B234 Final Exam Study Guide 2024 PDF

**B234 Final Exam Study Guide** DISCLAIMER-This is only a guide: It is very thorough but may not necessarily cover [specifically] everything you need to know. **New Material (about 55 questions)** **Young and middle-aged adults (about 10)** 1. Young adults (readings) a. Know leading cause...

**B234 Final Exam Study Guide** DISCLAIMER-This is only a guide: It is very thorough but may not necessarily cover [specifically] everything you need to know. **New Material (about 55 questions)** **Young and middle-aged adults (about 10)** 1. Young adults (readings) a. Know leading causes of death. i. preventable-unintentional injuries, suicides, and homicides ii. risk taking, drowning b. Alcohol abuse, binge drinking. iii. In 2018, 26.5% of adults aged 18 years or older reported that they have engaged in binge drinking in the previous 30 days. Binge drinking is generally defined as 5+ drinks for men, and 4+ drinks for women, consumed in a 2-hour period. Rates of binge drinking are higher in college student populations. In 2018, 28.3% of college students reported binge drinking in the past 30 days. iv. Alcohol-related accidents among individuals aged 15 to 24 years continue to be a leading cause of preventable morbidity, disability, and death. v. Primary prevention for substance and alcohol abuse is complex, especially because adults consume these agents for many reasons c. Developmental task (Erickson) for this age. vi. Isolation vs Intimacy: In developing self-esteem, the young person learns to be truly open and capable of trust through the formation of intimate relationships that are characteristic of this period. 2. Middle-aged adults (readings) d. Know how lifestyle affects morbidity/mortality-leading cause of death. vii. Sedentary lifestyles and unchanged dietary habits: diminished motility through the gastrointestinal tract (colon cancer), cardiovascular system problems, increase fat e. Roles and relationship patterns, changes viii. Job demands and new roles in life give new learning situations. ix. Changing relationship with children as they become independent, couple (divorce) and peer relations, f. Developmental task (Erickson) for this age. x. Generativity versus Stagnation or self-absorption. Generativity includes a sense of productivity and creativity as evidenced by reaching previously established goals versus stagnation, the failure to achieve lifelong goals. Generativity also encompasses a desire to care for others versus self-absorption, the tendency to direct most of one's interest and attention to oneself thereby excluding other 3. Know intimate partner violence (presentation) g. Risk factors, protective factors. xi. Risk Factors 1. Lack of nonviolent social problem-solving skills 2. Conflict within families/Poor parent-child relationships 3. Neighborhood poverty 4. Harmful norms around masculinity & femininity xii. Protective Factors 5. Social connectedness to the community and neighborhood 6. Connection and commitment to school (& other institutions) 7. Access to mental health and substance dependency treatment services h. Trauma-informed care, trauma and memory. xiii. Trauma Informed Care 8. Recognize the impact of trauma in the development of coping mechanisms and social development 9. Changes paradigm from "What's wrong with you, and how can we fix it?" to "What's happened to you, and how can we help you cope with it?" 10. Emphasizes strengths and provides resources to build skills; collaborative relationship between survivor and service provider xiv. Trauma & Memory 11. Trauma can result in memory being spotty, or only existing in bits & pieces a. Affect the prefrontal cortex function at the slower rate due to Fear Circuitry 12. Be mindful of how we ask clarifying questions 13. Potential for influencing memory formation 14. Be mindful of the languages you use when asking questions xv. Survivors deserve to be believed no matter how coherent their memory is **Older Adult (about 10 questions)** 1. Know how the older adult can maximize their potential, regardless of life changes (healthy aging). a. exercise, good nutrition, sexual safety, and appropriate sleep-rest patterns, check up. 2. Know fall prevention b. Tai chi, meds, shoes, home safety, vit d, visual can cause/prevent falls. c. Screen adults 65+ once a year for fall risk. i. CDC 3 questions. Say yes to 1 -\> at risk ii. CDC stay independent. Score 4 or more or report falling -\> at risk. d. Assessment (for those at risk) + intervention iii. Review history iv. Assement of gait, strength balance: Time up + go, 30 sec chair stand, 4 stage balance test 1. Refer to physical therapist 3. Cognitive function (normal/impaired). e. Know the difference between Alzheimer/dementia changes and typical age-related changes v. Brain weight decreases with aging, and a shift occurs in the proportion of gray matter to white matter. Some slowing in cognitive processes but not significant memory or functional impairments. Risk factors like obesity may influence cognitive aging. vi. Dementias include Alzheimer disease, the most common dementia. 