Community Health Study Guide 3f4e37

Community Health Study Guide

BASIC CARE AND COMFORT (4) ● Cancer Disorders: Promoting Nutrition for Esophageal Cancer  -obtain daily weight  - nutrition with a high-calorie diet, semi-soft foods, thickened liquids, & supplements  avoid alcohol consumption  -promote smoking cessation  -avoid foods containing nitrates  -treat GERD with diet, positioning, and medications

● Postpartum Physiological Adaptations: Interventions for Perineal Lacerations     

stool softeners -peri care to prevent infection ice packs anaglesia dermoplast

● Nutrition Assessment: Client who has Chronic Obstructive Pulmonary Disease       

high-calorie, high-protein meals, low carb encourage 3L of fluid a day small, frequent meals. Limit liquid intake at meal times Consume foods w/ protein (like eggs) Maintain an upright position (High Fowler's position) to promote ventilation Use milk instead of water when making soup

● Osteoarthritis: Teaching About Disease Management  Take a hot shower or bath daily = improves t mobility + pain  Get 8-10 hours of sleep + additional 1-2 hrs during the day  Consume well-balanced diet + weight loss can reduce severity of disease  Exercise Daily HEALTH PROMOTION AND MAINTENANCE (7) ● Communicable Diseases, Disasters, and Bioterrorism: Vector-Borne Illnesses    

Via a carrier such as a mosquito or tick Lyme Disease Malaria Rocky Mountain spotted fever

● Overview of Community Health Nursing: Tertiary Prevention Strategy Maximize recovery AFTER injury/illness (REHAB) Nutrition Counseling Exercise REHAB Case Management of chronic illnesses Physical Therapy Groups Exercise of hypertensive clients Teaching a client with rheumatoid arthritis measure to prevent t deformities  Teaching foot care to adults who have Diabetes        

● Overview of Community Health Nursing: Principles of Epidemiology  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

● Community Health Program Planning: Planning Primary Prevention Activities  Prevention of the initial occurrence of disease/injury (DOES NOT have it)

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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)

● Community Health Program Planning: Initial Phase of Planning a Smoking Cessation Program ● Overview of Community Health Nursing: Epidemiological Triangle  The Agent is the animate or inanimate object that causes the disease. Chemical Agents: Drugs, Toxins, Physical Agents: Noise, Temperature, Infectious Agents: Viruses, Bacteria

 The host is the living being that is affected by the agent. Susceptible Host: Age, Gender, Genetics, Ethnicity, Immunological status, Physiological state, Occupation  The environment is the setting or surrounding that sustains the host. Physical Environment: Geography, Water/food supply, Presence of reservoirs/vectors Social Environment: Access to health care, High-risk working conditions, Poverty

● Overview of Community Health Nursing: Goal of Screening MANAGEMENT OF CARE (13) ● Managing Client Care: Use of Web-based Information  Telehealth useful in rural areas.  Telehealth audio: data Voice conversation, heart sounds, lung sounds, bowel sounds  Telehealth physical data: BP, weight, Blood O2, Blood glucose, HR, temp, ECG results  Telehealth visual data: images of wounds, images of surgical incisions ● Overview of Community Health Nursing: Ethical Principle  Beneficence, non-maleficence, autonomy, distributive justice, veracity ● Care of Special Populations: Migrant Population ● Practice Settings and Aggregates: Primary Prevention Activity          

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)

● Practice Settings and Aggregates: Reporting to Governmental Agency State departments of Health  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 istration of the medicaid program.  Reports notifiable communicable disease within the state to the CDC.  

