Test 2 Flashcards
Founders of environment health
Florence, Lillian wald, and Virginia Henderson (fostered prevention and self sufficiency in the environment)
Lead contamination
Over 10 ug/dL is bad, Symptoms include anorexia, apathy, irritability, headache, dizziness, sleep disturbances, anemia, weight loss, encephalopathy, peripheral neuropathy and seizures. Exposure may manifest reduced intellectual and neuropsychologic development.
Healthy people goals
Want 85% of people to live in an area that meets EPA standards for pollution
Increase protection from radon
Decrease beach closings from bacteria
Strategies for protection
Educate, permits, guidelines/standards, use of non-disposable products
Nurses role
Advocate for policy change, provide accurate information, spokesperson
Four environmental principles
- Everything is connected to everything else
- Everything has to go somewhere
- The solution to pollution is dilution
- Today’s solution may be tomorrow’s problem
Epidemiology
The study of the distribution or patterns of health events in populations and the determinants or factors that influence those patterns.
Provides baseline data for utilization in the community
Focus on population, cause, prevention and maintenance
Descriptive epidemic
Looks at health outcome related to person place and time
Analytic epidemic
Looks at determinants of disease, the how and why
Study types
ECOLOGICAL looks at descriptive and analytical epidemiology ie comparison breast cancer rates and breat feeding
CROSS SECTIONAL general description of scope of problem, collection of simultaneous data like health status, potential risk factors and personal characteristics
CASE-CONTROL known to have or not have outcome
COHORT calculation of incidence rates and factor or exposure
Epidemiology basic concepts
Agent: factor present or lacking for the disease to exist (ex. Not having enough vit C leads to scurvy)
Host: living species capable of being affected or infected by the disease
Environment: all that is external or internal to host or agent that influences the host or agent
Environmental health
Environment is the primary determinant of health
Level of prevention
Primary, secondary, tertiary
To prevent or halt or reverse a disease as early as possible
Primary prevention
Promotes health and prevents disease from occurring
Pre-pathogenesis, risk factors, health promotion and protection
Secondary prevention
Detect disease early in process, before clinical S/S are present, enables early diagnosis and treatment
Pathogenesis, sub clinical signs, early detection/diagnosis through screenings, etc.
Tertiary prevention
Intervention begins once disease is obvious, to interrupt amount of disability that may occur and begin rehab
Advanced disease culmination, care and rehab
Natural history or progression of disease
Pre-pathogenesis (susceptibility)
Pathogenesis (before symptoms and clinical onset)
Culmination (death, disability, recovery)
Data measurement
Epidemiological Rates - measure frequency of event in a defined population and period of time
Incidence rates: new cases in a population during a period of time
Prevalence rates: measure of existing disease in a population at a particular time
Morbidity-event of illness
Mortality: death
Risk, probability illness will occur
John grunt
Used bills of mortality to study death patterns, forerunner of demographics
looked at births and deaths weekly
More male babies and more males died.
Infant mortality seasonal and high assess impact black plague on popuation london
Lemuel shattuck
Sanitation and public health
Experimental studies
Investigator initiates treatment or intervention that may influence the risk or course of disease
Clinical and community trials
Screenings
Give test to people who are a symptomatic but likely to have the disease
Validity and reliability
Communicable disease
A human or animal disease caused by an infectious agent and resulting from transmission of that agent from an infected person, animal or inanimate source to a susceptible host. Infectious disease may be communicable or non communicable.
Endemic
Constant presence of infectious disease within a specified geographic location
Epidemic
Occurrence of an infectious agent or disease within a geographic area in greater numbers than would be expected
Pandemic
Worldwide outbreak of epidemic
Communicable disease history
Communicable disease was the leading cause of death in 1800s
Epidemics were popular and wiped out entire populations
Decrease since 1900s
Reason for decrease in diseases
Improved nutrition and sanitation
Vaccination
Antibiotics
Categories of infectious agents
Bacteria, fungi, parasites, viruses
Agent factors
Infectivity, pathogenesis, virulence, toxicity, invasiveness, antigenicity
Host factors
Susceptibility, human or animal
Resistance-ability to withstand infection
Natural immunity-innate resistance to specific disease
Acquired immunity-acquired by host from other agent
Active immunization-administration of antigen
Passive immune-transfer antibody from immune person to non immune
Herd immune-group or community immune
Infectiousness-potential ability of infected host to transmit infection
Environmental factors
Facilitates transmission of infectious agents
Factors-physical, social, biological, cultural
Methods of transmission
Horizontal-person to person
Vehicle-non living transmission
Vector-living transmission from host to host
Other: airborne, direct, indirect, fecal, oral, insect, animal bites
Disease development
Infection-entry, development, and multiplication f agent within host
Disease-one of the possible outcomes of infection
Incubation-time between invasion of infectious agent and first appearance of signs and symptoms
Communicable-time infectious agent transfers directly or indirectly
Disease surveillance
Identify case, report suspected and confirmed cases, analyze, synthesize, and provide information
Notifiable infectious diseases
Vaccine preventable, food borne, enteric, std, zoonotic, meningitis, and other (environmental, occupational, bioterrorism)
STD history
Antibiotics in the 40s were thought to be able to get rid of all std, however viral strains had emerged leading to an increase in incurable std
How to combat std
Monogamous relationships, abstinence, condom use, routine screening, vaccination, and decrease exposure
HIV resources
Prevention, programs, support groups, research
TB
Foreign born 10 times higher than US born, 2nd greatest killer from a single infectious disease (hiv is first)
Highest rates are over 65 and Asian
Risk factors: urban, low income, nonwhite, foreign born, homeless, incarceration
Other communicable diseases
Malaria, fifth disease, hand foot and mouth disease, giardia, salmonella, Ebola
Culture
Learned set of ideas, values, & assumptions about life shared by a group of people.
