Community Health Nursing Quiz 1 & 2 Rn To Bsn

Front 1

what is a community?

Back 1

Group of people who share something in common and interact with one another who may exhibit a commitment with one another and may share a geographic boundary

ie: church parish, NYU students, city of Yonkers

Front 2

What is a population?

Back 2

Group of people who have at least one thing in common and who may or may not interact with one another

ie: long distance truck drivers, nurses who do night shift

Front 3

what is Community-focused Nursing

Back 3

A systematic process of delivering nursing care to improve the health of an entire community

ie:

Front 4

what is Community-based Nursing

Back 4

Nursing care provided outside of an acute care setting to individuals and families which contributes to the health of the community

ie:

Front 5

what is Population-focused Care

Back 5

Interventions aimed at health promotion and disease prevention that shape a community’s overall health status

Front 6

what is Public Health Nursing

Back 6

Practice of promoting and protecting the health of populations using knowledge from nursing, social and public health sciences.

-It is population-focused, with the goals of promoting health and preventing disease and disability for all people through the creation of conditions in which people can be healthy.

Front 7

what is managed care aka chronic care

Back 7

nurse is in charge of making sure that a particular group of people sty out of the hospital

-this involves telehealth

-this is happening so we can prevent a problem that nurses would traditionally see at the hospital (goal is to save $, lives)

Front 8

what is ACUTE CARE NURSING
(7 things)

Back 8

1) Provider control

2)Predictable routine

3) Maintenance of hospital policy

4) Resource availability

5) Collegial collaboration and consultation

6) Controlled patient compliance

7) Standardization of care

Front 9

what is Community-based NURSING

Back 9

1) Familiar and comfortable environment for patient

2) Routine less determined by the nurse or health professional

3) Diverse resources (ie; church volunteers, grocery delivers)

4) Autonomy and choice in health decisions for the pt.

-community health nursing req. flexibility & patience;

-its not regimented like acute care nursing

Front 10

what is health?

Back 10

client will dictate description of health

Front 11

what is Professional Health Promotion

Back 11

the organized actions or efforts that enhance support or promote the well-being/health of individuals, families, groups, communities or societies

ie: school nurses, health fairs, clinics w/ flu vaccines, free dental screening

Front 12

What are the 3 levels of Prevention

Back 12

1) Primary

2) Secondary

3) Tertiary

Front 13

what is Primary Prevention

Back 13

Reduction of risk factors before occurrence of disease condition or injury

Front 14

what is Secondary Prevention

Back 14

Early detection of the potential for disease or disability or, the existence of disease while asymptomatic

ie: nurse monitoring telehealth machine would be in secondary/tertiary prevention

Front 15

what is Tertiary Prevention

Back 15

Treatment of an existing or symptomatic disease to prevent or delay progress

Front 16

what is Health Promotion

Back 16

relates to the events or activities that result in wellness

-is relative to where the person is at

Front 17

what is Wellness

Back 17

Integrated method of functioning which is oriented towards maximizing the potential of which the individual is capable of

Front 18

what is UPSTREAM thinking

Back 18

why treat people...w/o changing what makes them sick?

-find out why bodies are flowing down the river, go upstream to try to stem it

Front 19

who is Lillian wald

Back 19

-founded community/public health nursing

-also started Visiting Nurse Services

-focused on home healthcare & hygiene among LES tenements

-founded Henry Street Settlemtn

Front 20

what are the 8 attributes of a community health nurse?

Back 20

1) Population focused

2) Autonomy

3) Continuity

4) Collaboration

5) Interactivity

6) Public Accountability

7) Sphere of Intimacy

8) Health orientation

Front 21

what is Population focused

(attribute of community health nurse)

Back 21

Emphasis is on health of population groups rather than individuals or families.

Front 22

what is Autonomy

(attribute of community health nurse)

Back 22

nurse is independent; not as much structure as is the case w/ a hospital

Front 23

what is Continuity

(attribute of community health nurse)

Back 23

Provision of care on a continuing, comprehensive basis rather than a short-term, episodic basis.

Front 24

what is Collaboration

(attribute of community health nurse)

Back 24

Interaction between nurse and client as equals; greater opportunity for collaboration with other segments of society. (its a negotiation)

Front 25

what is Interactivity

(attribute of community health nurse)

Back 25

Greater awareness of interaction of a variety of factors with health.

