Direct Data
Informant Interviews Participant Observation Windshield Surveys
Secondary Data
Use of existing data (statistics) --> Prevalence of disease Medical Records Health Surveys Morbidity/Mortality statistics
Substance Abuse Prevention Program
Teach skills to counteract peer pressure increases self-responsibility = awareness of various strategies to resist drug use
Oxygen Therapy
(1) Don't adjust the flow rate = could eliminate the client's hypoxic drive to breathe (2) Use when starting strenous exercise (3) Use non-petroleum based lip moisturizer on lips/nares (oxygen dries out pores) (4) contact provider when feeling SOB
Preschool Children
(1) May exhibit more aggressive behavior (2) Many have imaginary friends + are highly imaginative (3) Set limits on behavior
Steps to develop an education program
(1) Identify needs of community (2) Develop objective to be achieved with education (3) Select educational strategies that are appropriate for audience (4) Implement education
Intestinal Parasitic Disease
To prevent transmission wipe changing tables with a dilute bleach solution between children
Ethnocentrism
Tendency of people to view the world from the perspective of their own cultural background + viewpoint
Cultural Imposition
Process of forcing one group's cultural beliefs on others
Social Organization
Pattern of relationships among a cultural group + how that group structures itself to carry out role functions
Tracheostomy Post-Op
*Use tap water to clean inner cannula (clean technique) *Leave the old soiled ties in place until the new ones are secured to prevent accidental dislodging of the trach tube * Never place the thumb over the suction port while inserting the catheter (don't suction while inserting) * Insert the catheter 5 inches into the trach tube
How to prepare for outbreak of Avian Influenza
*Have a 2 week supply of food + water at home (may need to stay at home for several weeks to prevent spread) - Flu vaccine does not protect against Avian Influenza - Receive 2 injections of H5N1 vaccine 28 days apart when an outbreak occurs - Antivirals can minimize symptoms but do not prevent transmission
Immunizations for Infants
(1) Can give acetaminophen for fever after immunizations (2) A cold or other minor illnesses are not contraindications for receiving immunizations (3) Child needs MMR vaccine at 12 months (1 year) (4) Don't give influenza vaccine if have egg allergy
Cultural Assessment
* Religious Preference * Food Patterns * Health Practices (immunizations)
Asthma (inhaled corticosteroids + Prednisone)
(1) Use metered-dose inhaler attached to a spacer when taking corticosteroids (2) Pace activities depending on effort required for breathing (3) Avoid environmental triggers (4) Report the highest of 3 peak expiratory flow rates instead of average (5) Take prednisone until prescription is complete
Responsibility of Nurses
(1) Make referral in accordance with client's decision (respect autonomy) (2) Does not include verification of insurance coverage (3) Never provide advice (non-therapeutic + does not respect autonomy) (4) Do not assess families decisions (goes against confidentiality + autonomy)
Prefilled Epinephrine Injector for allergic reaction
(1) store at room temperature in a dark place (2) Remove gray tip to activate device --> Leave black tip on (covers spring-loaded needle) (3) First dose of epinephrine controls allergic symptoms for about 20 mins = after dose is administered transport to hospital immediately (4) Inject medication in outer thigh = can be injected through clothing
Best source of information about local safety concerns
Interviewing community members (Informant Interviews = provide specific information about community)
A community health nurse contributes to disaster preparedness by....
