Nursing Fundamentals: Healthcare Delivery, Community Health, Facility Environment, and Emergency Preparedness

A comprehensive set of 200 question-and-answer flashcards covering healthcare delivery systems, community health, facility environment, safety models, and emergency preparedness based on lecture notes.

What is the primary healthcare focus shift in the 21st century aimed at lowering overall costs?

An emphasis on wellness and preventive care, encouraging individuals to take more responsibility for their own health.

How has the terminology for individuals receiving healthcare services changed in recent years?

The terminology has changed from "patient" to "client" to reflect individual autonomy and participation.

What is the main purpose of Health Maintenance Organizations (HMOs)?

To provide managed care that emphasizes disease prevention and health promotion through prepaid, in-network services.

What are three examples of preventive health services commonly emphasized in managed care?

Immunization programs, diabetic support groups, and cardiac rehabilitation.

What are four alternative terms used to describe managed care plans?

Critical pathways, care maps, clinical pathways, and standard nursing care plans.

Why are Unlicensed Assistive Personnel (UAPs) increasingly utilized in healthcare delivery?

To administer nursing care due to financial constraints and the evolving structure of managed care.

What level of client acuity is generally required for admission to acute care hospitals today?

Only clients with high acuity are admitted to acute care hospitals.

What major legislative reform significantly changed access to healthcare insurance in the United States?

The Affordable Care Act (ACA).

How does the Affordable Care Act protect individuals with pre-existing medical conditions?

It prohibits insurance companies from denying care or coverage based on preexisting conditions.

What platform was created by the Affordable Care Act to allow consumers to choose health insurance?

The Health Insurance Marketplace.

What document associated with the ACA outlines expectations for client rights and care?

The Patient's Bill of Rights.

How does the increasing use of UAPs impact the responsibilities of LVNs/LPNs?

It increases the nurse's supervisory duties and overall clinical responsibilities.

Why is disease prevention considered more cost-effective than treatment?

Preventing a disease (e.g., providing a smallpox vaccine) costs far less than treating an active case of the disease.

What is the primary goal of Acute Care Hospitals?

To admit clients for short periods to stabilize acute conditions, after which clients often require continued care elsewhere.

What type of care is provided in Intensive Care Units (ICUs)?

Care for critically ill clients using high-tech equipment, monitors, and specially trained nurses.

What is another name for Subacute Care Facilities?

Step-down units.

Why are Outpatient Care Centers growing in popularity?

They provide same-day surgery and discharge, which significantly saves money for clients and insurers.

What defines a Specialized Hospital?

A facility that admits only one specific type of client and often focuses on education and research alongside clinical care.

Who acts as the primary caregiver in most Home Healthcare settings?

The client's family or significant other, with the visiting nurse assisting and guiding care.

What is the primary focus of Hospice care?

Specialized care for terminally ill clients to maintain comfort and quality of life near the end of life.

What service does Respite Care provide to primary caregivers?

Part-time supervision of chronic clients to give primary caregivers a temporary break from 24-hour caregiving duties.

How does Telehealth improve healthcare delivery?

It uses telephone, video, and audio technology to connect clients and providers in remote or underserved areas.

What are the two main categories of Extended Care Facilities (ECFs)?

Skilled Nursing Facilities (SNFs) and Intermediate Care Facilities (ICFs).

What is the staffing requirement for a Skilled Nursing Facility (SNF)?

24-hour nursing care provided under the direct supervision of a Registered Nurse (RN).

What is the staffing requirement for an Intermediate Care Facility (ICF)?

24-hour care from nursing assistants under the supervision of an LVN/LPN and an RN consultant.

What low-cost services are typically provided by Community Health Services?

Immunizations, well-baby checks, prenatal and pediatric care, and diabetic management.

What is the function of nurses working in industrial and occupational settings?

Health promotion, prevention, emergency interventions, and serving as a liaison between the company and OSHA.

Are Intensive Care Units considered Extended Care Facilities?

False; ICUs treat clients with high acuity in acute care facilities, whereas ECFs provide longer-term care.

What is Quality Assurance (QA) in healthcare?

A pledge to the public that healthcare services will deliver optimal achievable goals and maintain high standards.

Which organization is responsible for accrediting hospitals and setting rigid clinical care standards?

The Joint Commission.

In Quality Assurance, what is the difference between process and outcome?

Process refers to how care is delivered, whereas outcome refers to the result of the care provided.

