Unit 1 Flashcards

Community health nursing

Focuses on the health of individuals, families, and the community as a whole; aims to promote, protect, preserve, and maintain population health.

Public health nursing

Emphasizes the health of the community as a whole and aims to prevent disease and disability while promoting overall community health.

Healthy People 2030

A national framework with goals to improve health, emphasizing preventable problems and social determinants of health.

Social determinants of health

Conditions in the environment that influence health outcomes, including economic stability, education, healthcare access, neighborhoods, and social context.

Economic stability

A category of determinants including housing, poverty, health, and food security.

Education access and quality

Education level influences health; higher education is linked to healthier, longer lives.

Healthcare access and quality

Access to primary care and preventive services; quality of care affects health outcomes.

Neighborhood and built environment

Impact of living environment on health, including safety, air and water quality, and exposure to toxins.

Social and community context

Role of social support networks; lack of support can lead to anxiety, depression, and mental health issues.

Goals of Healthy People 2030

Four goals: longer, healthier lives; health equity; elimination of disparities; and environments that promote health and quality of life.

Vulnerable population factors

Economic resources, age, chronic disease, obesity, and history of abuse/trauma that increase risk.

Florence Nightingale

Pioneer who promoted health through environmental cleanliness, warmth, and sanitation.

Lillian Wald

First community health nurse; founded the visiting nurse service in New York.

Clara Barton

Founder of the American Red Cross.

Margaret Sanger

Founded Planned Parenthood and promoted birth control education.

Roles of community health nurses

Client advocacy; education; collaboration with other health professionals; counselor; case manager.

Case manager

Coordinator who handles referrals, agency links, funding, and insurance for clients.

Home health care in the home

Care provided in the home to maintain self-care, independence, and support caregivers; utilize client resources.

Direct care

Hands-on, in-person patient care provided by CHN professionals.

Indirect care

Planning, coordination, and administrative activities that support patient care.

Durable Medical Equipment (DME)

Medical equipment used at home, such as walkers, wheelchairs, oxygen, and hospital beds.

Hospice care

Care for life-limiting conditions emphasizing comfort, quality of life, and end-of-life support.

Home health team

RN coordinates care; includes providers, LPNs, therapists, pharmacists, family, and others.

Disaster readiness and response

Planning and response by nurses to natural, technological, or biological disasters.

Windshield survey

A quick community assessment by observing from a car or during presence in the area.

NANDA International taxonomy

Nursing diagnoses classification used in community health assessment.

Omaha System

A problem-solving model organizing care around environmental domains (psychosocial, physiological health status, behaviors).

Assessment in community health

Collect data from databases, records, and community perceptions; analyze and synthesize findings.

Planning in CHN

Writing goals and outcomes using domain concepts; planning interventions to promote health.

Goals of home health care

Provide in-home care for complex, chronic, or terminal illness; sustain independence and support caregivers.

School nursing

Nursing care for students, health education (e.g., smoking cessation, activity), and health screening.

Occupational health nursing

Nurses in workplaces who promote health, conduct screenings, pre-employment checks, and manage workers’ health issues.

Faith community nursing

Nursing in faith-based settings focusing on holistic health beliefs and supportive ministries.

Educator role

Explain health concepts and educate patients and families.

Communicator role

Liaise among patients, families, and health teams to ensure clear information exchange.

Client advocate

Support patients’ rights and help access needed services.

Medicare (home health)

Federal program for eligible individuals; requires skilled care, homebound status, intermittent nursing, provider-approved plan recertified every 60 days.

Medicaid and private pay

Medicaid: state/federal program for low-income individuals; private pay: out-of-pocket or insurance–based payments.

Referral to home health

Provider-approved referrals often initiated in hospitals; may come from primary care or mental health workers.

International nursing

Nurses work abroad in relief, disaster response, or areas with poor sanitation.

Census and census tracts

Census counts population; census tracts are small geographic areas used for demographic data.

Demographics

Structure of a population including biological, emotional, and social data.

Comprehensive interview and exam

Full health history plus complete head-to-toe physical assessment.

Focused examination

Exam directed at the presenting problem or specific body system.

System-specific examination

Examination limited to one body system.

Ongoing assessment

Repeated assessments as needed to monitor status or outcomes.

Privacy

Protection of client confidentiality and modesty during assessment.

Noise control

Reducing ambient noise to improve concentration and communication.

Environment preparation

Setting up room, temperature, lighting, and equipment for assessment.

Rapport

Building trust and a positive relationship with the client.

Positioning

Proper placement of the client to enhance comfort and assessment accuracy.