2. forgetfulness, inattentiveness, disorganized thinking, and altered levels of consciousness, perceptual disturbances, sleep-wake disorders, psychomotor disturbances, and disorientation. 4. Developmental task (Erickson) for this age. f. Ego integrity versus Despair: "The process of bringing into balance feelings of integrity and despair involves a review of and a coming to terms with the life one has lived thus far" **Sexually Transmitted Infections (about 5 questions)** 1. Know management strategies. a. Condoms, Vaccines are available for some STIs, like HPV and hepatitis, screening 2. Signs/symptoms. b. Chlamydia i. Often asymptomatic. Can cause urethritis in men c. Gonorrhea ii. Men: Urethral discharge, urethritis iii. Women: Asymptomatic, dysuria, vaginal discharge, PID d. Syphilis iv. Primary: Painless genital ulcer (chancre) 1. Appears 3-4 weeks after exposure v. Secondary: Rash 2. Approximately 6 weeks after ulcer 3. Fever, swollen lymph nodes, flu sx vi. Latent 4. Asymptomatic 5. Without treatment can last for years vii. Tertiary 6. 10-30 years after initial infection 7. Can be fatal, can spread to multiple organ systems e. HIV viii. Illness associated with initial HIV infection ix. Fever, body aches, sore throat, swollen lymph nodes common 3. Expedited Partner Therapy (EPT) f. Instruct patient to refer most recent sexual partner, and all partners during the 60 days preceding onset of symptoms g. If sexual partner(s) unlikely to present for treatment, consider: (EPT) x. Patient must inform partner, provide written material to seek evaluation for symptoms or complications (testicular pain, pelvic pain) h. Patient-delivered prescription or antibiotic for partner(s) i. Not for Men who have sex with Men (MSM) xi. Partners need testing/treatment xii. Significant rate of concurrent infections, such as HIV, syphilis 4. Communicable disease reporting j. Reportable (must report to authorities) xiii. Human immunodeficiency virus (HIV) xiv. Chlamydia xv. Gonorrhea xvi. Syphilis k. Nonreportable (not legally mandated to report) xvii. Herpes simplex virus (HSV) xviii. Human papillomavirus (HPV) **Reproductive Health (about 8 questions)** 1. Know risks associated with estrogen and who should use different delivery forms. a. Estrogen can cause nausea, breast tenderness, fluid retention. b. Clients who have a history of thromboembolic disorders, stroke, heart attack, coronary artery disease, gallbladder disease, cirrhosis or liver tumor, headache with focal neurologic findings, uncontrolled hypertension, diabetes mellitus with vascular involvement, breast or estrogen-related cancers, pregnancy, lactating, less than 6 weeks postpartum, or smoking (if over 35 years of age) are advised not to take oral contraceptive medications/patches. 2. Understand who is best candidate for long-acting birth control. c. Implant and IUDs d. People in a relationship, no allergies, people with conditions that increase the risk of adverse health events during pregnancy 3. Understand the different types of birth control and nursing implications/teaching. e. Behavioral methods (fertility awareness/breastfeeding etc\...). i. Fertility awareness: Track menstrual cycle ii. Breastfeeding to suppress ovulation only affective for at most 6 months f. Estrogen/progestin combinations (pill, patch, ring). iii. Pill: Do not miss a pill iv. Patch: patch replaced once a week for 3 weeks on dry skin. v. Ring: In vag. g. Progestin-only pill (POP), medroxyprogesterone injection (Depo-Provera), implants. vi. Take pill at the same time daily, Wear condoms to prevent STI h. Emergency contraceptive pills. vii. Take within 72 hours i. IUD (copper/progestin). Place in cervix viii. Pregnancy test, Pap smear, and cervical cultures should be negative prior to insertion. Sign consent form and most monitor IUD. j. Barrier methods (male/female condom). ix. One-time use, leave a space at tip, use latex and water-soluble lub. **Prenatal care (about 11 questions)** 1. Know what screenings are done in pregnancy. a. Chlamydia/gonorrhea b. Syphilis (everyone screened) c. HIV d. Herpes simplex virus (HSV) e. Hepatitis B f. Group B strep g. Rubella 2. Be able to calculate a due date using Nagelle's rule. h. Add 7 days to the date of the first day of the last normal menstrual period and subtracting 3 months. 