NUR426 Exam 1 Study Guide PDF

**NUR426 Exam 1 STUDY GUIDE** **Module 1** **ATI: Ch. 1, 2, & 5-7** **SAVAGE: Ch. 1, 2, & 7-8** **LEVELS OF PREVENTION:** - **Prevent** - Prevent diseases or outbreaks - **Detect** - Detect diseases and protect the community and patients - **Manage** - Manage existi...

**NUR426 Exam 1 STUDY GUIDE** **Module 1** **ATI: Ch. 1, 2, & 5-7** **SAVAGE: Ch. 1, 2, & 7-8** **LEVELS OF PREVENTION:** - **Prevent** - Prevent diseases or outbreaks - **Detect** - Detect diseases and protect the community and patients - **Manage** - Manage existing illnesses **PRIMARY PREVENTION (line of defense):** **Preventing injury or disease BEFORE it occurs** *Primary "think" Prevent Problems Prior to their development* - Education (Nutrition, sex Ed, etc.) - Prenatal classes - Immunizations (VACCINE CLINICS) **this is an answer** - Advocating for access to health care, healthy environments - Enforcing use of seatbelts - HANDWASHING---school nurse **this is an answer** \*\*This level of prevention limits potential outbreaks & disease stops potential injuries or accidents before they can happen and keeps community members safe &healthy. **SECONDARY: there was a question only one just remember they prevent** **Early detection and treatment of disease with the goal of limiting severity and adverse effects** *Secondary "think" Screen Early to Catch\-\-- **screening helps identify unrecognized complications, diseases**, **etc. know this*** - Community assessments - Mammograms (Cancer) - Colonoscopies (Cancer) - Routine bloodwork - Annual physicals \*\*Screenings and monitoring help to: detect cancer & serious diseases, identify new or evolving status changes, and identify diseases or outbreaks in the community. **TERTIARY ("third"): a crap ton of questions** **The condition or disease already exists & has been diagnosed---Prevention Focus: treatment, management, and to prevent worsening or progression of disease and symptoms.** *Tertiary "think" Treatment of an existing disease* - Nutrition (low sodium diet)**this is one with cvd pt.** - PT & OT - Support groups - Exercise for a client who has HTN (individual) - Medications---\*\*controlling the disease - Rehabilitation **\*\*\* Tertiary prevention can help to reduce the burden of chronic diseases\*\*** **UNIVERSAL PREVENTION: targeted at the entire population= know this** - **Information translated to the entire population---billboards, TV, etc**. **What are the six Public health nursing standards of practice; what is their purpose? Who do they serve? What are some challenges health depts face trying to provide public health services?** **Refer to table on FA Davis page 12 (box 1-5 & 1-4)** 1. **ASSESSMENT:** a. The PHN collects comprehensive data pertinent to the health status of populations. 2. **DIAGNOSIS:** b. The analyzes the assessment data to determine actual or potential diagnoses, problems, and issues related to health and well-being. 3. **OUTCOMES IDENTIFICATION:** c. The PHN identifies expected outcomes for a plan specific to the health status of the population or the situation. 4. **PLANNING:** d. The PHN develops plans that prescribe strategies to attain optimal health and well-being 5. **IMPLEMENTATION:** e. The PHN implements identified plans 6. **EVALUATION:** f. The PHN evaluates progress toward attainment of goals and outcomes. \*\*Specific standards related to implementation of public health activities include coordination of care, health teaching and health promotion, consultation, and policy and regulatory activities= know this A close-up of a medical exam Description automatically generated I believe it was 4,6,8 for the answer it was a select all apply with this above **Core Public Health functions: Assessment, Policy Development and Advocacy, Assurance -- what are some examples how they implement these functions?** **Assessment:** - Focuses on the systematic collection, analysis, and monitoring of health problems and needs **Policy Development:** - Refers to using scientific knowledge to develop comprehensive public health policies **Assurance:** - Refers to assuring constituents that public health agencies provide services necessary to achieve agreed-upon goals **Challenges of public health systems:** - Funding, IT systems, and staffing **Population-focused healthcare:** - Combination of these two terms; health, and population---understanding of all factors listed in the ecological model that contribute to the health of a population. - There are multiple determinants of health - A population and environmental approach are critical - Linkages and relationships among the levels are important - Multiple strategies by multiple sectors are needed to achieve desired outcomes **Ecological Model: Upstream approach-focuses on eliminating factors that increase risk to population's health ** - The use of the ecological model within the context of *health promotion, health protection, and risk reduction* requires the inclusion of s*ocial relations, neighborhoods and communities, institutions, and social and economic policies* in development of prevention strategies. - **Health promotion:** process of enabling people to increase control over, and to improve, their health - **Health Protection:** puts