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477- Public Health > Exam 2 > Flashcards

Exam 2 Flashcards

1
Q

sex

A

assigned at birth
someones biologic/chromosomal status

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2
Q

gender

A

societal definitions that go with sex

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3
Q

gender identity

A

core sense of being male or female or both
does NOT have to correspond w/ biological sex
ex. male anatomy but feels like a female

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4
Q

transgender

A

umbrella term
for ppl whose gender identity or gender role does not conform to sex
*not all trans id as transgender

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5
Q

gender nonconforming (general)

A

umbrella term
gender expression or gender identity differs from sex

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6
Q

genderqueer

A

gender id not align with binary understanding
“they, them”

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7
Q

nonbinary identity

A

gender id is not exclusively male or female
ex. pangender or agender

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8
Q

types of gender affirmation

A

social, psychological, medical and legal

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9
Q

gender nonconformity

A

persons gender id differs from cultural norms

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10
Q

gender dysphoria

A

discomfort by a discrepancy btw a person’s gender id and sex assigned at birth

*not all ppl experience dysphoria (distress) when transitioning

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11
Q

LGBTQ trends

A

population has increased
mostly younger generations, women, bisexual ppl and ppl of color

many more Americans now approve of same-sex relationships

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12
Q

LGBT disparities

A

access to healthcare
clinical preventative services
injury/violence
mental health
nutrition
obesity
physical activity
reproductive health
substance/tobacco abuse

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13
Q

LGBT population generalization

A

worse health outcomes
more likely to delay services
less insured
higher rate HIV/AIDS
higher rate chronic and psychiatric conditions
more substance abuse

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14
Q

LGBT disparity- causes

A

stigma
personal risk beh
economic strain
lack of knowledge abt population by providers

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15
Q

elder LGBT- main concerns

A

financial
social isolation (social stigma and discrimmination)
access to aging services
acute care issues
long term care issues (going back into closet) (mre vulnerable to enter hostile environment)
end of life

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16
Q

healthcare equality index

A

how equitably healthcare organizations trt LGBT ppl
can be used as assessment tool

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17
Q

LGBT- benefits of addressing health concerns

A

reduced hc costs
inc longevity
inc mental/physical wellbeing
reduces dis transmission/progression

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18
Q

LGBT- strategies to inc care

A

collect data
ask abt sexual orientation and gender id
provide culturally competent care
anti-bullying in schools/community
social services to dec suicide/homelessness in youth
interventions for HIV/STI

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19
Q

elder abuse risk factors

A

older age
women
low- modest financial resources
no family support/visiting
extreme dependence/frailty
mental/physical impairments

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20
Q

largest type of elder abuse

A

neglect

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21
Q

physical abuse

A

force that causes bodily injury, pain or impairment
ex. battery, assault, inapprop restraint

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22
Q

physical abuse perpetrators

A

family, spouse, intimate partner

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23
Q

behavioral abuse

A

manipulating, harassment, threaten, intimidate, isolate

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24
Q

s/s of beh. abuse

A

delay btw onset of injury and when seeking help

taken to diff. medical facil. each time
explanations for injuries differ

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25
Q

sexual abuse

A

sexual contact, comments or actions of any kind

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26
Q

sexual abuse s/s

A

don’t want to take clothes off, fearful, sti, bruises

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27
Q

elder abuse- barriers to reporting

A

fear
want to protect caregivers
social isolation (become conditioned)
self blame/denial
mental/physical impairment
lack of recognition of situation
worried about cost of care elsewhere
depression over situation
motivated to stay at home vs nursing home

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28
Q

elder abuse- primary prevention

A

support policy to prevent violence
crime watch
secure neighborhoods

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29
Q

elder abuse- secondary prevention

A

aps referrals
screening for IPV during visits
community services

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30
Q

elder abuse- tertiary prevention

A

coord agency interventions
mandatory reporting

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31
Q

domestic violence

A

escalating pattern of violence or intimidation; attempting to gain power or control

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32
Q

Domestic violence s/s

A

never alone, not allowed to make own decisions
isolated frm friends/family
no access to finances
not allowed to drive

