Community Health Nursing, Emergency Preparedness & Cultural Competence

Flashcards covering community assessment, disaster management, cultural competence, bioterrorism, and religious considerations.

What three major elements are assessed during a community assessment (people/place/social systems)?

A) People (demographics, biological, social, cultural factors) B) Place or Environment (physical & environmental factors) C) Social systems (health, economics, religious, welfare).

Which four stages make up the disaster management cycle?

Prevention (mitigation), Preparedness, Response, and Recovery.

Define an internal disaster and give two examples.

An event originating inside a health-care facility that threatens to disrupt care; examples: structural issues such as fire or power loss, and personnel-related events such as strikes or high absenteeism.

Define an external disaster and list two human-made and two natural examples.

An event outside the facility that affects it; human-made: terrorist bombing, chemical spill; natural: hurricane, earthquake.

What is the focus of community health nursing?

A population-focused approach to planning, delivering, and evaluating nursing care.

Name five social determinants of health that influence community health.

Neighborhood & built environment, social & community context, economic stability, health & health care access, and education.

List at least six vulnerable populations identified in community health nursing.

Violence victims, substance use disorders, mental health issues, poverty/homelessness, rural residents, migrant workers, veterans, people with disabilities, older adults, pregnant adolescents, individuals with communicable diseases.

What are the nurse’s primary responsibilities when making community referrals?

Link clients to resources, coordinate and ensure continuity of care, and evaluate outcomes using thorough knowledge of individuals/agencies.

Give four common types of community nursing referrals.

Psychological services, support groups, medical equipment suppliers, meal delivery, transportation services, life-care planners.

Identify four common community health nurse practice settings.

Home health, hospice, occupational health, parish nursing, school nursing, case management.

What is the role of The Joint Commission regarding hospital emergency preparedness?

It mandates that hospitals have an Emergency Operations Plan (EOP) with staff training, activation criteria, and scenario-specific actions.

How often should hospitals conduct disaster drills, and what must one drill include?

At least twice a year; one drill should involve community-wide resources and real or simulated clients.

List three key components of a family disaster plan.

Evacuation procedures, plan for family pets, and a designated meeting place.

Name five essential items in a family disaster kit.

Flashlight with extra batteries, battery-powered radio, nonperishable food & manual can opener, one gallon of water per person, first-aid supplies, matches in waterproof container, bleach, emergency blanket, rain gear, prescriptions, toiletries, important documents.

What is triage in disaster nursing?

The process of prioritizing clients so that those needing immediate care are treated first to achieve the greatest good for the greatest number.

Match the disaster triage tag to its description: Red, Yellow, Green, Black.

Red – immediate/life-threatening; Yellow – major injuries, treatment can be delayed 30 min-2 hr; Green – minor injuries, treatment can be delayed 2-4 hr; Black – expected/allowed to die.

During facility disaster planning, what actions may be taken regarding current inpatients? (name four)

Premature discharge of stable clients, transfer of stable ICU clients, postponement of elective admissions/operations, mobilization of off-duty staff, protection/evacuation of personnel and visitors.

Who manages federal response and recovery efforts during U.S. disasters?

The Federal Emergency Management Agency (FEMA), part of the Department of Homeland Security.

What is the purpose of crisis-incident stress debriefing for health care providers?

To reduce risk of post-traumatic stress by discussing feelings (defusing) shortly after the event and holding formal debriefings later to process the incident.

Define Category A bioterrorism agents and give three examples.

Highest-priority agents that are easily transmitted and cause high mortality; examples: smallpox, anthrax, botulism, plague, tularemia, Ebola/viral hemorrhagic fevers.

What are Category B bioterrorism agents characterized by, and provide two examples.

Second-highest priority; moderately easy to disseminate with moderate morbidity and low mortality. Examples: ricin toxin, typhus fever, diarrheagenic E. coli, West Nile virus.

Give two characteristics of Category C bioterrorism agents and two examples.

Emerging pathogens that could be engineered for mass dissemination, easy to produce, potential for high morbidity/mortality; examples: hantavirus, influenza, tuberculosis, rabies.

Define culture in the context of nursing.

The shared knowledge, beliefs, values, and traditions of a group that guide their worldview and are passed to the next generation.

Differentiate cultural competence and cultural humility.

Cultural competence is the ability to integrate cultural knowledge into care; cultural humility is ongoing self-reflection to recognize one’s own biases and provide better care.

What does the acronym CLAS stand for and what is its goal?

Culturally and Linguistically Appropriate Services; aims to promote equitable, high-quality health care for diverse populations.

List four CLAS standards related to language services.

Provide free language assistance, use only qualified interpreters, offer written materials in common languages, ensure continuous quality improvement and accountability.

Provide three guidelines for using an interpreter in health care.

Address the patient not the interpreter, choose qualified interpreters familiar with medical terminology, avoid using family members, observe non-verbal cues, review translated info with patient.

What question would you ask to assess a client’s dietary cultural practices?

“What dietary preferences or prohibitions do you follow?”

