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79 Cards in this Set
- Front
- Back
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what type of prevention is preventing disease occurence
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primary disease prevention
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what type of prevention is early detection of disease
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secondary disease prevention
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what type of prevention prevents disablity of disease
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tertiary disease prevention
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important prevention measures for diabetes
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eye, foot exam, urine test
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important prevention for drug use
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hepatitis immunizations, HIV, TB tests
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important prevention for alcohlism
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influenza, pneumococcal immunizations, TB test
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important prevention for overweight
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blood sugar test for diabetes
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important immunization for homeless, recent immigrant, inmate
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TB test
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high-risk sexual behavior prevention tests
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HIV, heaptitis B, syphilis, gonorrhea, chlamydia test
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name the reportable infectious diseases (12)
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hep A, hep B, gonorrhea, syphilis, AIDS, chickenpox, measles, mumps, rubella, TB, salmonella, shigella
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is HIV infection reportable?
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depends on the state
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leading cause of death in infants
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congenital abnormalities, SIDS, respiratory distress syndrome
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leading cause of death age 1-14
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accidents, cancer, congenital abnormalities, homicide
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leading cause of death 15-24
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accidents, homicides, suicides
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leading cause of death 25-64
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cancer, heart disease, accidents, injuries
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leading cause of death 65+
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heart disease, cancer, stroke
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medicare part A
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hospital
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medicare part B
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doctor's bills
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obligation to respect patient and to honor their preferences in medical care
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autonomy
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oral advance directive
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prior oral statements used as guide - difficulties in interpretation
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what makes oral advance directive more valid?
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patient was informed, directive is specific, patient made a choice, decision was repeated over time
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define living will
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patient directs physician to withdraw life-sustaining treatment if develops terminal disease or is in persistent vegitative state
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define durable power of attorny
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patients designates surrogate to make medical decisions if loses decision-making capacity. surrogate has power until revoked by patient.
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what has precedence: living will or durable power of attorny
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durable power of attorney
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nonmaleficience
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do no harm. but if benefits > risks, patient can make informed consent decsion
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beneficience
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physician has obligation to act in patients best interest but patient has right to decide
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exceptions to confidentiality (5)
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potnetial harm to others, potential harm to self, no alternative measures exist to warn those at risk, child/elder abuse, impaired automobile driver
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confidentiality in infectious disease
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warn public officials and people at risk
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what is the tarasoff decision
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law requiring physicians to directly inform and protect those from harm
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3 D's of malpractice
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dereliction, damage, direct (breach of duty caused harm)
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what is the most common factor leading to litigation?
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poor patient-physician relationship
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situation: patient is noncompliant
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work to improve patient-physician relationship
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situation: patient has difficulty taking meds
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provide written instructions, attempt to simplify regimen
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situatoin: family members ask for prognosis
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do not give without permission of patient
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situation: 17 year old girl wants abortion
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need to get parental consent
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situation: terminally ill patient wants physician assisted suicide
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illegal but physiican can give indirectly give painkillers that patient can use to kill themselves
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patient finds you attractive
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direct, close-ended questions, chaperone. never appropriate
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patient refuses necessary procedure
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attempt to understand, address concerns
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patient wants unnecssary procedure
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avoid doing unnecssary procedures
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patient is angry about time in waiting room
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apologzie but don't give explanation
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patient is upset about way he was treated by another doctor
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tell him to directly talk to other doctor, if staff: say will talk to staff personally
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child wishes to know more about illness
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ask child what parent told him. parents decide how much information is given.
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patient continues to smoke
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ask how patient feels about smoking, offer advice only if patient wants to quit
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APGAR score components
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appearance, pulses, grimace, activity, respiration
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low birth weight definition
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<2500 grams, greater incidence physicial and emotional problems, prematurity or intrauterine growth retardation
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what are complications of low birth weight (5)
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infections, respiratory distress syndrome, necrotizing enterocolitis, intraventircular hemorrhage, persistent fetal circulation
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how long until infant deprivation leads to irreversible changes
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>6 months
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7 consequences of infant deprivation of affection
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decrease muscle tone, poor language skills, poor socialization, poor trust, anaclitic depression, weight loss, physical illness
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define anaclitic depression
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failure to thrive, withdrawn, unresponsive
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when do children display regression behavior?
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when udner stress: physical illness, punishment, birth of new sibling, tiredness
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child abuse evidence
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healed fractures, cigarette burns, subdural hematomas, multiple bruises, retinal hemorrhage/detachment
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who primarily causes child abuse
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primary caretaker (female)
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who primarily causes sexual abuse of children?
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male who knows victim
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what are 3 signs of sexual abuse of children
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uti, std, genital/anal trauma
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age when infant holds head up, moro reflex disappears, social smile
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3 months
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age when infant rolls front to back, sits when propped, recognizes people
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4-5 months
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age when infant sits alone, crawls, stranger anxiety, orients to voice
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7-9 months
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age when babinski disappears
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12-14 months
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age when child walks, says few words, separation anxiety
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15 months
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age when infant climbs stairs, stacks 3 blocks, object permanence
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12-24 months
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age when child stacks 6 blocks and rapprochement
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18-24 months
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age when child has parallel play
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24-48 months
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age when child has core gender identity
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24-36 months
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age when child stacks 9 blocks, toilet trains
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30-36 months
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age when child rides tricycle, copies line/circle, group play
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3 years
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age when child makes simple drawings, hops on one foot, cooperative play, imaginary friends
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4 years
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age when child reads, understands death, develops conscience, same-sex friends, ID w/ same-sex parents
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6-11 years old
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age of puberty in boys and girl
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13, 11
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milestones in puberty
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abstract reasoning, formation of personality
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does sexual interest decrease in elderly?
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no
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what are some sexual changes in elderly men?
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slower erection/ejaculation, longer refractory period
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what are some sexual changes in elderly women?
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vaginal shortening, thinning, dryness
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what are some changes in sleep patterns in elderly?
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decrease REM sleep, decrease slow-wave sleep, increase sleep latency, increase awakenings at night
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what are some common elderly medical problems
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hypertension, arthritis, heart disease, osteoporosis
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describe psychiatric conditions in elderly
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more prevalent, more suicides
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does intelligence decrease in elderly?
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no
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how long does normal grief last
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6 months to 1 years
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what is the normal grief response
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shock, denial, guilt, somatic symptoms, illusions
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define pathologic grief
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excessively intense or prolonged grief or grief that is delayed/denied/inhibited. may have depression, delusions, hallucinations
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