Exam 1 Study guide Health Promotion,Disease Prevention PDF

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Community 1st exam study guide...

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8 NUR 3047C Ex1 Community study guide (ch 1, 3, 4, 6, 7, 15) Ch 1 Trending in nursing employment sites (p 2):  

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Between 1980 and 2015, the number of nurses employed in the community, health, and ambulatory care settings more than doubled. The decline in the percentage of nurses employed in hospitals and the subsequent increase in nurses employed in community settings suggests a shift in focus from illness and institutional based care to health promotion and preventative care. This shift will likely continue into the future as alternative delivery assistance, such as ambulatory and home care, employ more nurses.

Ethical beliefs in current health care p 2: 

The mission of public health is social justice, which entitles all people to basic necessities such as adequate income and Health Protection and accepts collective burdens to make it possible.

Healthy people 2020 -personal choices p 5: 

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Personal choices (A total of 12 leading health indicators were identified that reflected the major public health concerns in the United States; health outcome determinants): -they are individual behaviors (e.g. tobacco use, nutrition, physical activity, and obesity); Each of these indicators can affect the health of individuals and communities and can be correlated with leading causes of morbidity and mortality. For example, tobacco use is linked to heart disease, stroke, and cancer; substance abuse is linked to accidents, injuries, and violence; irresponsible sexual behaviors can lead to unwanted pregnancy as well as sexual transmitted diseases, including human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS; and lack of access to health care can contribute to poor pregnancy outcomes, untreated illness, and disability. -physical and social environmental factors (e.g. Environmental Quality, injury, and violence) -health systems issues (e.g access to health services) -biology and genetics It has been estimated that individual behaviors are responsible for 50% of all premature deaths in the United States (p 4). Lifestyle choices contribute markedly to early deaths. Every 10 years, the U.S. Department of Health and Human Services publishes a national prevention initiative titled Healthy People. One of the new objectives for Healthy People 2020 is to improve the nation's ability to prevent, prepare for, respond to, and recover from a major health incident. Broad goals of healthy people2020: -Attain high-quality, longer lives free of preventable disease, disability, injury, and premature death. -Achieve high equity, eliminate disparities, and improve the health of all groups.

-Create social and physical environments that promote good health for all. -Promote quality of life, healthy development, and healthy behaviors across all life stages. Community health def of health p 6 & 4:  

The term community health extends the realm of public health to include organized health efforts at the community level through both government and private efforts. A group or collection of individuals interacting in social units and sharing common interests, characteristics, VALUES, and GOALS. Community health extends the realm of public health to include organized health efforts at the community level through both government and private efforts. (concepts, ideas put into efforts); Public health and community health overlap.

Public health efforts (p 5, 6) Vs medical efforts: 

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Public health efforts focus on prevention and promotion of population health At the federal, state, and local levels. These efforts at the federal and state levels concentrate on providing support and advisory services to public health structures at the local level. The local level structures provide direct services to communities through two avenues: 1) community health services, which protects the public from hazards such as polluted water and air, tainted food, and unsafe housing; 2) personal health care services, such as immunization and family planning services, well infant care , and sexually transmitted disease treatment Public health efforts are multidisciplinary because they require people with many different skills. The local level of the health care system provides direct services to community members through community and personal health services. An example of a health service that targets the larger community, rather than individuals, is (Select all that apply.): Correct Answer: B. a mobile immunization clinic. C. condemning or repairing unsafe housing. E. airing a weekly public service announcement to remind women to do breast selfexamination. A mobile immunization clinic, repairing unsafe housing, and airing weekly public service announcements all target the larger population of a community. Public health efforts, such as immunization and clean air and water, and medical care, including management of acute episodic illnesses (e.g, cancer, heart disease), have also contributed significantly to the increase in life expectancy. Medical-care efforts: Focuses on disease management and “cure” (not prevention), in contrast to public health efforts, which focus on health promotion and disease prevention.

Primary prevention…egs of:  

Prevention of problems before they occur (immunizations) Disease prevention activities that protect people from disease and the effects of disease.

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An example of primary disease prevention is administering vaccines to children before kindergarten. Educate students on their practice of sexual abstinence or “safe sex” by using barrier methods Secondary prevention refers to early detection and prompt intervention during the period of early disease pathogenesis, such as checking the skin for signs of skin cancer or identifying and treating individuals who have been exposed to contagious diseases. (e.g., screening for sexually transmitted disease) -encourage testing and counseling for clients with known exposure or who are in high risk groups; provide referrals for follow-up for clients who test positive for HIV Tertiary: Correction and prevention of deterioration of a disease state (teaching insulin administration in the home); e.g. provide education on management of HIV infection, advocacy, case management, and other interventions for those who are HIV positive

Promotion of primary health 

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Health promotion activities enhance resources directed at improving well-being, whereas disease prevention activities protects people from disease and the effects of disease. there are three levels of prevention commonly described in nursing practice: primary prevention, secondary prevention, and tertiary prevention. Much of public health nursing practice is directed toward preventing the progression of disease at the earliest period or phase while using the appropriate levels of prevention.