Race
Group of individuals who share common biological features
Ethnicity
Classification of people based on some commonality or affiliation
Cultural assessment
Culture awareness-Appreciation of/sensitivity to the client’s/family values, beliefs, practices, lifestyle.
Cultural knowledge-Information about that culture to provide care.
Cultural skill – Integration of cultural awareness & clinical knowledge to meets the client’s/family need
Cultural encounter – Nurses learn directly from the family life experiences & significance of these experiences for health.
Cultural preservation – Support use of client’s culture that promote healthy behaviors
Cultural accommodation – Integrate culturally relevant practice that lacks scientific utility.
Cultural repatterning – Nurse makes changes in practices that are harmful.
Cultural brokering - Nurse is the advocate, mediator, negotiator, & intervenes between the health care system and the client’s/family culture.
Variations among culture groups
Communication, space, social organization, time perception, environmental control, biological variations
Family
Two or more individuals who depend on one another for emotional, physical, and/or financial support (Hanson)
Two or more individuals who share a residence or live near one another; posess some common emothional bond, engage in interrelated social positions, roles and tasks, and share a sense of affection and belonging (Murray & Enter, Friedman)
Families main unit of service in community
Family in mind for bulk of health care and related services- Senior centers, IZ’s, Parenting classes
Characteristics of a healthy family
Communicate, support, respect, trust, plays together, interact, share leisure time together, shared responsibility, traditions and rituals, religious core, privacy, open boundaries and admit wrongs
Assessment of family strengths (Herman Otto)
Similar to healthy family characteristics, look at slides for in depth description
Family primary prevention
Health promotion and disease prevention, family takes responsibility for health and incorporates wellness
Family secondary prevention
Early diagnosis and treatment, screenings, assessments, family pathology
Family tertiary prevention
Reduce extent and severity of health problems to minimize disability and restore/preserve function
Learn to live with disabilities in families
Alleviate or heal emotional, physical, or suffering
Family assessment model (Friedman)
Families are viewed as an open social system in which the family’s structure & functions & the family’s relationship to other social systems are the focus
Friedman categories
Identify data, developmental stage and history, environmental data, family structure/function, family stress, coping and adaptation
Genogram
Displays pertinent family information in a family tree format over last three generations. Shows health history, morbidity, mortality, illness.
Eco map
Visual picture of the family in relation to the community. Allows nurse to have holistic & integrated perception of the family.
Family influences across decades
Marriage/divorce, single parent, children in poverty, women in workforce, economy, families continue to evolve, different definitions of family
Meet goals of health promotion
Increase understanding of health, raise community standards of health, increase positive healthy behaviors
Neonatal issues
Educating parents on nutrition, elimination, sleep, development, safety
Low birth weight risk factors
Minority, poverty, stress, poor nutrition, smoking, substance abuse, altitude, lack of prenatal care
Florence nightingale and child care
made the connection in 1894 between the importance of good child care to build health: “Money would be better spent in maintaining health in infancy and childhood than in building hospitals to alleviate disease. It is much cheaper to promote health than to maintain people in sickness.”
Toddler concerns
Teeth, weight gain, anterior fontanels, other common health issues
Women’s health
Through entire lifespan, focus on all aspects: physical, mental, social, cultural, & economic
PHN roles in women’s health
Stop tobacco use, decrease obesity, fat and sun exposure, increase exercise, decrease alcohol and drugs, screenings, stress management
3 major causes of mortality in women
Cardiovascular disease, cancer and cerebrovascular disease
Major health problems for women
Obesity, osteoporosis, urinary incontinence, depression
Healthy people goals 2020 for women
Osteoporosis, uterine cancer, mammograms, rape, maternal death, pregnancy
Men’s health
Shorter life span, and more die at birth, and have higher rates of disease
Men’s health problems
Suicide, violence (risky behavior), alcohol and drugs,
Healthy people goals 2020 for men
Cancer, heart disease, stroke, hiv, injury/violence prevention, mental health, substance abuse, family planning
Elder health
Increased life expectancy=increase chronic problems, difficulty with ADL, economic insecurity, pets and plants
PHN goals for elders
Optimize functional level and minimize decline, remain in home, improve quality of life, prevention focused
Elder health issues
Arthritis, dementia, delirium, Alzheimer’s, advance directives, assisted living, nursing home, comprehensive health assessments
Issues for disabled and handicapped
Effects on others, individual effects, abuse, income level, support
PHN role for disability
Advocate, case finder, change agent, case management, educator, coordinator
All ages and health level goals
Health promotion, education, injury prevention, and health maintenance
