Community 315 - Exam 1

olanjones's version from 2017-01-29 17:33

Public Health Functions

Question Answer
Core Functions of Public Health NursingAssessment of the community, Health policy development, Assurance that services are provided
Primary prevention correlates with which stage of Natural Hx of Disease model?Susceptibility - Primary focuses on preventing the health condition before it occurs (immunizations, education)
Secondary prevention correlates with which stage of Natural Hx of Disease model?Sub-clinical - Secondary focuses on early detection through diagnosis and intervention (screening)
Tertiary prevention correlates with which stage of Natural Hx of Disease model?Clinical & Recovery/Disability/Death - Tertiary focuses on preventing further deterioration (physical therapy, diabetic foot care)
What are risk factors?Conditions that increase the probability of a disorder (smoking --> heart disease, cancer)
What are protective factors?Conditions that inhibit, reduce, or buffer probability of a disorder (daily walking -/-> heart disease)
Focus of Community-oriented nursing practice?Community diagnosis & investigation of major health problems, health surveillance, monitoring & eval of community health status (prevent disease/disability; promote/protect/maintain health)
Focus of Public Health nursing practice?Community as a whole & effect of community's health status & resources on health of individuals, families, & groups - It is a type of community-oriented nursing
Focus of Community-based nursing practice?Acute & chronic care and provision of comprehensive, coordinated & continuous services (Do not usually provide care for every aggregate)
Steps of the Prevention Science FrameworkDefine problem; Identify Risk/Protect factors; Intervention, Implement/Eval
What are social determinants of health?Factors that influence a patient's health (Income, Education, Race/Ethnicity, Transportation, Housing, Insurance, Food access, Complex health needs)
4 goals of Healthy People 20201. Attain high-quality/longer lives free of preventable disease 2. Achieve health equity 3. Create social/physical environment that promote good health 4. Promote quality of life/development across all life stages

Responsibilities of Public Health Nursing

Question Answer
Providecare to the disabled in their homes, including teaching of caregivers
Maintainhealthful environments
Teachabout health promotion & prevention of disease & injury
Identifythose with inadequate standards of living & untreated illnesses & disabilities & refer them for services
Preventand report neglect & abuse
Advocatefor adequate standards of living & healthcare services
Collaborateto develop appropriate, adequate, acceptable health care services
Carefor oneself & participate in professional development activities
Ensurequality nursing care & engage in nursing research

Scope & Standards of Public Health Nursing

Question Answer
What is the purpose of the Scope & Standards of Public Health Nursing? Provides guidance in the form of standards & competencies for generalist and the advanced public health nurses
Assessmentcollects comprehensive data pertinent to the health status of populations (Standard 1)
Population Dx & Prioritiesanalyzes the assessment data to determine the population diagnoses and priorities (Standard 2)
Outcome Identificationidentifies expected outcomes for a plan that is based on population diagnoses and priorities (Standard 3)
Planningdevelops a plan that reflects best practices by identifying strategies, action plans, and alternatives to attain expected outcomes (Standard 4)
Implementationimplements the identified plan by partnering with others (coordination, health ed & promotion, consultation, & regulatory activities) (Standard 5A-D)
Evaluationevaluates the health status of the population (Standard 6)

Public Health Nursing (MN) Wheel & 10 Essential Public Health Services

Question Answer
What are the Interventions found on the Minnesota Wheel?- Surveillance, Disease & Health Event Investigation, Outreach, Screening (Case Finding)
- Referral & follow-up, Case management, Delegated functions
- Health teaching, Counseling, Consultation
- Collaboration, Coalition building, Community Organizing
- Advocacy, Social Marketing, Policy development & enforcement
What are the 3 levels of practice in the Minnesota Wheel?Individual/Household, Community, Systems
Which interventions involve helping individuals/community?[Surveillance, Disease & Health Event Investigation, Outreach, Screening] - [Referral & follow-up, Case management, Delegated functions] - [Health teaching, Counseling, Consultation]
What interventions involve helping systems?[Collaboration, Coalition building, Community Organizing] - [Advocacy, Social Marketing, Policy development & enforcement]
Which Essential services fall under assessment?Monitor health; Diagnose & investigate
Which Essential services fall under policy development?Inform, educate, empower; Mobilize community partnerships; Develop policies
Which Essential services fall under assurance?Enforce laws; Link to/Provide care; Assure competent workforce; Evaluate