Community based nursing -ATI:   

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Focus of care: individual families Primary goal: Management of acute or chronic conditions Nursing activities: Direct (one-on-one); Illness care: management of acute and chronic conditions in settings where individuals, families, and groups live, work, and “attend”(schools, camps, prisons) Community-based nursing—minor acute and chronic care that is comprehensive and coordinated where people work, live or attend school; illness care provided outside the acute care setting. Community-based nursing is setting specific and emphasizes care to individuals, often in homes and ambulatory clinics, and typically addresses acute and chronic health conditions.

Community health nursing-ATI (community-oriented nursing/public health nursing [populations focused]):   

Focus of care: aggregates, communities, populations (public health). Can include at-risk or unserved individuals and families Primary Goal: health promotion and disease prevention Nursing activities: Usually indirect (program management). Can include direct care of atrisk individuals and populations

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focus on population health through continuous surveillance and assessment to promote health and wellness, prevent disease, etc. Community health nursing—use of systematic processes to deliver care to individuals, families and community groups with a focus on promoting, preserving, protecting, and maintaining health Public health nursing—population-based practice, defined as a synthesis of nursing and public health within the context of preventing disease and disability and promoting and protecting the health of the entire community Which is an example of "community health nursing" rather than "community-based nursing"? An RN reviewing school clinic records to determine which children are not up to date on their immunizations

The best definition of health p3: 

The WHO Define health as “a state of complete physical , mental, and social wellbeing and not merely the absence of disease or infirmity.”

Ch 3 n 4 Upstream thinking (macroscopic approach):      

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Focus on economic, political, and environmental factors It is a conceptual model to assist the nurse in community health planning. It helps to focus the time, energy, and programmatic resources available to community health nursing clients. It focuses the nurse on long-term, "bigger picture" issues related to community health practice, such as social justice or power. Theory assists the community health nurse in applying upstream thinking, including a proactive approach to population-focused care. The Upstream view: society is the focus of change (macroscopic): upstream thinking is used to focus on interventions that promote health or prevent illness, as opposed to medical treatment models that focus on care after an individual becomes ill. Definition of upstream thinking: Actions focus on modifying economic, political, an environmental factors that are precursors of poor health throughout the world. Which of the following statements is NOT true about the "thinking upstream" model of community health nursing practice? It focuses the nurse on short-term, individual-based nursing interventions. Thinking upstream: Examining the origins of disease, nurses identify social, political, environmental, and economic factors that often lead to poor health options for both individual and populations. Refocus the efforts of nurses “upstream,” where the real problem lies (root cause analysis).

Orem theory (microscopic):    

Orem's self-care deficit theory is based on individual self-care needs and explains the level of nursing interventions required to assist clients to obtain optimal health. Based on the assumption that individual needs and related activities are the focus of nursing care. Which of the following assumptions makes Orem's theory difficult to use? That clients are able to control their environment. Weakness: Assumes that people are able to exert purposeful control over their environments in the pursuit of health; however, people may have little control over their physical or social aspects of their work environment. On the basis of this thesis, conclusion that the self-care model is incompatible with the practice domain of occupational health nursing.

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Most nursing theories focused on microscopic individual concerns. Were narrow, depicted health care situations that involved only one nurse and one patient, ignored care in context (family members and other HCP were noticeably absent from the context of care).

Health belief model-weaknesses (microscopic):    

Which of the following assumptions of the health belief model (HBM) is problematic? People have both free will and access to health resources. It ignores the need to reduce health system barriers to action. The choice and the burden for acting are entirely with the client. The HBM allows only two possible outcomes :“acts”, “fails to act”: Did the client act or fail to act in their health promotion; Did the client act or fail to act in their health promotion

Milios’s concept/advantages (macroscopic; framework for prevention; upstream thinking; p 41-43):  

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The belief that health deficits result from an imbalance between the population's health needs and its health-sustaining resources. Milio believed that national level policy making was the best way to favorably affect the health of most Americans rather than concentrating efforts on imparting information in an effort to change individual patterns of behavior. She said that government and institutional policies set the range of health options, so community health nursing needs to examine a community's level of health and attempt to influence it through public policy. Compared with the health belief model, Milio’s framework provides for the inclusion of economic, political, and environmental health determinants; therefore, the nurse is given broader range in the diagnosis and interpretation of health problems.