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33
Q

neglect

A

failure to fufuill obligations to elder
ex. burnout, lack of knowledge
clothing unkept, no food, unclean, holding persons meds

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34
Q

neglect v self neglect

A

self neglect- failure by oneself to provide services to avoid threat
often isolated w/ no family contact
ex. hoarding

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35
Q

psychological/verbal abuse

A

infliction of mental/ emotional anguish by threat, humiliation or verbal/nonverbal conduct

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36
Q

psychological/ verbal abuse s/s

A

sad, fearful, timid, negative self image, withdrawn

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37
Q

financial exploitation

A

inc risk

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38
Q

financial abuse warning signs

A

lack of amenities victim could afford
elder voluntarily giving inapprop. financial reimbursement for needed care or companionship
caretaker living off elder
caretaker controls elders money
elder signed property transfers when physically unable or aware

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39
Q

warning signs of psychological abuse

A

caretaker isolates elder
caretaker is verbally aggressive, controlling, overconcerned about money

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40
Q

warning signs of physical abuse

A

inadeq explained frx, bruises, welts, cuts etc

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41
Q

warnings signs of neglect

A

lack basic hygiene, nutrition, medical aids, clothing
bed bound person left w/o care
dementia person unsupervised
home cluttered
untreated pressure sores
no utilities in the home

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42
Q

abuse reporting agencies

A

APS
long term care ombudsman- nursing home
law enforcement

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43
Q

hospice referral criteria

A

terminal condition
will die w/in next 6 mo
agreed to stop life saving treatments
CHF- EF
terminal cancer
non-verbal dementia
CKD

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44
Q

palliative care

A

approp at ANY time
alleviate symptoms
pain, SOB, n/v, fear of dying

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45
Q

example interventions- palliative care

A

scopolamine for secretions
ativan- anxiety, nausea, sob
d/c non essential meds
less restrictive diet

O2 and suction contraindicated

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46
Q

acute delerium- causes

A

new meds
infection (dental, UTI)
recent fall***
sleep changes

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47
Q

elder abuse- primary prev

A

policies

financial security
affordable housing/transportation

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48
Q

elder abuse- secondary prevention

A

detecting abuse early

making report easy
screening at routine visits

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49
Q

elder depression- protective factors

A
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50
Q

occ health purpose

A

prevention of dis/injury
promotion optimal health
productivity and social adjustment
(id trends before they affect lrger pops)

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51
Q

occ health focus shift

A

from ag to industrial/tech

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52
Q

occ health type of care focus

A

upstream interventions
health promotion

not so much reactive or emergency care anymore

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53
Q

impacts of injury at work

A

dec productivity
dec income

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54
Q

current working themes

A

longer hrs
compressed wrking weeks
reduced job security
1/3 of adult life spent at work

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55
Q

at risk occupations

A

ag
construction
health care (home health aids)
manufacturing
mining
oil
public safety
transportation (truck drivers)
wholesale (solar panels)

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56
Q

american disabilities act

A

employeer must make accommodations for persons with disabil
incl. DM

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57
Q

HP 2023 occ health goals

A

dec death, injury, stress, injury from repeated activity
skin irritants and hearing loss*

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58
Q

challenges of OHN

A

pressure from company to release wrkr when not appropriate
determinants complex
long latency periods (s/s can show up yrs later)

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59
Q

determinants complex

A

companies do not want to pay for exposure safety precaution equipment

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60
Q

occ health death/injuries trends

A

up recently

but overall have been trending down
coal mining fatalities dec 72%

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61
Q

biologic/ infectious agents

A

bacteria, virus, fungi, parasites

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62
Q

chemical agents

A

meds, solutions, gases, particulate matter

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63
Q

enviromechanical agents

A

ergonomic factors, lifting, slippery floors, repeated motions

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64
Q

physical hazards/agents

A

radiation, electricity, weather
Noise

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65
Q

ae working- shrt term (wks to months)

A

dermatoses (allergic/irritant)
ha
acute psychoses
respir problems
cardiac problems
abd pain
hepatitis