Front 26

what is Public Accountability

(attribute of community health nurse)

Back 26

Accountability to society for the health off the general population.

Front 27

what is Sphere of Intimacy

(attribute of community health nurse)

Back 27

– Greater awareness of the reality of client lives and situations than may be true in other areas of nursing.

ie: u see roaches in apt

Front 28

what is Health Orientation

(attribute of community health nurse)

Back 28

Emphasis on health promotion and disease prevention rather than the cure of illness.

Front 29

what are some Community Health nursing roles (titles)

Back 29

Care giver

Educator

Counselor

Referral resource

Role model

Advocate

Primary care provider

Case manager

Coordinator

Collaborator

Liaison

Discharge planner

Case finder

Leader

Change agent

Researcher

Front 30

what are the types of Community Health Jobs

Back 30

Public Health Nurse

Home Health/Visiting Nurse

Hospice Nurse

School Nurse

Occupational Health Nurse

Parish Nurse

Advanced Practice Nursing (PNP, FNP, CNM, etc

Front 31

5 steps of Nursing Process in Community Nursing (ADPIE)

Back 31

1) Assessment

2) Diagnosis

3) Planning

4) Implementation

5) Evaluation

Front 32

What is Assessment in community nursing

Back 32

looking at the characteristics in a population & we need to compare it to another community

(ie: demographics, age group, health problems, economic status)

Front 33

what is Diagnosis in community nursing
vs. acute care setting

Back 33

risk of, among, related to

Front 34

what is planning in community nursing

Back 34

create an intervention that the community agrees wit/after you have assessed

-planned intervention has to be achievable/measurable

Front 35

6 steps for Using the nursing process for the community

Back 35

1) Conducting a community assessment

2) collecting data

3) community diagnosis

4) Planning & Prioritization Phase

5) Implementation Phase

6) Evaluation Phase

Front 36

Conducting a community assessment means

Back 36

includes:
-population assessment

-primary informants aka key informants

-gaining entry into the community -->who do u talk to 1st to learn about the community (ie: mayor, relg leaders)

Front 37

what is Kauffman's 5 Phases of gaining entry into the communtiy

Back 37

1) Impressing

2) Behaving

3) Swapping

4) Belonging

5) Chilling out

Front 38

Impressing

Back 38

-one of Kauffman's 5 phases of gaining entry into the community

- you're new & being judged by community

-wariness from the community

-u should be neutral, an observer & a resource to the community

Front 39

Behaving

Back 39

-one of Kauffman's 5 phases of gaining entry into a community

-as relationship develops, myths about you & your own myths about the population begin to erode (try to learn the language)

Front 40

Swapping

Back 40

-one of Kauffman's 5 phases of gaining entry into the community

-they are giving things to you & u are sharing things w/ them

Front 41

Belonging

Back 41

-one of Kauffman phases of gaining entry into the community

-people are starting to share things w/ u that they wouldn't share w/ an outsider

-"the hidden becomes exposed"

Front 42

Chilling out

Back 42

-one of 5 Kauffman phases of gaining entry into a community

-true partnership & future planning

Front 43

Collecting data--7 methods
(pt of nursing process for the community)

Back 43

1) Informant interviews

2) Observation

3) Secondary analysis of existing data

4) Constructed surveys

5) Focus groups

6) Community forums

7) Windshield surveys

Front 44

Community Diagnosis (pt of nursing process for the community)

Back 44

Risk of (specific problem or health risk )

Among (specific group or population affected by the problem/risk)

Related to (strengths and weaknesses in the community that influence the specific problem or health risk in the community)

Front 45

Planning & Prioritization phase (pt of nursing process for the community)

Back 45

Priorities established--> the community determines what the priority is/what they want changed

Goals and objectives identified

Community focused interventions--> make sure u have community buy in

Front 46

Implementation phase (pt of nursing process for the community)

Back 46

consists of Action phase:

Role of community health nurse (should avoid paternalism--> telling community what to do); role is to help educ, implement plan

Social change and community action:
Lay advisors
Focus groups
Policy legislation
Mass media
Media advocacy
Education

Front 47

2 types of evaluation? (pt of nursing process for the community)

