Community Focused Nursing; Excelsior Bsn

Front 1

Population-Based Practice is defined as practice that....

Back 1

a) focuses on entire populations
b) grounded in community assessment
c) considers all health determinants
d) emphasizes prevention
e) intervenes at multiple levels

Front 2

What are Population Groups?

Back 2

Populations, in community health nursing, can be groups of people who may or may not interact with each other. It may refer to residents of a specific geographic area, but can also include specific groups with common trait or attribute.

Hint 2

Exmpls:
geographic area:
residents of Los Angles, Seattle

common trait or attribute: minority groups, homeless population, company employees, school aged children, college campus students.

Front 3

What is the main focus of community health nursing?

Back 3

Front 4

Neighborhood in CFN refers to...

Back 4

neighborhood: smaller, more homogeneous group than a community; involves an interface with others living nearby and a level of identification with those others

Hint 4

Expls:
Neighborhood defined by a common language or cultural heritage: A Hispanic neighborhood; A Fillapino neighborhood

Front 5

In CFN, a family is defined as...

Back 5

A social system consisting of two or more people who define themselves as a family and who share bonds of emotional closeness.

Front 6

In CFN, a community is defined as...

Back 6

Community: a group of people who share common interests, who interact with each other, and who function collectively within a defined social structure to address common concerns

Hint 6

The critical distinction between Community and Neighborhood is that Community has a defined social structure containing institutions designed to accomplish designated functions such as education and social support services.

Front 7

What are the two subdivisions of communities?

Back 7

Geopolitical Community: characterized by geographic and jurisdictional boundaries.

Communities of Identity:
communities with common interests.

Hint 7

Expls:
Geopolitical Community: city; county; state; country

Community of Identity: college campus; student of a nursing program; members of a religious group; members of ethnic or cultural groups

Front 8

Define Population Health

Back 8

population health: the attainment of the greatest possible biologic, psychological, and social well-being of the population as an entity and of its individual members

Front 9

Define Population Health

Back 9

population health: the attainment of the greatest possible biologic, psychological, and social well-being of the population as an entity and of its individual members

Front 10

Community Health Nursing accomplishes...

Back 10

Ultimate goal is to raise the level of health of the citizenry.
To help communities and families to cope with the discontinuities in health and threats in such a way as to maximize their potential for high level wellness, as well as to promote reciprocally supportive relationship between people and their physical and social environment.

Front 11

Public Health Nursing accomplishes...

Back 11

Practice that promotes and preserves the health of populations, looking at the community as a whole and its effect on health of individuals, families, and groups.

Front 12

Health promotion activities are those that...

Back 12

Activities designed to improve or maintain the health status of individuals, families, and communities.
It is the science and art of helping people change their lifestyle to move toward a state of optimal health.

Hint 12

Expls:
annual screenings; smoking cessation classes; self-care of minor illness; successful management of chronic disease, use of sunscreen when outdoors; decreasing or cease of the use of pesticides on gardens and landscapes.

Front 13

WHO's definition of Health Promotion

Back 13

Health Promotion is the "process of enabling people to increase control over, and to improve, their health"

Front 14

Health Protection involves..

Back 14

science which is concerned with elements of the environment that influence people's health and well-being. Factors include: workplace conditions; home and community conditions; chemical, physical, and psychological forces.

Hint 14

Expls:
overpopulation; indoor and outdoor air pollution; water pollution; safe drinking water; noise pollution; radiation exposure; biological pollutants; hazardous waste management; disposal of garbage; vector control and pesticide management; deforestation of wetlands; inadequate housing; contaminated food; environmental work and home hazards like lead paint, exposed wiring, etc. etc.

Front 15

Define Advocacy

Back 15

Advocacy can be defined as action taken on behalf of, or in concert with, individuals, families, or populations to create or support an environment that promotes health.

Hint 15

Expls:
a) Education for healthier behaviors
b) Promotion of access to health care services
c) Changes in societal conditions that endanger health.

Front 16

What are the three roles of practice that community health nurses engage in?

Back 16

1. Client-oriented
2. Delivery-oriented
3. Population-oriented

Front 17

What are the client-oriented roles that the community health nurse engages in?

