how you get direct data during a community assessment
informant interviews, participant observation, windshield surveys
secondary data
medical records, health surveys, vital statistics (morbidity/ mortality statistics)
someone asks info on their neighbour-like if they have tb
ask: do You have questions about tb?
substance abuse program education for adolescents
help students develop skills for resisting peer pressure
Oxygen therapy for COPD pt at home
pt should not adjust oxygen; dr has to order it
Oxygen therapy-copd pt
use before activity, non petroleum moisturizer for lips and nares, contact dr if SOB often
preschooler age
normal to have imaginary friends; set limits for them; 4-6 oz of juice per day acceptable; may begin to have aggressive behavior-normal
educational program for a community steps in development
needs assessment; develop measurable objectives; select educational strategies appropriate for the audience; implement educational program
intestinal parasitic disease prevention of transmission in a daycare
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 and viewpoint
cultural imposition
forcing one's group cultural beliefs on others
tracheostomy care post op more than 1 month
clean technique when providing care: tap water to clean inner cannula; insert catheter 5 into the trach tube; placing the tumb over the port applies suction; suction is applied during pulling out of catheder; live the old ties in place until the new ones are secured to prevent accidental dislodging of the trach tube
influenza outbreak preparation
have 2 weeks of water and food at home; antivirals will not prevent transmission but could minimize symptoms; during an outbreak, individuals should receive two injections of H5N1 vaccine 28 days apart; seasonal flu vaccine does not protect from avian influenza
immunizations for infant
cold or other minor illnesses are not contraindicated to receive immunizations; they can receive acetaminophen for fever after immunization; in case of anaphylactic egg allergy, don't give influenza vaccine; MMR-12 months
asthma client with prescribed inhaled corticosteroid and prednisone
use metered-dose inhaler attached to a spacer when taking corticosteroids; pace activities depending on his breathing-based on the effort required for breathing; avoid environmental triggers; report the highest of three peak expiratory flow rates (not the average); take prednisone until prescription is complete
stage 4 cancer pt-decides to go to hospice
nurse's responsibility is to make referral
Epi pen
inject medication into the thigh in case of an allergic reaction; can be injected through clothing; first dose of Epi will provide control of symptoms for about 20 mins; after injection is given, transport to hospital; store Epi pen at room temp in dark place (no refrigeration needed); remove gray thing to activate device, leave black thing in place
Best source of information about local safety concerns
interviewing community members
community assessment
state officials' observation might be benefiting; national health care trends; data collected from surrounding counties
disaster preparedness role of nurse
organize community-wide disaster drills; assist people in knowing appropriate procedures to follow during a disaster
report
PT of 15 secs (above normal)
HbA1c
5% is normal
T3
90 is normal
Rinne test
after placing a tuning fork behind the year, tell me when you no longer hear the sound
audiometry
you will have headphones, press button when you hear a sound
whispered voice test
use your finger to close one ear, tell me when you no longer hear the sound
Weber test
after I place the tuning fork on your scalp, tell me if you hear the sound better in one year or the same in both ears
child abuse
more common in homes where intimate partner abuse is present; abused children are more likely to become abusers; no connection between economic status and abuse
TB transmission education for newly diagnosed patient
household members should take Isoniazid (INH) for 6 to 12 months; no need to use disposable utensils for pt; no need to isolate household members
nurse role as a case manager
providing referral information to clients; facilitation, negotiation and collaboration
health education program
pamphlets should be written at 8th grade level, not 12; attendance should be voluntary;
visual/ auditory learners
power point is fine
priority pt
child with vomiting, febrile, petechial rash-meningococcemia-Unstable
rotavirus
diarrhea, abd pain, fever 37.4C
otitis media
irritable, pulling ear, fever
allergic conjuntivitis
itching eyes with stringy discharge and red conjunctiva
Levothyroxine
A/E heat intolerance, hypertension, weight loss, tachicardia
Office of Emergency Management
responsible for a development of a local disaster plan
American Red Cross
works with other agencies to provide relief services after a disaster; not responsible for local disaster plan
Department of Homeland Security
focuses on protecting US from threats and hazards
Centers of Public Health Preparedness
provide emergency preparedness training to public health employees
Epidemiological triangle
Mycobacterium tuberculosis for TB is the Agent (biological, chemical or physical entity that is responsible for the health alteration)
Epidemiological triangle
host-living species that can be affected by a disease-producing entity
Epidemiological triangle
reservoir-person, animal, arthropod, plant, soil, substance in which an infectious agent lives
Epidemiological triangle
environment: everything that influences an individual host
q to determine if client is socially isolated
how often do you have visitors come to see you?
