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147 Cards in this Set
- Front
- Back
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Intimate partner violence
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I p v is a pattern of assault is an course if behaviors that may include inflicted physical injury, psychological abuse, sexual assault, progressive isolation, stalking, deprivation, intimidation, and threats. These behaviors are perpetrated by someone who is, was, or wishes to be involved in intimate for dating relationship with an adult or adolescent entertained establishing control by one partner over the other
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Honeymoon period
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everything seems fine they treat you well they apologized a lot
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Controlling behaviors
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Constantly needs to know where you are. May try to convince you to get surgeries you aren't sure you want
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Escalation
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Control turns into arguments, yelling. They may call you names or hide your hormones to control you
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Violence
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Arguments become violent. They may hit or hurt you or your pets or possessions
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What not to do as a nurse for an abusive patient
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Address the issue with the partner present assume you must convince her to leave, suggest marital counseling, give and solicited advice, tell her to go to a shelter, be annoyed if the victim has done something by her next appointment.
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Framing questions
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Because so many women I see in my practice are involved with someone who hits them or threatens them I now ask all my patients abuse. Example: I don't know if this is a problem for you but many of the women I see you're dealing with abusive relationships some are too afraid or uncomfortable to bring it up themselves so I asked it routinely
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Indirect questions
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You mentioned that your partner uses alcohol how does he act when intoxicated? Does he ever act in ways that frighten you?
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Direct questions
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Did someone hit you? Who was it? Was it your partner? I'm concerned that your symptoms may have been caused by someone hurting you. Has someone been hurting you?
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Questions not to ask
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You're not being hit by your boyfriend are you? This is asking in a negative way which makes it hard to say yes. How did you get hurt? This question makes it easy for both the women and the provider to deny the source of the abuse
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Assess the immediate needs safety first
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Is the victim's partner here now more likely to return? Does she want you to call security or the police? Does she want to leave with her partner? Does she need to call someone to pick up her children? Does she need to be home by a certain time to avoid further abuse?
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Management
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Successfully controlling something such as in organizations financial for human resources directing and supervising others
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Leadership
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Leaders carry many roles. They are teachers, visionary, decision makers and mentors.
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4 types of followers
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Sheep, yes people, alienated followers, effective followers
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Sheep
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Dependent uncritical thinkers. Do what told not overly engaged
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Yes people
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Dependent uncritical thinker. Go about their work without making a greater contribution to the organization just doing their assigned task. If there's a problem they won't tell anybody.
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alienated followers
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Independent critical thinker. Go home and complain
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Affective follower
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Independent critical thinker trying to make a difference
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disaster
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sudden natural or man made event that causes widespread destruction and distress
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internal disasters
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disrupts within the hospital
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external disaster
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occurs in community and effects large number of people in community
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multiple patient incident
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fewer than 10
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multiple mass casulty incidents
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100 or more. can effect transportation and can be man made or environmental.
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disaster management stages
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preventative,prepardeness/plan stage, response,recovery
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preventative stage
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identify potential disaster risks,create risk maps,educate citizens regarding what actions to taketo prepare for disasters,individual,family and community levels. develop a plan for meeting potential disasters identified.
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prepared and planning stage
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training in first aid,establishing a predetermined meeting place away from home,making family communication plan.
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response stage
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begins immediately after disasters. the community plans that have been established are now initiated.
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recovery stage
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begins when the danger from the disaster has passed,amd all local,state, amd federal agencies are present in area to help victims rebuild their lives amd help community restore public services.
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community response to a disaster
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heroic,honeymoon, disillusionment phases, reconstruction phase.
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heroic phase
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everyone feels need to rush in and help, medical responders work hours wothout sleep.
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honeymoon phase
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people that have survived gather aroind and discuss similar experiences
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disillusionment phase
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time has elapsed andand a delay in receiving aid that was promised. people realize thimgs aren't the way they used to be.
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reconstruction phase
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once community has restored some of the buildings, businesses, homes and services. people begin looking into the future.