● Continuity of Care: Role of Negotiator ● Care of Special Populations: Teaching Pregnant Adolescent Clients ● Community Health Program Planning: Priority Teaching for Inmates ● Practice Settings and Aggregates: Primary and Secondary Needs of Congregation ● Overview of Community Health Nursing: Scope of Practice for CommunityOriented Nurse ● Communicable Diseases, Disasters, and Bioterrorism: Triage and Priority Care Following a Tornado ● Practice Settings and Aggregates: Nursing Role in Planning Client Care ● Practice Settings and Aggregates: Evaluating Family Understanding of Hospice Care

PHARMACOLOGICAL AND PARENTERAL THERAPIES (4) ● Medications Affecting Urinary Output: Preventing Adverse Effects of High-Ceiling Diuretics      

obtain baseline data weigh clients monitor BP, I&O avoid istering at night to prevent nocturne consume foods high in K monitor blood glucose levels

● Medications Affecting Coagulation: Risks for Adverse Effects Heparin  Hemorrhage secondary to Hep overdose: monitor VS, observe for bleeding  Hep induced thrombocytopenia (abnormally low amt. of platelets): monitor platelet count  Hypersinsitivity rxn: chills, fever, uticaria  small test dose prior to .  Toxicity/overdose: ister protamine Warfarin Hemorrhage:

 -monitor for bleeding  -check PT, PTT, INR  -ister vit K Hepatitis: -monitor liver enzymes AST/ALT, check for jaundice Toxicity:  - vit K to promote synthesis of coag factors  -if vit K doesnt work, frozen plasma or whole blood. DO NOT GIVE TO: -Pregnant women. category X -Pt with low platelet counts -Pt who have uncontrollable bleeding -Pt going for surg of eye, brain, spinal cord, LP, regional anesth. -Pt who have K deficiencies

● Cardiovascular Diagnostic and Therapeutic Procedures: Teaching Central Line Care in the Home Setting Capping, cleaning ends with alcohol, hand hygiene, change dressing if wet/dirty, sterile technique

● Oxygen and Inhalation Therapy: Teaching About Metered-Dose Inhaler Use  fungal infections of the oral cavity may occur with corticosteroid use; assist the child with rinsing his mouth after istration  shake the inhaler 5-6x,  attach the spacer for proper inhalation,  hold the inhaler with the mouthpiece at the bottom,  hold the inhaler with the thumb near the mouthpiece, and the index and middle fingers at the top,  take a deep breath and then exhale, tilt the head back slightly, and press the inhaler. While pressing the inhaler, begin a slow, deep breath that lasts for 35 sec., hold the breath for about 10 sec., take the inhaler out of the mouth and slowly exhale through the nose, resume normal breathing PHYSIOLOGICAL ADAPTATION (4) ● Hypothyroidism: Assessment Findings Weakness, muscle fatigue, arthralgias, cramps, cold intolerance, constipation, weight gain

Dry skin, thinning hair, brittle nails, pufffy eyes, thick tongue, edema of hands and face, bradycardia, alopecia, ascites, hypoactive bowel sounds ● Communicable Diseases: Clinical Findings Associated with Fifth Disease  spreads by blood and droplet  incubation 4-14 days can be up to 20 days  *onset of symptoms before rash appears  low fever, fatigue, a "slapped cheeks" rash, t aches, and a whole body rash. ● Cancer Treatment Options: Adverse Effects of Radiation Therapy  Nausea, dysguesia, fatigue, skin damage, mucositosis ● Tuberculosis: Evaluating Client Teaching  return for a reading of theinjection site by a health care provider within 48 to 72 hr  Instruct clients to take medication on an empty stomach.  family need to be tested for TB.  continue medication therapy for its full duration of 6 to 12 months. Emphasize that failure to take the medications may lead to a resistant strain of TB  Clients are no longer considered infectious after three negative sputum cultures  Teach clients to cough and expectorate sputum into tissues that are disposed of by clients into provided sacks

PSYCHOSOCIAL INTEGRITY (7) ● Care of Special Populations: Providing Culturally Sensitive Care ● Care of Special Populations: Interventions for Suspected Victims of Abuse       

Build trust and confidence with a client. Focus on the client rather than the situation. Assess for immediate danger. Provide emergency care as needed. Develop a plan for safety. Make needed referrals for community services and legal options. If abuse has occurred, complete mandatory reporting, following agency guidelines.