Back 17

1. Caregiver
2. Educator
3. Counselor
4. Referral resource
5. Role model
6. Primary care provider
7. Case manager

Hint 17

Client-oriented roles involve direct provision of services to individuals, families, and occasionally groups of people.

Front 18

What are the population-oriented roles that the community health nurse engages in?

Back 18

1. Case-finder
2. Leader
3. Change Agent
4. Community Mobilizer
5. Coalition Builder
6. Policy Advocate
7. Social Marketer
8. Researcher

Hint 18

Population-oriented roles are those directed toward promoting, maintaining, and restoring the health of the population.

Front 19

What are the delivery-oriented roles that the community health nurse engages in?

Back 19

1. Coordinator/Care Manager
2. Collaborator
3. Liaison

Hint 19

Delivery-oriented roles are those designed to enhance the operation of the health care delivery system, resulting in better care for clients.

Front 20

What is program-focused nursing?

Back 20

Program-focused nursing is a service delivery system in which nurses focus their activities and efforts on specifically designated health problems or specific target populations. In program-focused nursing, community health nurses become specialists in a single program area.

Hint 20

Expls:
1. A nurse becomes involved in coordinating a tuberculosis screening program in a local clinic.
2. A nurse develops a program promoting child development at a local head start center.

Front 21

What are the attributes of community health nursing?

Back 21

a) Population consciousness
b) Orientation to health
c) Autonomy
d) Creativity
e) Continuity
f) Collaboration
g) Intimacy
h) Variability

Hint 21

Expls:
For examples of how these attributes are applied, see "Highlights" pg. 13, Clark.

Front 22

What are the standards of public health nursing practice?

Back 22

a) Assessment
b) Population Diagnosis and Priorities
c) Outcomes Identification
d) Planning
e) Implementation
f) Coordination
g) Health education and health promotion
h) Consultation
i) Regulatory activities
j) Evaluation

Hint 22

Expls:
For examples of each of these, see pg. 13, Clark.

Front 23

What are the standards of public health nursing professional performance?

Back 23

a) Quality of practice
b) Education
c) Professional practice evaluation
d) Collegiality and professional relationships
e) Collaboration
f) Ethics
g) Research
h) Resource utilization
i) Leadership
j) Advocacy

Hint 23

Expls:
For examples of each of these, see "Special Considerations" pgs. 13-14, Clark

Front 24

Health care for populations takes place at three levels, often referred to as the three levels of prevention. These levels are?

Back 24

1. Primary prevention
2. Secondary prevention
3. Tertiary Prevention

Front 25

The nurse is gathering community assessment data about concerns of the elderly. The elderly group in this situation would be an example of what type of subgroup of a population?

Back 25

Aggregate.

Rational: aggregates are sub-populations within the larger population who possess some common characteristics, often related to high risk for specific health problems.

Front 26

Define Primary Prevention

Back 26

Primary Prevention: Providing specific protection against disease to prevent its occurrence is the most desirable form of prevention. Primary preventive efforts spare the client the cost, discomfort and the threat to the quality of life that illness poses or at least delay the onset of illness. Preventive measures consist of counseling, education and adoption of specific health practices or changes in lifestyle.

Hint 26

Exmpls:
a. Mandatory immunization of children belonging to the age range of 0 – 50 months old to control acute infection diseases.

b. Minimizing contamination of the work or general environment by asbestos dust, silicone dust, smoke, chemical pollutants and excessive noise.

Front 27

Define Secondary Prevention

Back 27

Secondary Prevention: consist of organized, direct screening efforts or education of the public to promote early case finding of an individual with disease so that prompt intervention can be instituted to halt pathologic processes and limit disability. Early diagnosis of a health problem can decrease the catastrophic effects that might otherwise result for the individual and the family from advanced illness and its many complications.

Hint 27

Exmpls:
a. Public education to promote breast self-examination, use of home kits for detection of occult blood in stool specimens and familiarity with the seven cancer danger signals.

b. Screening programs for hypertension, diabetes. Uterine cancer (pap smear), breast cancer (examination and mammography), glaucoma and sexually transmitted disease.