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66
Q

ae working- chronic

A

respir problems
cancer (lung, bladder)
periph neuropathy
behavioral changes
EPS/TD
aplastic anemia, leukemia

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67
Q

occ health plan elements

A

clinical services
environmental monitoring
survelliance
education
health promotion
referral
emergency preparedness

68
Q

occ health- hosts

A

workers and their families

69
Q

occ health- agents

A

bio chem, ergonomic, physical, psychosocial

70
Q

occ health- environment

A

all external factors

71
Q

occ health- risk assessment

A

population focused
emphasis- prevention

72
Q

factors that increase life expectancy

A

robust social network
physically/mentally healthy

73
Q

factors that dec life expectancy

A

self neglect
social isolation

74
Q

elder def

A

60+ yrs of age

75
Q

vulnerable adult def

A

60+ of (18+ if disability) who is being abused, neglected or exploited

76
Q

roles of school nurse

A

bridge HC and ed
provide care coord
advocate for quality student centered care

77
Q

school health services model

A

center- student
external factors- emergency care, care coord, family engagement, chronic dis mngmnt

78
Q

school nurse- actions for reporting suicidal thoughts

A
79
Q

common causes of anaphylaxis

A

`peanuts, tree nuts, shellfish, fish

80
Q

examples of SDOH that affect learning

A

poverty, food insecurity, educational quality, literacy, access to primary care, culture, exposure to neighb. violence, access to green space

81
Q

school nurse delegation

A

CAN delegate to unlicensed people
*anyone avaliable to help

82
Q

school nurses in MT

A

NOT required by law
98% MT students have no RN or too few nurses in the county
almost half of MT counties have no school nurse

83
Q

school nurse roles

A

direct caregiver
health educator (primary prevention)
communicable dis prevention
exclusion from school, referral to primary c
health screenings (if child isn’t screened it has to be reported to state w/in 10 days)

84
Q

case manager

A

coord of care for COMPLEX health problems
PT, OT, ST

85
Q

school health screenings

A

vision, dental, growth (BMI)
acute/chronic problem eval (student contacts and referrals)

86
Q

NASN standards of practice

A

dev school health p/p
eval own nursing practice
continuing ed

87
Q

grade school- common mortality

A

accidents, malignant neoplasm, congen. anomalies

88
Q

Junior high- common mortality

A

accidents, malg neoplasm, suicide

89
Q

high school- common mortality

A

accidents and injury, homicide, suicide

90
Q

common health problems- school

A

accidents, upper respir illness (influenza and pneumonia)
GI
schoolitis
asthma

91
Q

school nurse- conjunctivitis

A

inflamm of conjunctiva (muc mem covering front of eyeball)
bacterial (pink eye)
viral
allergic
chronic
trachoma/chlamydial
*eye drops are not a cure all
erythromyc eye drops contraindicated

92
Q

school nurse- chicken pox

A

viral dis
excluded from school until 6th day after rash appears
prevention- immunization

93
Q

YRBSS

A

youth risk beh surveillance system

monitors:
obesity
physical act
sexual beh
use/misuse of rx drugs
suicide

94
Q

school nurse- background causes of violence

A

??????

95
Q

reasons why elders are vul.

A

changes in mental status
social isolation
polypharm

96
Q

elder statistics

A

22% of yellowstone county is 60+
more than quarter of states pop will be seniors by 2030
“aging tsunami”- social and economic change- impact health c, retirement, housing, employment

rural counties have higher %

97
Q

effect of retirement on healthcare

A

retired ppl have less income, but utilize healthc more
= inc medicaid cost= inc state healthcare cost

98
Q

trends in school health

A

inc outbreaks r/t declining vaccines
need to do immuniz checks

99
Q

foster care- risk factors

A

hx of exposure to trauma
inconsist. management of health
(not all dr.’s accept medicaid)
lower educational attainment