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nerve agents
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highly toxic, systemic effects similar to organophosphate poisoning. v-series amd g-series SARIN most common. exposure results in cholinergic crisis. antidote :atropine and pralidoxime.
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SARIN
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high lethality. treatment:move to fresh air,wash skin, drugs limited effectiveness. likely a nerve agent, chemicals needed to produce this are banned.
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blister agents/vesicamts
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exposure is topical or by inhalation. blistering of skin and mucous membranes most common signs. anticipate need for aggressive airway management. decontamination includes thorough washing of skin.
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pulmonary agents
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chlorine and phosgene. exposure most likely from inhalation. pulmonary symptoms manifest quickly. aggressive airway and breathing management.
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blood agents
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cyanide : odorless gas, almond smell. cyanide poisoning causes metabolic acidosis. interferes with oxygenation at cellular level. found in consumer products and pesticides.
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anthrax
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(incubation 2-60 days)lethality very high, prevention vaccine, treatments antibiotics early if late nothing, likely agent that is resistant to weather, can be stored.
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plague
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icubation 1-3 days. 100%lethality if not treated. no vaccine for prevention. antibiotics treatment. not considered a likely agent. difficult to turm into a weapon.
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smallpox
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high lethality. vaccine prevention. treatment is symptomatic: secondary infections. one person could possibly cause a natiomal epidemic.
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botulism
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high lethality. vaccine being tested for prevention. treatment: antitoxin requiring intensive supportive care. not considered a likely weapon
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biologic agents
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requires high index of suspicion. observe for patterns or clues, large number of patients presentimg with similar signs amd symptoms. unusual age distribution for a common disease.
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radiological weapons
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simple radiological device. radiological device
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primary prevention
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knowing there is potential for disaster
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secondary prevention
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disaster already happened-triage ( red cross) helping find safe place
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tertiary
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returning back to normal
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nursing roles in disaster management
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triage of patients, direct patient care, disaster systems planning, disaster prepardeness education, prevention, policymaking, research.
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risk map
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geographic map of an area that is analyzed for impact of a potential disaster on the population and building in area that would be involved.
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resource map
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geographic map that outlines the resource that would be available in or near the area. ex:shelters,
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imminence
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speed of onset of an impending disaster and relates to the extemt of forewarning possible and the anticipated duration of the incident. ex:weather fprecaster tellimg wjen when a hurricane may be developing days ahead of its expected arrival.
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environmental health
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aspects of human health, disease, and injury that are determined or influenced by factors in the environment. this includes study of direct pathological effects or various chemical,physical and biological agents .
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critical theory is a way of thinking upstream.
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approach that raises questions about oppressive situations involves community members in the definition and solution of problems and facilitates intervention that reduces health damaging effects of environments.
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precautionary principle
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when an activity raises threat of harm to human health or the environment precautionary measures should be taken even if some cause effect relationships are not established scientifically.
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environmental health history can:
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increase awareness of factors,improve timeline and accuracy of diagnosis, prevent disease and aggrevation of conditions, identify potential work related evironmental hazards or hazards in and around client's home.
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living patterns
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relationship among people, communities and their surrounding environments that depend on habits, interpersonal ties, cultural values amd customs. ex: drunken driving, secondhand smoke, noise exposure, urban crowding, technological hazards.
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work risks
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quality of employment environment amd tbe potential for injury or illness posed by working conditions. ex: occupational toxic poisoning, machine operating hazards, sexual harassment, repetitive motion injuries, carcinogenic worksites
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atmospheric quality
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refers to protectiveness of atmospheric layers, risks of severe weather, and purity of air for breathing purposes. ex:gaseous pollutants, greenhouse effect,destruction of ozone layer,aerial spraying of herbicides and pesticides,acid rain.
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water quality
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availability and volume of water supply and mineral content levels, pollution by toxic chemicals. ex: contamination of drinking water by human waste, oil spills in worlds waterway, pesticides or herbicides infiltration of ground water, heavy metal poisoning of fish
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housing
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environmental health comcern and refers to availability,safety,structural strength, cleanliness,location of shelter. ex: homelessness,rodent amd insect infestation, poisoning from lead based paint, sick building syndrome, unsafe neighborhood.
