an 8th grade education?
False; the median education level is 6th
Which reflects the health of migrant families?
A. Coordinated care
B. Wide-ranging health resources
C. Exposure to violence
D. Increased social opportunities
C. Migrant families are exposed to violence. Children are educationally, socially, and physically disadvantaged. Health care fragmented.
What affects air quality (health concern)
in the environment
Dust from plowing, wind blown pesticides, mycotoxins, animal dander, hay, grass
What affects soil quality (health concern)
Pesticides, fertilizes
What affects water quality? (Health concern)
Pesticides, fertilizers, livestock growth producing agents, antibiotics, radon.
What are long term pesticide effects?
Birth defects, cancers, blood disorders, neurological problems.
What are health disparities of urban populations?
Poverty
Environmental exposures
Poor housing quality
High sound levels
Violence
Lack of access to healthy foods
Increased alcohol and drug abuse
What are barriers to healthcare for urban residents?
Unaware of services/necessity of services
Lack of transportation
Fare for transportation
Illiteracy
Insurance
Work obligations
T or F, An urban community health nurse must work within the realm of shortened time commitments.
False, an urban community health nurse needs to be able to manage a sense of time, that is, an awareness of the long term commitment to the client and community
How does urban substance abuse compare to rural communities?
Drug and alcohol abuse high.
Give examples of risk factors for an individual for violence
low education, lack of problem solving skills, impulsivity, history of being the victims, witnessing violence, mental health, substance abuse
Give examples of risk factors for a community
poverty, availability of drugs and alcohol, community violence, unemployment
Give examples of risk factors for a society for violence
cultural norms, media, income, health, social laws, etc.
Give examples of relationship risk factors
isolation, lack of support, poor parent-child relationships, family conflicts
What is the tension building phase of the cycle of violence?
longest-phase
victim walking on eggshells
abuser is edgy, negative mood
victim attempts to appease partner
small arguments
What is the acute explosion phase of the cycle of violence?
shortest phase
tension is released
triggered by external event or state of abusers mind
violence can be physical, sexual etc.
victim may fight, flee, or try to calm abuser
What is the honeymoon phase of the cycle of violence?
abuser promises to change
abuser tries to rectify actions
abuser tries to justify actions
tensions building begins
List characteristics of the batterer (of partner violence)
Poor sense of self-worth
- Low earnings of unemployed
- Not doing well in academics or dropping out of school
- Conduct disorders as child
- Heavy substance use
- Mood disorders
- Angry or hostile behavior
- Personality disorder
- Physically abusive to others
- A loner with no or few friends
- Emotional immaturity
- “Belief in strict gender roles”
- Desire for power and control in relationships
- Being a prior victim of abuse
What are risk factors for vulnerability?
What makes a person vulnerable to violence?
poor health, increase age, and disability, LGBTQ member, dementia,
What are primary preventions for partner violence?
parenting classes, promote education on gun violence, teach new coping strategies
What are secondary prevention strategies for partner violence?
assist with reaction to event, allow for feelings of anger or grief, ensure safety
What are tertiary prevention strategies for partner violence?
Rehab from the violent event
What are the warning signs of suicide?
previous suicide attempt, talking about no reasons to live, feeling trapped, or suicide
isolation, sleeping too much, increase use of drugs and alochol
depression, humiliation, anxiety
What is substance abuse disorder?
use of substances which affects
brain and behavior. Individuals are unable to stop use despite
harmful affects. May involve multiple substances.
s/s of sexual child abuse?
STIs
- Trauma to perineal area, blood may be seen on sheets or undergarments
- Discharge from genital or anus
- Pain during bowel movement or urination
s/s of shaken baby syndrome?
Bilateral retinal hemorrhages, subdural or subarachnoid hematomas, no other external signs of abuse, possible breathing difficulties, seizures, dilated pupils, lethargy, and unconsciousness
list characteristics of a victim (lf IPV)
Prior history of IPV
- Being female
- Young age (especially if pregnant)
- From low-income household
- Witnessing or experiencing violence as a child
- Lower education level
- Unemployment
- Being a single parent with children
- For men, having a different ethnicity than your partner
- For women, having a greater education level than partner
- For women, being American Indian/Alaska Native or African American
- For women, being disabled
- Childhood sexual and/or physical violence
- For women, having a verbally abusive, jealous, or obsessive partner
-Veterans and active-duty members
- Higher levels of IPV in same-sex couples
Give examples of primary prevention of violence
Health promotion and education: anticipatory guidance; parenting skills, positive coping strategies, social support
Health protection: reduce factors that increase vulnerability and other hazards
Give examples of secondary prevention of violence
Early diagnosis: recognize signs and symptoms of crisis; signs and symptoms of abuse
Prompt treatment:
Provide necessary assistance including emergency medical and emotional support, and assist with reaction to the event and functioning.
