Community Health Final Exam

Measles

s/s Fever, runny nose, cough, rash all over body, Koplik Spots

Rubella

s/s fever, enlarged lymph nodes, pink rash

Pertussis

s/s begins as a URI —> irritating cough

Salmonella

s/s headache, abdominal pain, diarrhea, n/v, occurs 48 hrs within eating contaminated food

Lyme Disease

s/s fever, fatigue, muscle pain, bulls eye lesion

Chlamydia

s/s often asymptomatic, “Silent Disease”

Gonorrhea

s/s Purulent penile drainage, dysuria

syphilis

s/s Lesion at site of entry present for 3-6 weeks then disappears

Human Papillomavirus

s/s raised cauliflower-like growth occurs 2-3 months after infected

Herpes Simplex Virus-2

s/s painful lesion occurring on the vulva, vagina, rectum, or penis

Human-made disaster

Fires, building collapse

Natural Disaster

Blizzard, tornado, hurricane

Target/Key population

people with no support system

FEMA Before

planning, preparedness plans, education, training, grants

shared responsibility between the federal government and communities

FEMA During

local government officials submit a request for a federal disaster declaration

Disaster Assistance: individual and/or public assistance, disaster recovery centers

FEMA After

National disaster Recovery framework, mitigate future hazards

Prevention

planning ahead and thinking

Goal: reduce risk to people and properties when disaster occurs

Preparedness

Develop personal, professional, and community disaster plans

Personal: nurse thinks, “What can I do personally to help?”

• disaster plan/ “I need to be available”

Professional: nurse involved in emergency preparedness plans

• mock disaster plan

Community: all aspects of public and private hospitals

• testing sirens, making sure 911 is available, shelters, pet places

Response

Local Response → state response → federal/national response

• county can step in after local if needed before going to state level

Goal: reestablish basic needs of the people in the community

RN Role:

• assessment: is it safe

• Advocating for the needs of people

• Case finder and referral agent

• Traiage

• Shelter management

Black

People who are expected to die without extensive resources

Red

People who have life-threatening injuries and need immediate intervention to survive

RR > 30

Cap refills > 2 seconds

doesn’t obey commands

Yellow

People who require intervention, but their condition is not expected to worsn over several hours

Green

People who have minor injuries but can stand and walk (walking wounded)

Recovery

Longest Phase: returning to a new normal

RN Role:

• assessment: homes and community are safe, environmental factors

• Referral for citizens

Heroic

those affected are mainly concerned with survival

main focus: to get themselves and others to safety

Honeymoon

After threat is gone, phase sets in

those affected come together and discuss what they experienced during the disaster (tells their story)

Disillusionment

describes the feeling of disappointment while recovery efforts are being made (slow pace)

Reconstruction

involves rebuilding, resuming normal activities if possible, establishing a new normal, and referrals survivors and first responders for mental health services

Ethical Issues

conflict between 2 or more moral principles

Ethical Dilemmas

occurs when a person, a group, or a community is faced with a decision that can be solved from many perspectives

• a provider treating a terminally ill pt, they requests physician-assisted suicide

Moral Distress

occurs when a person is unable to act in a way that they think is right due to internal or external constraints

Ethical Decision-Making Process

orderly process that considers ethical theories, ethical principles, client values, and professional obligations when making a decision

Health Economics

study of how care resources affect the health care industry

Retrospective Reimbursement

Fees for services are billed after they are delivered

based on costs to the organization or changes from the provider

Prospective Reimbursement

third-party payers (insurance) establish the amount you are going to pay beforehand

similar to Preferred Provider

Fee-for-Service

Providers are paid for each service they provide regardless of cost of service

• advantage: providers have more flexibility in how they deliver care

Preferred Provider

providers negotiate fees with the insurer and are reimbursed a set rate for services provided

Capitation

providers are paid a fixed amount per patient, regardless of the number of services they recieve

• advantage: incentive to provide preventative care and keep patients helathy in order to reduce the number of services the need to provide

• Disadvantage: providers may be reluctant to order expensive care as they might not be reimbursed for it

Health Care Rationing

Restrictive provider networks requiring clients to use only in-network providers for health care services

Limits access to certain types of services or providers

increase barriers to services to decrease frivolous use

Nurse Practice Act

Defines the practice of professional Nursing

Identifies the scope of nursing practice

set educational qualifications and other requirements for licensure

Determines the legal titles nurses may use to identify themselves

Deontology

a decision is made based on doing what is right and not doing what is wrong

Utilitarianism

right action is the one that produces the greatest amount of good or the least amount of harm

Principlism

a decision is made by considering ethical principles

Virtue Ethics

a decision is made based on reasoning and character building

Feminist Ethics

decision is made based on economic, social, and political equity

Autonomy

right to make own decisions

Nonmaleficence

do no harm, act in the best intrest

Beneficence

act in a way that benefits others (moral obligations)

Distributive Justice

Fair distribution of benefits and burdens

Devolution

action by the federal government to shift responsibility for planning, delivering, and financing of health programs to the state level

Coverage to care through center for Medicare and Medicaid Services

What services is focused on improving access to primary care for the disabled?