What is the function of Continuous Quality Improvement (CQI) committees?

To monitor and evaluate the quality of ongoing client care continuously.

What are four alternative titles for a client representative?

Client representative, consumer advocate, liaison, and ombudsperson.

Who appoints hospital administrators in a facility's organizational structure?

The board of directors, board of trustees, or board of regents.

How are governmentally owned healthcare facilities classified in terms of funding?

Nonprofit organizations owned and operated by local, state, or federal government.

What is the main distinction between proprietary and not-for-profit private healthcare facilities?

Proprietary facilities are investor-owned and for-profit, while not-for-profit facilities reinvest profits into operations.

What is a Fee-for-Service insurance plan?

A traditional insurance plan where coverage pays providers specifically for each medical service or procedure rendered.

How does an HMO handle out-of-network provider costs?

Clients incur extra costs for out-of-network care, which is generally not covered unless preapproved by plan administrators.

What is a Preferred Provider Organization (PPO)?

A network of contracted healthcare providers delivering care within a managed system, allowing out-of-network choices at a higher cost.

How does a Point of Service (POS) plan manage client care?

A primary care physician within the network manages the client's care, but clients may seek outside care at a higher cost.

Who is eligible for Medicare health insurance?

Individuals age 65 and older, people under 65 with qualifying disabilities, and individuals with end-stage renal disease (ESRD).

How is Medicaid funded and who qualifies for it?

It is a joint federal and state tax-supported program providing healthcare coverage based on low income levels and specific eligibility groups.

What are Diagnosis-Related Groups (DRGs) in prospective payment systems?

Predetermined financial allocations set by federal agencies for treating specific diagnoses, forcing facilities to control costs.

What are five examples of complementary healthcare practices?

Chiropractic care, acupuncture/acupressure, herbalism, meditation, and therapeutic touch.

What major risk do clients face when falling victim to consumer health fraud?

They risk delaying vital, proven medical treatment for serious conditions like cancer or arthritis until it is too late.

How is a 'community' defined in public health?

A group of individuals interacting for mutual benefit to support a sense of unity or belonging based on common interests.

What is Demography?

The study of populations examining dynamic balances among size, racial/ethnic distribution, economic opportunities, and growth potential.

What metric is used to continuously monitor aggregate community health?

Leading Health Indicators.

What is the primary objective of the World Health Organization (WHO)?

To strengthen health systems globally and assist countries struggling to provide basic healthcare services.

What agency focuses specifically on nutrition, safe water, immunizations, and education for children in developing countries?

United Nations Children's Fund (UNICEF).

What are four historical achievements of the United States Public Health Service (USPHS)?

Vaccinations, motor vehicle safety, safer workplaces, and control of infectious diseases.

Based on this graph, how did life expectancy in the United States change overall between 1970 and 2017?

Overall life expectancy steadily increased across all demographic groups, rising from around 60 to 75+ years depending on group.

Is the Department of Health and Human Services (HHS) an executive agency of the U.S. President?

True.

What is the mission of the Centers for Disease Control and Prevention (CDC)?

To promote health and quality of life by preventing and controlling disease, injury, and disability.

What is the purpose of Global Disease Detection Centers operated by the CDC?

To detect, respond to, identify, and assist with treating infectious disease outbreaks worldwide.

What is the mission of the Food and Drug Administration (FDA)?

To promote and protect public health by ensuring safe and effective products reach the market promptly.

Does the FDA conduct direct development and testing of new consumer drugs?

False; the FDA reviews applications and safety evidence but does not develop or test products itself.

What agency serves as the main medical research agency of the U.S. federal government?

National Institutes of Health (NIH).

When was the National Institute for Nursing Research (NINR) established, and why was it significant?

Established in 1993, it formally recognized nursing as a unique and essential component of the healthcare system.

What parent department does the Occupational Safety and Health Administration (OSHA) belong to?

The U.S. Department of Labor (DOL).

What role does the Bureau of Labor Statistics play in workplace injuries?

It assists with workers' compensation administration, providing financial aid for work-related injuries or occupational diseases.

At what age does the Social Security Administration provide financial retirement support?

Persons older than 62 or 65 years.

Which federal agency administers the WIC program?

The United States Department of Agriculture (USDA).

What is the primary target group of the WIC program?

Pregnant women, new mothers, and their infants.

Who founded the American Red Cross in 1881?