the emphasis on increasing the person's ability to protect against disease. - *Health protection* involves biological protection such as the use of vaccines. - When an individual is vaccinated, the body develops immunity to the infectious agent and is therefore protected from the disease. - **Risk Reduction:** refers to actions taken to reduce adverse outcomes - *Risk reduction* encompasses more than biological protection and can involve removing risk from environment or reducing the level of risk. \*\*\* The ecological model reflects a deeper understanding of the role not only of the physical environment but also the social conditions that create poor health, referred to as an "upstream" approach. **Upstream vs downstream thinking in public healthcare -- what are some examples in current health issues?** - **Upstream** **approach** (community impact) focuses on eliminating the factors that increase risk to a population's health. - Upstream efforts seek to create community-level impact and improve community conditions by addressing social determinants of health through policy, laws, and regulations. **There was a lot of questions about upstream know this well** - **Downstream approach** represents actions taken after disease or injury has occurred. - Downstream efforts seek to create patient-level impact by providing clinical care and medical interventions.  **What is the World Health Organization? How does the WHO benefit health efforts globally?** - Provides daily information regarding the occurrence of internationally important diseases. - Establishes world standards for antibiotics and vaccines - Primarily focuses on the health care workforce and education, environment, sanitation, infectious diseases, maternal and child health, and primary care. \*\*Right arm of the Federal government, similar to CDC however to help global health (Set standards, identify problems, and make recommendations) **What is Healthy People 2030 and what are the priorities based on results from Healthy People 2020** **\*\*REFER TO PAGE 7 (ATI)\*\*** - **The intention of HP is to continue national efforts to plan, implement, and evaluate health promotion and disease prevention interventions.** **Social determinants of health definition and examples there was a select all that apply** **1. Economic stability** - People with steady employment are less likely to live in poverty and more likely to be healthy - By helping people earn steady incomes, we can achieve economic stability for all. **2. Education access and quality** - People with higher levels of education are more likely to be healthier and live longer - By helping students excel in school, we can improve educational access and quality **3. Healthcare access and quality** - Many people in the U.S. are unable to get the health care services they need - Increasing access to high-quality health care services will ensure more individuals can attain their full potential for health and well-being. **4. Neighborhood and built environment** - Health and safety risks, like high rates of violence and unsafe air or water, impact health and quality of life. - By creating safe communities, we can provide opportunities to promote playing and physical activity **5. Social and community context** - Increasing relationships and interactions with family, friends, neighbors, and community members is beneficial to an individual's health and well-being. Health is variable and influenced by a range of factors... - Who they are (individual factors) - Age, sex, genetic makeup - What they do (health behaviors) - Smoking, physical activity, alcohol, and diet - **Conditions in which people are born, grow, live, learn work, worship, and age = SOCIAL DETERMINANTS OF HEALTH (5): related "gaps" in health outcomes between populations** - Networks, socio-economic, cultural, environmental, health systems. - SDOH are shaped by the distribution of *money, power, and resources* at an international, national, and local level. - SDOH have a marked influence on *health inequities* CANT REMEMBER ? BUT KNOW WHAT THESE MEAN BELOW **Health Inequities:** unfair and avoidable health differences between different groups of people within countries or between countries. (Ex: a person diagnosed with DM2 cannot afford medication in which link them to a vulnerable state experiencing adverse effects). **Health Equity:** each person and communities recognized as having their own distinct needs and receives the exact same resources and opportunities required to reach their own ideal outcome. (Ex: providing everyone with the same care regardless of their height weight, color, age, situation, etc.) **Health Equality:** each individual or group is given the same resources or opportunities (Ex: providing vaccinations to people) **REMEMBER THIS HOW WE WOULD GIVE TO ALL THERE IS A QUESTION ABOUT A HURRICANE OR SOMETHING AND YOU WILL GIVE ALL OF THEM WATER** A cartoon of a person and a child standing on a fence Description automatically generated **Ecological determinants of health:** include \...potable water and sanitation, affordable and clean energy, climate action, life below water and life on land ***\*\*\*Seven of the top 11 leading causes of death in the United States are Non-Communicable Diseases (NCDs), including heart disease, cancer, stroke, chronic lower respiratory diseases, Alzheimer's disease, diabetes, and kidney disease*** **Vulnerable populations: What factors 'make' them vulnerable? What are their disparities?