Community Health

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Community of interest orientation

Back 1

A relational bond of shared interests or goals

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Feeling Community

Back 2

Relational bond is an emotional feeling of belonging or camaraderie

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Territorial bond communities

Back 3

specificall defined boundaries that may be spatial, temporal, or both defining the "where" and "when" demensions of community

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Geopolitical communities

Back 4

communities with defined geographic and jurisdictional boundaries, such as towns, cities and counties.

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Aggregates

Back 5

groups of people with some common caracteristic

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Community of identifiable need

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"the locale within which a particular problem exist, the area that encompasses any type of health problem and its contributiing factors.

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Community Solution

Back 7

boundries within which a problem can be defined, dealt with, and solved (as defined by the 1967 National Commission on Community Health Services).

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Community of identifiable Need

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"the locale within which a particular problem exist, the area that encompasses any type of health problem and its contributing factors.

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Community Based/ Community Health Nursing

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Provided where a pt. lives, works, plays or studies.

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Community Based/ Community Health Nursing ROLES

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Client Oriented roles,
Delivery Orientated Roles, Population Orientated Roles.

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Publice Health Practice

Back 11

Not stated in terms of disease, but rather on the promotion of health and development of maximum potential of individuals, families, and communities.

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Levels of Prevention/Care

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Measures that protect people from disease

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PRIMARY Levels of Prevention/Care

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prevention of health problems before they occur. Such as seatbelts

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SECONDARY Levels of Prevention/Care

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Early detection through dx and prompt tx when pathology exists. (screening tests, pap smears)

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TERITIARY Levels of Prevention/Care

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Designed around rehab of a person with a permanent, irreversible condition. Goal is to restore to optimal level of functioning within conditions of their permanent disability. (teaching stroke victims to walk w/assistance)

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GLOBAL Community Health Systems; policy and legislation

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World Health Organization (WHO) and American Red Cross

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National/ Federal Community Health Systems

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Medicare, Social Security, Supplemental Security income (for the blind, aged, disabled. Funded by contributions from employees, employers and self-employed individuals)

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Healthy People 2000

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1- increase lifespan 2-Reduce disparity for all americans to have preventive services. 3- Decrease the race-based disparity in life expectancy

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STATE Programs

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Medicaid and Local health departments

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Home Health Nursing Practice (ANA) Generalist

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Direct care provider, educator, resource manager, collaborator and supervisor of ancillary personnel.

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Home Health Nursing Practice (ANA) Specialist

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Master's degree prepared nurse consultant, administrator, researcher and clinical specialist.

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The Epidemiologic Process
Defining the Condition

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1- Determining the Natural History of the Condition. 2-Identifying Strategic Points of Control 3- Designing, Implementing, and Evaluation Control Strategies

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The Epidemiologic Triad

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1-Host
2-Agent
3-Environment

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Dever's Epidemiologic Model

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Human Biological Factors
Environmental Factors
Lifestyle Factors
Health Care System Factors

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The Epidemiologic Studies

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rely on frequency rates that are more accurate counts that take the size of the population into account

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ENDEMIC

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Constant presence of infectious disease within a certain geographic locale.

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EPIDEMIC

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rate of disease, injury or other condition is in excess of the usual level.

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MORTALITY

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risk of death for a person in a pop for that year

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MORBIDITY

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prevalence and incidence rates of disease. Prevalence is the measure of existion diisease and incidence that reflects the number of new cases developing in the same pop at a particular time.

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COMMUNICABLE DISEASE
Principals of control of the spread of infection: Contact Notification is what?

Back 30

State Law NOT Federal Laws mandate requirements for disease reporting in the U.S. TB, Hepatitis are 2 ex of reportable communicable diseases.

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COMMUNICABLE DISEASE
Principals of control of the spread of infection: Chemoprophylaxis is what?

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The use of meds to prevent the onset of disease in exposed people. Increasing Host Resistance and other control measures.

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MEDICAL FUTILITY

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The determination that a particular therapy is of no value and shouldn't be given

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Beneficence

Back 33

the doing good for the client

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Role of the nurse in the community

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Provider of care, teacher, manager of care advocate

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Role of the Home Health Nurse

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Teritiary preventative nursing care, Rehab and restore maximum health function to individual clients in their home

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Role of a Community Health Nurse is?

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minimize progress of disease maintain health of populations promote heath of populations.

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DEVIANCE

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Bx that go against societal norms -- often considered chronic illnesses (ex: addictions)

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ILLNESS BEHAVIORS

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Activities undertaken by a perosn who feels ill to define the state of his health and to discover a suitable remedy

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BAUMAN -3 CRITERIA TO DETERMINE ILLNESS

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1-Presence of Sx
2-perception of how they feel
3-ability to carry out ADL's

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Pender: -2 Considerations

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1- Importance of health to person.
2- Perceived control - locus of control

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Consanguinity

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Related by blood

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Affinal

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Marital Relationships. Connected with, having things in common

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Family System Theory

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Focus on interaction of members

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Family Stress Theory

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Crisis intervention stratagies focus on helping members cope

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Developmental Theory

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anticipatory guidance that prepares members for transition to the next family stage.

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Rold discontinuity

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conflicting role expectations ie children in the US are to be submissive, yet as adults dominent

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Role Continuity

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Value the same bx in children as are valued in adults (other cultures). Role conception transmitted by socializing agents parents peers authority figures via use of positive and negative reinforcement.

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Role Structuring

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initialy within family shaped by parents use direct or indirect pressure to induce desired patterns of behavior

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Role Taking Skills

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Learned by reciprocal transactions learning to discriminate there own perspective from that of others (learn to get along)

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You begin your examination of 4 yr old Pika, who is smiling at you and eating ice out of a Dixie cup. What are some of the clinical manifestations of lead toxicity?

Back 50

Unfortunately, there is little correlation between blood levels and clinical manifestations of lead toxicity. ***The probability of severe sx increases, however, as the blood levels increase. Encephalopathy is the most severe sx, which can appear suddenly or as a prodrome of bx changes and/or led colic including occasional vomiting, intermittent abd pain and constipation (Piomelli, 1996).

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What are the clues to lead encephalopathy?

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In acute presentation, there may be persistent vomiting, seizures, ataxia, altered mental status, papilledema, and coma. A spinal tap(carefully performed after a CT) might reveal pleocytosis, mild elevated protein, and increased opeing pressure.

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EDTA Test

Back 52

If iron blood levels such as 28.5 from a venous blood sample it is recommended to perrom an EDTA-provocative chelation test to ascertain the usefulness of tx. This done by giving EDTA (500mg/m2) perferably IV, in 5% Dextrose, over 30 min., followed by a urinary collection of 8-hr duration. The urinary excretion of lead is measured, and the results are expressed as the following ratio: Lead excreted (mcg)/EDTA given (mg) The ration greater than 0.7 is considered abnormal (positive) provocative test result and suggest that tx will be effective and thus indicated. Only tx w/EDTA is recommended at this level. EDTA should be given at a dose of 1,000mg/m2/24hr.