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food quality
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refers to availability, relative costs,variety, amd safety of foods, health of animal and plant food source. ex:malnutrition, bacterial food poisoning, food adulteration, disrupted food chains by ecosystem destruction, carcinogenic chemical food additives.
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waste control
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management of waste materials resulting from industrial and municipal processes, human consumption,and efforts to minimize waste production. ex: non biodegradable plastics, poorly designed solid wastedumps, inadequate sewage system.
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radiation risk
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health danger posed by various forms of ionizing radiation relative to barriers preventing exposure of humans amd other life forms. ex: nuclear facility emissions, radioactive hazardous wastes, radon gas seepage in homes and schools, nuclear testing, excessive xray2
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disaster
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event that causes a level of destruction, death or injury that affects the ability of the community to respond to incidemt using available resources.
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casualties
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classified as a direction victim, an indirect victim,displaced person or refugee.
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direct victim
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an individual who is immediately affected by the event
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indirect victim
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may be a family member or friend of victim or a first responder.
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displaced persons
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those who have to evacuate their home, school or business as a result of a disaster.
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refugee
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group of people who have fled their home or even their ciuntry as result of famine,drought,natural disaster, war,or civil unrest.
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types of disaster
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natural-blizzard, wildfires, hurricanes. man made - terrorism, fires, toxic spills. combination. na-t ech natural technological -widespread technological problems.
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terrorism
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unlawful use of force and violence against persons or property to intimidate or coerce a government civilian population.
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weapons of mass destruction
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any weapon that iis designed or intended to cause death or serious bodily injury through release, dissemination, or impact of toxic or poisonous chemicals. ex: Vx, radon, chlorine, hydrogen cyanide, sarin.
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characteristics of a disaster
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frequency, predictability, preventability, primary prevention, risk map,resource map,secondary prevention, tertiary prevention, imminence,scope and number of casualties, and intensity.
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frequency
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how often event occurs
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preventability
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some not stopable, hurricane, tornadoes, earthquake, flooding is controllable.
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secondary prevention
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happens once the disaster has occurred (search, rescue, triage )
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imminence
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speed of onset of the impending disaster
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scope and number of casualties
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range of its effects
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hot zone
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chemical warfare -to assist in determining priorities for resuscitation, decontamination, pharmacological therapy, site evaluation.
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focus of nursing assessment
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focus is on community or population health staus rather than individuals health status. we are challenged to balance short term crises with progress towards long term goals
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communities and population
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community is the patient. locality based entity, composed of systems, formal organizations reflecting society's institutions, imformal groups and aggregates. the definition includes 3factors of person,place,and function.
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community as a client
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community is the client only when nursing focus is on collective or common good of population instead of individual health. community oriented practice seeks healthy healthful change for whole communities benefit. the nurse ,ay work with individual, family,or other interacting groups,aggregates or institutions or within a population,the resukting changes are intended to effect entire community.
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goal of community - oriented practice in community health
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status ( outcome dimension ), structural dimension, process dimension
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status ( outcome dimension )
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physical parameters, physical,emotional,and social ( morbidity and mortality), life expectancy indexes,risk factor profiles
emotional parameters, consumer satisfaction, mental health index social parameters-crime rate and function levels |
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structural dimension
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measures of community health services, resources such as use patterns, treatment data from various agencies and provider to client ratios. also included are attributes of the community structure itself, commonly identified as social indicators or correlates of health such as demographic data (sociak and racial distrubution, age and educational status).
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Process dimension
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notion of community competence,a process where part of the community are able to collaborate effectively in identifying the problems and needs of a community. achieving a working consesus on goals and priorities, agree or ways and means to implement the goals amd collaboration effectively.
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health planning model
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developed in response for the needs to be population focused. it is aimed at the large aggregate within the system. In the system approach it uses assessment, planning, intervention and evaluation.