Ensure safety.
Allow behavior (dependence, grief, etc.).
Refer to resources.
Set goals with the client.
Reporting of abuse
Give examples of tertiary preventions of violence
Rehabilitation
-Promote adaptation to a changed level of wellness.
-Promote interdependence.
-Reinforce newly learned behaviors, lifestyle changes, and coping strategies.
-Explore application of learned behaviors to new situations.
-Identify and use additional resources.
Continue primary prevention to avert future crises.
What are faith community nursing characteristics?
Provide care in a variety of locations and to a variety of congregations
- Holistic support for patients
- Integrate spiritual component and members of faith community into care of clients
What are the roles of the faith community health nurse?
*Health educator
*Health counselor
*Advocate
*Referral agent
*Developer of support groups
*Coordinator of volunteers
*Integrator of faith and health
What are the roles and responsibilites of an occupational health nurse?
Works with employees to cultivate create and business appropriate health and safety programs
- Meet and comply with OSHA standards
- Work to prevent work associated injuries
- Work to maintain health and wellness of employees
List barriers to the homeless population?
Socioeconomic status
- Shorter life expectancy
- Relationships
- Living/housing environment
- Interpersonal barriers, difficulty trusting others
- Impaired neurological status
- Communication barriers
- Lack of routine care and screenings
- Premature development of age-related conditions
- Difficulty obtaining essential needs of living
- Acute and chronic illness
What are health issues of the homeless?
Common health problems they have
Malnutrition, HIV/AIDS, skin and wound infections, and respiratory disease
What are examples of colorectal cancer screenings?
Fecal occult blood test
- Flexible sigmoidoscopy
- Colonoscopy
- Virtual colonoscopy
- Fecal immunichemic AL Test
- Fit-DNA Test
s/s of colorectal cancer?
blood in stool, abd discomfort, change in bowel habits
What are barriers to expectant mothers using e-cigarettes?
Much of the research on the use of vapes during pregnancy is nonexclusive, leaving women to make decisions about their health based on limited information.
What are some warnings for suicide?
ISPATHWARM: Ideation, Substance abuse, purposelessness, anxiety, trapped, hopelessness, withdrawal, anger, recklessness, mood changes
what are the s/s of marijuana withdrawal?
irritability, anger, aggression, anxiety, sleep difficulty,
decreased appetite, depression
what are the s/s of marijuana intoxication?
increased appetite, dry mouth, tachycardia,
hallucinations
What are opioids?
Opioids are drugs derived from or mimic substances in the
opium poppy plant.
Examples of opioids include: oxycodone, morphine,
hydrocodone, fentanyl, codeine, tramadol, and heroine.
Used for pain control, treatment of cough
May be administered orally, injection, transdermal, sublingual,
IV
May cause a euphoria resulting in an addiction
What are the different treatments for opioids?
Medication Assisted
Treatment (MAT) –
buprenorphine, extended
release naltrexone
Behavioral Counseling
Naloxone (Narcan)
Using the upstream focus a Public Health
Nurse might recognize what as a factor
contributing to heart disease?
A. Unhealth Diet
B. Decreased Physical Activity
C. Smoking Tobacco
D. Lack of Safe Places to Exercise
D. Lack of safe places to exercise
Rationale: The upstream approach focuses on
the factors at the institutional and system level
rather than looking at healthy lifestyle issues.
Healthy diets, increased physical activity, and
smoking cessation are all healthy lifestyle
issues. The root causes of the decreased
physical activity would include lack of safe
places to exercise.
Is the following statement true or false?
The precautionary principle identifies root
causes of disease and manufacturers of
illness.
False
Rationale: It is the upstream focus that
identifies root causes of disease and
manufacturers of illness
What are the 9 healthy people 2030 objectives for environmental health?
- Outdoor air quality
- Use of mass transit
- Improved water supply
- Reduce blood lead level in children 1-5 years
- Reduce risk from hazardous sites
- Reduce pollutants released in to the environment
- Reduce exposures to arsenic, lead and bisphenol A
- Reduce mercury exposure in children
- Reduce heat related deaths
Describe the assessment core public health function
Assessment; monitoring health status, the diagnosis and investigation of health hazards into the community
Describe the assurance core public health function
Assurance: the enforcement of policy
Describe the policy development core public health function
Policy development: provides guidance through the essential community services, engages scientists to analyzes an develop Olivier to ensure health based upon sound evidence.
T or F, When using the “I Prepare”
method to perform and
environmental health assessment
the nurse would the second “P” in
the mnemonic addresses present
work
False – It addresses past work.
The first P addresses current
work
What can be affects of harmful alcohol use?
liver cirrhosis, mouth cancer, pancreatitis, tuberculosis, colorectal cancer, breast cancer, hypertensive heart disease
