Term
| 1.Discuss the importance of applying an ecologic perspective to any investigation of human–environment relationships. |
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Definition
| A single casual factor cannot be isolated, because there are many casual relationships. Within an ecosystem, any minipulation of one element or organism may have hazardous effects on the rest of the system. Therefore no one factor, whether organism or substance, can be viewed in isolation. The community health nurse acknowledges that people can effect their enviroment, and their enviroment can effect them. Preventing and promoting health measures can be applyed to all aspects of the enviroment, including us. |
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Term
| 2.Explain the concepts of prevention and long-range environmental impact and their importance for environmental health |
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Definition
Long- range enviromental impact= must be viewed not only in terms of its consequences for people living now but also in terms of long-range impact on the human species. One must consider the health of the future generations as well as present ones. Considerations should include food and fuel limitations of the natural enviroment, attendance to conserve through balancing of present and future needs, and prevention of the consequences of enviromental abuse. Prevention helps preserve the long- range enviroment.
• Long-Range Environmental Impact: Consider present and future needs
o Food and fuel limitations of the natural environment
o Conservation by balancing present and future needs
o Preventing consequences of environmental abuse
• Safety in home, worksite, and community: Government Role
o Standards and regulation
o Monitoring of chemical use and production
o Public education & community safety programs |
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Term
| 3.Describe the four dimensions of a home environment assessment according to the PEHA tool: housing characteristics, indoor pollutants, home environment, sleep environment |
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Definition
Housing: Type of ownership( like own house, rental, shelter..ect); age of home; Structural foundation ( basement, slab ob grade, crawlspace, don't know); Floors lived in (basement, 1st, 2nd, 3rd or higher); Heating: Fuel used, sources in home, filters changed, control; cooling, ventilation.
Indoor pollutants: Mold and moisture; Pet: presence, management; Pests: mice, rates, bedbugs; lead paint hazards, Abestos, Radon, Health and safety alarms, tabacco smoke exposure, other irritants, types of cleaning.
Home enviroment: Drinking water source; kitchen : cleanliness, ventilation; bathroom, basement, living room, laundry area
Sleep enviroment: patients sleep area, # beds, allergens impermeable encasings onbeds, pillows, bedding, flooring, dust & mold cathcers, windows, other irritants. |
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Term
| 4.Relate the effect of selected hazards on people's health in the home: mold, pests, lead-based paint, radon, tobacco smoke, carbon monoxide |
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Definition
MOLD :It is an environmental hazard grow in a warm damp environment and reproduces by spores, and survives harsh conditions. It is a biological hazard and can cause acute and chronic illness, allergy attacks, chronic lung diseases depending on the different kinds of molds
• Factors for risk exposure: those who are sensitive to mold, workers in occupational settings (flower shops, farms, antique shops), people with COPD have a more risk for it. Any warm moist areas, most everyone is at risk for it. Immuno comprimise people especially at risk because immune system is already shot.
• What happens if you are exposed: you can get lung disease, or asthma
• Tips to prevent it : use your AC, keep humidity below 50%, don’t carpet bathroom and basements, clean and damp or wet material or furnishing within 24-48 hours to prevent mold.
PESTS:
• Include insects, fungi, bedbugs, mesquitos
• Risk to exposure: germy cockroaches in the home
• Geographic locations; really wooden areas
• Storing food in non air type containers, pipes can become infested
• It is a hazard because pests carry diseases, allergic reaction from the bites, and bedbugs are hard to get rid of.
• Pesticides can be toxic when you use those to get rid of pests can affect pregnant women and can effect their fetus. Pesticides are a huge hazard.
• Coach roaches body parts, and dropping can cause asthma
• Mesquitos can cause skin irritation, and malaria
LEAD BASED PAINT:
• Environmental hazard heavy soft blue stream metal that occurs naturally in the earths crust
• Lung cancer, nervous system damage
• There is no taste or spell undetectable unless you are specifically looking for it
• Paint chips do taste sweet that its why kids eat them
• People are at risk: developing countries do not regulate it a lot so they are at risk, older homes, hobbies auto industry, construction, plumbing, soil, tap water, lead based dust on the toys
• 1995 they took lead out of gas
RADON:
• Ionizind radiation comming from all sorts of sources, everyone comes in contact with it, in the soil, in the organs
• The second leading cause of lung cancer next to smoking
• More common in the environment
• If there is loose connections in your home radon can get in easier
• It is effected by elevation the higher you are the more you are likely to have exposure ( the northen states)
• Men are more susceptible than women
• Basements and attics are a likely place for radon
• You have to look for cracks and things but definitely comes from the soil
• People who work under ground are at higher risk
TABACCO SMOKE:
• Was a chemical hazard
• Affects body from inhalation
• Factors that place someone at risk: being around anyone that smokes, 3rd hand smoke is worst than 2nd hand smoke, if you smoke outside it still gets on your clothes, walls, and car, and it mixes with the air and is just as toxic as second hand smoke.