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steps in the needs assessment process
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1. identify aggregate for assessment 2. identify required information 3.select method of data gathering 4 develop questionairre or interview questions 5develop procedures for data collection 6 train data collectors 7 arrange for a sample representative of the aggregate 8 conduct needs assessment 9 tabulate and analyze data 10 identify needs suggested by data 11 develop an action plan
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american fact finder
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find population,housing, and economic and geographic data for your city based on U.S. census data
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fedstats
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easy access to statistics and information produced by more than 100 us federal government agencies
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informant interviews
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informants could be people who are familiar with and interact with population on a regular basis. long term residents or informal leaders will be best source of information. this can help with residents personal insights and beleifs about the problem. ex of questions :strengths/assets of community. areas of improvement of community. concerns of community behaviors, access to health care
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focus groups
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small groups of 6-12people can be helpful when one is gathering information about specific areas of concern within the population. this involves open dialogue about population, whereas an interview or survey yields only individual respomses.
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surveys
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needs to take into consideration the developmental level of the group that is being assessed. questions should be written at appropriate developmental level sothey are answered in a way that makes data useful. surveys include closed ended multiple choice likert scale or open ended questions
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data interpretation
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after data has been collected it is important to analyze the info to identify significant trends or themes.
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nursing process in community
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assess and analyze, diagnosis, planning, implementation, evaluation
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assessment amd analysis
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include community members in process
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diagnosis
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identify health issues and problems
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planning
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involve community leaders
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implementation
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health education,screening, direct health services.
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evaluation
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include both process and outcome evaluation. community contribute to evaluation process
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kellerman 5 type of followers
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1 isolates/ 2 bystanders 3 participants / 4 activists 5 diehards
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isolates/bystanders
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little interest or attachment to work place
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participants amd activists
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engaged, make significant impact upon success of work unit
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diehards
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individuals who always come back early from coffee breaks, complete charting on time, lend extra hand of help to others when needed. often are whistle blowers and take steps to right their wrongs.
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management process 5 step
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planning, organizing, staffing, directing,controlling
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leadership roles
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provide a vision, be a mentor, increase productivity for the organization: time and motion studies, use experienced workers,formal system, hire, train, promote based on competence, economic incentives( more productive), manage plans, prepares and supervises ( not works)
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theory y manager
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workers enjoy their work,self motivated and willing to work, hard to meet personal and organizational goals.
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global health
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state of complete physical, mental, amd social well being amd not merely absence of disease or infirmity (w.h.o.)
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world population distribution is uneven
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over 50 percent live in China ( 1.3 billion ) india 1.2 billion former soviet union (mostly russia 141 million ) larger land mass. u.s. 317 million Indonesia 225 million
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children deaths
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9 million children under age of five die every year. 70%of these deaths due to conditions that could be prevented ot treated with access to simple affordable interventions. leading cause of death pneumonia, diarrhea, and health problems during first month of life. one third of deaths are malnutrition
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significant progress in children dying under 5
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children in sub Sahara africa more than 15 times more likely to die before age of five. millennium development goal 4 by 2015 was to reduce by 2/3 the under 5 mortality rate.
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life expectancy
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Andorra (between France and spain) notoriously wealthy and state funded health services -highest life expectancy on avg 83.5 America -78.37
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urbanization
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people live closer together and migrate to urban areas for work. with crowding increase environmental factors and disease.
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poor health
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poor health of mothers is linked in poor health of babies and failure of children to reach their full mental and physical potential. if we can get mother wic. by educating women country more stable wic monitors and limits what they buy
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how do you develop the country?
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high rates of malaria or HIV have difficulty attracting the investment needed to develop their economy. companies beleive that it is hard to make profit because their workers would be infected.
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technical cooperation
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some global health issues require technical cooperation across countries because few countries themselves have the technical capacity to deal with them.
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global cooperation
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worldwide can't even agree statewide. global cooperation is needed to establish standards for drug safety,to set protocol for treatment of certain health problems such as malaria or to develop aids vaccine that could serve needs of low income countries
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global health
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implies that ome considers health problems from a global perspective rather than from point of view of am individual country. global health implies that countries work together not only to understand critical health issues but also to solve them.
