Term
| often in hospitals we find the bio-medical model as the guide for care. In the comunity we instead refer to : |
|
Definition
"the web of causality:
(ie prevention of illness) |
|
|
Term
| in the community the balance of power has shifted to the _________ |
|
Definition
| patient (not on hospital turf) |
|
|
Term
| public health nursing concerns itself mainly with ________ and ___________ |
|
Definition
-epidemiology
-surveilence |
|
|
Term
| In community health nursing, the nurse works with _________ |
|
Definition
populations
( to prevent outbreaks, do screenings, plan for emergency preparedness, there are very few of these positions) |
|
|
Term
| Name some examples of community based nursing environments |
|
Definition
school nursing
adult day health centers
home care
community health centers
homeless shelters |
|
|
Term
| Define Geo political community: |
|
Definition
| a community with geographic and political boundries (ie brookline, or the city of boston) |
|
|
Term
| define phenomenological community: |
|
Definition
| a community not defined by geographic or political boundries, but serve to support included individuals and serve a social function (ie the Russian community of brookline, an international club at a university) |
|
|
Term
| classify the function of communities (7 things): |
|
Definition
-meet the collective needs of members
-share values beliefs and instituations
-pursue common goals
-provide structure for living and working with others, for sharing resources.
-Preserve history, culture and identity
-to care for the vulnerable |
|
|
Term
| community health began around the time of the influx of imigrants to the united states between _______ and _________? |
|
Definition
| 1820-1910 (the progressive era) |
|
|
Term
Lilian wald started the first ____________?
What was it called? |
|
Definition
major home care nursing for vulnerable populations.
it was called "the henry st tenaments"
(lilian also lived in these tenaments) |
|
|
Term
| Primary prevention refers to the _________________ of __________. |
|
Definition
| prevention of illness (esp things like vaccines and education) |
|
|
Term
| secondary prevention refers to |
|
Definition
| catching a disease at an early stage in order to intervein and prevent further complications. esp screenings |
|
|
Term
| tertiary prevention refers to |
|
Definition
| preventing further complications or minimizing complications of an illness already present. (ie medications to treat infection) |
|
|
Term
define rate:
how is it determined? |
|
Definition
rate is a measure of the frequency of a health event.
Rate is determined by dividing the number of people experiencing the health event bby the number of people at risk of acquiring the health problem. |
|
|
Term
| rates need to be ___________ in order to accurately compare them to each other |
|
Definition
-standardized
(ie make it per 1000, 10,000 or 100,000 for all you are comparing) |
|
|
Term
|
Definition
| -the number of new cases of a health problem in a particular period of time |
|
|
Term
|
Definition
| -the amount of cases of a health event in a particular population at a particular time (preexisting) |
|
|
Term
|
Definition
| refers to amount of illness/suffering |
|
|
Term
|
Definition
| refers to number of deaths |
|
|
Term
Define infant mortality:
What makes this statistic particularly important? |
|
Definition
-infants that died either before the moment of birth until 1 month (is 1 month right?).
-This statistic is important because it reflects the overall state of a communities health because pregnant women and infants are the most vulnerable members of the community. |
|
|
Term
| Who is Lina Rogers and what is she known for? |
|
Definition
| she is known for investigating why children would miss so much school. was a henry st nurse who became one of the first school nurses. She found that treament , prevention, and screening lead to decreased absences from school |
|
|
Term
| who is credited with bringing about the establishment of milk stations, playgrounds, recreation programs, brought nurses to rural settings to help poor access health care, and advocated for factory reform and child labor laws along with photographer who p |
|
Definition
|
|
Term
| What is margret sanger given credit for? |
|
Definition
| she was a henry street nurse who wanted to spread the word on birth control methods to poor communities. She was arrested and instead of going to trial she fled to europe to continue to learn about birth control methods. When she returned she opened the BROWNSVILLE clinic, and later spent some time in jail. |
|
|
Term
| Premature death refers to a death before the age of |
|
Definition
|
|
Term
| what is the amount of money a single person must earn under each year to be considered for social services for health care? |
|
Definition
|
|
Term
| What amount must a family of 4 earn less than to be considered for social services for health care? |
|
Definition
|
|
Term
| In general Bostons population of white persons has _____________ from 1990 to 2000 and the population of hispanic individuals has _____________ |
|
Definition
white- deccreased
