Community Health ATI

Highlights the relationship between an individual's environment and health. Depicts health as a continuum. Emphasizes preventative care.

purpose is to predict or explain health behaviors. Preventative health to avoid disease. Emphasizes change at the individual level.

Complements the health belief model. Emphasizes change at the community level. Identifies relationship between health deficits and availability of health-promoting resources. Theorizes that behavior changes within a large number of people can ultimately lead to social change.

an aggregate who shares one or more personal characteristics within the community is the client in community health nursing

focus: individuals and families Activities: management of acute and chronic conditions where individuals, families, groups live, work and attend schools.

Focus: at risk individuals, families, groups. Community. Activities: determining the health needs of a community, and intervening at the individual, family, and group level to improve the collective health of the community.

Focus: synthesis of nursing and public health theory. Activities: Promote, preserve, and maintain the health of populations by the delivery of health services to individuals, families, and groups in order to impact "community health"

Focus: synthesis of nursing and public health theory Activities: promote, preserve, and maintain the health of populations through disease and disability prevention and health protection of the community as a whole. Core functions: systematic assessment of the health of populations development of policies to support the health of populations ensuring that essential health services are available to all persons

individuals select those actions that fulfill their goals

no harm is done when applying standards of care

to do good and max benefits

fair distribution of the benefits and burden in society

the nurse plays the role of informer, supporter, and mediator for the client. Clients are responsible for their own health.

study of health-related trends in populations for the purposes of disease prevention, health maintenance, and health protection. Relies on statistical evidence to determine the rate of spread of disease and the proportion of people affected. BROAD understanding of the spread, transmission, and incidence of disease and injury.

study of the relationships among an agent, a host, and an environment (epidemiological triangle)

animate or inanimate object that causes disease

living being that is affected by the agent

setting or surrounding that sustains the host

number of new cases of disease

number of existing cases of disease in the population

number of deaths divided by the population total

number of infant deaths before 1 year of age in a year divided by the numbers of live births in the same year time 1,000

when the rate of disease exceeds the usual level of the condition in a defined population

Prevention of the initial occurrence. Education, immunizations, prenatal classes.

limiting severity and adverse effects. Screenings, community assessments.

Recovery after an illness. Nutrition counseling, case management, exercise for hypertensive clients.

is impacted by the availability of services in a community, as well as individual, family, and community circumstances

provides daily information regarding the occurrence of internationally important diseases. Establishes world standards for antibiotics and vaccines. Primarily focuses on health care workforce and education, environment, sanitation, infectious diseases, maternal and child health, and primary care.

U.S. department of health and human services -under direction of the secretary of health -funded through federal taxes Consists of Children and Families, community living, Medicare and medicaid, HIPPA, SSI, AFDC

older than 65 and receiving social security, have been receiving disability benefits for 2 years, have amytrophic lateral sclerosis, and receive disability benefits, or have kidney failure and be on maintenance dialysis or had a kidney transplant to qualify. Part A - hospital care, home care, limited skilled nursing care Part B - medical care, diagnostic services, physiotherapy Part C - Medicare advantage plan - is a combo of Part A and Part B and is provided through a private insurance company Part D - Prescription drug coverage

coverage for low socioeconomic status and children, through the federal and state governments. Eligibility is based on household size and income. Priority to children, pregnant women, and those who are disabled.

Manages women, infants and children (WIC) program oversees children's health insurance program, which offers expanded health coverage to uninsured children whose families do not qualify for Medicaid. Establishes public health policies. Provides assistance to public health departments. Responsible for the administration of the medicaid program. Reports notifiable communicable disease within the state to the CDC.

development and oversight of the state's nurse practice act. Licensure of registered and licensed practical nurses. Oversight of the state's schools of nursing.

primary focus is the health of its citizens. offer various services and programs. Report notifiable communicable diseases to state departments of health. funded through local taxes with support from federal and state funds.