osteoporosis prevention
encourage the women to participate in weight-bearing activities; sun exposure-ok with precautions; this will increase the absorption of vitamin D (important for bones); vitamin E-no relationship to bone density or prevention of osteoporosis
ADHD school-age child
reward and consequence system throughout the day-provide positive feedback while trying to minimize negative behaviors; will concentrate better in the morning, not afternoon; limit distractions/no music during study ; have a consistent daily routine
hip arthroplasty postop
use assistive devices to retrieve items that are on the floor; no pillow under the knees; use incentive spirometer q 2hrs while awake; apply antiembolic stockings before getting out of bed
Mitoxantrone q 3 months for pt with MS
report sore throat-greatest risk is severe infection due to myelosuppression
outbreak of scabies suspected
action for nurse to take First: determine incidence rate (nursing process)
Ethical decision making: utilitarian aproach
a public health nurse examines potential negative consequences of proposed public policy
utilitarianism
ethical approach to decision making that considers only the outcomes or consequences in determining which choice to make
nurse functions as an advocate when
serves on a community task force for suicide prevention
nurse functions as a clinician when
administers immunization to a group of migrant workers; conducts cholesterol screening at a senior center
nurse functions a nurse manager when
she supervises a home health aide on proper hygiene care
older adults age related health changes
decrease sensitivity to pain due to loss of neurons and fibers; decreased peristalsis, delayed gastric emptying; prebyopia-may require near objects to be held further away in order to be seen; distance vision decreases, narrowing the client's visual field
Osteoarthritis
take a hot shower or bath daily; consume a well-balanced diet; if overweight, lose some lbs; get 8-10 hrs of sleep at night, and a nap during the day of 1-2 hrs; exercise daily; of high pain days, client should limit repetitions or intensity of activity
COPD malnourished pt
use milk instead of water when making soup-will increase protein intake and calories; maintain an upright position such as High Fowler or the orthopneic position; foods high in protein-such as eggs are good; limit liquid intake at meal times
student at local high school diagnosed with syphilis
report to state health dept;
pt in Hospice care-Denial stage
"I'm looking forward to my daughter's wedding next year"
family member caring for another family member that has cancer
barrier to care: the primary wage earner in the family recently became unemployed
kidney disease pt decides to quit dialysis
role of nurse is to seek clarification why: "What has changed to make you decide this?"
this pt is a priority
Active pulmonary TB, nonadherent to prescribed treatment-nurse has to check if he is breathing ok and and if disease is progressing; also this is a community problem-communicable disease
HbA1c
know values
postpartum blues
normal first 10 days
parish nurse role
facilitating substance abuse groups
home health/wound care nurse role
wound care for clients in their home
occupational nurse role
planning safety services for employees in local workplace
home health/hospice nurse role
provide pharmacologic pain management for clients with terminal ilness
Tertiary level of prevention
teaching a client with RA measures to prevent joint deformities
Secondary level of prevention
obtaining blood pressure on a client being treated for anxiety; screening older adult clients for new-onset depression
HPV transmission
oral contact; sexual contact;
family genogram
used to determine the client's non modifiable risk factors
Modifiable risk faactors
dietary habits, exercise, home safety
this pt is a priority
a client with diabetes mellitus and reports new erythema to the L foot-prevention of infection, common in diabetes foot ulcers
Captopril
! report Angioedema-life threatening;
Captopril
S/E weight loss, bradicardia,
Smallpox
rash appears first on FACE; not on abdomen