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NRSG 477 > Exam I > Flashcards

Exam I Flashcards

1
Q

How was health/illness perceived pre 1800s?

A

It was perceived as religious/moral forces

  • Epidemics
  • Did not understand the causes of disease
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2
Q

Lillian Wald

A

Coined “public health nurse:

  • Henry street settlement
  • First school nurse and after school program
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3
Q

Late 20th century public health focused on what?

A

Chronic illness/disease and increasing life expectancy

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4
Q

2000+ public health efforts

A

Emergency preparedness

Growth in public health and policy

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5
Q

Public health mandates

A
  • Communicable diseases
  • Environmental issues
  • Prevalent illnesses
  • Health behaviors
  • Disaster and recovery
  • Quality and accessibility
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6
Q

Health impact pyramid

A

Going up: Increasing individual effort needed
Going down: Increasing population impact
- Utilization of the social determinants of health

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7
Q

What are essential services of the public health wheel?

A

Assurance ( evaluate ), assessment and policy development ( mobilize )

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8
Q

How is public health achieved?

A

Via local health departments

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9
Q

State health department functions

A
  • Funding oversight
  • Health codes regulations
  • Creating partnerships assistance to local health departments.
  • Not as much direct care
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10
Q

Federal public health

A
  • Money
  • Assessment
  • Standards/practices
  • Coordinate report cards
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11
Q

What are the three CORE FUNCTIONS of public health***

A

Assurance
Policy development
Assurance

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12
Q

Social marketing in public health

A

Inform, educate, and empower about health issues

-providing accessible health information resources at community levels

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13
Q

Community collaboration in public health

A

Mobilize partnerships t ID and solve health problems

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14
Q

Principles of partnership

A

Mission
Trust and respect
Strengths, assets and areas of improvement
Open communication

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15
Q

Policies and plans that support individual and community health

A
  • Systematic planning
  • Tracking measurable outcomes
  • Developing codes, regulations and legislation
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16
Q

T/F: Link people to services and provide health care only when available

A

False: Link people to services and provide health care when unavailable

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17
Q

T/F: Enforce laws and regulations that protect health and ensure safety

A

True

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18
Q

Public health worker characteristics

A
  • Ability to deal with complex problems
  • Tolerating ambiguity
  • Focusing on big picture
  • Commitment to the work
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19
Q

Important themes in PHN

A 
Confidentiality
Privacy
Autonomy
Ethics-available to all
Resilience
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20
Q

Home visits: Skilled Care

A

Reimbursable by Medicare
-Short term/acute-care focused; usually direct nursing care.
-

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21
Q

Is skilled care reimbursable by Medicare?

A

Yes

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22
Q

Home visits: Care Management

A

Funded privately or through Medicaid

  • Services of nurse/social worker/case manager
  • Focus is on chronic health problems including mental
  • Focus on maintaining client in home via prevention and referral to services
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23
Q

T/F The nursing student must always communicate with care manger before offering new services or appliances

A

True

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24
Q

The focus on chronic health problems and maintaining the client within the home via prevention and referrals is characteristic of which type of home visiting service?

A

Care management

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25
Q

How is care management paid for?

A

Privately or via Medicare

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26
Q

What are the two types of Home visiting?

A

Skilled care and Care management.

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27
Q

Why home visits?

A

Not everyone can come in to seek needed care
Opportunity to interact with clients in their own environment.
More cost-effective
Independence in nursing practice

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28
Q

Advantages to home visiting

A

Access to debilitated
Awareness of the quality of family life
Family less anxious, increased readiness to learn

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29
Q

Challenges and barriers of home visiting

A

Finding privacy

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30
Q

T/F: It is not essential that the nurse be focused and prepared when making home visits- not simply a social call

A

False: It IS essential

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31
Q

Disadvantages to home visiting

A

May have increased distractions from family members
Clients may be difficult to reach by phone, may be HOH
Often need to problem solve independently

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32
Q

Components of home visits

A 
Preparation- scheduling when and where
Introduction
Build trust
Interventions
Closure- summarize and set next appt
Charting & documentation completed per agency policy
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33
Q

How can a nurse build trust?

A

Consistency, keeping things private, confidentiality

34
Q

What are the types of home visiting agencies?

A 
Private, non-profit
Proprietary
Official
Hospital-based
Combination
35
Q

Current issues in public health: Home visiting

A 
Indigent care
Discharge planning
Use of technology in the home
Family and nurse stressors
Lack of adequate funding
36
Q

Oasis-C Goal

A

Goal is to demonstrate cost effectiveness; Measures of clinical outcomes

  • Diabetic foot care, pain management
  • Areas foci include nurse specific measures
37
Q

Who is the father of Epidemiology

A

John Snow; Cholera

38
Q

Reliability

A

Precision; consistency or repeatability

39
Q

Validity

A

Accuracy; is it measuring what its supposed to measure

40
Q

Something that measures what is supposed to measure is reliable or valid?