Back 47

1) Formative

2) Summative

Front 48

what is Formative Evaluation

Back 48

something you do during the process

-"evaluation in process"

ie: @ bedside doing assessment & pt says it hurts so you stop & do something else

Front 49

what is Summative evaluation

Back 49

-done @ the end

-you've looked at assessment, plan & intervention & now u grade yourself at the end

Front 50

what are the 2 types of community assessment frameworks

Back 50

1) WHO--> community empowerment

2) Community as Partner Model:

Community core
Eight interacting community subsystems
Community stressors/boundaries
Normal level of defense
Flexible line of defense
Lines of resistance

Front 51

what is health education

Back 51

Any combination of planned learning experiences based on sound theories that provide individuals, groups, and communities the opportunity to acquire the information and skills needed to make quality health decisions

- Remember that information alone does not change behavior

Front 52

what are Goals for health education

Back 52

To help individuals, groups and communities achieve, through their own actions and initiative, optimal states of health

Should facilitate voluntary actions to promote health

Empowerment

Advocacy

Self-efficacy

Front 53

Example of Primary Prevention r/t Community Health education

Back 53

Education at Health Fairs such as Immunizations for children and adults

Front 54

example of Secondary Prevention r/t Community Health education

Back 54

Education at Health Fairs to include early diagnosis of diabetes/provide screenings before disability occurs

Front 55

example of Tertiary Prevention r/t Community Health education

Back 55

Education in Rehab Centers such as helping clients post CVA maximize their functioning

Front 56

what are the 9 ways to facilitate learning

Back 56

*Use methods to stimulate senses

*Use active learning

*Establish a comfortable environment

*Assess readiness of learner

*Make information relevant

*Use repetition

*Make learning positive

*Proceed from simple to complex

*Generalize and pace appropriately

Front 57

what are the 4 behavioral learning theories

Back 57

1) health belief model

2) harm reduction model (controversial)

3) goal-setting therapy

4) theory of reasoned action

Front 58

what is health belief model (behavioral learning theory)

Back 58

Perceived susceptibility, severity, benefits and barriers. Also includes self-efficacy

ie: I’m at risk for colon cancer and I will follow up with annual FOB and screening per HCP, even though its unpleasant

Front 59

what is Harm reduction model

Back 59

Based on understanding that accurate information can help people make responsible decisions/focus is on education and not aimed at complete abstinence.

ie: I know my risk for colon cancer , but I love my beef.

ie: I’ll decrease it to once a week if my wife helps me

-argument against this theory is that you are encouraging the bad behavior

Front 60

what is goal-setting theory (behavioral learning theory)

Back 60

ie: My goal is to lose 12 lbs over the next 6 months. I know that 2 lbs a month is realistic for me.

Front 61

what is theory of reasoned action

Back 61

ie: I will sign up for Weight Watchers because they helped me years ago, and I can go with my friend

Front 62

what is the Transtheortical Model ?

Back 62

- is a change process model/most common

-Provides a framework for exploring if a client is ready to make changes in behavior

- Useful in persons who are engaged in “risky behavior”

- Movement through stages may be sequential or not, i.e. May move back and forth through the stages

Front 63

what are the 6 stages of change in the Transtheortical Model

Back 63

1) Precontemplation

2) Contemplation

3) Preparation

4) Action

5) Maintenance

6) Termination

Front 64

Precontemplation (transtheortical model)

Back 64

I smoke/I like it/dont care if I die

-person not gonna change

Front 65

Contemplation (transtheortical model)

Back 65

smoking might be a problem, I might get COPD/CA/, I get that it will cause that

Front 66

Preparation (transtheortical model)

Back 66

maybe i should quit, maybe try 1 pack to 1/2 pack a day

--preparing to quit/thinking about it

Front 67

ACTION (transtheortical model)

Back 67

I quit. Im gonna have withdrawal but Im quitting anyway

Front 68

Maintenance (transtheortical model)

Back 68

I must not go back again/ I need to stop going to these bars cuz dont want to be tempted

Front 69

Termination (transtheortical model)

Back 69

I used to be a smoker but the smell makes me gag/Im allergic to smoke now

Front 70

Driving Forces & Restraining Forces

Back 70

If you want to change the present stage (ie: smoking) you must increase the driving forces (ie: teach pt. how much cigs cost) & decrease the restraining forces (ie: making it easier to quit smoking by avoiding the bar)