** **Vulnerable populations are those that have multiple risk factors for negative health outcomes** - Identifying modifiable risk factors and targeting interventions can promote better health outcomes for the populations. - *This promotes population resilience* - **Vulnerable populations** include individuals who are subject to issues such as the following: - Violence - Substance abuse disorders - Mental health issues/illness - Poverty and homelessness - Rural residency - Migrant employment - Veteran status - Disability - **POVERTY\--Lower Socioeconomic Status (SES)** is associated with INCREASED vulnerability. - **Structural racism and discrimination** result in INCREASED vulnerability and poorer health outcomes for black populations, as well as other marginalized populations. - **KNOW DISCRIMINATION THAT IS AN ANSWER TO A QUESTION** - **Social capital** usually refers to a person's or a community's capacity to obtain support from the social connections available to the person or community. **FACTORS THAT CAN THREATEN HEALTH:** - Low income - Difficulty accessing health care, uninsured or underinsured - **Uninsured or underinsured individuals access health services less often and have decreased management of chronic conditions.** - Poor self-esteem - Young or advanced age - Chronic stress - Environmental factors - Presence of communicable disease - Racial and ethnic minority status - Individuals of ethnic or racial minorities often face social environmental, and economic barriers. - These barriers are linked to reduced access to care, decreased use of preventative care, and poorer health outcomes. - **Health disparity** exists when "a health outcome is seen to a greater or lesser extent between populations." \*\*\*Health disparities can be linked to gender, ethnicity, race, education, and income differences\*\* **STIGMA:** "a mark of shame or discredit." \-- Stigmatized individuals either possess or are believed to possess some attribute that is not valued in a particular social context. - For example, being diagnosed with a mental health disorder or a substance use disorder can result in being stigmatized in a demeaning way and seen as "less than." **Common struggles experienced with different vulnerable populations:** - **LGBTQ+ (ie, suicide, violence, stigma,...): a couple questions about this** - Violence and depression - discrimination---not seeking medical care (1 in 5)\*\*\* know this they don't seek care - offering inclusive intake forms (address how they identify) - become insensitive and design clinics for a SafePlace of this group - suicide risk! - Poor mental health, increased risk for disability and substance use - Partner violence - Stigma---HIV/AIDS stems from LGBQT+\-- however not true \*\*\* know this - **Transgender= less likely to go to college, or obtain higher degrees \*\*\* know this** - **[Migrants (ie, trafficking], language, limited healthcare,...)** - pesticides - food insecurity - inconsistent income - poor and unsanitary - less access to medical care - LANGUAGE BARRIER - Immigration status---fear that seeking care will lead to deportation - **Elderly (falls, abuse/neglect,...) QUESTION ABOUT THIS AND ANSER IS TO EDUCATE ON FALL/SAFETY PRECAUTION WITH family, staff and someone** - Physical and mental limitations - Lack of resources- both economic and social - Nonintentional and intentional injury risk - Falls---similar to childproofing the home as a nurse (access chemicals, assess home---grab bars in place, rugs, cords not hanging - Falls can increase the length of stay\*\*\-- fall bracelet - Falls are a NEVER event in the hospital---should never happen - Falls (fractures)---comprehensive assessment on contributing factors to the fall - Cognitive health - Noncommunicable & communicable disease - **Alcohol is the MOST abused substance**---following opioids (prescriptions---over prescribing) \*\* ADVOCATE FOR THEM the answer about drinking is they can three per day - STI's - UTI's---NEVER event - Hygiene (living with another person and lack of hygiene is considered NEGLECT---us as nurses are mandated to REPORT) - Follow up on care! - **Incarcerated (communicable diseases, lack of access to health care,...)** - violence (more specifically in LGBTQ+) - **medical care---can't transfer out for care= answer** - substance use - disproportion of demographics\*\* - communicable diseases are increased - **mental health issues---PTSD= answer** - **Refugees/asylees (language, lack of access to healthcare,...) (CH 7 & 8)** - **Refugees:** flee---usually war related (PERSECUTION) - Forced to leave place of origin due to disaster, war, or threatening environment. - **Asylees:** get permission\*\* through approved message to come---can seek asylum - **Immigrant:** a person who comes to a country to take up permanent residence - **Migrant "migratory birds":** living in a country other than their country of birth - **Remember this its answer Migrant worker:** a subset of this population who move from place to place to get work - Mental health status - Poor coping techniques - Insecurity---unknown outcomes (persecution) - Poor sanitation - Exposure to multiple CD's - Violence - Limited medical care---refugee camps in their flee of country - Intimate partner violence - Migrants are at risk for human trafficking, language barriers, and access to healthcare. - **Homeless population: (page 64- ATI)** - Severe mental illness - Veterans - Substance use disorders - Low income and unemployed adults - elder adults 55 + - wounds---resources to keep it clean (containers of sterile water, box of dressing changes, etc.