Organizing community-wide disaster drills * Planning + practicing drills will help people know what procedures to follow during a disaster
Rinne Test
Place a tuning fork behind ear, tell when no longer hear the sound (compares air conduction + bone conduction of sound)
Weber Test
Place tuning fork on scalp, tell if hear sound better in one ear or the other
* Whispered Voice Test
Initial screening to determine need for further testing of client's hearing (Use fingers to close one ear while whisper some numbers into other ear)
Audiometry
Precise measurement of hearing ability = wear headphones + press button when hear sound (hearing tones of various intensities)
Domestic Abuse Factors
(1) No link between race + abuse (2) No link between economic status + abuse (3) Child abuse is more common in homes where intimate partner abuse is present (4) Children who are abused are more likely to become abusers
Transmission of Active TB
(1) Household members should take Isoniazid (INH) for 6-12 months (2) Respiratory isolation is not necessary (3) Client with active TB should receive a chest x-ray for future screenings
Role of Case Manager
(1) Provide referral info Facilitates movement of client through health care system (2) Negotiation (3) Collaboration
Health Education Program Concerns
(1) Content should be organized to make it easier to comprehend + retain material (2) Majority of adults comprehend info at 8th grade level (3) Powerpoints are good sources of teaching = addresses both visual + auditory learners (4) More likely to benefit from a voluntary program since they have the choice to attend
Signs for meningococcemia
Vomiting, febrile, petechial rash (unstable)
Signs for rotavirus
Diarrhea, abdominal pain, fever of 99.4F
Levothyroxine effects
Used to restore client's metabolic rate * Toxic effects = heat intolerance, Tachycardia, Weight loss, Hypertension
Which agency is responsible for developing local disaster plan?
Office of Emergency Management (develops + coordinates emergency response plans within the defined area)
American Red Cross
Works with other agencies to provide a relief service after a disaster (not responsible for developing local disaster plan)
Department of Homeland Security
Focuses on protecting the US from threats + hazards
Centers for Public Health Preparedness
Provide emergency preparedness training to public health employees
Ways to prevent Osteoporosis
*Encourage women to participate in weight-bearing activities * Sun exposure --> absorption of Vitamin D --> Absorption of Calcium (prevents osteoporosis)
ADHD teaching
*Methylphenidate (1) Use a reward + consequence system throughout the day (have difficulty recognizing inappropriate behavior = provide positive feedback to minimize negative behaviors (2) Limit distractions to promote focus (no music) (3) Have a consistent routine daily (4) Better ability at focusing in the morning when on methylphenidate
Hip Arthroplasty Post-Op teaching
(1) Put antiembolic stockings on BEFORE getting out of bed (2) Use incentive spirometer every 2 hours (3) Do NOT place pillow under knee (increases risk for deep vein thrombosis) (4) Use an assistive device to retrieve items on floor (decreases risk for hip dislocation)
Multiple Sclerosis Patient Mitoxantrone SE's
Mitoxantrone IV every 3 months (chemo drug) * Report Sore Throat (greatest risk for client is severe infection due to myelosuppression from mitoxantrone) * Vomiting = causes dehydration * Hair Loss = emotional distress * Amenorrhea = emotional distress
What action should nurse take FIRST if there is a Scabies outbreak
Determine the incidence rate (determine # of new cases in community)
Utilitarian approach to ethical decision making
Considers ONLY the OUTCOMES or CONSEQUENCES in determining which choice to make (ex: A public health nurse examining potential negative consequences of proposed public policy)
Community health nurse functioning as an advocate
Serving on a community task force for suicide prevention (Supporting a course of action relative to a community health issue)
Role of nurse clinician
*Conducting cholesterol screening at senior center * Administer immunizations to a group of migrant workers
Age related health changes in older adults
(1) Decreased Sensitivity to Pain* = loss of neurons + nerve fibers = places older adults at increased risk for injury (2) Decreased peristalsis = delayed gastric emptying (3) Vision changes (presbyopia = hold near objects further away in order to be seen) + distance vision decreases (narrows client's visual field) (4) Decreased intellectual capacity is NOT an age-related health change
Osteoarthritis disease management strategy
(1) Take a hot shower or bath daily = improves joint mobility + pain (2) Get 8-10 hours of sleep + additional 1-2 hrs during the day (3) Consume well-balanced diet + weight loss can reduce severity of disease (4) Exercise Daily
Malnourished COPD patients
(1) Limit liquid intake at meal times (2) Consume foods w/ protein (like eggs) (3) Maintain an upright position (High Fowler's position) to promote ventilation (4) Use milk instead of water when making soup
Diagnosed with Syphilis
*Report the case to the state health department (reportable disease) * Refer student to provider (not appropriate to report the case to student's provider = breach of confidentiality + privacy) * DON'T notify parents * DON'T notify principal
Anger stage of grief process
Client exhibits increased anxiety + may project anger toward self + others "I don't deserve to die, this isn't fair"
Bargaining Stage of Grief Process
Client acknowledges the impending loss while remaining hopeful "If I could just make it through this, I'd never smoke again"