Front 71

6 Principles that guide the educator

Back 71

1) Message

2) Format--has to be something the client will appreciate

3) Environment

4) Experience-client should practice how to draw insulin

5) Participation

6) Evaluation-did u learn anything

Front 72

3 Domains of the Nature of Learning

Back 72

1) Cognitive domain

2) Affective domain

3) Psychomotor domain

Front 73

what is Cognitive domain

Back 73

includes memory, recognition, understanding, application and problem solving

-where much of your education happens

Front 74

what is Affective domain

Back 74

includes attitudes and values (what people think, feel and value)

Front 75

what is Psychomotor domain

Back 75

includes performance of skills that require some degree of neuromuscular coordination and emphasize motor skills

Front 76

what is health literacy

Back 76

The ability to read, understand, and act on health care information

-seen as the 6th vital sign

Front 77

What are the Consequences of low functional health literacy

Back 77

1) Less likely to Understand written and oral information given by the health care provider

2) Less likely to Act upon necessary procedures and directions such as medications and appointment schedules

3) Less likely to Be able to navigate the health care delivery system to obtain needed services

Front 78

what are the strategies to assist low-literate health care consumers

Back 78

HCPs can create a ‘Shame Free” environment

Provide surrogate readers to decipher information

Clinic staff can tell client what is needed prior to an appointment (medication list, insurance card etc)

Tailor medication schedules to fit daily routine, color coding medications etc

Teach-back method (ie. Can you tell me in your own words?)

If low health literacy is suspected, give individual an out such as “A lot of people have trouble with this material.”

Use common words, not medical jargon

Use tools designed for low literacy levels

Limit information given (less than ½ of info is retained)

Front 79

How to effectively TEACH clients

Back 79

TEACH mnemonic:

Tune in-Listen before you start teaching.

Edit information-Teach necessary information first

Act on each teaching moment-Teach whenever possible. Develop a good relationship

Clarify often-Make sure your assumptions are correct. Seek feedback

Honor the (individual, family, group, community, population) as partner. Build on experience. Share responsibilty

Front 80

Best way to promote learner retention

Back 80

90 % of what they say as they do a thing

Front 81

What are the 8 Factors that influence health behavior change

Back 81

1) Intention

2) Environmental Constraints

3) Ability

4) Anticipated Outcomes

5) Norms

6) Self-Standards

7) Emotion

8) Self-Efficacy

Front 82

Intention

Back 82

The person has made a commitment to perform a behavior

Front 83

Environmental Constraints

Back 83

No external conditions or circumstances exist that make it impossible for the behavior to occur

** to facilitate health behavioral changes you need to create an environment that facilitates behavioral changes

Front 84

Ability

Back 84

The person has the skills necessary to perform a behavior

Front 85

Anticipated outcomes

Back 85

The person believes that the advantages (benefits) of performing the behavior outweigh the disadvantages (costs); the person has a positive attitude toward performing the behavior

Front 86

Norms

Back 86

The person perceives more social pressure to perform the behavior than not perform the behavior

Front 87

Self-Standards

Back 87

The person perceives performance of the behavior as more consistent than inconsistent with his/her self image

Front 88

Emotion

Back 88

The person’s emotional reaction to performing the behavior is more positive than negative

Front 89

Self-Efficacy

Back 89

The person perceives that s/he has the capabilities for performing the behavior under a number of different circumstances

Front 90

What is Cohesion?

Back 90

Attraction of group members to one another

Front 91

what is Conflict?

Back 91

The opposite of harmony; antagonistic points of view

Front 92

what is Group ?

Back 92

A collection of interacting individuals who have a common purpose or purposes

Front 93

what is group-culture ?

Back 93

A composite of the group norms that comes to dictate perceptions and behaviors

Front 94

what is leadership ?

Back 94

Influencing others to achieve a goal

Front 95

what is Member Interaction ?

Back 95

The ways that group members behave and relate toward each other

Front 96

what is Task functions ?