3. Be able to read a pregnancy wheel. 4. Know how to use GTPAL and GPA (gravida, para, abortion). i. GPA i. Gravida- Number of pregnancies (including current) ii. Para- Births ≥ 20 weeks gestation iii. Abortion- Pregnancies ending before 20 weeks j. GTPAL iv. Gravida- Number of pregnancies (including current) v. Term- Pregnancies ending ≥ 37 weeks vi. Preterm- Pregnancies ending ≥20 \ 18.5 (\< 5^th^ percentile) b. Normal BMI: 18.5 - 24.9 (5^th^-85^th^ percentile) c. Overweight BMI: 25 - 29.9 (85^th^ -95^th^ percentile) d. Obese BMI: 30+ (95^th^+ percentile) 2. Know how many calories are in carbohydrates, fats, and proteins. Be able to calculate calories and percentages of macronutrients. e. Carbohydrate/Protein: 4 calories/gram f. Fat: 9 calories/ gram 3. Know how to read a food label. 4. Know the functions, food sources, risk factors, and key recommendations for the micro- and macronutrients covered. Focus on the nutrients of public concern, those associated with specific health risks/disease, and drug interactions: g. Calcium h. Vitamin D i. Potassium j. Vitamin B12 k. Vitamin K and Vitamin E l. Iron (know how to improve absorption) m. Folic acid **Population Health (about 4)** 1. Understand levels of prevention. a. Primary Prevention i. **Targets healthy individuals/communities** ii. **Goal: Prevention of illness** iii. **Examples: Hand hygiene, Education, Immunizations** b. **Secondary Prevention** iv. **Targets those "at risk"** v. **Goal: early detection/treatment** vi. **Examples: Screening, STI testing** c. **Tertiary Prevention** vii. **Target individuals with health conditions** viii. **Goal: Minimize complications and maximize health** ix. **Examples: Education on management, rehabilitation, long term social support, home health services** 2. Understand the social determinants of health. d. **Economic Stability** e. **Access to and quality of education** f. **Access to and quality of healthcare** g. **Neighborhood/built environment** h. **Social and community context** **Vaccines (about 3)** 1. Be able to use an immunization schedule. 2. Know difference between live and inactivated vaccines and nursing implications. a. Live Vaccine i. Microbe in vaccine is alive but has been weaken (Attenuated) ii. Microbe retains the ability to replicate, but it does not cause illness, only mild disease iii. Can cause severe reactions for people with immunodeficiency iv. Fragile, can be damaged by light and heat b. Inactivated Vaccine v. Dead microorganisms that are unable to replicate. Need multiple doses. 3. Know the difference between active and passive immunity and how both are acquired. c. Active immunity vi. Protection that is produced by the persons own immune system vii. By infection or vaccination. Can last many years or even lifetimes d. Passive Immunity viii. Transfer of antibodies. Protection that is produced by something else and is typically administered by injection 1. Infant receive antibodies from mother, globulin ix. Immunity wanes with time **Growth and development: Infant -- adolescent (about 10)** 1. Understand overall growth and development concepts unique to the infant, toddler, preschooler, school-aged child, and adolescent. a. 2. Know Erikson for the infant through adolescent age groups.  3. Know leading causes of injury/death for each age. 4. Know how to promote breastfeeding and prevent SIDS. 5. Know S/S of eating disorders. b. Anorexia nervosa: Symptoms or warning signs include a relentless pursuit of thinness, self-starving with significant weight loss, lack of menstruation (in females) and decreased sexual interests (in males), compulsive physical activity, preoccupation with food, portioning food carefully, and eating small amounts of only certain foods. Brittle hair and nails; dry, yellowish skin; growth of fine hair over the body; constipation; mild anemia and muscle weakness; and often complains of feeling cold c. Bulimia Nervosa: Dramatic weight fluctuations, dehydration, fetal electrolyte imbalance, erosion of tooth enamel. 6. Review concussion information.