Comprehensive Nursing and Public Health: Infectious Diseases, IPV, Substance Use, and Epigenetics

Staphylococcus aureus

Agent (biologic agents capable of producing an infection or disease)

Potential vector

Mosquitos

Infectious disease

Presence and replication of an infectious agent in the tissues of a host, with manifestations of signs and symptoms

Incubation period of chickenpox

10-21 days

Endemic

The constant or usual prevalence of a specific disease or infectious agent within a population or geographic area (a disease that is always present in a certain area or among a specific group of people)

Epidemic

Significant increase in the number of new cases of a disease than past experience would have predicted for that place, time, or population; an increase in incidence beyond that which is expected. (a disease that suddenly spreads and affects a large number of people in a certain area or population)

Potential common source outbreak

A higher than usual rate of food-borne illnesses in a restaurant and outbreak ended as soon as the restaurant was closed.

CDC

Agency responsible for surveillance system

Pathogenicity

Ability of the agent to produce an infectious disease in a susceptible host (ability to create disease)

Infectivity

Investigating whether a certain organism can invade a host and replicate (can the host get sick?)

Listeria monocytogenes

Foodborne illness; diarrhea and flu-like symptoms with recent meal of deli meats and cheese

Intimate partner violence (IPV)

Can lead to the development of chronic conditions (STDs and physical conditions like infertility)

Screening for IPV

YES!

Best person to identify children of victims or perpetrators

School nurse

Community support for IPV

Increase the number of rooms at local shelters for people experiencing IPV

Questions to ask for IPV

Always ask questions such as "can you tell me more"... "are you in danger now..." But start the question with saying that "I ask all of my clients about past or current abuse in their lives to better take care of you for your well-being..."

Reporting IPV/abuse

YES

Femicide

A homicide committed by an intimate partner

Increased risk for substance use disorder

First use of an illicit substance before the age of 15

Major mental health disorder and substance use

Younger you use... more mental health disorders you will have.

World Health Organization principles alcohol policies

Sensitivity to the use of alcohol in cultural and religious contexts; Access to prevention services for people affected by harmful alcohol use; Protections for people affected by harmful alcohol use by others

Concern if a patient is developing a tolerance for a drug

Client seeks multiple refills

Significant risk factor for alcohol use disorder

Narcan/naloxone

A medication used for overdose; if a nurse is given it and the patient is unresponsive, the student needs to be transported for emergency treatment to a medical center.

Signs and Symptoms of Substance Withdrawal

Shaky, Sweaty, Agitated, Tachycardic, Diaphoresis, Tremors.

Withdrawal in Pregnant Mothers

Seizures, memory problems, hyperactivity.

Nursing Assessment for Substance Use

Begin with less threatening health questions about diet, sleep, and exercise.

Mental Status Exam in Substance Abuse

When you think substance abuse, you must perform a mental status exam.

CRAFT Screening Questionnaire

A yes to 2 or more questions indicates need for intervention; includes Car, Relax, Alone, Forget, Friends, Trouble (for adolescents).

Epigenetics

The study of how environmental and behavioral factors affect how genes are expressed and DNA is sequenced.

Factors Impacting Epigenetics

Nutrition, smoking, exercise.

Nutrition's Impact on Epigenetics

A mother's diet during pregnancy can influence how certain genes in the baby are expressed.

Smoking and Epigenetics

Chemicals from cigarette smoke can cause epigenetic changes linked to cancer development.

Exercise and Epigenetics

Regular physical activity can activate genes that protect against inflammation and chronic disease.

Department of Agriculture Factors in Rural Areas

Administrative, Land use, Economic.

Medically Underserved Regions

Areas with a lack of medical care services due to decreased healthcare providers, infant mortality rate, incomes below the poverty level, and populations 65 years or older.

Definition of Availability

Insufficient number and diversity of formal services and providers; lack of acceptable services and human service infrastructure.

Definition of Accessibility

Shortages of adequate, appropriate, and affordable transportation; cultural and geographic isolation.

Children's Defense Fund Initiative

Supports individual, family, community, organizational, and government levels to ensure children in foster care and detention receive quality treatment to address their mental, behavioral, and emotional needs.

Female Veterans' Risks

Higher risk for sexual trauma, suicide, communicable diseases.

Correctional Health Facility Assessment

Should screen for communicable diseases.

HAI Nurses

Nurses who play an important role in the prevention of healthcare-associated infection and represent the first line of defense for such ADR outcomes.

Contact Tracing

A public health strategy used to identify and monitor people who have been in close contact with someone who has tested positive for an infectious disease.

ACE

Adverse Childhood Experiences; a term used to describe traumatic events that occur in childhood.

Adverse Childhood Experiences (ACE)

Events occurring during childhood that can have an immediate traumatic effect and potential negative effects on future development and lifelong health such as neglect, violence, childhood abuse, and substance use.

ACE assessments

Find out exposure toxic living environment, substance use, child household dysfunction and the impact it has throughout the lifespan.

Violence against women vs. violence against men

Women: 1 & 3; Men: 26%.

Nurses' role in decreasing ACE

Working with local groups to identify adults and children who will be allies in prevention, training teachers and other bystanders in identifying and intervening for high-risk children, providing high-quality childcare that is accessible and acceptable for working parents and families.

Domestic violence reporting

Many more survivors of domestic violence are not reporting their abusers to the police or accessing services at domestic violence services due to reasons such as shame, fear, or being prevented from doing so by their abusers.

Leading causes of accidental death

Heroin, Fentanyl, Drug overdoses.

Attributable causes of death, disease, and injury

Fetal alcohol syndrome, cirrhosis, oral cancer, violence, self-harm, etc.

CAGE question

Have you felt GUILTY about drinking? Have you ever felt you needed to cut down on your drinking? Have people annoyed you by criticizing your drinking? Have you ever felt you needed a drink first thing in the morning (eye-opener) to steady your nerves or to get rid of a hangover?

Leading country in substance use disorder

USA.

Scope of substance abuse

Alcohol misuse is a global public health threat that poses significant issues.

Training nurses to recognize violence/abuse

Building trust with patients, reporting abuse, providing empathetic support, attentive listening, referring clients to legal protection.

Mandatory reporting for child abuse

Disclose to the parent that a mandatory report will be made and help the parent identify potential resources to keep her and baby safe.

Forensic nursing

Advance training focuses on taking a history, collecting evidence, providing treatment and follow-up.

ANA standards for forensic nursing

Practice environment, trends, education, ethical considerations.

Best efforts for victims

Coordination with the medical team and police (ER nurse well positioned for this).

Motivational interviewing

Client centered counseling for behavior change to resolve issues and create a new action plan to which the client is willing to commit.

Abstinence

A person is considered abstinent with no use of illicit substances or alcohol in the preceding 12 months.

Social injustice

The belief of those in power that others are inferior, denial of human rights to certain populations, disparities in access to services such as healthcare.

Screening for substance use

Screening for substance use is the FIRST step in assessing if a person has substance use disorder. The efficacy of screening instruments is highly dependent on the candor of client responses.