Community Health Review

Environmental Health

• When assessing a neighborhood with high rates of childhood asthma, high levels of air pollution from nearby factories is the most concerning environmental factor
• Air pollution from industrial sources can trigger asthma and other respiratory conditions
• Community health initiatives should address air pollution
• A statement indicating a need for further teaching about safe drinking water is: "Drinking from lead pipes is safe if the water looks clear."
• Lead contamination is not visible in water, and clear water can still contain toxic levels of lead
• Reducing lead exposure in children in older homes involves avoiding playing near peeling paint or renovating old homes
• Peeling lead paint is a primary source of lead poisoning because the dust is inhaled or ingested

Disaster Triage & Preparedness

• During a mass casualty event, a patient with an open chest wound and a respiratory rate of 32 breaths/min receives an immediate (red tag) designation
• The red tag means a patient requires immediate intervention to survive life-threatening respiratory issues.
• The most essential element in a community emergency preparedness plan is developing a system for communication
• Effective communication ensures coordinated efforts and timely interventions during a diasater
• An appropriate response to a client asking about bioterrorism emergency preparedness is that unusual clusters of illness should be reported to health authorities
• Reporting unusual illness patterns can help detect bioterrorism threats in their early stages

Tuberculosis (TB)

• A statement from a client with latent tuberculosis infection (LTBI) that indicates a need for further teaching is: "I don’t need treatment because I don’t feel sick."
• Latent TB requires treatment to prevent progression to active TB
• The priority nursing intervention for a patient with active infection is to place the patient in airborne isolation
• TB is an airborne disease, so isolation precautions prevent transmission

Mental Health & Schizophrenia

• When assisting a client with schizophrenia who has stopped taking medication, the priority is to assess for hallucinations and delusions
• Safety is the priority when a client with schizophrenia stops medication because psychotic symptoms may return
• An example of secondary prevention in mental health is providing crisis intervention for suicidal individuals
• Secondary prevention involves early detection and immediate intervention

Substance Abuse

• An example of tertiary prevention for substance abuse is outpatient counseling for addiction recovery
• Tertiary prevention focuses on treatment and rehabilitation

Violence & Underserved Populations

• If a nurse suspects child abuse, the priority action is to report suspected abuse to child protective services
• Nurses are mandated reporters and must report suspected abuse immediately
• A homeless client with schizophrenia benefits most from a referral to a mental health outreach program
• Outreach programs provide mental health support and case management for homeless populations

Environmental Health - Lead Poisoning (Select All That Apply)

• Teaching parents about reducing lead exposure in children should include:
  • Washing children's hands and toys frequently
  • Encouraging children to eat foods high in calcium and iron
  • Testing homes built before 1978 for lead
• Handwashing prevents the ingestion of lead dust
• Calcium and iron reduce lead absorption
• Hot tap water can contain higher lead levels
• Older homes may have lead-based paint
• No level of lead exposure is safe

Disaster Preparedness & Bioterrorism (Select All That Apply)

• Statements that demonstrate correct understanding of preparing for a bioterrorism event include:
  • Anthrax can be treated with antibiotics if identified early
  • Botulism can cause paralysis and requires an antitoxin
  • Radiation exposure may require potassium iodide to protect the thyroid
• Anthrax responds to antibiotics
• The smallpox vaccine exists but is rarely used today
• Botulism affects the nervous system and requires an antitoxin
• Radiation exposure requires potassium iodide to protect the thyroid
• Tularemia is treatable with antibiotics and is not instantly fatal

Substance Abuse in the Community (Select All That Apply)

• Community health nurses should implement these interventions to address opioid addiction:
  • Provide naloxone (Narcan) training to at-risk individuals
  • Advocate for medication-assisted treatment (MAT) programs
  • Educate the community on proper disposal of prescription opioids
  • Offer harm reduction programs such as needle exchanges
• Naloxone reverses opioid overdoses
• MAT (e.g., methadone, buprenorphine) assists in long-term recovery
• Criminalizing addiction worsens health outcomes
• Safe disposal reduces misuse of prescription opioids
• Needle exchanges reduce disease transmission

Mental Health in the Community - Suicide Prevention (Select All That Apply)

• A community program for suicide prevention should include:
  • Crisis intervention and 24-hour helpline access
  • Training community members to recognize suicide warning signs
  • Increased access to mental health resources in underserved areas
  • Screening high-risk individuals for depression and substance abuse
• Suicide prevention includes crisis intervention and public awareness
• Talking about suicide does not increase risk; it encourages help-seeking behavior

Case Study: Tuberculosis in the Community

• A 45-year-old migrant farmworker presents symptoms, so obtain a sputum culture for acid-fast bacilli (AFB) testing
• A positive tuberculin skin test (TST) requires confirmatory sputum cultures and chest X-ray to differentiate between latent and active TB
• The priority infection control measure is to place the client in a negative pressure isolation room due to suspected active TB with airborne precautions until confirmed non-infectious
• If the client has active TB, contact tracing and screening of close contacts is required as it is a reportable disease to prevent community spread

Case Study: Intimate Partner Violence (IPV)

• A 28-year-old woman presents with signs of potential intimate partner violence (IPV), so ask directly if she is experiencing abuse with direct but non-judgmental questioning as the first step in identifying IPV
• If the client admits to abuse but refuses to leave her partner, respect her decision but develop a safety plan, because many victims of IPV are not ready to leave, but nurses can help them plan for safety
• The most appropriate intervention for IPV victims in the community is increasing access to shelters and legal resources, as providing safe housing, legal assistance, and community resources is critical for IPV victims