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global health issues
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number of low birth weight babies being born,high rates of death of babies in first month of life,measles in young children, diarrhea amd pneumonia in young children, health of hiv/aids in orphans, sti's in young women,tb,malaria, parasitic infections such as hookworm,increase 8f diabetes amd heart disease (except Africa heart disease is number one killer)
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m.g. 1
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eradicate extreme hunger and poverty -target halve the proportion of people whose income is less than $1day halve the proportion of people who suffer from hunger
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m.g.2
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achieve universal primary education -ensure boys girls everywhere will complete full course of primary education
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m.g.3
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promote gender equality and empower women- eliminate gender disparity in primary amd secondary education in all levels of education by 2015
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m.g. 4
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reduce child mortality -reduce by 2/3 between 90-2015 the under 5 mortality rate
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m.g. 5
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improve maternal health reduce by 3/4 the maternal mortality ratio
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m.g.6
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combat aids/hiv,malaria and other diseases . have halted by 2015 and begun reverse the spread of hiv. reverse incidence of malaria and other major diseases
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m.g. 7
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ensure environmental sustainability - integrate principles of sustainable development into country policies and programs and reverse loss of environmental resources. halve by 2015 the %of people without access to safe drinking waterand basic sanitation. have achieved by 2020 a significant improvement in lives of at least 100 million slum dwellers.
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m.g. 8
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develop a global partnership for development- develop further an open rule based predictable non discriminatory trading amd financial system,. address special needs of least developed countries,deal comprehensively with debt problems of developing countries through national and international measures in order to make debt sustainable long term
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nurses in Indonesia
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when not providing direct client care, help clean up hospital grounds
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infant mortality rate
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# of deaths of infants under age of 1 per 1000 births in a year
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life expectancy at birth
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avg # of years a newborn baby could expect to live if current mortality trends were to continue for rest of newborns life.
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maternal mortality ratio
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#of women who die as result of pregnancy and childbirth complications per 100,000 live births that year
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neonatal mortality rate
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#of deaths of infants under 28 days of age in a year per 1000 live births that year
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under 5 mortality rate
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probability that newborn baby will die before age 5 expressed as a number per 1000 live births
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morbidity
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sickness or any departure subjective or objective from a psychological or physiological state of well being
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incidence rate
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flow of new cases of people woth disease each year in that pool
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prevalence
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pool of people with a disease at particular time
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HALE SCORE CALCULATION
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world health organization calculates HALEs for most countries, using standard methodology. they use years of ill health which are weighted according to severity and subtracted from overall life expectancy. the greater number of years that people in any population are likely to spend in ill birth and health adjusted life expectancy.
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Disability Adjusted Life Year (daily)
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composite indicator of health staus that is most commonly used in global health work. A unit for measuring the amount of health lost because of a particular disease or injury. calculated as present value of future years of disability free life that are lost as the result of premature deaths or causes of disability occurring in a year. it measures how many healthy years of life are lost between populations being measured and healthiest possible population which is used as standard. It does this by adding together the losses of healthy years of life that occurfrom illness,disability, amd death.
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daly score
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value of disability is based on values that have been established for severity of different disabling conditions. by using Dalys you have better estimate that measured deaths alone. DALY score offers a true health of a population. ( some diseases cause disability not death - mental health so it is a more valuable tool.) a society that has more premature deaths, illness and disability has more DALY than a society that is healthier and has less illness, disability and premature death. one of the goals of healthy policy is to avert these DALY in the most cost efficient manner possible.
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theory x manager
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believe employees are lazy,need supervision, amd that they are indifferent.
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Great man theory
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some born leaders
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trait theories
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some have personality characteristics and strengths that make them better.
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authoritarian
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autocratic, tight control
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Democratic
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less control, involves others
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laissez-faire
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non directed leadership
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good leaders
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finds ways to provide employees with more predictability, understanding control, and compassion, and reward is long term loyalty.
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cultural bridge
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need to serve as cultural bridge, seek out and respect other viewpoints. create a work environment where cultural differences are recognized and valued.
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