Front 28

Define Tertiary Prevention

Back 28

Tertiary Prevention: It begins early in the period of recovery from illness. Activity aimed at returning the client to the highest level of function and preventing further deterioration in health. Minimizing residual disability and helping the client learn to live productively with limitations are the goals of tertiary prevention. Tertiary prevention also focuses on preventing recurrences of the problem.

Hint 28

Exmpls:
1. Such activities as consistent and appropriate administration of medications to optimize therapeutic effects.
2. Moving and positioning to prevent complications of immobility and passive and active exercise to prevent disability.
3. Continuing health supervision during rehabilitation to restore an individual to an optimal level of functioning.
4. Placing a client on a maintenance diet after the loss of a desired number of pounds.

Front 29

A client is placed on a maintenance diet after the loss of a desired number of pounds. This is an example of which type of level of prevention?

Back 29

Tertiary

Hint 29

Tertiary prevention is activity aimed at returning the client to the highest level of function and preventing further deterioration in health. It also focuses on preventing recurrences of the problem.

Front 30

A legislation to promote a living wage for all workers to prevent recurrent homelessness is passed. This would be an example of which type of level of prevention?

Back 30

Tertiary

Hint 30

Tertiary prevention is activity aimed at returning the client to the highest level of function and preventing further deterioration in health. It also focuses on preventing recurrences of the problem.

Front 31

A health care program to diagnose and treat HTN in the community is formed. This would be an example of which of the three levels of prevention?

Back 31

Secondary Prevention

Hint 31

Secondary prevention consist of organized, direct screening efforts or education of the public to promote early case finding of an individual with disease so that prompt intervention can be instituted to halt pathologic processes and limit disability. Early diagnosis of a health problem can decrease the catastrophic effects that might otherwise result for the individual and the family from advanced illness and its many complications. Secondary prevention activities include screening and early diagnosis, as well as treatment for existing health problems.

Front 32

A public health clinic has a screening program for HTN. The clinic also makes diagnosis and treats cases of HTN. This would be an example of which of the three levels of prevention?

Back 32

Secondary Prevention

Hint 32

Secondary prevention consist of organized, direct screening efforts or education of the public to promote early case finding of an individual with disease so that prompt intervention can be instituted to halt pathologic processes and limit disability. Early diagnosis of a health problem can decrease the catastrophic effects that might otherwise result for the individual and the family from advanced illness and its many complications. Secondary prevention activities include screening and early diagnosis, as well as treatment for existing health problems.

Front 33

What are some examples of Primary prevention measures that can be implemented for poverty and homelessness populations?

Back 33

Provide health education in teh level area for prevention of disease related to multiuse of needles

Hint 33

Primary prevention is providing specific protection against disease to prevent its occurrence is the most desirable form of prevention. Primary preventive efforts spare the client the cost, discomfort and the threat to the quality of life that illness poses or at least delay the onset of illness. Preventive measures consist of counseling, education and adoption of specific health practices or changes in lifestyle.

Front 34

A public health nurse gives a child an immunization. This would be an example of which of the three levels of prevention?

Back 34

Primary Prevention

Hint 34

Primary prevention is providing specific protection against disease to prevent its occurrence is the most desirable form of prevention. Primary preventive efforts spare the client the cost, discomfort and the threat to the quality of life that illness poses or at least delay the onset of illness. Preventive measures consist of counseling, education and adoption of specific health practices or changes in lifestyle.

Front 35

A city ordinance is passed that prohibits the use of one's yard for a garbage disposal site. This is an example of which of the three levels of prevention?

Back 35

Primary Prevention

Hint 35

Primary prevention is providing specific protection against disease to prevent its occurrence is the most desirable form of prevention. Primary preventive efforts spare the client the cost, discomfort and the threat to the quality of life that illness poses or at least delay the onset of illness. Preventive measures consist of counseling, education and adoption of specific health practices or changes in lifestyle.

Front 36

A nurse at a public health clinic conducts screening, such as urine testing for pesticide exposure for migrant farm workers. This is an example of which of the three levels of prevention?