Name three time-orientation types and their implications for health teaching.

Past-oriented (respect traditions), Present-oriented (focus on immediate benefits), Future-oriented (emphasize long-term outcomes).

Describe biomedical, naturalistic, and magico-religious health beliefs.

Biomedical: every effect has a cause; Naturalistic: health as harmony with nature; Magico-religious: health/illness linked to supernatural forces.

Give two nursing interventions to support a patient’s spiritual needs.

Provide privacy for prayer/rituals, facilitate contact with spiritual leaders, offer diet consistent with beliefs, allow family involvement.

What is a key dietary restriction common to Islam?

Prohibition of pork and alcohol; meat must be halal.

In Buddhism, what end-of-life practice is common, and what is the usual method of body disposition?

Chanting by monks is common during last rites; cremation is common.

Which religion often requires males to be circumcised and includes a prayer in the infant’s ear at birth?

Islam (Muslim faith).

Name two religions that discourage or prohibit alcohol, coffee, and tea.

The Church of Jesus Christ of Latter-day Saints (Mormon) and Seventh-Day Adventist.

What is kosher dietary law regarding meat and dairy in Judaism?

Milk and meat cannot be served or prepared together; pork and shellfish are prohibited.

For Catholic patients, what sacrament might be requested in the hospital, especially when ill?

Anointing of the sick (last rites) or confession/communion.

Why should family members generally not be used as medical interpreters?

Potential breaches of privacy, difficulty with medical terminology, and possible alteration of information.

When providing care to a Muslim woman, what modesty consideration should nurses remember?

She may prefer female health care providers and clothing that covers her entire body; privacy during prayer is important.

What are the goals of crisis intervention following a disaster?

Reduce emotional intensity, assist recovery, and prevent long-term psychological problems.

Define post-traumatic stress disorder (PTSD) in the context of disasters.

A mental health condition that may develop weeks to years after a traumatic event, affecting survivors, first responders, or families.

What is the purpose of the mitigation phase in disaster management?

To reduce or eliminate risks and protect people, property, and the environment before a disaster occurs.

Identify two actions included in disaster prevention.

Protecting buildings/infrastructure and improving security/public health awareness.

Which agency is authorized by the U.S. government but not part of it, and provides shelters and blood products during disasters?

The American Red Cross.

What tag color would a client with airway obstruction receive in mass-casualty triage?

Red tag – emergent, immediate threat to life.

What is the acceptable delay for treating a Yellow-tagged patient?

Treatment can be safely delayed 30 minutes to 2 hours.

What nursing action comes first when using the community-based nursing process during disaster preparedness?

Assess the community for risks and resources.

Why is economic stability considered a social determinant of health?

Income and employment affect access to resources like housing, nutritious food, and health care, influencing overall health outcomes.

Which vulnerable group may face unique challenges related to service-connected injuries and mental health issues?

Veterans.

Explain the importance of electronic and telecommunication technologies in community nurse referrals.

They allow collection and sharing of physical, audio, and visual data, improving coordination and continuity of care.

What principle guides triage in a mass casualty when resources are overwhelmed?

Provide the greatest good for the greatest number of people.

During disaster recovery, what is an administrative review?

A systematic evaluation of the agency’s response to identify effective areas and needed improvements.

Give two examples of combined internal/external disasters.

A severe snowstorm causing mass casualties while preventing staff from reaching the hospital; a hurricane causing power loss inside the hospital and community flooding.

What is the significance of ‘evidence-based practice and research’ among the 12 standards of culturally competent care?

It ensures care practices are grounded in scientific evidence while respecting cultural differences.

Describe the folk healer belief system.

Clients may seek care from spiritual healers, folk doctors, or shamans based on cultural traditions.

What nursing consideration applies to clients from present-oriented cultures when discussing disease prevention?

Emphasize immediate benefits of interventions rather than distant future outcomes.

How much water per person should be included in a family disaster kit?

At least one gallon of water per person.

What is the main function of a Hazardous Material (Hazmat) response team?

To respond to incidents involving dangerous substances and coordinate decontamination using specialized protective equipment.

Which hand is traditionally used for eating in Hindu culture, and why is this relevant for nurses?

The right hand; the left is reserved for hygiene, so nurses should respect this practice when assisting with meals.

When should defusing occur for health care staff after a critical incident?

Shortly after the event, often at the end of the shift.

What is the recommended action for elective surgeries when a hospital’s disaster plan is activated?

Postpone or cancel all elective operations to free resources for disaster victims.

List two reasons why lactose intolerance may be more common among Jewish individuals of European origin.

Genetic predisposition and dietary patterns; nurses should consider this when providing dairy products in kosher meals.

What is the priority communication step when the incident command center has been established during a disaster?

All units should follow the established chain of command to coordinate resources and information effectively.

Why is ‘critical reflection’ a standard of culturally competent care?

It requires nurses to examine personal beliefs and biases to prevent them from impacting patient care.

What items are considered haram (prohibited) in Islamic dietary law?

Pork, alcohol, gelatin, and animals with fangs.