Back 96

Behaviors that focus or direct movement toward the main work of the group

Front 97

7 things that DECREASE group Cohesion & Productivity

Back 97

1) Conflicts between personal and group goals

2) Lack of interest in group goals and activities

3) Poor problem solving and communication skills

4) Lack of leadership

5) Disagreement about leadership

6) Aversion to other members

7) Behaviors and attributes poorly understood by others

Front 98

6 ways to Resolve Conflict

Back 98

1) Give a full description of concerns and divergent views

2) Clarify assumptions on the conflict issue

3) Specify underlying factors, including beliefs, individual desires, and expectations

4) Identify the real issue or issues

5) Use a problem solving approach to search for a resolution

6) Find a resolution (which may be only a compromise)

Front 99

6 types of Group Role Behavior are?

Back 99

1) Follower

2) Gatekeeper

3) Leader

4) Maintenance Specialist

5) Peacemaker

6) Task Specialist

Front 100

What is a Follower ?

Back 100

Seeks and accepts the authority and direction of the group

Front 101

what is a Gatekeeper ?

Back 101

Controls outsiders’ access to the group

Front 102

what is a Leader ?

Back 102

Guides and directs group activity

Front 103

What is a Maintenance Specialist?

Back 103

Provides support for group members; holds the group together

Front 104

What is a Peacemaker ?

Back 104

Attempts to reconcile conflict

Front 105

What is a Task Specialist ?

Back 105

Focuses or directs movement
toward the main work of the group

Front 106

What is meant by “the social determinants of health?

Back 106

- making sure pt.'s environment is conducive to health & wellness

- Poorer people live shorter lives and are often more ill than the rich.

-This disparity has drawn attention to the remarkable sensitivity of health to the social environment.

-social environment here is educ, work, transportation, access to food/living wage that will enable person to achieve what we hope they can achieve

Front 107

health is more than health care

Back 107

social conditions – the jobs we do, the money we’re paid, the schools we attend, the neighborhoods we live in – are as important to health as our genes, our behaviors and even our medical care.

--working "upstream"

Front 108

health is tied to the distribution of resources

Back 108

The single strongest predictor of our health is our position on the class pyramid

Front 109

racism imposes an added health burden

Back 109

Past and present discrimination in housing, jobs, and education means that today people of color are more likely to be lower on the class ladder. But even at the same level, African Americans typically have worse health and die sooner than their white counter-parts.

-institutional racism ie: hospital wont allow nurse to wear a head covering

Front 110

the choices we make are shaped by the choices we have

Back 110

Individual behaviors – smoking, diet, drinking, and exercise – do matter for health.

But making good choices isn’t just about self-discipline. Some neighborhoods have easy access to fresh, affordable produce; others have only fast food, liquor joints and convenience stores

Front 111

high demand + low control = chronic stress

Back 111

It’s not CEOs dying of heart attacks, it’s their subordinates.

People at the top certainly face pressure but they are more likely to have the power and resources to manage those pressures.

The lower in the pecking order we are, the greater our exposure to forces that can upset our lives

Front 112

chronic stress can be deadly

Back 112

when threats are constant and unrelenting, our physiological systems don’t return to normal

Front 113

Inequality-economic & political is bad for our health

Back 113

The United States has by far the most inequality in the industrialized world – and the worst health

Front 114

social policy is health policy

Back 114

Social measures like living wage jobs, paid sick and family leave, guaranteed vacations, universal preschool and access to college, and guaranteed health care can further extend our lives by improving them.

-These are as much health issues as diet, smoking and exercise.

Front 115

health inequalities are neither natural nor inevitable

Back 115

Inequities in health – arising from racial and class-based inequities – are the result of decisions that we as a society have made. Thus, we can make them differently.

Front 116

we all pay the price for poor health

Back 116

It’s not only the poor but also the middle classes whose health is suffering.

Front 117

Public Health & Public Policy

Back 117

Public health is a governmental responsibility embodied in
- federal
- state
- local agencies

Front 118

what are the 3 Policy Development Strategies

Back 118

- these are the building blocks for how u go about building a policy that will positively effect your community

1) Bargaining--> u have to gather like-minded people & hash it out w/ your opponents--> "i'll support your policy if you'll support mine" --> negotiatioon

2) Information Through the Mass Media--> be media friendly "social marketing"

3) Health Information--> health info is not enough

Front 119

Implementation & its role in creating policy

Back 119

Authorization--has to be done by Congress & Appropriations committee

Rule making

Evaluation--> 2 types: formative & summative
- outcomes