hispanic- increased |
|
|
Term
name the number of infant mortalities per 1000 people in boston for:
1. whites
2. Blacks
3.Hispanics |
|
Definition
|
|
Term
| what racial group in boston is most effected by child poverty? what about the second highest? |
|
Definition
|
|
Term
| which racial group has the highest percentage of its members without a HS diploma? |
|
Definition
|
|
Term
| what ethinic/racial group has the lowest incidence of gunshot and stabbing injuries? |
|
Definition
|
|
Term
| which ethnic/racial group in boston is least likely to have health insurance? |
|
Definition
|
|
Term
| ethnic/racial group with the largest percentage of people who speak little or no english (in boston)? |
|
Definition
|
|
Term
| who was known for her work in w. virginia with pregnant women and their infants in appalachia who were poor. She and her collegues would ride on horseback to towns in the mts to treat these people. |
|
Definition
|
|
Term
name the highest risk medications for elders (5 meds)
in general name 3 reasons these drugs can be dangerous
what is the name of the list that names about 35 meds that should not be used in elders? |
|
Definition
Tricyclic antidepressents
psychotropics
benzos
analgesics
anticholinergincs
1.cause a change in mental status
2.change in gait
3.inc risk for falls
Beers list |
|
|
Term
| elders over 65 years old on ____ or more perscription drugs had a possible med error rate of 50% |
|
Definition
|
|
Term
| On average comminity dwelling elders use ______ prescription medications in addition to their OTC medications |
|
Definition
|
|
Term
| This otc drug is often used as an antioxident and as a natural blood thinner. In addition it has adverse reactions with anticoagulants, OTC pain relievers (adverse bleeding), anticonvulsants, and antidepressants? |
|
Definition
|
|
Term
| This OTC drug decreases stress and effects of aging. It has adverse interactions with digoxin, anticoagulants, antidepressants, and analgesics |
|
Definition
|
|
Term
| This OTC drug is often used as an antidepressant. It has adverse reactions with chemotherapy, indinavir, cyclosporine, digoxin, and theophylline |
|
Definition
|
|
Term
| what are 3 things (the biggies) that can be done to guard againt medication errors (there are others)? |
|
Definition
1)frequent med profile review
2) ask about otc and herbal supplements
3) check ortho signs frequently |
|
|
Term
| what changes in vital indicate orthostatic hypotention? |
|
Definition
a sustained drop in SBP of 20 mm and/or
a drop of 10mm or more of DBP accompanied by an inc in HR of 20bpm or more |
|
|
Term
| name the three steps in assessing for otho signs |
|
Definition
1) assess BP and Pulse with patient supine
2) assess again immediately after pt goes from supine to either sitting or standing.
3)continue to assess at 1-3 minute intervals over the next 10 mins |
|
|
Term
| what are the two places most fractures in elderly persons occur? |
|
Definition
|
|
Term
| what is the most common room/area where elderly people fall? the least common? |
|
Definition
| the most common is the living room while the least common is the hallway. |
|
|
Term
death from fall related injuries is greatest for____________.
why? |
|
Definition
| older white males because they keep trying to do high risk behaviors, and are more likely to own homes and cars which require maintanence. |
|
|
Term
| what were the major causes of morbidity and mortality in 2005? |
|
Definition
|
|
Term
| If a person recieves successful treatment for a chronic illness it may be possible that they can reverse their illness, T or F |
|
Definition
| False. chronic illness is irreversible and the pt must live with the illness for the remainder of his or her life. they may be able to manage symptoms but there is NO CURE |
|
|
Term
| of people with a chronic illness this percent of them are effected with 3 or more chronic illnesses... |
|
Definition
|
|
Term
| name activities of daily living (11) |
|
Definition
BCDE triple T GSW
Bathing
Communicating
Dressing
Eating
Toileting
Thinking
Transferring
Grooming
Seeing
Walking |
|
|
Term
| name 7 examples fo intrumental activities of daily living |
|
Definition
DUH D PMS
Driving
Using telephone
House cleaning
Doing laundry
Preparing food meals
Managing Money
Shopping |
|
|
Term
| what activities can the home health aid help with? |
|
Definition
|
|
Term
| the homemaker is to be responsible only for ____________ ____________. |
|
Definition
|
|
Term
| 18% of people over the age of 65 have this disease, which is estimated to be over 65% by 2050? |
|
Definition
|
|
Term
| what is the goal for HgbA1c in most people. Who is the exception to this rule? |
|
Definition
| an ALC percentage below 7. In the elderly an ACL percentage below 7 may mask signs of hypoglycemia, therefore elderly people should be kept at an ACL percentage slightly higher than 7 |
|
|
Term
| what are three ways to assist diabetes patients to achieve glycemic control? |
|
Definition
medical Nutritional therapy (MNT)
excercise
medication management |
|
|
Term
Medical nutritional therapy includes limiting carbohydrates. how many grams of carbs are recommended per meals?