100
Q

3 types of stress

A

positive
tolerable
toxic

101
Q

toxic stress

A

strong, freq stress response
w/ no protection via supportive, adult relationship

negatively effects brain dev

102
Q

traumatic stress

A

can include neglect
exposure can begin before birth

103
Q

toxic stress s/s

A

adhd, emotional dysreg, oppositional beh, reactive attachment dis

104
Q

trauma r/t genes

A

gene expression influenced by experience– epigenetics
inc trauma= inc severity/ longevity of issues

105
Q

ACE’s inc risk for

A

social factors
mental h issues
substance a
intimate partner violence
adopting risky beh as an adult

106
Q

foster care common concerns

A

aneurysis- bed wetting
caprices- soiling
attention/ sleep issues
mental h issues
PTSD

107
Q

nursing care for foster kids

A

ensure med recs are complete
schedule visits at critical times (bdays, court dates, etc)
focus on strengths- roster resilience
minimiz school absences
encourage relationships w/ adult mentors
refer to specialists

108
Q

types of homelessness

A

chronic (no supp. network, mental illn)
transitional (out of foster care, college, house forclosure)
episodic (couch surfing, temp jobs in new cities (migrant workers))

109
Q

antecedents of homelessness

A

divorce
low ed
parental mental illness
housing
poverty
lack of employment
lack of afford health care
addiction
mental illness

110
Q

homelessness- protective factors

A

community programs

111
Q

profile of homeless pop

A

majority are individ (65%)- many vets
35% families (has been increasing over the years)
31% youth

shelters-
50/50

112
Q

rural homeless profile

A

white
female
married
currently working
homeless for first time
stay homeless for shorter period

113
Q

homelessness- vulner and risk relationship

A

inc vulnerability (sub a, mental illness etc)= inc risk (poor economic status)
ex. when vulnerable bc of x reason ppl are hesitant to trust , therefore making them more prone to bad outcomes

114
Q

gentrification

A

demo of old housing and replace w/ new high-cost structures
displaces ppl

115
Q

homeless relationships

A

less likely to trust healthc workers
less likely to receive physical resources from school
often no family support

disaffiliation- inab form working relationships w/ o/ bc they cannot balance give/take

116
Q

VA in MT

A

MT has one of the largest pops of veterans
many of the indivi are women (number continues to rise)
however, % that utilizes VA is <50%

117
Q

women veteran profile

A

majority of the pop is around 55 yrs old

118
Q

VA- younger wmn concerns

A

childcare
reproductive health (1/4 experience sexual abuse, only 50% report), infertility
mental h, musculoskel, HTN, sleep apnea

119
Q

VA- middle age wmn concerns

A

bone density (preven care)
inc r/f mental h concerns bc they are sandwich gen.

120
Q

VA-older wmn concerns

A

pain mngmnt, inpt/extended care, grief couseling
DM, COPD, HTN, HF

121
Q

VA protective factors

A

policy
call centers (advocacy)
education
outreach

122
Q

roles of the VA nurse

A

education
outreach
advocacy

123
Q

Indian disparities

A

inadeq ed
dispropor poverty
economic adversity
poor social conditions
discrimm in del. of health services

124
Q

indian protective factors

A

education
policy (indian child protection and family violence prev. act 1990)

125
Q

indian historical trauma

A

leads to toxic stress and epigentic changes

126
Q

IHS locations

A

12 regions
35 states (mostly western)

127
Q

IHS services

A

health promotion
dis prev. services
immuniz services
etoh/substance abuse
mental h services
school health
NO long term care

128
Q

indian leading mortality causes

A

heart dis
malign neoplasms
unintent injuries
DM

129
Q

indian co-morb

A

mental h
chronic conditions (heart dis, dm, Ca)
tobacco use

130
Q

environment- upstream interventions (primary)

A

policy/ programs (climate change, clean air and water)
addressing social inequal

gov, schools

131
Q

environ- secondary prevn

A

physical environment (housing, land use, transportation)
smoking, nutrition, physical act

parks/housing

132
Q

environm- tertiary prev

A

infectious dis/ injury
mortality

hospitals/clinics

133
Q

effect of maintaining healthy environ

A

inc QOL and inc yrs of healthy life

134
Q

environm deaths

A

26% < 5 yrs old
23% total

135
Q

causes of environ death

A

exposure to hazard sub in air, water, soil or food
natural/tech disasters
climate change
occ hazards (pesticides, radiation)
built environmnt

