Exam 2 Flashcards
(165 cards)
1
Q
sex
A
assigned at birth
someones biologic/chromosomal status
2
Q
gender
A
societal definitions that go with sex
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
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
5
Q
gender nonconforming (general)
A
umbrella term
gender expression or gender identity differs from sex
6
Q
genderqueer
A
gender id not align with binary understanding
“they, them”
7
Q
nonbinary identity
A
gender id is not exclusively male or female
ex. pangender or agender
8
Q
types of gender affirmation
A
social, psychological, medical and legal
9
Q
gender nonconformity
A
persons gender id differs from cultural norms
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
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
12
Q
LGBT disparities
A
access to healthcare
clinical preventative services
injury/violence
mental health
nutrition
obesity
physical activity
reproductive health
substance/tobacco abuse
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
14
Q
LGBT disparity- causes
A
stigma
personal risk beh
economic strain
lack of knowledge abt population by providers
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
16
Q
healthcare equality index
A
how equitably healthcare organizations trt LGBT ppl
can be used as assessment tool
17
Q
LGBT- benefits of addressing health concerns
A
reduced hc costs
inc longevity
inc mental/physical wellbeing
reduces dis transmission/progression
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
19
Q
elder abuse risk factors
A
older age
women
low- modest financial resources
no family support/visiting
extreme dependence/frailty
mental/physical impairments
20
Q
largest type of elder abuse
A
neglect
21
Q
physical abuse
A
force that causes bodily injury, pain or impairment
ex. battery, assault, inapprop restraint
22
Q
physical abuse perpetrators
A
family, spouse, intimate partner
23
Q
behavioral abuse
A
manipulating, harassment, threaten, intimidate, isolate
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
25
sexual abuse
sexual contact, comments or actions of any kind
26
sexual abuse s/s
don't want to take clothes off, fearful, sti, bruises
27
elder abuse- barriers to reporting
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
28
elder abuse- primary prevention
support policy to prevent violence
crime watch
secure neighborhoods
29
elder abuse- secondary prevention
aps referrals
screening for IPV during visits
community services
30
elder abuse- tertiary prevention
coord agency interventions
mandatory reporting
31
domestic violence
escalating pattern of violence or intimidation; attempting to gain power or control
32
Domestic violence s/s
never alone, not allowed to make own decisions
isolated frm friends/family
no access to finances
not allowed to drive
33
neglect
failure to fufuill obligations to elder
ex. burnout, lack of knowledge
clothing unkept, no food, unclean, holding persons meds
34
neglect v self neglect
self neglect- failure by oneself to provide services to avoid threat
often isolated w/ no family contact
ex. hoarding
35
psychological/verbal abuse
infliction of mental/ emotional anguish by threat, humiliation or verbal/nonverbal conduct
36
psychological/ verbal abuse s/s
sad, fearful, timid, negative self image, withdrawn
37
financial exploitation
inc risk
38
financial abuse warning signs
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
39
warning signs of psychological abuse
caretaker isolates elder
caretaker is verbally aggressive, controlling, overconcerned about money
40
warning signs of physical abuse
inadeq explained frx, bruises, welts, cuts etc
41
warnings signs of neglect
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
42
abuse reporting agencies
APS
long term care ombudsman- nursing home
law enforcement
43
hospice referral criteria
terminal condition
will die w/in next 6 mo
agreed to stop life saving treatments
CHF- EF
terminal cancer
non-verbal dementia
CKD
44
palliative care
approp at ANY time
alleviate symptoms
pain, SOB, n/v, fear of dying
45
example interventions- palliative care
scopolamine for secretions
ativan- anxiety, nausea, sob
d/c non essential meds
less restrictive diet
O2 and suction contraindicated
46
acute delerium- causes
new meds
infection (dental, UTI)
recent fall***
sleep changes
47
elder abuse- primary prev
policies
financial security
affordable housing/transportation
48
elder abuse- secondary prevention
detecting abuse early
making report easy
screening at routine visits
49
elder depression- protective factors
50
occ health purpose
prevention of dis/injury
promotion optimal health
productivity and social adjustment
(id trends before they affect lrger pops)
51
occ health focus shift
from ag to industrial/tech
52
occ health type of care focus
upstream interventions
health promotion
not so much reactive or emergency care anymore
53
impacts of injury at work
dec productivity
dec income
54
current working themes
longer hrs
compressed wrking weeks
reduced job security
1/3 of adult life spent at work
55
at risk occupations
ag
construction
health care (home health aids)
manufacturing
mining
oil
public safety
transportation (truck drivers)
wholesale (solar panels)
56
american disabilities act
employeer must make accommodations for persons with disabil
incl. DM
57
HP 2023 occ health goals
dec death, injury, stress, injury from repeated activity
skin irritants and hearing loss*
58
challenges of OHN
pressure from company to release wrkr when not appropriate
determinants complex
long latency periods (s/s can show up yrs later)
59
determinants complex
companies do not want to pay for exposure safety precaution equipment