Acceptance stage of grief process
Client establishes coping strategies + accepts the impending loss "I'm going to plan my memorial service next week"
How should you respond when client wants to discontinue dialysis
"What has changed to make you decide this?" = Seek clarification from client to establish mutual understanding while staying therapeutic * Never ask "why" questions * Never make value judgements or give advice * Don't generalize client's statement = minimizes feelings
Parish Nurse's Role
Facilitating substance abuse support groups
Hospice Nurse's Role
Provide pharmacologic pain management for clients with terminal illness
Occupational Health Nurse Role
Plan safety services for employees at local workplace
Tertiary Prevention
Maximize recovery AFTER injury/illness (REHAB) *Nutrition Counseling * Exercise REHAB * Case Management of chronic illnesses * Physical Therapy * Support Groups *Exercise of hypertensive clients * Teaching a client with rheumatoid arthritis measure to prevent joint deformities * Teaching foot care to adults who have Diabetes
Secondary Prevention
Early detection + treatment of disease (goal = limit severity + adverse effects) * Community Assessments * Home safety checks * Disease Surveillance (communicable diseases) * SCREENINGS * Control outbreaks of communicable diseases (Implementing program to notify individuals exposed to a communicable disease)
HPV transmission
Direct Contact ONLY (1) Oral Contact (2) Sexual Contact
Which client's take priority when scheduling visits?
(1) ABC's = always airway first if compromised (2) Acute, new onset of symptoms
Captopril + SE's
Angiotensin-converting enzyme = converts Angiotensin 1--> 2 (treats HTN + Heart Failure) * Report Angioedema (fatal reaction) * SE's = Tachycardia, Wt. Loss * Dry Cough = from accumulation of bradykinin
Where does smallpox rash first appear?
FACE
Safety Information to parents of an Infant
(1) Keep bathroom doors closed to prevent accidental drowning (2) Crib slats need to be less than 2.375 inches apart to prevent accidental strangulation (3) Water heater should be no higher than 120F (49C) to prevent accidental burns (4) Clip pacifier onto clothing during naps (not around neck) to prevent strangulation
AIDS patients
(1) examine oral mucous membranes (candidiasis) (2) Watch for wasting syndrome (encourage client to consume 1.2 - 2.0 g/kg of protein daily) + Increase calorie intake by 25%
Medicaid eligibility
Low income + no insurance
What should the nurse do when one member of a support group expresses anger repeatedly?
Focus more on the group members who have a positive outlook (Speak to group member privately to uncover source of anger)
What should nurse do when a member of support group tries to monopolize (control) the discussion
Remind the group that everyone should have a chance to participate
What should nurse do when a member of support group remains silent throughout meetings?
Divide the group into pairs + give each pair a topic for discussion + Give member extra time to compose thoughts before expressing them
Tuberculin skin testing = false-negative results from...
(1) Advanced HIV or AIDS = immunocompromised patients who are unable to produce an immune response (2) Time between exposure + screening = 9 weeks following exposure (3) Age of client = older adults due to changes in immune system
Tuberculin skin testing = False-Positive results
(1) BCG Vaccination = up to 10 years following vaccination
Urgent vs Nonurgent Approach to Client Care
FIRST assess the NEED (collects data on client/community = program planning) *Needs of community determines all other steps of planning process*
Prevalence Proportion
# of EXISTING cases in population at specific time/Total population
Attack Rate
Population exposed to specific agent who develop the disease/ Total people exposed
Incidence Proportion
# of NEW cases in population at specific time/ Total population (Newly diagnosed)
Lead exposure teaching
(1) Increase amount of red meat + milk in child's diet (Increase IRON + CALCIUM to prevent lead absorption from environment) (2) Use Wet sanding technique to prevent aerosolizing lead particles (3) Wet mop wood floors (don't vacuum) to prevent aerosolizing lead particles (4) Use cold tap water when preparing infant formula since hot water dissolves lead more quickly from pipe
12-step programs
"At NA meetings, your willingness to change will be crucial for sobriety" (1) must be willing to make amends (2) People who have addictions are powerless over them (3) Disease theory = not responsible for their symptoms but are responsible for getting treatment for their diseases (4) Must be able to admit defeat + surrender to a higher power
Asthma Teaching
(1) Stay indoors during cold weather = triggers asthma (2) Still able to play sports (3) Rescue medication is used when experiencing an exacerbation (NOT DAILY) (4) Receive a flu shot to decrease risk of flu-related respiratory complications
Type 1 DM teaching
(1) Consult with dietician to determine appropriate school lunch for child (2) Eat a snack within 2 hrs of physical activity (3) DON'T provide info to insurance company (4) Test ketone levels when client is sick or blood glucose levels are elevated (not daily)
Primary Prevention
Prevention of the initial occurrence of disease/injury (DOES NOT have it) *Nutrition Education *Family planning/Sex education *Smoking education *Communicable disease education *Education about health + hygiene *Safety education *Prenatal education *Advocating for access to health care, healthy environments * Immunizations (prevents disease)
What med does Ginkgo Biloba effect?