• Risk factors: work place, construction worker smoking on the site, certain states have smoking bands in restraints and some don’t,
• Lung cancer, heart disease, COPD, the leading preventable cause of death in the US
"the best way to maintain a smoke-free house is to refrain from smoking.
In addition, adopting smoke-free rules in homes reduces involuntary
exposure to secondhand smoke and improves health. Opening a window;
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sitting in a separate area; or using ventilation, air conditioning, or a fan
cannot eliminate secondhand smoke exposure. "e only way to fully protect
yourself and your loved ones from the dangers of secondhand smoke is
• through 100% smoke-free environments
CARBON MONOXIDE:
Removing or controlling carbon monoxide sources in the home is the most
important way to prevent carbon monoxide exposure. For example, gas
generators, gas grills, and other fuel-burning appliances should never be
operated in the house. Converting from wood stoves or kerosene heaters
may decrease both carbon monoxide and particulates in the home, although
this may not always be practical. In addition, installing and maintaining
carbon monoxide detectors can prevent death and injury from carbon
o monoxide exposure |
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Term
| 5.Discuss appropriate interventions for addressing these health problems, including community health nursing’s role |
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Definition
o Education-Providing information about hazards and ways to protect from hazards
- Access to information: Utilizing Right to Know laws
- Must have knowledge of local resources
- Ability to access resources
- Risk Communication
- Community Education
- Internet Consumer Resources
o Advocacy
- Advocacy Enforcement of existing regulations
- New protections or regulations
- Providing testimony
o Referrals
- Nursing Colleagues: Occupational Health Nurses
- Environmental engineers/industrial hygiene
- Public Health agencies
- Legal Organizations
- Social Services
o Case management
six places to prevent, homes, workplace, recreational sites, schools, farms, highways. Working with the police, fire personell,and social service, and many other community groups. |
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Term
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Definition
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Term
| Explain the three Stages of Change. |
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Definition
a.Unfreezing- Finding a method of making it possible for people to let go of an old pattern that was counterproductive in some way Determine a convincing reason : why the change needs to take place,what needs to happen for this change to occur, when these things should take place . Who needs to be involved in the steps to the change.
b. Moving to a new level- Involves a process of change in thoughts, feeling, behavior, or all three, that is in some way more liberating or more productive. Put into action all those thoughts, plans and ideas you formed during the Unfreeze phase Give yourself lots of positive reinforcement. Remind yourself why you are making the changes and what the rewards and benefits will be. Appeal to those people who have committed to help you
c. Refreezing- Establishing the change as a new habit, so that it now becomes the “standard operating procedure.” Without this stage of refreezing, it is easy to backslide into the old ways.Set in concrete that your change is now a permanent part of your life. Continue to rely on your support system Look at what steps worked well and which did not and adjust accordingly
* unfreezing( when desire for change developes), changing/ moving ( when new ideas are accepted and tried out), refreezing( when the change is integrated and stabalized in practice). |
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Term
| Describe the Planned Change Process |
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Definition
| The planned chane process involves a systematic sequence of activities that follows the nursing process. Following its eight basic steps leads to the successful managment of change: (1) recognize symptoms, (2) diagnose need, (3) analyze alternative solutions, (4) select change, (5) plan the change, (6) implement the change, (7) evaluate the change, and (8) stabalize the change. |
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Term
| Identify three planned-change strategies. |
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Definition
(1): empiric- rational change strategies- are used to effect change based on assumption that people are rational and, when presented with empirica information, will adopt new practices that appear to be in their best interest. Goal is to provide information only. Assume rational, informed actors who can digest and use information in their best interest. Transform the information into knowledge. Make informed decisions.
(2)Normative-re-educated strategies: are used in influence change that not only presents new information but also directly influences peoples attitudes and behaviors through persuation.Goal is to expose people( individuals, groups/ organizations) to new values and norms and the need to adopt these new values and norms, etc…May be based on rational ( such as scientific evidence) or emotional appeals ( such as charismatic leaders) Example: anti-smoking commercial.
Power- Coercive strategies: use coersion based on fear to effect change. Application of economic, political, and moral power and institutions to make people change attitudes, beliefs, behaviors, values, ect…This can be formal or informal authority. May withhold reward or administer punishments to reach goal. Use of money , bribes, payment for complying. |
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Term
| Summarize the six principles for effecting change in community health |
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Definition
(1) Principle of participation: persons affected by a proposed change should participate as much as possible in every step of the planned change process. Collaboartion with those who have a vested interest in the change can produce a wealth of ideas and insights that can greatly improve the change plan. This ensures a greater likelihood that change will be accepted and maintained.