60
occ health death/injuries trends
up recently
but overall have been trending down
coal mining fatalities dec 72%
61
biologic/ infectious agents
bacteria, virus, fungi, parasites
62
chemical agents
meds, solutions, gases, particulate matter
63
enviromechanical agents
ergonomic factors, lifting, slippery floors, repeated motions
64
physical hazards/agents
radiation, electricity, weather
Noise
65
ae working- shrt term (wks to months)
dermatoses (allergic/irritant)
ha
acute psychoses
respir problems
cardiac problems
abd pain
hepatitis
66
ae working- chronic
respir problems
cancer (lung, bladder)
periph neuropathy
behavioral changes
EPS/TD
aplastic anemia, leukemia
67
occ health plan elements
clinical services
environmental monitoring
survelliance
education
health promotion
referral
emergency preparedness
68
occ health- hosts
workers and their families
69
occ health- agents
bio chem, ergonomic, physical, psychosocial
70
occ health- environment
all external factors
71
occ health- risk assessment
population focused
emphasis- prevention
72
factors that increase life expectancy
robust social network
physically/mentally healthy
73
factors that dec life expectancy
self neglect
social isolation
74
elder def
60+ yrs of age
75
vulnerable adult def
60+ of (18+ if disability) who is being abused, neglected or exploited
76
roles of school nurse
bridge HC and ed
provide care coord
advocate for quality student centered care
77
school health services model
center- student
external factors- emergency care, care coord, family engagement, chronic dis mngmnt
78
school nurse- actions for reporting suicidal thoughts
79
common causes of anaphylaxis
`peanuts, tree nuts, shellfish, fish
80
examples of SDOH that affect learning
poverty, food insecurity, educational quality, literacy, access to primary care, culture, exposure to neighb. violence, access to green space
81
school nurse delegation
CAN delegate to unlicensed people
*anyone avaliable to help
82
school nurses in MT
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
school nurse roles
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
case manager
coord of care for COMPLEX health problems
PT, OT, ST
85
school health screenings
vision, dental, growth (BMI)
acute/chronic problem eval (student contacts and referrals)
86
NASN standards of practice
dev school health p/p
eval own nursing practice
continuing ed
87
grade school- common mortality
accidents, malignant neoplasm, congen. anomalies
88
Junior high- common mortality
accidents, malg neoplasm, suicide
89
high school- common mortality
accidents and injury, homicide, suicide
90
common health problems- school
accidents, upper respir illness (influenza and pneumonia)
GI
schoolitis
asthma
91
school nurse- conjunctivitis
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
school nurse- chicken pox
viral dis
excluded from school until 6th day after rash appears
prevention- immunization
93
YRBSS
youth risk beh surveillance system
monitors:
obesity
physical act
sexual beh
use/misuse of rx drugs
suicide
94
school nurse- background causes of violence
??????
95
reasons why elders are vul.
changes in mental status
social isolation
polypharm
96
elder statistics
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
effect of retirement on healthcare
retired ppl have less income, but utilize healthc more
= inc medicaid cost= inc state healthcare cost
98
trends in school health
inc outbreaks r/t declining vaccines
need to do immuniz checks
99
foster care- risk factors
hx of exposure to trauma
inconsist. management of health
(not all dr.'s accept medicaid)
lower educational attainment
100
3 types of stress
positive
tolerable
toxic
101
toxic stress
strong, freq stress response
w/ no protection via supportive, adult relationship
negatively effects brain dev
102
traumatic stress
can include neglect
exposure can begin before birth
103
toxic stress s/s
adhd, emotional dysreg, oppositional beh, reactive attachment dis
104
trauma r/t genes
gene expression influenced by experience-- epigenetics
inc trauma= inc severity/ longevity of issues
105
ACE's inc risk for
social factors
mental h issues
substance a
intimate partner violence
adopting risky beh as an adult
106
foster care common concerns
aneurysis- bed wetting
caprices- soiling
attention/ sleep issues
mental h issues
PTSD
107
nursing care for foster kids
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
types of homelessness
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
antecedents of homelessness
divorce
low ed
parental mental illness
housing
poverty
lack of employment
lack of afford health care
addiction
mental illness
110
homelessness- protective factors
community programs
111
profile of homeless pop
majority are individ (65%)- many vets
35% families (has been increasing over the years)
31% youth
shelters-
50/50
112
rural homeless profile
white
female
married
currently working
homeless for first time
stay homeless for shorter period
113
homelessness- vulner and risk relationship
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
gentrification
demo of old housing and replace w/ new high-cost structures
displaces ppl
115
homeless relationships
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
VA in MT
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
women veteran profile
majority of the pop is around 55 yrs old
118
VA- younger wmn concerns
childcare
reproductive health (1/4 experience sexual abuse, only 50% report), infertility
mental h, musculoskel, HTN, sleep apnea
119
VA- middle age wmn concerns
bone density (preven care)
inc r/f mental h concerns bc they are sandwich gen.