direct discussion with community members for the purpose of obtaining ideas and opinions from key informants. Strengths: no cost Limitations: built-in bias

open public meeting Strengths: community input Limitations: challenging to get participation

use of existing data (death statistics, birth statistics, census data, mortality, health records) Strengths: ability to trend health issues over time Limitations: data might not represent current situation

observation of formal or informal community activities. Negative - bias, time-consuming

descriptive approach that assesses several community components by driving through a community.

directed talk with a representative sample.

specific questions asked in a written format.

people place location of health services natural environment housing social systems

Gather collected data assess completeness of data ID and generate missing data synthesize data and id themes ID community needs and problems ID community strengths and resources

nursing care to clients were they reside. this includes traditional homes, assisted living facilities, and nursing homes. Functions as education, provider of skilled nursing interventions, and coordinator of care.

skilled assessment, wound care, lab draws, med education and administration, parenteral nutrition, IV fluids and medication, central line care urinary catheter insertion and maintenance. Must also evaluate the living environment for safety, paying close attention rugs, electrical outlet, and extension cords, use of oxygen, safety devices in the bathroom. Also educate the client when to contact ER.

enhances the quality of life through the provision of palliative care, supporting the client and family through the dying process, and providing bereavement support to the family following the client's death. Relief of pain and suffering and enhance of QOL. The hospice nurse may work with the family for up to 1 year following the death of a client.

assess the ricks for work-related illness and injury, plan and deliver health and safety services in the workplace, facilitate health promotion activities that lead to a more productive workplace

occupational host - worker characteristics, such as job inexperience, age, and pregnancy occupational agent - biological agents (viruses, bateria, fungi, pathogens), chemical (smoke), mechanical agents (musculoskeletal or other strains from repetitive motions, poor workstation worker fit, lifting heavy loads), physical agents (temperature extremes, vibrations, noise, radiation, lighting), physiological agent (threats to psychological or social well-being resulting in work-related stress, burnout, and violence) Occupational environment factors - physical (heat, odor, pollution), social (sanitation, overcrowding) psychological (addictions, stress)

Primary prevention- teaching good nutrition and knowledge of health hazards, immunizations, and use of protective equipment Secondary prevention- ID workplace hazards, early detection through health surveillance and screening, counseling and referral Tertiary prevention- restoration of health through rehab

develops and enforces workplace health regulations to protect the safety and health of workers

gathers data on the incidence and prevalence of occupational illness and injury. Prevention education related to occupational injury and illness, as well as determining hazards associated with new workplace technologies.

work with a group of clients who share common faith traditions. Circle model of spiritual care: CIRCLE Caring Intuition Respect for religious beliefs and practices Caution Listening Emotional support

seeks to promote health and prevent disease by meeting spiritual, physical , and emotional needs of people across the globe.

promotes the health and wellness of populations of faith communities. The population often includes church members and individuals and groups in the geographical community.

case manager - coordinates comprehensive services for children who have complex health needs. Community outreach - strives to meet the needs of all school-age children by cooperative planning and collaboration between the educational system. Consultant - assists students, families, and personnel in information gathering and decision-making about a variety of health needs and resources. Counselor - supports students on health needs direct caregiver - provides nursing care to all ill or injured children at school health educator - helps prepare children, families, school personnel and the community to make well-informed health decisions

often related to substance use, usually committed by someone known to the victim. Abuse often precedes homicide within families. Increasing among adolescents

males more likely to be assaulted, youths at higher risk

majority of violence against women is intimate partner violence. Incidence occurs higher in cities, between 8 pm-2 am, on weekends, and in summer months

women report attempting suicide more often than men. Rates are highest in men and individuals over the age of 65. Risk factors for suicide include depression or other mental disorders, substance use and intimate partner issues.

Neglect: lack of physical care, such as food, shelter, hygiene. Emotional are (interacting with child), education for child, needed health or dental care.