Warfarin due to hindering coagulation properties
How do you report Lyme Disease?
Based on Individual State Law
What is the best strategy to determine if teaching was effective?
Demonstration on breast model
Roles of School Nurse
*Case Manager = schedule speech therapy + physical therapy appointments that do not interfere with academic schedule
School child is diagnosed with pertussis
(1) Instruct parent to keep child home until coughing stage has passed (when disease is most communicable) (2) Encourage family members to obtain prophylactic treatment (erythromycin, clarithromycin, azithromycin) (3) Check immunizations status of child's classmates (4) pneumococcal vaccine is not effective against pertussis
Peripheral IV vs (PICC) Peripherally inserted central catheter
(1) Central Cath can stay in place for a year or more (peripheral catheters must be replaced every 72 - 96 hrs) (2) Both can have clots but an anti-thrombolytic agent can dissolve a clot in PICC (peripheral IV = clot must be removed + replaced by nurse) (3) Both causes infections (4) PICC requires daily flushing to maintain patency
Primary Syphilis vs Secondary Syphyilis
Primary = Chancre (painless, ulcer) Secondary = Malaise, Maculopapular rash on palms + soles of feet, Lymphadenopathy
Risk Factors for Family Violence
(1) Attempting to END relationship with partner (2) Physical problems + cognitive decline = elder abuse (abusers thrive on dependence + codependence with victim (3) Substance use disorder (alcohol + drugs)
Hepatitis C
Disease affects the liver (usually asymptomatic) --> Cirrhosis * Transmitted through Blood + Bodily Fluids (sex) * Consume diet high in carbs + calories
Inhalation Anthrax
(1) Exposed person may develop dry cough, mild chest pain, fever, fatigue (2) Not transmitted from person to person (3) Tx = COMBO of ATB's (4) Fatality rate = 95 - 100%
Pollution effects on preschool children
(1) Children drink more water for their body weight (take in more toxins from water) (2) Kidneys filter at smaller rate in children (less able to filter out toxins that enter body) (3) Children breathe more rapidly (increases exposure to air pollutants) (4) Both indoor + outdoor pollutants increase frequency + severity of asthma attacks
Diabetes patient w/ Peripheral Neuropathy
(1) Test bath water w/ thermometer (prevent burns) (2) Wear shoes that extend 2.54 cm (1 inch) past longest toe (3) Don't use heating pads or ice packs (4) Inspect feet for areas of redness + skin breakdown daily (5) Monitor temperature of feet + lower extremities for changes
Public Health nurse.....
Reviews morbidity + mortality data for the community
Community Health Nurse...
(1) Cares for mothers + newborns (health of individuals, families, groups in community) (2) Review meds (individual + family illnesses) (3) Provide allergy shots (illness care)
What can help a hospice patient who has dyspnea?
A fan in the client's room (moves air which stimualtes trigeminal nerve + minimizes sensation of dyspnea)
When should you stop oral intake on a hospice patient?
When they experience noisy breathing
What immunizations are CONTRAINDICATED for pregnant women + which SHOULD be given?