120
VA-older wmn concerns
pain mngmnt, inpt/extended care, grief couseling
DM, COPD, HTN, HF
121
VA protective factors
policy
call centers (advocacy)
education
outreach
122
roles of the VA nurse
education
outreach
advocacy
123
Indian disparities
inadeq ed
dispropor poverty
economic adversity
poor social conditions
discrimm in del. of health services
124
indian protective factors
education
policy (indian child protection and family violence prev. act 1990)
125
indian historical trauma
leads to toxic stress and epigentic changes
126
IHS locations
12 regions
35 states (mostly western)
127
IHS services
health promotion
dis prev. services
immuniz services
etoh/substance abuse
mental h services
school health
NO long term care
128
indian leading mortality causes
heart dis
malign neoplasms
unintent injuries
DM
129
indian co-morb
mental h
chronic conditions (heart dis, dm, Ca)
tobacco use
130
environment- upstream interventions (primary)
policy/ programs (climate change, clean air and water)
addressing social inequal
gov, schools
131
environ- secondary prevn
physical environment (housing, land use, transportation)
smoking, nutrition, physical act
parks/housing
132
environm- tertiary prev
infectious dis/ injury
mortality
hospitals/clinics
133
effect of maintaining healthy environ
inc QOL and inc yrs of healthy life
134
environm deaths
26% < 5 yrs old
23% total
135
causes of environ death
exposure to hazard sub in air, water, soil or food
natural/tech disasters
climate change
occ hazards (pesticides, radiation)
built environmnt
136
environm hazards
radioactive items
vaping
smoking
pesticides
flame retardants in bb products
BPA
thalidomide (causes birth defects)
137
role of environm nurse
assess (community risk a, windshield survey)
diagnose
plan (policies in place?)
intervention
eval (immed v long term response)
138
lead contamination
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
s/s of lead toxicity
renal/nervous system damage
learning disability
hearing damage
speech, langu and beh problems
poor musc coord
screen btw age 1-2
140
environ- factors that inc kids vuln
rapid cell grwth /division (metabolism)
higher metabolic rate= inc absorp)
close proximity to ground
low body weight
developing nervous system
141
what pop if most effected by water quality if contaminated
immunosupp individuals
kids/elderly
142
factors that put libby at inc risk
18% no health insurance
median income is half of US avg
more living below poverty line
small population
143
concern w/ libby
exposure to vermiculite ore (contained in asbestos)
15-20 yr nonsymptomatic phase
144
ae of environm impact on kids
asthma
adhd
depression
cancers (esp brain and nervous system)
145
environm impact- vul pops
low income black communities
16% more at risk than whites
12% more at risk than high income areas
146
prereqs for good health
clean air
stable climate
adeq water
sanitation and hygiene
safe use of chemicals
sound agricultural practices
preserved nature
147
climate- children
r/f heat stroke and dehydr
148
climate- changes in ecology
inc r/f vector borne dis (espec preg wmn (zika))
149
climate- comm of color
exposure to multip pollutants
ca, respir dis
150
climate- elderly
extreme events (weather or power outages)
heat stroke/dehydration
151
climate- low income
r/f mental/physical illness
malnutrition
152
climate- outdoor pollution ae
particulate matter causes
ca, respir dis, heart dis, stroke
153
profile for ED visits d/t heat stroke
1/3 young men
many are athletes
154
disaster trends
natural and man-made - continues to inc
deaths = dec
number of ppl affected= inc
155
disaster mngmnt nursing role
prevention (mitigation)
preparedness
response
recovery
156
disaster prevention
inspections, improved surveillance
immunizations
isolation/quarantine
halting of chemical, biologic, radiological or nuclear threats
157
disaster preparedness
personal (disaster kits)
professional
community
national
158
disaster response
first level- local
first responders (fire dep, law enforcement, public health, emergency services)
national incident mngmnt system
159
ae of disasters
stress
mental illness
exac of chronic dis
160
disaster response- phn role
triage
epidemiology and ongoing surv
rapid needs assessment
disaster comm
sheltering
161
HIV screening
once btw ages 13-64
annually if IV drug use
162
HIV at risk pops
multiple sex partners
IV drug use
youth 13-24
transgender and or black wmn
men who have sex w men
partner w/ HIV
163
CD4 count <200
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
HIV- undetectable viral load
cannot transmit HIV to sexual partners
165
HIV transmission prevention
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)