● Factors Influencing Community Health: Conducting a Cultural Assessment  Religious Preference  Food Patterns

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Health Practices (immunizations) Gather data about the client's cultural beliefs Nutritional practices, family structure, health care interactions, views about illness

● Care of Special Populations: Recognizing Signs of Abuse Child Abuse/Neglect: Unexplained injury ◯ Unusual fear of the nurse and others ◯ Injuries/wounds not mentioned in history ◯ Fractures, including older healed fractures ◯ Presence of injuries/wounds/fractures 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”  ● Recognizing Potential or Actual Older Adult Abuse: Unexplained or repeated physical injuries ◯ Physical neglect and unmet basic needs ◯ Rejection of assistance by caregiver ◯ Financial mismanagement ◯ Withdrawal and ivity ◯ Depression 

● Factors Influencing Community Health: Planning Meals for a Client who has Diabetes Mellitus  instruct client to limit calories and decreased total fat intake to 30% of total daily calories  -Encourage diet low in saturated fats to decrease low-density lipoprotein (LDL)  assist with weight loss for secondary prevention of diabetes/reduce risk of heart disease  Modify diet to include Iomega-3 fatty acids/fiber to lower cholesterol levels  improve blood glucose for client to have diabetes, secondary prevention of diabetes/to reduce risk of heart disease ● Care of Special Populations: Exploring Suicidal Intent ● Care of Special Populations: Neglect of a Client who has Alzheimer’s disease REDUCTION OF RISK POTENTIAL (2) ● Coagulation Disorders: Thrombocytopenia Clinical Findings ● Diabetes Mellitus Management: Providing Education        

Test bath water w/ thermometer (prevent burns) Wear shoes that extend 2.54 cm (1 inch) past longest toe Don't use heating pads or ice packs Inspect feet for areas of redness + skin breakdown daily Monitor temperature of feet + lower extremities for changes Consult with dietician to determine appropriate school lunch for child Eat a snack within 2 hrs of physical activity DON'T provide info to insurance company

 Test ketone levels when client is sick or blood glucose levels are elevated (not daily) SAFETY AND INFECTION CONTROL (9) ● Practice Settings and Aggregates: Safety Evaluation ● Communicable Diseases, Disasters, and Bioterrorism: Developing Disaster Plan Priority Action ● Home Safety: Home Oxygen Use    

family must smoke outside no nail polish near oxygen a no smoking sign on the front door a fire extinguisher required inside

● Factors Influencing Community Health: Federal Agencies and Asbestos ● Overview of Community Health Nursing: Secondary Level of Prevention 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) ● Communicable Diseases, Disasters, and Bioterrorism: Providing Education for a Client who has Pertussis  Instruct parent to keep child home until coughing stage has ed (when disease is most communicable)  Encourage family to obtain prophylactic treatment (erythromycin, clarithromycin, azithromycin)  Check immunizations status of child's classmates  pneumococcal vaccine is not effective against pertussis ● Communicable Diseases, Disasters, and Bioterrorism: Disaster Preparedness s ● Communicable Diseases, Disasters, and Bioterrorism: Priority Principles of Triage  Triaging involves identifying those who have serious versus minor injuries, prioritizing care of victims, and transferring those requiring immediate attention to medical facilities.  Triage Emergent category (class I) - Highest priority is given to clients who have life-threatening injuries but also have a high possibility of survival once they are stabilized

 Triage Urgent category (class II) - Second-highest priority is given to clients who have major injuries that are not yet life-threatening and usually can wait 45 to 60 min for treatment  Triage Nonurgent category (class III) - The next highest priority is given to clients who have minor injuries that are not life-threatening and do not need immediate attention  Triage Expectant category (class IV) - The lowest priority is given to clients who are not expected to live and will be allowed to die naturally. Comfort measures may be provided, but restorative care will not ● Communicable Diseases, Disasters, and Bioterrorism: Assessment Following Tuberculosis Outbreak