Inspection

Visual observation of body surfaces, movements, and behavior.

Palpation

Using touch to assess texture, size, tenderness, and temperature.

Percussion

Tapping body surfaces to assess underlying structures by sound.

Auscultation

Listening to body sounds with a stethoscope (heart, lungs, abdomen).

Olfactory examination

Using the sense of smell to detect abnormal aire odors or cues.

Infants (age modification)

Parents hold the infant; ensure safety during examination.

Toddlers (age modification)

Allow exploration or sitting on a parent’s lap; perform invasive procedures last; offer choices; use praise.

Preschoolers (age modification)

Use dolls for demonstration; parental contact allowed; involve child in examination.

School-age children (age modification)

Show approval, develop rapport, allow independence, teach about the body.

Adolescents (age modification)

Provide privacy; address normal concerns; use exam to teach healthy lifestyle; screen for suicide risk.

Older adults (age modification)

Adapt positioning for mobility; account for vision/hearing changes; assess ADLs and need for rest.

General Survey

Overall impression including appearance, behavior, posture, speech, mental state, hygiene, vitals, height/weight.

Integumentary system

Skin, hair, nails; includes color, temperature, moisture, texture, turgor, and lesions.

Skin color

Pigmentation and uniformity of skin tone.

Skin temperature

Warmth of the skin indicating perfusion and hydration.

Skin moisture

Level of hydration reflected by skin dampness.

Skin texture

Surface feel of skin (smooth, rough, flaky, etc.).

Turgor

Elasticity of the skin, indicating hydration status.

Lesions

Any abnormal skin findings such as rashes, ulcers, or moles.

Nails

Nail color, shape, texture, and capillary refill affecting circulation assessment.

The head: skull and face

Size and shape assessment of skull and facial structures.

Visual acuity

Clarity of vision; assessed through vision testing and fields.

Pupils

Size, equality, and reaction to light; part of pupil examination.

CN I – Smell

Olfactory nerve tested by smelling substances to assess sensory function.

Ears: tympanic membrane

Eardrum integrity examined via otoscopy; part of hearing assessment.

Weber’s test

Tuning fork test to detect lateralization of hearing loss.

Rinne’s test

Air vs bone conduction hearing test using a tuning fork.

Nose/Mouth & oropharynx

Examination of lips, mucosa, teeth, tongue, and oropharynx.

Cervical lymph nodes

Nodes along the neck checked for size, consistency, and tenderness.

Trachea and thyroid gland

Assessment of tracheal position and thyroid enlargement.

PMI (point of maximal impulse)

Best point to hear the heart beat; location gives cardiac size/health clues.

Heart sounds S1 and S2

S1 = mitral/tricuspid closure; S2 = aortic/pulmonic closure.

S3 and S4

S3 = early diastolic filling; S4 = late diastolic filling (stiff ventricle).

Murmurs

Abnormal heart sounds from turbulent blood flow, often indicating pathology.

Auscultation sites (heart)

Aortic (right 2nd rib), Pulmonic (left 2nd rib), Erb’s point (left 3rd), Tricuspid (left lower sternal border), Mitral (left 5th intercostal).

Central vessels

Carotid arteries palpated for pulse; assess for bruit; jugular venous pressure.

Peripheral vessels

BP, peripheral pulses, signs of hypoxemia, varicosities.

Abdomen examination order

Inspect, Auscultate, Percuss, Palpate (note the reverse order from exam of other systems).

Musculoskeletal system

Assessment of body shape, posture, gait, ROM, strength, and joint function.

Romberg’s test

Balance test assessing vestibular function and proprioception.

Cranial nerves

12 paired nerves tested to assess sensory and motor function.

Glasgow Coma Scale (GCS)

Tool to assess level of consciousness; scores for Eye, Verbal, and Motor responses (3–15).

Motor/cerebellar function

Assessment of movement, coordination, tone, balance, and proprioception.

Sensation tests

Stereognosis, Graphesthesia, Two-point discrimination, Point localization, Extinction.

Genitourinary system (male/female)

Assessment of external genitalia; presence of hernias; regional lymph nodes.

CV A tenderness (CVAT)

Costovertebral angle tenderness; test for kidney pathology (stone/pyelonephritis).

Vital signs

A set of measurements that reflect core physiological functions (temperature, pulse, respiration, and blood pressure) used to assess health and body-system function.

Normal body temperature range

Approximately 36.1–37.2 C (97–99 F); average around 98.6 F.

Fever (pyrexia)

Elevated body temperature, typically 100.4 F (38 C) or greater, often due to pyrogens resetting the hypothalamic thermostat.