Back 36

Secondary Prevention

Hint 36

Secondary prevention consist of organized, direct screening efforts or education of the public to promote early case finding of an individual with disease so that prompt intervention can be instituted to halt pathologic processes and limit disability. Early diagnosis of a health problem can decrease the catastrophic effects that might otherwise result for the individual and the family from advanced illness and its many complications. Secondary prevention activities include screening and early diagnosis, as well as treatment for existing health problems.

Front 37

A nurse provides services for early detection of teen pregnacy at a public health teen clinic. This is an example of which of the three levels of prevention?

Back 37

Secondary Prevention

Hint 37

Secondary prevention consist of organized, direct screening efforts or education of the public to promote early case finding of an individual with disease so that prompt intervention can be instituted to halt pathologic processes and limit disability. Early diagnosis of a health problem can decrease the catastrophic effects that might otherwise result for the individual and the family from advanced illness and its many complications. Secondary prevention activities include screening and early diagnosis, as well as treatment for existing health problems.

Front 38

A nurse counsels the young person or young couple at a planned parenthood clinic about available options, including keeping the baby, abortion and adoption. This is an example of which of the three levels of prevention?

Back 38

Tertiary Prevention

Hint 38

Tertiary prevention is activity aimed at returning the client to the highest level of function and preventing further deterioration in health. It also focuses on preventing recurrences of the problem

Front 39

A nurse provides community education to teach health lifestyles; focus on how to resist getting involved in substance abuse. This is an example of which of the three levels of prevention?

Back 39

Primary Prevention

Hint 39

Primary prevention is providing specific protection against disease to prevent its occurrence is the most desirable form of prevention. Primary preventive efforts spare the client the cost, discomfort and the threat to the quality of life that illness poses or at least delay the onset of illness. Preventive measures consist of counseling, education and adoption of specific health practices or changes in lifestyle

Front 40

The nurse is providing an education packet for home health clients, which includes information regarding nutrition and food-choice. This is an example of which level of prevention?

Back 40

Primary Prevention

Hint 40

Primary prevention is providing specific protection against disease to prevent its occurrence is the most desirable form of prevention. Primary preventive efforts spare the client the cost, discomfort and the threat to the quality of life that illness poses or at least delay the onset of illness. Preventive measures consist of counseling, education and adoption of specific health practices or changes in lifestyle

Front 41

What is Healthy People 2010?

Back 41

Healthy People 2010 is a set of health objectives for the Nation to achieve over the first decade of the new century. It can be used by many different people, States, communities, professional organizations, and others to help them develop programs to improve health.

Healthy People 2010 builds on initiatives pursued over the past two decades. The 1979 Surgeon General's Report, Healthy People, and Healthy People 2000: National Health Promotion and Disease Prevention Objectives both established national health objectives and served as the basis for the development of State and community plans. Like its predecessors, Healthy People 2010 was developed through a broad consultation process, built on the best scientific knowledge and designed to measure programs over time.

Front 42

What are the goals of Healthy People 2010?

Back 42

#
Goal 1: Increase Quality and Years of Healthy Life

The first goal of Healthy People 2010 is to help individuals of all ages increase life expectancy and improve their quality of life.

Goal 2: Eliminate Health Disparities

The second goal of Healthy People 2010 is to eliminate health disparities among different segments of the population.

Hint 42

There are two.

Front 43

What are the focus areas of Healthy People 2010?

Back 43

a) Access to quality health services
b) Arthritis, osteoporosis, and chronic back pain
c) Cancer
d) Chronic Kidney Disease
e) Disability and secondary conditions
f) Educational and community-based programs
g) Environmental health
h) Family planning
i) Food safety
j) Health communication
k) Heart disease and stroke
l) HIV
m) Immunization and infectious diseases
n) Injury and violence prevention
o) Maternal, infant, and child health
p) Medical product safety
q) Mental health and mental disorders
r) nutrition and overweight
s) Occupational safety and health
t) Oral health
u) physical fitness and activity
v) public health infrastructure
w) Respiratory disease
x) Sexually transmitted diseases
y) Substance abuse
z) tobacco use
zz) Vision and hearing

Hint 43

There are 27

Front 44

What does the first goal of Healthy People 2010 address?