Contraindicated = Herpes Zoster + Varicella + MMR (measles, mumps, rubella) Should give = TDaP (Tetanus, Diphtheria, Pertussis)
Patient recovering from a stroke
(1) Use a hand-held mirror to improve ability to see objects around you (altered visual perception + decreased visual fields) (2) Encourage self-care (3) Nurse manager should coordinate outpatient therapy BEFORE discharge (4) Dress + Care for affected side of body first to prevent unilateral body neglect
Which Virus(s) is NOT transmitted through Blood?
Hepatitis A + HPV
Which Virus(s) are transmitted through Blood?
HIV + Hep B + Hep C
Early stages of Alzheimers
(1) Difficulty Learning New things (2) Short term memory loss (3) Subtle changes in personality
Later stages of Alzheimers
(1) Withdrawal from social activities (2) Loss of language skills + moderate cognitive decline (3) Neglecting personal hygiene (lose ability + willingness to perform ADL's = bathing, grooming, dressing)
Long term effects of NSAIDS (Ibuprofen)
Gastric Ulcerations, perforations, hemorrhage, hypertension
Health Belief Model
Change at individual level Take an action to avoid disease
Milio's Framework for Prevention
Based on health belief model Change at COMMUNITY level Relationships between health deficits + resources Behavior changes w/ large number of people = social change
Community-Based Nursing Focuses on....
Individuals + Families Illness Care = manage acute/chronic conditions (1) Home health nurse performing wound care for client who is immobile (management of acute condition) (2) A school nurse teaching a student who has asthma about medications (management of chronic condition)
Community-Oriented Nursing Focuses on....
At-risk Individuals, Families, Groups + community Health Care: Determine HEALTH NEEDS of community, Intervene to improve collective health of community (1) Occupational Health nurse providing classes on body mechanics at a local industrial plant (2) A parish nurse teaching a class on low-sodium cooking techniques (3) A mental health nurse discussing stress management techniques with support group
Community Health Nursing Practice
Maintain health of population by delivering health services to individuals, families, groups to impact "community health" PREVENT + MAINTAIN Disease
Public Health Nursing Practice
Maintain health of population through disease + disability prevention + health protection of community as a whole - Assessment of health of populations - Development of policies to support health of populations - Ensuring essential health services are available to all persons
Distributive Justice
Fair distribution of benefits + burdens in society based on needs + contributions of members = eligibility for health care services based on income + fiscal resources
Epidemiology is the study of...
Health-related trends in populations * Based on statistical evidence to determine rate of spread of disease + proportion of people affected * Spread, transmission, incidence of disease + injury * Relationships among agent, host, + environment
Fidelity
Keeping commitments + following through with promises
Veracity
Concept of telling the truth
What are part of Host Factors in Epi Triangle?
* Ethnicity * Altered Immunity
Acculturation
Adapting to a new culture = changes in daily living practices * Merging w/ or adopting traits of a different culture *Change in language, education, work, recreation, social experiences, health care system
What is method for determining current + past environmental exposures?
"I PREPARE" I = Investigate potential exposures P= Present work R = Residence E = Environmental concerns (air, water, soil) P = Past work A = Activities (hobbies, activities) R = Referrals + Resources E = Educate (risk reduction, prevention, follow-up)
International Health Organizations
World Health Organization (WHO) * Provides daily info regarding occurrence of diseases * World standards for ATB's + Vaccines * Focuses on health care workforce + education, environment, sanitation, infectious diseases, maternal/child health, primary care
Medicare
Must be older than 65 + receiving Social Security or disability for 2 years A = Hospital + Home care B = Medical care + Diagnostic services C = Private insurance company (A + B) D = Prescription drug coverage
Medicaid
Provides health care coverage for individuals of low socioeconomic status + children *Eligibility based on household size + income *Inpatient + Outpatient hospital care, vaccines for children, family planning, screening, diagnosis, treatment of children younger than 21
State Health Agencies
State Departments of Health * WIC (Women, Infants, Children) programs *Medicaid program administration * Notifiable communicable diseases within state to the CDC
What is first action of cultural assessment?
