Risk Assessment Flashcards
How often do adolescents (13-19) need a complete PE
Three visits (11-14, 15-17, 18-21)
When should syphilis screening start for both males and females
when sexually active
Who should get meningococcal vaccine?
- All adolescents age 11-18.
- Re-vaccinate for special populations (college dorms, military, immunecompromised, travelers) after 5 years
Who should get pneumococcal vaccine?
- Age 19-64 who is smoker or has asthma
- COPD, diabetes, and ETOH abuse. PPSV23
- Age 65 or older. PPSV23 and PCV13
How often do young adults need PE (age 20-39)?
Every 5-6 years
How often do young adults need a pap smear? (20-39)
every 3 years (with chlamydia and GC screen)
4 leading causes of death?
- Heart disease
- Cancer
- Lower resp diseases (COPD, PNA, Asthma, influenza)
- CVA
How often should early adults have their BP checked? What is the desired range?
every two years
How often should the early adult have a cholesterol panel checked. what is the desired range?
Starting at age 20 and every five years unless chol >200
How often do adults need tdap?
every 10 years
Leading cancers in women?
- Lung-highest mortality
- Ovarian-highest OB/GYN mortality CA
- Breast- highest incidence
Leading cancers in men?
- Lung-highest mortality
2. Prostate- highest incidence, increased mortality
Leading cancers in men and women combined?
- Lung-highest mortality
2. Colorectal-highest incidence.
When should women start getting mammograms and on what schedule?
At age 45
Every 2 years until age of 55
Some discrepancy. Continue as long as pt healthy and has life expectancy of 10+ years.
What age should men start having DRE and PSA for prostate CA?
beginning at age 40 and annually if family history or african american
Age 50 for all males
When should colorectal screening/colonoscopy start for men and women? How often?
Age 50 and every 10 years
How often do older adults (age 60 and older) need a PE?
every two years
At what age can PAP smear be discontinued? What is the criteria?
> 65-70 with three consecutive negative tests or no abnormal tests in past 10 years.
When should a pt get a baseline ECG?
At age 40
Define sensitivity
True positives. the degree to which those who have a disease screen/test positive
Define Specificity
True Negatives. the degree to which those who do NOT have a disease screen/test negative.
Define Inicidence
The frequency at which something occurs
Define prevalence
the proportion of population affected.
What is primary prevention?
measure to promote health prior to the onset of sx
i.e. diet exercise, immunization
What is Secondary prevention?
Focuses on early ID and tx of existing problem
i.e. pap smear, cholesterol screen
What is tertiary prevention?
Rehab and restoration of health
i.e. cardiac rehab after MI, PT after MVC
What is an antigen?
substance capable of inducing an immune reponse
“Bad Guy”.
What is an antibody?
Molecules synthesized in reaction to antigen. “Fighter”
Who should get Hep A vaccine?
Military, travelers to endemic area, men who have sex with men.
What hepatitis strain is highest risk for fulmanent liver failure?
Hep B
What is the major risk for herbal supplements that start with the letter G?
Bleeding
What are the goal s of Healthy People 2020?
- To increase the quality and years of healthy life
2. Eliminate health disparity amoung Americans.
Which 5 diagnoses are reportable to the CDC?
gonorrhea chlamydia syphilis HIV TB
What is the strongest method to assess teaching?
returned demonstration
What is the most powerful data collected from a patient?
Subjective data from patient and observation.
What does a prblem focused exam entail?
a limited exam of the affected body area or organ system
What does an expanded problem focused exam entail?
A limited exam of the affected area or organ system and any other symptomatic or related areas or organs
What does a detailed exam entail?
An extended exam of the affected body area or organ and any other symptomatic or related areas or organ
What is a comprehensive exam?
A general multi-system exam or complete exam of a single organsystem and other symtomatic organs or area.
Medicare A
covers inpatient/hospital, SNF, home health, hospice
Medicare B
covers physician services, outpatient hospital services, lab, diagnostic, medical equipment and some home health.
*NP’s recieve 85% of physician reimbursement for services supplied in collaboration with physician.
Medicare C
A+B=C
Known as Medicare Advantage
Medicare D
Limited Rx coverage.
Monthly premium required
To qualify to be a Medicare provider, the NP must…
Hold a state license
Be certified by a recognized national certifying body
Hold at least an MSN degree
who sets scope of practice?
State nurse practice acts
who takes care of credentialing?
Hospital Credentialing Committee
What is the most common form of documentation with regards to risk management?
Incident reports
what are satisfaction surverys intended for?
To ID problems before developing into actual incidents or claims.
Quantitative futlity
Where the likelihood that an intervention will benefit the pt is extremely poor
Qualitative futilty
Where the quality of benefit an intervention will produce is extremely poor,
define competence
a state in which a pt is able to make personal decisions about his/her care.
implies ability to understand, reason, differentiate good and bad and communicate
Nonmaleficence
the duty to do no harm
utilitarianism
the right act id the on that produces the greatest good for the greatest number
beneficence
the duty to prevent harm and promote good
often in conflict with autonomy
justice
the duty to be fair
fidelity
the duty to be faithful
veracity
the duty to be truthful
autonomy
the duty to respect an individual’s thoughts and actions.
often in conflict with beneficence
Four distinct roles of NP’s
- clinician
- consultant/collaborator
- educator
- researcher
reliability
the consistency of a measurement or the degree to which an instrument measures the same way over time with the same objects
validity
the degree to which a variable measures what it is intended to measure