How many per snack?
what are carbohydrates? |
|
Definition
-30-35gm per meal, and 15gm per snack
-carbs are foods that are converted to 100% glucose during digestion. |
|
|
Term
| a diabetic foot ulcer will not heal if ones BS is above _______? |
|
Definition
|
|
Term
| who is the only person who should cut a diabetics nails? |
|
Definition
|
|
Term
to obtain a 50% reduction in risk of a cardiovascular event in a person with type II diabetes one can drop just _____mmhg in diastolic BP
In addition a 10lb weight loss will result in a ________mmHg reduction in BP |
|
Definition
|
|
Term
| a licsence is required to do mircrofilament testing. T or F |
|
Definition
|
|
Term
| for persons with diabetes hypertention is indicated by a blood pressure greater than |
|
Definition
|
|
Term
| you are taking a pts blood pressure and obtain a reading of 182/113. What is your next course of action? |
|
Definition
| although typically one reading is not sufficient to determine a blood pressure problem, any reading over 180/110 warrants immediate contact of the pts physician. |
|
|
Term
| persons with diabetes should NOT moisturize between their toes during foot care. T or F |
|
Definition
|
|
Term
| TB is a viral infection. T or F |
|
Definition
| false it is a bacterial infection |
|
|
Term
| TB presents as both a(an) _______________ and a(an) ____________ |
|
Definition
| an infection and a disease |
|
|
Term
| the test used to screen for TB that includes a PPD being implanted is called a ______________ test |
|
Definition
|
|
Term
PPD is.......
after it is implanted it should be read within ________________________
If the test is positive for TB you will see that the site has...........
a person with a positive test must them get a ---------------? |
|
Definition
-a modified form of tuberculum bacterium
-within 42-72 hours from administration
-raised, red, and indurated.
-chest xray |
|
|
Term
| name 7 symptoms of active TB |
|
Definition
CCC WW FN
Cough
Chest pain
Coughing up blood
Weakness/fatigue
Weightloss/wasting
Fever
Night sweats |
|
|
Term
What does AFB stand for?
How many negative AFBs must be obtained to no longer consider a TB carrier to be infectious? |
|
Definition
-Acid Fast Bacillus
-3 cultures |
|
|
Term
| How many days of rehab will medicare pay for |
|
Definition
|
|
Term
| what does DRG stand for? What are DRG's used for? |
|
Definition
- DRGs stand for:
Diagnosis
Related
Groups
- agencies use these to determined pay out for care |
|
|
Term
| The goal of homecare is to help elderly people into assisted living communities or nursing homes. T or F |
|
Definition
| False. the goal of home care is to assist pt and thier families to become as independent as possible managing illness, preventing relapse or recurrence of disease, and promoting health. |
|
|
Term
| the 4 conditions of participation or (COPS) that need to be met for pts to qualify for medicare services are: |
|
Definition
- that they must be skilled (expertice of a nurse) that includes teaching, wet to dry, (but not dry sterile).
-services must be intermittent (not round the clock)
-services must be ordered by a physician (not an NP or CNS)
-pts must be homebound (leaving home is very taxing and only done if absolutely necessary) |
|
|
Term
| Prefilling med boxes requires the skills of a nurse. T or F |
|
Definition
| False. this is considered "a non-skilled task" and does not need to be done by a nurse (therefore is not enough to require home services though medicare) |
|
|
Term
| what is considered the "gold card" of health care for the elderly |
|
Definition
| when they have both medicare and medicaid |
|
|
Term
| medicare is based on ______ while medicaid is based on ________. |
|
Definition
medicare = age (65 or older)
medicaid = income |
|
|
Term
| medicaid will pay for unskilled services. T or F. |
|
Definition
| True. although medicare states a covered service needs to require the services of a nurse, medicaid does not have this restriction. |
|
|
Term
medicare provides care for ______episodes of illness and ________term care.
while medicaid provides for both _____and ______ as well as the cost of _________. |
|
Definition
-acute
-short
-acute and chronic
-meds |
|
|
Term
| medicaid requires that an individual be homebound to recieve services. T or F |
|
Definition
| F. there is less focus on being homebound with medicaid. |
|
|
Term
| medicare is a __________ program while medicaid is administered by ________ |
|
Definition
-federal program
-individual states |
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|