Back 44

The first goal addresses the issues of longevity and quality of life. Increasing the number of years of life addresses the concern that people are living longer but with chronic health problems that interfere with the quality of their lives. Quality of life is also an issue for those people unable to achieve a long life.

Front 45

What does the second goal of Healthy People 2010 address?

Back 45

The second goal, eliminating health disparities, addresses the growing problems of access to care; differences in treatment based on race, gender and ability to pay; and related issues such as urban versus rural health, insurance coverage, Medicare and Medicaid reimbursement, and satisfaction with service delivery.

Front 46

Healthy People 2010 is centered on the 10 leading health indicators that "reflect the major public health concerns in the United States". What are the 10 major public health concerns that Healthy People 2010 are based upon?

Back 46

1. Physical activity
2. Overweight and obesity
3. Tobacco use
4. Substance abuse
5. Responsible sexual behavior
6. Mental health
7. Injury and violence
8. Environmental quality
9. Immunization
10. Access to health care

Front 47

What are the three core public health functions?

Back 47

a) Assessment
b) Policy Development
c) Assurance

Front 48

Define the main items of the first core public health function; Assessment

Back 48

* Monitor health status to identify community health problems.
* Diagnose and investigate health problems and health hazards in the community.
* Evaluate effectiveness, accessibility, and quality of personal and population-based health services.

Front 49

Define the main points of the second core public health function: Policy Development.

Back 49

* Develop policies and plans that support individual and community health efforts.
* Enforce laws and regulations that protect health and ensure safety.
* Research for new insights and innovative solutions to health problems.

Front 50

Define the main points of the third core public health function: Assurance

Back 50

* Link people to needed personal health services and assure provision of health care when otherwise unavailable.
* Assure a competent public health and personal health care workforce.
* Inform, educate, and empower people about health issues.
* Mobilize community partnerships to identify and solve health problems.

Front 51

Neuman's systems model involves a client system striving to prevent "penetration" or disruption of the system by a variety of stressors. What is Neuman's definition of "stressors"?

Back 51

Stressors are problems or conditions capable of causing instability in the system or tension producing stimuli or focuses occurring both with the internal and external environmental boundaries of the client system.

Front 52

In Neuman's model, the client is viewed as a basic, core structure. This basic core structure is an open system of five categories of variables. What are the five categories?

Back 52

1. Physiological
2. Psychological
3. Sociocultural
4. Developmental
5. Spiritual

Front 53

In Neuman's model, the basic core structure is surrounded by three protective boundaries. Name the three boundaries.

Back 53

1. The lines of resistance
2. Normal lines of defense
3. Flexible lines of defense

Front 54

Using Neuman's model, what is meant by the "normal line of defense"?

Back 54

The normal line of defense is the client's usual state of wellness or the normal range of response to stressors.

Front 55

Using Neuman's model, what is meant by the "flexible line of defense"?

Back 55

The flexible line of defense is a dynamic state of wellness that changes over time and is composed of factors that fluctuate ( like fatigue levels). The flexible line of defense provides a protective cushion that prevents stressors from penetrating the normal line of defense.

Front 56

Using Neuman's model, what is meant by "lines of resistance"?

Back 56

The lines of resistance are internal factors that act to return the client to a normal or improved state of health and protect against stressor penetration of the basic structure.

Front 57

Using Neuman's model, what is meant by "reconstitution"?

Back 57

Reconstitution involves stabilization of the system and movement back toward the normal line of defense.

Front 58

The Dimensions model consists of three elements. What are these elements?

Back 58

1. The dimensions of health
2. The dimensions of health care
3. The dimensions of nursing practice

Front 59

The dimensions model acknowledges the interaction of multiple factors in population health and illness. The dimensions consist of six categories of factors that can be used to organize a community health assessment. These six factors are?

Back 59

1. The biophysical dimension
2. The psychological dimension
3. The physical environmental dimension
4. The sociocultural dimension
5. The behavioral dimension
6. The health system dimension

Front 60

The Public Health Nursing Interventions model has 17 identified community health nursing interventions that cross over three levels of population-based practice. What are the three levels of population-based practice associated with this model?

Back 60

1. Individual-focused
2. Community-focused
3. Systems-focused