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Milio's theory demonstrates upstream conceptualization of understanding the community's health needs and resources; this theory complements the Health Belief Model (HBM). The HBM offers indicators of the perceived seriousness, perceived susceptibility, and cues to action related to specific health behaviors. A nurse is using Milio's framework to promote healthy eating choices among members of the community. Which of the following interventions would the nurse most likely implement? Promote legislation to increase taxation on unhealthy food choices A nurse is using Milio's framework for prevention to improve the health of clients. Which of the following would the nurse most likely implement? Create appropriate national health policies A nurse is using Milio's approach when caring for a client. Which of the following advantages will the nurse experience? It will encourage the assessment of the personal and societal resources of the client.

Using Healthy People 2020 to improve health of community p 52: -Goals of Healthy People 2020: 1. attain high quality, longer lives free of preventable disease, disability, injury, and premature death 2. achieve health equity, eliminate disparities, and improve the health of all groups 3. create social and physical environments that promote good health for all 4. promote quality of life, healthy development, and healthy behaviors across all life stages  

foundation of national health promotion and the underlying premise is that the health of the individual is almost inseparable from the health of the larger community A nurse is using Healthy People 2020 as a guide to improve the health and well-being of the community. Which of the following strategies would the nurse most likely implement? Address the root causes of health problems

Examining self to work with the community:  Health protection as part of primary prevention (vaccines) p 52: 

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Health Protection consists of those behaviors in which one engages with the specific intent to prevent disease, to detect disease in the early stages, or to maximize health within the constraints of disease. Immunizations and cervical cancer screening are examples of Health Protection activities. Action taken prior to the occurrence of a health problem: ex) TB vaccine Educate students on the practice of sexual abstinence or safer sex by using barrier methods

Definition of health p52: 

Health is a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.

Theory of planned behavior p56-57:

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Theory of planned behavior was an addition to the theory of reason to action which is based on the assumption that all behavior is determined by one's behavioral intentions. With the addition of perceived control the theory of planned behavior was developed. One's subjective norm is determined by one's normative beliefs, or whether or not important people in one’s life approve or disapprove of the behavior under consideration, are weighed by ones motivation to comply with those important persons. A nurse is using the theory of planned behavior when working with a client to change her behavior and improve her health. Which of the following considerations should be made by the nurse? The client's belief about factors that may facilitate or impede the behavior

Tertiary prevention egs:   

Aims of tertiary prevention are to keep health problems from getting worse, reduce the effects of disease and injury, and restore individuals to their optimal level of functioning. Examples of tertiary prevention include teaching prevention of complications from disease or referring a patient with a stroke for rehabilitation. Activity aimed at returning the client to the highest level of function and preventing further deterioration: ex) medical tx for TB

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A nurse is using the critical theoretical perspective in practice. Which of the following best describes how the nurse would respond when a client suggests that the physician prescribe a widely advertised medication for tension and anxiety? (Select all that apply.) a. Can you tell me what is going on in your life right now? f. What have you tried in the past to relieve tension and anxiety? According to the critical theoretical perspective, which of the following should be held responsible for many of the illnesses of Americans today? (Select all that apply.)all correct (a, b, c, f) a. Advertisers who market sugar- and fat-saturated food products b. Alcoholic beverage manufacturers, marketers, and sellers c. Manufacturers of products that increase morbidity and mortality f. Tobacco manufacturers who sponsor sports events

Ch 6 Community assessment p 101-102:

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Community assessment is a comprehensive approach that emphasizes the community as a client, with the goal of providing benefit to the people of the area as a whole, rather than to individuals. ATI book chapter 4 Community assessment and diagnosis are the foundation for community specificprogram planning (ATI) using the nursing process (ADPIE), nurses can determine health needs within the community and assist in developing and implementing strategies to meet those needs. In doing this it is necessary to expand the assessment, diagnosis, planning, intervention, and evaluation efforts from the individual to the community or aggregate level. (ATI) Community assessment begins with defining the community to be studied. The community can be those in a shared place (geographic community), those with a shared characteristic (demographic group), or with a common interest (functional community) (ATI) The community health nurses role is to interact and establish contracts with community partners serving the community at large Factors to consider when determining the health of the community: status, structure, process

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Community assessment components: demographic, biological factors (health and disease status, genetics, race, age, gender, causes of death), social factors, cultural factors, physical factors, environmental factors, and social systems.

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A needs assessment is completed by the community health nurse to gain understanding of the community's perspective on health status, the services used or required, and concerns. A large-scale community needs assessment may help the nurse determine gaps in service. Involving community members in the planning of the assessment builds trust and ownership in the process, and subsequently in the improvements that result. Steps in the Needs Assessment process: 1. identify aggregate for...