---consider the situation). **Types of homelessness (3)** - **Primary homelessness: "rooflessness" its ask about this one they are in an abandoned building** - everyone who is living without adequate shelter - Those living in vehicles, surviving on the streets, and staying in parks or abandoned buildings. - **Secondary homelessness:** - Those who are staying in a temporary form of housing because they have nowhere else to go - Those living with friends (couch surfing) or family or in shelters. - **Tertiary homelessness:** - Those who rent single rooms on a long-term basis without the security of a fixed or permanent residence. - Accommodations are below minimum standards - **Severe-overcrowded spaces** - Extended stay at hotels - Over-run trailer park - Low-income apartment with many friends - **ALSO KNOW ALL THE HOMELESS THE OTHER TYPE THEY ARE NOT ON HERE** - **THERE IS A SELECT ALL** **Priorities for caring for homeless: (treating people where they are at): THIS IS A SELECT ALL** - Free health clinics - Distribution of free condoms - Vaccine clinics - REMEMBER---definition of family varies from everyone---doesn't have to be biological, some don't have any left. **What is the Ages and Stages Screening tool (ie, Assesses for developmental delays in youth)** Developmental screening tool- **"kids at risk for developmental delays" (UPSTREAM STRATEGY)** - pinpoints developmental progress in children between the ages of 1 month to 5 ½ years. - Screening tool used at every well child check ages 1 month to 5 years - Are they meeting their milestones? (especially for children) - Looking for congenital (inherited) problems. - Newborn screening screens for up to 50 diseases - Example: autism screening **What is a geriatric assessment, why do we use it and what do we do with information obtained?** - A comprehensive evaluation of an older adult\'s physical, mental, and functional status. - Use it to identify health issues, develop a plan of care, and improve overall wellbeing. - Adult protective services - Financial burden---financial abuse\*\* **Common vaccines for elderly ** - Pneumonia (65+) - Influenza - Covid-19- COVID boosters - Shingles (50+) - Tetanus - RSV & MMR **Keys to healthy aging ** - Control hypertension - Stop smoking - Lower cholesterol - Screen for cancer - Keep current with immunizations - Regulate blood glucose - Combating depression - Preventing bone loss and muscle weakness - Maintaining social contact **[Define]** Health literacy/ Why do we need to understand KNOW ABOUT HEALTH LITERACY IT IS AN ANSWER - The capacity for a client to locate, understand and apply healthcare information - It is important to understand that if an individual has a limited health literacy, then they are at a higher risk of misunderstanding information that is important to achieving and maintaining health or losing their way in the fragmented health care system. Prevalence REMEMBER - Reflects the total number of cases of a disease in a population. - The number of total cases of disease divided by the total number of people in the population Prevalence pot - A way of depicting the total number of cases of the disease in the population that considers issues related to duration of the disease and the incidence of disease Community collaboration YOU WILL HAVE A SELECT ALL KNOW THIS - Community collaboration is a process where organizations, citizens, and businesses work together in order to accomplish a common goal or vision. - Stakeholders (people in the same community have the same priorities as we do and work together to have the same beneficial outcome) Cultural competence/how do we attain it? CULTURAL ASSESSMENT ITS AN ANSWER EUTHPIAN LADY ? \*\*\*A core aspect for healthcare providers - Defined as the attitudes, knowledge, and skills to provide quality care to culturally diverse populations. - It requires an understanding in providing care in a diverse environment and knowledge related to the culture of others. - Awareness---language barriers, beliefs about illness, herbal medicine, etc. Social Justice - Defined as "acting in accordance with fair treatment regardless of economic status, race, ethnicity, citizenship, disability, or sexual orientation." What type of prevention is a big anti-smoking campaign? Universal prevention Universal prevention- applicable to the whole population and is not based on individual risk=ANSWER ON TEST **A public health nurse/ doing breast feeding teaching- individual teaching/ based on intervention wheel= ANSWER ON TEST** **THE TESTBANK I SENT HAS A LOT OF QUESTIONS AND ANSWERS ON TEST DON'T FOCUS ON PALLATIVE/HOSPICE AT ALL NOT ON TEST**