Gather data about the client's cultural beliefs *Nutritional practices, family structure, health care interactions, views about illness
Local Health Department
Provide EDUCATION to achieve community health goals Coordinate directives from state personnel (1) Identify + intervene to meet health needs of local community (2) Work closely w/ local officials, businesses (3) Report notifiable communicable diseases to state departments of health
What is the foundation for community-specific program planning?
Community ASSESSMENT + DIAGNOSIS
6 Steps of Analyzing Community Assessment Data
(1) Gathering collected data into database (2) Assess completeness of data (3) Identify + generate missing data (4) Synthesize data + identify themes (5) Identify community needs + problems (6) Identify community strengths + resources
Informant Interviews
Direct conversations with individual community members for the purpose of obtaining ideas + opinions
What are aggregates?
Receive services from community health nurses *Individuals (infancy - death) * Families * Groups in community
What is priority of Hospice care?
CONTROLLING SYMPTOMS
Occupational Health Nurse Role
Health + Safety of Workers *Improvement + maintenence of health *OSHA *NACOSH = collects data on incidence + prevalence of occupational illness + injury
What is CIRCLE Model of Spiritual Care
C = Caring I = Intuition R = Respect for religious beliefs C = Caution L = Listening E = Emotional Support
Faith Community Nurse
(1) Missionary Nurse = promote health + prevent disease by meeting spiritual, physical, and emotional needs of people across the globe (2) Parish Nurse = Promote health + wellness of populations of faith communities (church members) (Holistic approach to healing = body, mind, spirit) - Liason between faith communities + local resources - Spiritual support (strengths for coping)
School Nurse Roles (7)
(1) Case manager = coordinates services for children with complex health needs (2) Community outreach = meet needs of all school-age children (3) Consultant = assists student, families, in info gathering + decision-making about health needs + resources (4) Counselor = Supports students (5) Direct Caregiver = nursing care to ill or injured (6) Health Educator = prepare people/community to make well-informed health decisions (7) Researcher = contributes to knowledge for school health + educational needs
Physical Agents in work-related illness/injuries
NOISE + LIGHTING
Biological Agents in work-related illness/injuries
Virus
Work site survey includes....
Work practices of employees as a WHOLE
Individual Assessment of individual potential for violence
*History of being abused * Low self-esteem * Poor self-control * Fear + Distrust of others * Inadequate social skills * Minimal social support * Weak coping skills
What is priority when dealing with abuse clients?
(1) Develop a plan for safety (2) Make referrals for community services
Alcohol Use Manifestations of Withdrawal
Body burns 0.5 oz of alcohol per hour * Withdrawal appears within 4-12 hours * Irritability + Tremors + Anxiety * Nausea + Vomiting + HA * Diaphoresis * Sleep Disturbances * TACHYCARDIA + HTN Use Benzodiazepines = tx
Health Issues of Homeless Populations
*Upper Respiratory Disorders * TB * Infestations (scabies, lice) * Dental Carries * Hypothermia + Heat-related illness * Malnutrition
Rural Residents .....
(1) Higher infant + maternal morbidity rates (2) Higher rates of DM (3) Higher rates of SUICIDE (4) Less likely to receive preventative care
Veterans in US
25 million veterans *2 million women * 9 million > 65 years old
What are signs of Child Neglect?
* Underweight = malnourished * Poor Hygiene
What are signs of Child Abuse?
* Healing spiral fracture * Burns on palms of hands
Nicotine Teaching
(1) Tolerance to nicotine develops quickly (2) Smoking is the FIRST preventable cause of death in the US (3) Nicotine is a CNS STIMULANT (4) Withdrawal effects from smoking are substantial = increase physical dependence
What is the FASTEST growing segment of homeless population?
Families with Children
Communicable Diseases: Airborne Transmission
Inhaled by susceptible host *Measles *Chickenpox *TB *Pertussis (whooping cough) *Influenza
Communicable Diseases: Foodborne
Bacterial, Viral, Parasitic infection of food *Salmonellosis *Hepatitis A = Oral/Fecal stool * Trichinosis * E.Coli
Communicable Diseases: Waterborne
Fecal contamination of water *Cholera * Typhoid Fever * Gardia lamblia
Communicable Diseases: Vector-borne
Via a carrier such as a mosquito or tick *Lyme Disease *Malaria *Rocky Mountain spotted fever
How does reporting communicable diseases work? Who mandates them?