Public Health Leaders & Theorists

Question Answer
Mary SeacoleSelf-funded trip to Crimea to est. British Hotel near Balaclava to provide 'a mess-table &comfortable quarters for sick and convalescent officers' – rivaled Florence Nightingale
Florence NightingaleUsed mortality stats to show causes (preventable, wounds, accidents/other) to change hygiene standands
Lilian WaldHenry St. Settlement Founder (based on needs of community- food/shelter/clothing/health, arts, vocation/college prep)
Dr. John SnowBroad Street water pump/cholera spread in London – removed handle, deaths declined. Links btwn hygiene & health
Mary BreckenridgeFrontier School of Midwifery (KY) caring for children starts with care of mother
Dorthea DixPenitentiary reform for prisoners, mentally ill. Wrote Memorial to legis Massachusetts. In Civil War era became superintendent of nursing
Margaret SangerReproductive rights to rebel against Comstock Act (“immoral literature”). Opened first BC clinic in Brooklyn
Ignaz SemmelweisLobbied for hand-washing to prevent “child-bed” puerperal fever spread by Strep pyogenes
Urie BronfenbrennerSocio-ecological model - series of environmental systems that influence a child’s development which in turn may change how others respond to them which in turn further influences development (individual, influencers, community, society)
Sigmund FreudPsychosexual theory - personality is determined by age 5 (childhood). 5 stages, if not met fixation can occur
Lev VygotskySocio-cultural cognitive development theory - Importance of social interaction on development of cognition, Child internalizes the info they get from interaction with others
Lawrence KohlbergMoral development theory – Focus on moral-reasoning, how people think about right vs wrong. 3 levels (6 really) of moral development

Family Nursing Theory

Question Answer
What is a family?An open & developing system of interacting personalities with a structure & process enacted in relationships among the individual members, regulated by resources & stressors, and existing within the larger community
Goals of Public nursing in the home- Promote support systems that are adequate & effective
- Promote adequate, effective care of family member with specific problem r/t illness/disability
- Encourage normal growth & development of family members & educate about health promotion/illness prevention
- Strengthen family functioning & relatedness
- Promote healthful environment
Phases of Family visit relationship1. Preinitiation/pre-planning 2. Initial/introductory 3. Working 4. Ending
Family Needs ModelAssesses and analyzes family needs, family style, family strengths, and family functioning; The nurses assess, diagnose, plan, implement, and evaluate their nursing care for & with families.
Bowen's Family Systems Theory: Level of DifferentiationA person's ability to separate his/her emotions from thoughts (mindfulness - learn to respond instead of react)
Bowen's Theory: Triangle conceptAny 2 person system is unstable, tension develops between them, resulting in triangling in a 3rd person (In periods of calm, the distant position is uncomfortable, In periods of anxiety, the distant position is preferred)
Bowen's Theory: AnxietyThe more anxiety that is present, the more likely it is that people will react with automatic rather than thoughtful actions


Question Answer
EpidemicOutbreaks of infection affecting a larger number of people than would be expected, all at the same time
EndemicDisease/condition regularly found among particular people or in a certain area
PandemicOutbreaks affecting extremely high numbers of people, usually in may countries
Morbidityillness rates
Mortalitydeath rates
Incidencenew cases in a specified time, direct measure of magnitude of a new illness in a population, reflect the development of a disease
Prevalenceall existing cases a given point in time, determines measures of chronic illness in the populations and is affected by duration of disease, relevant in planning for health care services
Sensitivitythe ability of a screening test to identify correctly persons who have the disease
Specificitythe ability of a screening test to identify persons who are normal or without disease
ReliabilityConsistency/reproducibility of test results over time and between examiners
ValidityAbility of screening test to distinguish correctly between persons with and those without the disease

