ATI Community Health Nursing Proctored Focus Already Passed Care of specific populations: Migrants Migrant workers health problems include: Correct Answer-1. Dental disease 2. TB 3. Chronic condi... tions 4. Stress, anxiety, & other mental health conditions 5. Leukemia 6. Iron deficiency anemia 7. Stomach, uterine, & cervical cancers 8. Lack of prenatal care 9. Higher infant mortality rates Primary Prevention for Rural or Migrant Health care: Correct Answer--educate on measures to reduce exposure to pesticides -teach on accident prevention -prenatal care -mobilize preventative services (dental, immunizations)Secondary Prevention measures for Rural/Migrant Health care: Correct Answer-SCREENING! screen for: -pesticide exposure -skin cancer -chronic preventable diseases -communicable diseases Tertiary Prevention measures for Rural/Migrant Health care: Correct Answer--treat for symptoms of pesticide exposure -mobilize primary care and emergency services Client's rights include... Correct Answer--right to info disclosure -privacy -informed consent -info confidentiality -participation in treatment decisions Autonomy Correct Answer-respecting a client's right to choose (i.e. refusing chemo) Nonmaleficence Correct Answer-doing no harmBeneficence Correct Answer-maximize benefits and minimize possible harms Justice situation: Correct Answer-determining eligibility for health care services based on income and fiscal resources HIPAA rules about information security: Correct Answer--only staff assigned to the patient may view/read client's health record (no other nurses or doctors) -client's have the right to read or obtain a copy of their health record -nurses may not photocopy any part of med record except for authorized exchange of docs between facilities & providers -staff must keep records/names of client in secured place -electronic records are password protected -no sharing info to family members w/out code in person, email, or phone call -talking about a client must be in a private setting so no one can overhear HIPAA info security protocols include: Correct Answer--log off computer before leaving workstation -never share ID or password -never leave med records where ppl can see it -shred any printed info about client after use-don't use or view social media in clinical settings -no posting about clinical stuff Agent Correct Answer--the animate or inanimate object that causes the disease. -ex. chemical (drugs, toxins); physical (noise, temperature); infectious (viruses, bacteria) Host Correct Answer-the living being that is affected by the agent -ex. age, gender, genetics, ethnicity, immunological status, physiological state, occupation environment Correct Answer-the setting or surrounding that sustains the host -ex. Physical (geography, water/food supply, presence of reservoirs/vectors); Social (access to health care, high-risk working conditions, poverty) Caring for a client with gonorrhea: Correct Answer--nationally notifiable disease -women are frequently asymptomatic -CDC recommends yearly screening for all sexually active women 25 yrs or older or w/risk factors-at risk pregnant women must be screened at first prenatal visit -identify & treat all partners -admin erythromycin to all infants following delivery -ceftriaxone IM or azithromycin PO -it is the responsibility of the provider to report gonorrhea to local health dept -state notification to CDC is voluntary -if left untreated in women it can lead to PID which can cause infertility Referrals: Client barriers include: Correct Answer--lack of motivation -inadequate info about community resources -inadequate understanding of the need for referral -accessibility needs -priorites -finances -cultural factors Referrals: Resource barriers include: Correct Answer--attitudes of health care personnel -costs of services -physical accessibility of resources-time limitations -limited expertise working w/culturally diverse populations Just because someone is exposed to asbestos once doesn't mean they will develop health problems... Correct Answer-long term exposure can lead to mesothelioma and lung conditions. Risk factors include workers (office buildings with it when they work there everyday). Priority action(s) in developing a disaster plan: Correct Answer--set up communication alternatives -highlight possible evac routes -identify local & distant meeting places -create disaster kit AS A NURSE: -identify at risk populations in community -identify community disaster warning system & how to access -identify 1st responders -make list of agencies for all levels of disaster -triage -gather equipment, check often Hyperthyroidism: Radioactive iodine therapy home safety: Correct Answer-Client is radioactive!-no pregnant people -no breastfeeding -keep distance from others, limit visits to 30 min at a 6 ft distance -drink lots of fluid -maintain good hygiene to prevent infection Teaching safe disposal of insulin syringes: Correct Answer--put in strong plastic container i.e. old detergent container (no soda bottles) -DO NOT recycle old needles, throw container in trash -seal the container when 3/4 full with duct tape -facilities throw it in sharps red container Teaching about use of crutches: Correct Answer--don't alter crutches after fitting -follow prescribed crutch gait -support body weight at the hand grips w/elbows flexed at 30 degrees -position crutches on unaffected side when sitting or rising from a chair Demographics of homeless population: Correct Answer--families w/children are the fastest growing segment -people with mental illness (large segment)-veterans -substance abuse disorders -youth and runaways -intimate partner abuse victims -people with HIV or AIDS -older adults Planning Primary Prevention Activities Correct Answer--determine solutions -establish goals -give responsibilities to individuals -determine resources -screening and education -determine funding, develop budget -plan for evaluation Parish nursing: Correct Answer-promotes health and wellness within populations of faith communities -work with: pastoral care staff, professional health care members, and volunteers to provide holistic approach to healing Functions:-personal health counseling -health education -liaison between faith & community & local resources -facilitate support groups -spiritual support Windshield survey: Correct Answer--nurse and other driver drive through community assessing components -time consuming -provides descriptive overview of community -results limited because it is only based on visualization & doesn't include community member input nurse looks for: -pets and animals -evidence of drug abuse/substance abuse -origin/race/ethnicity of population -general appearance -natural/man made boundaries -housing details -social systems: clinics, hospitals, dentists, parks & rec, worship places, stores, public protection & transportPositive Mantoux skin test for TB includes: Correct Answer-an induration-palpable, raised, hardened area of 10 mm or greater in diameter Positive Mantoux test indicates that... Correct Answer-the client has developed an immune response to TB it does not confirm active TB Mantoux test: an induration of 5 mm may be considered Correct Answer-positive mantoux test in immunocompromised clients Recognizing signs of abuse: Correct Answer-Child: -unexplained injury -unusual fear of nurses or others -injuries/wounds not mentioned in hx -fractures, including other healed fractures -presence of wounds/fractures/injuries in various stages of healing -subdural hematomas -trauma to genitalia -malnourishment or dehydration -general poor hygiene or inappropriate dress for weather conditions-considered to be a "bad child" Adult: -unexplained or repeated physical injuries -physical neglect & unmet basic needs -rejection of assistance by caregiver -financial mismanagement -withdrawal & passivity -depression Manifestations of alcohol withdrawal: Correct Answer--abd cramping -vomiting -tremors -restlessness -irritability -increased HR -transient hallucinations or illusions -anxiety -increased BP and RR-increased temp -tonic-clonic seizures -alcohol withdrawal delirium (2-3 days after stopping) Manifestations of alcohol withdrawal delirium or delirium tremens Correct Answer--increased BP -tachycardia -diaphoresis Provide culturally appropriate care by: Correct Answer--addressing clients by last name until told otherwise -introduce thyself and explain position -be authentic and honest about what you don't know about a culture -use culturally sensitive language -don't make assumptions about the client -encourage the client to ask questions -find out what the client knows about condition and treatments -respect beliefs, practices, and values -show respect for client's support systemsIdentifying hazards in occupational environments: Correct Answer--exposure to chemicals -worker inexperience/age/pregnancy -lifting heavy loads -constant sitting -stress and burnout and violence -temp extremes -noise extremes -not having proper protective equipment Diet teaching for adolescents: 1. Calories/day for 15 yr old male & female= 2. Adolescents have an increased need for... 3. Adolescents require at least ____/day of Calcium Teach them: Correct Answer-1. 2000 for female, 4000 for male 2. Iron (11-15 mg extra/day) 3. 1300 mg Teach: don't skip meals, eat more calcium, nutrient-dense snacks (fruit, pretzels, smoothies, cheese)identify agent factors in the epidemiological triangle: Correct Answer-Chemical agents: drugs and toxins Physical agents: noise and temp Infectious agents: viruses and bacteria Agent is the animate/inanimate object that causes the disease Using web-based info: Correct Answer--must be credible, avoid .com (use .gov) -must use appropriate terminology (no layman terms) -EBSCO, CDC, NICBH are good sources Providing information on immunizations is a part of the... Correct Answer-primary prevention Calculating prevalence proportion: Correct Answer-# of existing cases in the population at a specific time divided by population total= _____per 1000 Caregiver burden responses: Correct Answer-fatigue difficulty sleeping illnessPTSD interventions Correct Answer--therapeutic relationship w/client -assess for suicide idealization & use precautions if necessary -use multiple strategies to reduce anxiety -allow time to express feelings rationalization Correct Answer-coming up with reasons that avoid the true reason (i.e. I got cancer of the liver because its in my genes not because I drink to excess every day) Providing teaching to a patient who speaks a different language than the nurse: Correct Answer-- interpreters should not be family members -interpreters should have knowledge of health care terminology -client preferences should be considered when choosing the age and sex of interpreters -interpreters should not be from the same community as the client -health teaching materials should be available in the client's primary language Exposure to anthrax: Correct Answer--IV cipro prophylactically -abx to stop disease progression s/s:-headache -fever -muscle aches -chest discomfort -severe dyspnea -shock Pertussis education: Correct Answer--droplet precautions [Show More]
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