Mandated by STATE + LOCAL regulations - State notification to CDC is VOLUNTARY
Bioterrorism : Category A
Highest priority: national security = easily transmitted + high mortality rates * Smallpox (variola) * Botulism toxin * Anthrax * Tularemia * Hemorrhagic viral fevers * Plague
Bioterrorism: Category B
Second-highest priority: Moderately easy to transfer + high morbidity/mortality rates * Typhus * Cholera
Bioterrorism: Category C
Third-highest priority: emerging pathogens that can be engineered for mass dissemination (easy to produce) + high morbidity/mortality rates * Hantavirus
Manifestations of Inhalational Anthrax
HA + Fever + Muscle Aches Chest discomfort + Severe Dyspnea Shock *IV ciprofloxacin (Cipro) prophylactically for exposure or high-risk of exposure * ATB's DO NOT stop the disease progression
Manifestations of Botulism
Difficulty Swallowing + Breathing Progressive Weakness Nausea/Vomiting/Abdominal Cramps *Airway management *Antitoxin *Supportive Care
Manifestations of Smallpox
High FEVER + Fatigue Severe HA + Vomiting RASH (beginning on FACE + TONGUE --> rest of body) = pus-filled lesions NO CURE Prevention = vaccine (10 years of immunity)
Portals of Entry (diseases)
ORGANS (1) Respiratory passages (2) GI Tract (3) Mucous Membranes (4) Skin (5) GU Tract (6) Eyes (7) Blood Vessels
Portals of Exit (diseases)
LIQUIDS (1) Respiratory SECRETIONS (2) Feces (3) Blood (4) Semen + Vaginal Secretions (5) Saliva (6) Skin lesion exudates
What is component of Disaster Prevention?
Identifying community vulnerabilities
What is component of Disaster Recovery?
Providing stress counseling
What is component of Disaster Preparedness?
Outlining specific ROLES of community agencies
What is component of Disaster Response?
Prioritizing care of individuals
What is main priority for continuity of care?
Partnerships within the community --> desired health outcomes *Groups partnering to elicit needed change
What is role of Consultant?
Specialized knowledge who provide expert advice, services, + information * Notify provider of client's needs * Seek expertise from health care professionals * Request expert opinions
What are the steps in the Referral Process?
Educating clients about community resources + self-care measures (1) Engage working relationship w/ client (2) Establish criteria for referral (3) Explore resources (4) Accept client decision to use given resource (5) Make the referral (6) Facilitate referral (7) Evaluate outcome
When does Discharge planning begin?
At Admission
Case Management nursing involves:
*Decreasing cost by improving client outcomes * Providing education to optimize health participation * Advocating for services + client's rights
Informatics
Combination of nursing science w/ information + communication technologies in delivery of nursing care *Electronic records, database, billing
Telehealth
Delivery of quality health care through the use of technology *Transfers information easily between providers improving access to health care * Allows nurses to provide care to clients at home * Transmission of physical data * Transmission of Audio data * Transmission of Visual Data
Lobbyists
Persuade or Influence legislators
Coalitions
Facilitation of goal achievement through collaboration of two or more groups
Public Office
Serving Society + Advocating for change by influencing policy development through public service
What is an example of consultant role?
Updating state officials about health needs of local community *Concerned w/ healthcare NEEDS of individuals, families, + groups within community
What is an example of a nurse acting as a change agent?
Advocating for federal funding of local health screening programs
What is an example of a nurse acting as a Case Manager?
Review available resources w/ the client
What is an example of a nurse acting as a Caregiver?
Performing health screenings for high blood pressure at local health fair
What is the FIRST step in referring a patient?
Identify referrals that the client NEEDS
What is an example of resource barrier?
(1) Costs associated w/ services (2) Attitudes of health care personnel (3) Physical accessibility of resources
What are client barriers?
(1) Decreased motivation (2) Inadequate knowledge of resources (3) Lack of transportation (4) Finances + Cultural Factors