136
Q

environm hazards

A

radioactive items
vaping
smoking
pesticides
flame retardants in bb products
BPA
thalidomide (causes birth defects)

137
Q

role of environm nurse

A

assess (community risk a, windshield survey)
diagnose
plan (policies in place?)
intervention
eval (immed v long term response)

138
Q

lead contamination

A

paint (50% composition in white paint 1950’s)= kids at risk
soil- lead in gasoline
water (easier to absorb than lead in food, 50% ingested by infants)= test well water

139
Q

s/s of lead toxicity

A

renal/nervous system damage
learning disability
hearing damage
speech, langu and beh problems
poor musc coord

screen btw age 1-2

140
Q

environ- factors that inc kids vuln

A

rapid cell grwth /division (metabolism)
higher metabolic rate= inc absorp)
close proximity to ground
low body weight
developing nervous system

141
Q

what pop if most effected by water quality if contaminated

A

immunosupp individuals
kids/elderly

142
Q

factors that put libby at inc risk

A

18% no health insurance
median income is half of US avg
more living below poverty line
small population

143
Q

concern w/ libby

A

exposure to vermiculite ore (contained in asbestos)
15-20 yr nonsymptomatic phase

144
Q

ae of environm impact on kids

A

asthma
adhd
depression
cancers (esp brain and nervous system)

145
Q

environm impact- vul pops

A

low income black communities
16% more at risk than whites
12% more at risk than high income areas

146
Q

prereqs for good health

A

clean air
stable climate
adeq water
sanitation and hygiene
safe use of chemicals
sound agricultural practices
preserved nature

147
Q

climate- children

A

r/f heat stroke and dehydr

148
Q

climate- changes in ecology

A

inc r/f vector borne dis (espec preg wmn (zika))

149
Q

climate- comm of color

A

exposure to multip pollutants
ca, respir dis

150
Q

climate- elderly

A

extreme events (weather or power outages)
heat stroke/dehydration

151
Q

climate- low income

A

r/f mental/physical illness
malnutrition

152
Q

climate- outdoor pollution ae

A

particulate matter causes
ca, respir dis, heart dis, stroke

153
Q

profile for ED visits d/t heat stroke

A

1/3 young men
many are athletes

154
Q

disaster trends

A

natural and man-made - continues to inc
deaths = dec
number of ppl affected= inc

155
Q

disaster mngmnt nursing role

A

prevention (mitigation)
preparedness
response
recovery

156
Q

disaster prevention

A

inspections, improved surveillance
immunizations
isolation/quarantine
halting of chemical, biologic, radiological or nuclear threats

157
Q

disaster preparedness

A

personal (disaster kits)
professional
community
national

158
Q

disaster response

A

first level- local
first responders (fire dep, law enforcement, public health, emergency services)

national incident mngmnt system

159
Q

ae of disasters

A

stress
mental illness
exac of chronic dis

160
Q

disaster response- phn role

A

triage
epidemiology and ongoing surv
rapid needs assessment
disaster comm
sheltering

161
Q

HIV screening

A

once btw ages 13-64
annually if IV drug use

162
Q

HIV at risk pops

A

multiple sex partners
IV drug use
youth 13-24
transgender and or black wmn
men who have sex w men
partner w/ HIV

163
Q

CD4 count <200

A

at risk for opportunistic infections
kaposis sarcoma (lesions on muc. mem linings of mouth, nose and throat and internal organs)
TB
oral candida
pneumonia

164
Q

HIV- undetectable viral load

A

cannot transmit HIV to sexual partners

165
Q

HIV transmission prevention

A

clean needles
condoms
PrEP (pre-exposure prohylaxis) meds
reduce # of sexual partners
get tested and treated for STDs
ART therapy if HIV positive
PRP after HIV exposure (w/in 72 hrs) (take daily for 28 days)

477- Public Health (2 decks)

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