Mobility, Dexterity, Stamina

Physical disabilities include impairments in which of the following?

False

true or false— Every healthcare facility is easily accessible to the physically disabled population.

Drug Offenses

What is the leading cause of incarceration in the United States?

40%

no compelling public safety justification exists for what percent of those incarcerated?

Get involved with organizations that advocate and lobby for policy change

Work directly in corrections nursing

Educate other on problems faced by the incarcerated population

What are some ways for nurses to get involved in health advocacy for incarcerated people?

Tinnitus, hearing loss, PTSD, Lumbosacral or cervical, strain, depression

What are the top disability claims by veterans?

t/f: False

Veterans do not need to prove that their disability is service connected in order to get compensated.

5 million

What is the number of disabled veterans in the United States?

Language barriers making it difficult to access resources

Exploitation of migrant workers

Limited knowledge of labor laws

Which of the following factors below influence the development of mental health issues in migrant workers?

T/F: True

Migrant workers are more likely be exposed to violence and violation of human rights than non-migrant workers.

adequate economic stability with increased opportunities

Which of the following is NOT seen in migrant workers suffering from mental health issues?

Assists with the transition from homelessness to being housed

What does PATH assistance for the homeless help with?

Lack of transportation

Lack of Financial Resources

Lack of knowledge on the resources available

Which of these is a barrier that affects the homeless population from accessing healthcare?

False - T/F

Resources for the homeless population in Waterloo are widely known, easily accessible, and utilized to their fullest extent.

false

Pregnant adolescents do not have any serious health or social issues.

Premature Birth

Abuse/neglect

What are long term risks for pregnant adolescents and their babies?

Wize girlz program

What are current practices/methods used in Blawk Hawk County for pregnant adolescents?

provides resources on how to create a welcoming environment for LGBTQ individuals

The Safe Zone Project

Cedar Falls and Des Moines

The UnityPoint LGBTQ Clinics are located in

All of the above

• Physcial safety

• mental health

• access to informed care

LGBTQ individuals face greater risks concerning?

Economics

Supply and demand

Health Economics

studies how scarce resources are going to affect the healthcare industry

Public Health economics

focuses on producing, distributing resources

Public health financing

acquiring, using, and managing money to improve the health of populations

Trends and Shifts in Health Policy

largely influenced by politics

Social Security Act

Provides assistance to older adults and the unemployed, provided survivors’ benefits for widows and children, provides child welfare, health department grants, and maternal/child health programs

National Institute of Health

nation;s medical research agency. aim is to prevent disease and improve the health of the population

Medicare and Medicaid

Provides payments for health care services fro older adults, the disabled, and the poor

Devolution

shifts from federal government to the states, state and localities should be responsible for health care responsibility

Block Grants

government grant given to the states with very few restrictions on how to use it

• ex. community services block grant → used to reduce poverty

Categorical Grants

Government grant given to states for specific programs with many restrictions

• ex. Head Start Program → early education for children in low income families

Affordable Care Act

Improve the health of the nation by making health care affortable for all, and increase access to care

Direct services

federal, state, and local governments provide direct health care services to individuals and groups

• ex. Federal prison inmates, military families

Financing

federal government’s finance through

• ex. medicare, medicaid, CHIP, research

Useful Information

the federal gov. conducts research and gathers/analyzes data about health care and the health status of citizens

Policy Setting

Sets policies that will impact funding and how we use our resources

Public Protection

Functions from the federal government to protect the health of the population

Infectivity

ability to enter and multiply within the host

pathogenicity

agent’s ability to produce specific clinical reaction after infection occurs

Virulence

Ability to cause disease usually due to biological makeup

Toxicity

ability to produce a poisonous reaction

Invasiveness

agents ability to penetrate and spread throughout

Antigenicity

agents ability to create an immune response in the host's body

Natural Immunity

Born with immunity

Acquired Immunity

acquired from previous exposure on own or vaccine

Active Immunity

immunization or had disease to develop immunity

Passive Immunity

passed through mother-baby or transfusion of antibodies, providing temporary protection.

Herd Immunity

as long as a certian amount of population is vaccinated, the disease will not be able to spread

Vertical Transmission

passed from parent to offspring (sperm, placenta)

ex. Syphilis, STI’s, GBS