Hx or being abused or exposed to violence, low self-esteem, fear and distrust of others, poor self-control, inadequate social skills, minimal social support, immature miscarriage, weak coping skills.

unusual fear of the nurse, injuries not mentioned in hx, fractures including older healed fractures, subdural hematoma, trauma to genitalia, malnourishment or dehydration, inappropriate dress for weather conditions, considered to be a "bad child"

unexplained physical injuries, physical neglect, rejection of assistance by caregiver, financial mismanagement, withdrawal.

work stress, unemployment, media exposure to violence, crowded living conditions, poverty, feelings of powerlessness, social isolation, lack of community resources

Denial: defensiveness, lying about use, minimize use, blaming use, intellectualizing.

depressant, dulls the senses to outside stimulation and sedates the inhibitory centers in the brain.

body burns about 0.5 oz of alcohol per hr. alcohol withdrawal appears within 4 to 12 hours.

irritability, tremors, nausea, vomiting, headaches, diaphoresis, anxiety, sleep disturbances, tachycardia, elevated blood pressure. Use benzodiazepines for symptoms.

nicotine creates feeling of alertness and energy.

Primary- increasing public awareness Secondary- identify at risk individuals and assist them to reduce sources of stress. screen for substance use. Tertiary- refer client to community groups, AA. Provide emotional abusers including positive reinforcement.

High risk substance use disorders, high suicide risk.

Primary- educate populations regarding mental health issues, teach stress-reduction techniques, parenting classes. Secondary- screen to detect mental health disorders, conduct crisis intervention Tertiary- medication monitoring, interventions, referrals

Leading causes of death are acute respiratory infections (pneumonia and influenza), AIDS, diarrheal diseases, tuberculosis, malaria, measles.

young children, older adults, immunosuppressed clients, clients who have a high-risk lifestyle, international travelers, health-care workers

Measles, chickenpox, tuberculosis, pertussis, influenza

Salmonellosis, Hepatitis A, Trickinosis, E.coli

cholera, Typhoid fever, bacillary dysentery, Diardia Iamblia

Lyme disease, rocky mountain spotted fever, malaria

Sexually transmitted infections (HIV , gonorrhea, syphilis, genital herpes, hepatitis B, C, D), infectious mononucleosis, enterobiasis (pinworm), Impetigo, lice, scabies

respiratory passages, GI, Skin, mucous membranes, genitourinary tract, eyes, blood vessels

respiratory secretions, feces, blood, semen, vaginal secretions, saliva, skin lesion exudates

protection due to the immunity of most community members making exposure unlikely

Natural defense mechanisms of the body to resist antigens or toxins

develops through actual exposure to the infectious agent

production of antibodies by the body in response to infection or immunization with a specific antigen

transfer of antibodies to the host either transplacentally from mother to newborn, or through transfusions of immunoglobulins, plasma proteins, or antitoxins

prevent the occurrence of infectious disease, educate the public regarding the need for immunizations, counsel clients traveling to other countries about protection from infectious disease. Refer to immunizations.

increase early detection through screening and case finding, refer suspected cases of communicable disease for diagnostic confirmation and epidemiological reporting, provide post exposure prophylaxis (hep A, rabies), quarantine clients

Decrease complications and disabilities due to infectious diseases through treatment and rehab.

Activities to prevent natural and man-made disasters, increase surveillance, improve inspections and airport security, strengthening public health processes such as immunizations, isolation, and quarantine. Strengthen barriers to prevent flooding and teaching methods of preventing communicable disease transmission. ID and assess population populations at risk.

Stem from threats and vulnerabilities identified in the prevention level, and should coordinate community efforts as well as outline specific roles of local agencies. This level of management includes preparedness of natural or man-made disasters. Create an action plan and determine alternative methods of communication, highlight evacuation plans, ID local and distant meeting places, disaster kit. Set up communication protocol; should provide access to American Red Cross, and state and federal government agencies. Disaster drills.

FEMA, CDC, U.S. Department of Homeland Security, American Red Cross, Office of Emergency Management, public health system. If a federal emergency is declared, the National Response Framework is activated and provides direction for an organized, effective national response.

Begins when danger no longer exists and needed representatives and agencies are available to assist with rebuilding. Communicable disease and sanitation are important aspects of disaster recovery.