A

Valid

41
Q

Some that is consistent or repeatable is reliable or valid?

A

Reliable

42
Q

Infectivity

A

Ability to cause infection

43
Q

Virulence

A

Ability to produce illness

44
Q

Secular patterns

A

Long term patterns of mobility and mortality that reflect LONG TERM PATTERNS of social behavior or health practices.
-Changes over time; STI’s, HIV, depression

45
Q

Point epidemic

A

One temporal and spatial pattern of disease distribution

-sharp increase in time from outbreak

46
Q

Cyclical patterns

A

Cyclical time patterns of disease; seasonal

- Flu season

47
Q

Epidemic

A

Occurrence of a disease in a community or region in excess of normal expectancy
“outbreak”- more than the baseline number

48
Q

Pandemic

A

An epidemic occurring worldwide and affecting large populations

49
Q

Epidemiology

A

Study of distribution and determinants health related states or events in specified populations and the application of this study to control health problems.

50
Q

What are the two type of epidemiologic studies?

A

Descriptive and analytic

51
Q

Descriptive epidemiologic study

A

Seeks to identify disease entity according to PERSON, PLACE, and TIME; used in food born illness outbreaks

52
Q

Analytic epidemiologic study

A

Seeks to understand the etiology of disease; may be prospective or cohort study.

  • What are the causes of disease, ID risk factors
  • Cross sectional, retrospective, case control study, prospective cohort
53
Q

Food born illness outbreaks are usually descriptive or analytic?

A

Descriptive

54
Q

What are the three points on the epidemiologic triad?

A

Agent, host and environment

55
Q

Epi triad: Host characteristics (3)

A
  1. Genetic susceptibility- based on DNA
  2. Immune characteristics- Age, race, ethnicity, chromosomal makeup.
  3. Life style factors- Diet, education, activity, tobacco use, sexual practices, occupation, where you live
56
Q

Epi triad: Environment

A

Climate
Flora and Fauna
Population density
Socioeconomic factors

57
Q

Epi triad: Agents

A

Chemical, biological or psychosocial

  • Infectivity
  • Pathogenicity
  • Virulence
  • Invasiveness
58
Q

How do we prove relationships among variables?

A

We can’t prove but we can demonstrate a correlation

  • lung cancer and smoking
  • HIV and IV drug use
59
Q

Web of causation

A

All diseases and states of health have multifactor components and dimensions

60
Q

Example of web of causation: HTN why?

A

HTN can be caused by familial, weight, NA+ intake, stress, decreases physical activity etc.

61
Q

Epidemiologic factors/disease investigation steps (7)

A

1) Establish that a problem exists
2) Confirm homogenetity of events
3) History
4) Characterize events as epi, factors: person, place, time
5) look for patterns trends
6) formulate hypothesis
7) Test hypothesis

62
Q

Prevalence rates

A

A measure of existing disease in population at a given time

63
Q

When would you use a prevalence rate?

A

CHRONIC conditions; HIV, asthma, COPD, HTN, obesity, depression

64
Q

Incidence

A

Proportion of the population at risk who experience a new health event.

  • Acute and resolves
  • Influenza, norovirus, pertussis, teen pregnancy
65
Q

**Crude mortality

A

proportion of population that died in a given time frame (ALL DEATHS)

66
Q

Case fatality

A

Number of deaths d/t SPECIFIC cause

67
Q

Infant mortality

A

Number of deaths before ONE YEAR; in comparison to live births.
- A good measure of healthcare

68
Q

T/F An attack table does not allow us to find causation but shows relationships

A

True

69
Q

Odds ratio values
1 =
>1 =
< =

A 
1 = equal chance to
>1 = greater likelihood
<1 = not as associated with
70
Q

Attack table

A

Used in foodborne illnesses to ID offending food source

-List food products and determine percentages of those eating food who became ill.

71
Q

Community concepts

A

Place
People or person
Function
Each community is unique and the defining characteristics will affect your partnership

72
Q

Data analysis

A

Status
Structure
Process
Survey findings

73
Q

Data analysis: Status

A

Vital Statistics of population; literature review, health risk of group

74
Q

Data analysis: Structure

A

How are they structured

75
Q

Data analysis: Process

A

How community engages it members; engage around health issues.

76
Q

Data analysis: Survey finding

A

Creating a short survey

-What do they think issues are

77
Q

What are the first steps of the community assessment project

A

1) select population
2) probable health issues–> Healthy people 2020 objectives
3) Develop questions that relate to healthy people 2020 objectives

78
Q

CAP: Assessment process

A

Data collection- using systematic approach with goal to obtain usable information about the community and its health.

79
Q

CAP: What is the first step?

A

Gaining entrance into your population

80
Q

CAP: Preparation

A

Familiarize
Community observation
Volunteer to participate in activities to gain trust

81
Q

CAP: Evaluation

A

Important to gain input of community
Be honest with regard to what could be improved
Project evaluation tool included in guidance

NRSG 477 (11 decks)

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