Epidemiologic Triangle: Host -> Environment ->Agent

Question Answer
What is communicable disease control dependent on?finding a weak link in the triangle, developing measures that attack/reduce/eliminate that threat
What are Host factorsthings that effect host resistance (Genetic makeup, age, sex, race, ethnicity, religion, marital status, lifestyle, immunologic state, Personal behavior, co-morbidity)
What are Environmental factors?All that is external to the host including Physical, Biologic, Social, Cultural
What are Agent factors?Infectivity, Pathogenicity, Virulence, Toxicity, Invasiveness, Antigenicity
How may Community health nurses assist in communicable disease control?help identify contacts placed at risk by exposure, monitor persons under treatment/ensure compliance, engage in epidemiological investigations of new diseases/outbreaks of recognized illnesses
What factors contribute to newly emerging/reemerging infectious diseases?Failure to vaccinate, Reduced emphasis on public health, Drug resistance, Crowding (threatens sanitary & other environmental conditions)


Question Answer
Invalid contraindicationsMild illness, Antimicrobial tx, disease exposure/convalescence, pregnant/immunosuppressed person in household, Breastfeeding, Preterm birth, FH of adverse events, Tb skin test/Mult vaccines
Live attenuated vaccineWeak form of the "wild" virus/bacteria, must replicate to be effective. Immune response is similar to natural infection (usually effective in 1 dose)
Inactivated vaccineGenerally require 3-5 doses, Immune response mostly humoral. Antibody titer falls over time; Principle antigen may not be defined
What is one of the largest contributors of failure to vaccinate?"missed opportunities" - Immunization record not reviewed at EACH encounter, Lack of knowledge of True Contraindications for administration

Developmental Milestones

Question Answer
1 monthLift head, Track with eyes, Coo, Recognize parent
6 monthsSitting up, Raking grasp, Babbles, Stranger anxiety
9 monthsWalk w/ assistance, 3 finger grasp, Might say mama/dada, Waves bye-bye, Plays Pat-a-cake
12 monthsWalks (gross motor), 2 finger pincer grasp (fine motor), Says mama/dada, Imitates parent (social/cognitive)
18 monthsUsually time for well child visit screening for developmental delay & autism
24 months2 steps(climbs stairs), 2 word phrases, 2 step commands, Will stack 6 blocks
36 monthsRides tricycle, 3 word sentences, Brushes teeth, Draws a circle
48 monthsHops, Can copy a cross, Plays with others

Piaget & Erikson Developmental Stages

Question Answer
Piaget - birth to 2 yearsSensorimotor: learn about the world by sensory input/motor activity
Piaget - 2-7 yearsPreoperational: thinks by using words as symbols, but logic not well developed
Piaget - 7-11 yearsConcrete operational: child can reason quite well is concrete objects are used in teaching/experimentation
Piaget - 11-end of lifeFormal operational: fully mature intellectual thought is now attained
Erikson - birth to 1 yearTrust vs Mistrust: if basic needs not met, infant will eventually learn to mistrust others
Erikson - 1-3 yearsAutonomy vs Shame: children who are criticized for autonomy (or lack of control) will feel shame (or doubt their abilities)
Erikson - 3-6 yearsInitiative vs Guilt: constant criticism for initiating activities will lead to feelings of guilt and lack of purpose
Erikson - 6-12 yearsIndustry vs Inferiority: a child takes pride in accomplishments, if they cannot accomplish what is expected they will feel inferior
Erikson - 12-18 yearsIdentity vs Role Confusion: an adolescent who cannot est. meaningful definition of self will experience confusion in one or more roles in life
Erikson - 19-40 yearsIntimacy vs Isolation: success in love leads to strong relationships, failure results in loneliness and isolation
Erikson - 40-65 yearsGenerativity vs Stagnation: success results in a sense of having contributed to the world, failure results in a feeling of being unproductive and uninvolved in the world
Erikson - 65-end of lifeEgo Integrity vs Despair: success results in a general sense of satisfaction and wisdom, failure results in regrets, bitterness, despair, and a feeling that life has been wasted

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