Heroic - intense excitement and concern for survival. Rush for assistance. Honeymoon- affected individuals being to bond and relive their experiences. Disillusionment - responders may experience depression and exhaustion. Delays in receiving aid. Reconstruction- involves adjusting to a new reality and continued rebuilding of the area. Counseling may be needed.

highest priority, posing risk to national security because easily transmitted and have high mortality rates. Ex: smallpox (variola), botulism, anthrax, tularemia, hemorrhagic viral fevers, plague

second-highest priority because they are moderately easy to disseminate and have high morbidity(disease) rates and low mortality (death) rates. Ex: typhus and cholera

third-highest priority, emerging pathogens that can be engineered for mass dissemination because they are easy to produce, and/or have a potential for high morbidity and mortality rates. Ex: hantavirus

headache, fever, muscle aches, chest discomfort, severe dyspnea, shock. Give: IV Cipro

difficulty swallowing, weakness, nausea, vomiting, difficulty breathing. Give: airway management, antitoxin, eliminate the toxin, supportive care

high fever, fatigue, severe headache, rash (BEGINS of face and tongue, quickly spreads to trunk, arms, legs, hands, feet) then turns into pus-filled lesions, vomiting. Give: treatment - no cure, supportive care- hydration, pain meds, antipyretics. Prevention: vaccine (10 years of immunity)

fever, hemorrhage, vomiting, diarrhea, cough, jaundice, shock. Treatment: no cure, airway management, dialysis, supportive care. Prevention: avoidance of contaminated items/animals

Prepare with drills, vaccines, and ensuring availability of antibiotics for exposure prophylaxis. design a response plan, id the chain of command, define nursing roles, set up protocols.

early recognition, activate response plan, implement infection control measures - decontamination, protective equipment, SCREEN the populations for exposure, assist and educate the population regarding symptom identification and management, monitor mortality and morbidity.

Rehab of survivors, monitor medication regimens and referrals, evaluate effectiveness of the bioterrorism plan

shared power, shared goals, integrity, flexibility, negotiation

specialized knowledge who provides expert advice, services, or information. -seek expertise from health care professionals -seek expertise from health care professionals -seek expertise of other nurses -incorporate recommendations from a consultant -coordinate recommendations from multiple consultants -serve as expert witness -serve as a consultant regarding the health care needs of individuals

to assist in restoring, maintaining, or promoting health.

engage in working relationship with client establish criteria for the referral explore resources accept the client's decision to use a given resource (autonomy) make the referral facilitate the referral evaluate the outcome

Promotes interprofessional services and increased client/family involvement decreases cost by improving client outcomes provides education to optimize health participation advocate for services and client rights

useful in rural areas.

BP, weight, Blood O2, Blood glucose, HR, temp, ECG results

Voice conversation, heart sounds, lung sounds, bowel sounds

images of wounds, images of surgical incisions

advocate for needed change at local, state, federal level

persuade of influence legislators. Lobbying may be implemented by an individual, or collectively through professional nursing associations.

facilitation of goal achievement through the collaboration of two or more groups

serving society and advocating for change by influencing policy development through public service

Office of Emergency Management

The federal emergency management agency

Support emergency rescue and recovery services and is contacted when additional resources are needed by the community.

Contact in response to threats and hazards by acts of terrorism

eradicated worldwide since late 1970s, people who were immunized against smallpox before 1982 are now considered to be unprotected, unlike chickenpox, the vesicles of smallpox are more abundant on the face.

Nits that are shed into the environment are capable of hatching for up to 10 days. Pets do not transmit or carry lice.

Appear as grayish brown, threadlike burrows on the skin. Require private room.

Monitor for any change in size, contour, dimpling. Perform exam every month, 2 to 3 days after your period. Use finger pads of the three middle fingers.

no precautions other than protective.

immunization given at 11-12 years of age

given at 60 years or older

given during first year of life

nurse starts to flush the clients eyes with tepid water - secondary prevention