Clara Barton.

What are the five main service areas of the American Red Cross?

Armed forces emergency services, biomedical services, community services, health and safety services, and international services.

What is unique about the fee policy of the Visiting Nurse Association (VNA)?

It provides home health and hospice care to any person regardless of their ability to pay.

What health goal is promoted by Planned Parenthood of America?

Family planning and the prevention of sexually transmitted infections (STIs).

What health goal is promoted by La Leche League?

Maternal and newborn health through the encouragement and support of breastfeeding.

What role do state health departments play regarding healthcare professionals?

They establish certification and licensing requirements for healthcare professionals and ancillary providers.

What areas of environmental health are monitored by local health departments?

Food, water, housing, sewage, waste disposal, and air quality within their jurisdiction.

What is Ecology (or bionomics)?

The study of mutual relationships between living beings and their environment.

What federal agency is dedicated to controlling environmental and ecological pollution?

Environmental Protection Agency (EPA).

What respiratory conditions are exacerbated or caused by air pollution?

Chronic bronchitis, emphysema, and asthma.

Why is waterborne mercury pollution particularly dangerous to pregnant women?

Mercury enters the food chain via fish and can cause serious fetal developmental and neurological damage.

What radioactive chemical element can become trapped in buildings built on land sites and cause disease?

Radon.

What is the medical term for lead poisoning?

Plumbism.

What essential physiologic needs must be met in a healthcare setting?

Oxygen, water, nutrients, waste elimination, sleep and rest, activity, and exercise.

What is a 'Client Unit'?

The specific area where most client care is provided, containing the bed, standard furniture, and equipment.

What is a 'Nursing Unit'?

An area containing several client units, usually organized around a centralized desk or nurses' station.

What standard furniture pieces are included in a basic client unit?

Hospital bed with side rails, overbed table, bedside stand, chair, and lamp.

What toilet equipment is routinely kept at the client's bedside unit?

Washbasin, soap dish, lotion, toothbrush and container, toothpaste, urinal, and portable commode or bedpan.

What built-in clinical equipment is typically present in hospital client rooms?

Blood pressure equipment, nasogastric suction, oxygen outlets, and intercom systems.

Is a nurse permitted to access client information without a clinical care reason?

False; accessing client medical information without a valid reason violates privacy and can result in employment termination.

Why is maintaining neatness in the client unit clinically important?

Order prevents accidents and infections, enabling staff to locate emergency equipment quickly.

What action should a nurse take when discovering frayed electrical cords in a unit?

Remove and replace the damaged equipment immediately and report it to maintenance or biomedical engineering.

What is done to a client unit after a client is discharged or transferred?

All reusable items are disinfected, disposables are discarded, and the unit is thoroughly cleaned and restocked.

What diagnostic equipment is standard in a clinical Examination Room?

Ophthalmoscope, otoscope, scale with height measure, blood pressure apparatus, thermometer, and speculums.

What are the two mandatory client identifiers used prior to delivering nursing care?

Checking the client's arm ID band and asking the client to state their name and birth date.

Why should nurses avoid using words like "hurt" or "painful" when explaining procedures?

To reduce client anxiety; instead, nurses should state "You may feel some discomfort."

Why do healthcare facilities use the 24-hour clock (military time)?

To increase accuracy in recording procedures and medication administration, avoiding AM/PM errors.

What is the function of the Clinical Diagnostic Laboratory?

To perform tests on blood, body fluids, and tissue specimens to assist providers in diagnosing disorders.

What tests are performed in an Electroencephalography (EEG) department?

Brain wave tests, evoked potential examinations, sleep studies, and seizure monitoring.

What does EMG stand for?

Electromyogram.

Which hospital unit specializes in the care of clients with serious heart disorders?

The Coronary Care Unit (CCU).

What is the purpose of a Clinical Decision Unit (CDU) or Observation Unit?

To monitor and evaluate clients temporarily before deciding on formal hospital admission or safe discharge.

What support department is responsible for sterilizing and supplying reusable medical equipment?

Central Service Supply.

What department coordinates post-discharge care, financial resources, and community referrals?

Social Services or Case Management.

What is the primary goal of a facility's Safety Committee?

To maintain safety principles, analyze job hazards, investigate accidents, and prepare disaster plans.

What modifications are needed when caring for a left-handed client?

Rearranging bedside environment and equipment to accommodate left-hand and left-foot dominance safely.