(2) Principles of restistance to change: Resistance is expected with change, it poses a threat to changes of equilibrium of the mind and body. involving people in the planned change process, and establish and maintain open lines of communication to make ideas clearly understood and to solve disagreements quickly. The nurse can provide support, patience, and encourage response and expression of feelings.
(3)Principle of proper timing: Timing is everything, the client needs to be able to focus all their time on the change. The change idea must be appropriate, and change recipitant prepared, the climate right, and the resources available before the change can be fostered into full maturity and usefullness.
(4)Prinicple of interdependance: change does not take place in a vaccum. When workers learn new health and safety practices associated with their jobs, their relationships with one another, and their bosses, their overall productivity in the organizations may easily be effected.
(5)principle of flexibiliy: the nurse must be able to adapt to unexpected events and make the most of them. Second: a good change planner anticipates possible blocks or problems by prepareing strategies and alternative plans.
(6)Principle of self- understanding: The community nurse should be able to clearly define hsi role and learn how and learn how others define it. Understanding oneself is crucial to learning to making use of one's best qualities and skills to effect change. |
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Term
| Apply learning theories that are applicable to an individual, family, or aggregate client (focus on Pender's Health Promotion Model) |
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Definition
This was designed to see how the client would respond to a course of change in behavior. It includes three general areas. Starts with Individual characteristics and experiences ( prior related behavior, personal factors : biological, pyschological sociocultural); Behavior-specific cognitions and affects( preceived benefits of action, preceived barriers to action, preceived self effeciency, activity-related effect, interpersonal influences family, peers, providers, norms, support, models, situational influences, options, demands, characteristics, aesthetics); Behavioral outcomes( imediate competing demands either low or high control, commitment to a plan of action, health promoting behavior)
*Studies testing HPM model determine that following factors contribute to health-promoting behaviors:Perceived benefits of action,Perceived barriers to action, Perceived self-efficacy, Interpersonal influences, Situational influences. |
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Term
| Develop teaching plans focusing on primary and secondary levels of prevention for clients of all ages |
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Definition
Teaching strategies for developmental levels: preschool ( simple language, games, songs, rhymes, demonstration/return demonstration); school-aged ( language varies with grade level and cognitive ability, use interactive games, puzzles, matching and role playing); Adolescents ( cooperative learning, problem- based learning, discussion, demonstration); Adult( Adolescent plus lecture, discussion, demonstration, and role playing), Senior ( lecture, discussion, demonstrarion, and role playing with attention to mental level.
PRIMARY LEVEL OF PREVENTION: health education a nurse teaches a class on sensible weight control for teenagers, nurse teaches about the importance of pneumonia and flu vaccines.
SECONDARY PREVENTION: screening, treatment: a nurse teaches clients how to navigate through the complexities of healthcare delivery system to receive prompt treatment. |
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Term
| Identify educational activities for the nurse to use that are appropriate for each of the three domains of learning. |
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Definition
COGNITIVE(development of new facts and concepts): lecture, programmed instructions, simulations and games, CAI & modules
AFFECTIVE ( recognition of values, attitudes, beliefs): discussion, simulation, role playing, field experiences
Psychomotor(developing physical skills from simple to complex): demonstrating games, practice, peer teaching. |
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Term
| Describe the plain language strategy for clearly communicating health information |
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Definition
. Culturally appropriate printed materials ( pamphlets, brochures, booklets, flyers, and informational sheets). Audiovisual materials: DVD’s or videotapes, webcasts, audio tapes.
-Establish a trusting relationship
-Use the smallest amount of information needed to accomplish predetermined objectives
-Make information points as vivid and explicit as possible
-Teach one step at a time
-Use multiple teaching methods
- Allow people to restate information or demonstrate procedures
- Keep motivation high
- Tailor regimen into daily schedules
- Use repetition to reinforce |
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Term
| Explain the difference between developmental crises and situational crises and give examples of each within families. |
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Definition
developmental crisis - is are periods of disruption that occur at transitions points during normal growth and development . When developmental crisis occur people feel thratened by the demands placed on them and have difficulty making the change necessary to fit the new changes of development. Normally happens when you leave home, are getting married, having a baby, retire, or die. For example transition to parenthood you go from caring about yourself and your mate to more of a caring nurturing mental status.
Situational crisis- is a stressful, disruptive, event rising from external circumstances that occur suddenly, often without warning, to a person, group, aggregate, or community. Typically the external events requires behavioral changes and coping mechanisms beyond the ability of the person invvolved. For example a college student is raped in a parking garage, a baby grabs tea and spills it on their chest. |
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Term
| Discuss strategies to prevent the impact of a situational crisis and a developmental crisis at a primary, secondary, and tertiary level of prevention. |
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Definition
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Term
| Describe how the United States has responded to family violence |
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Definition
| The United States passed public laws and protection. One law made it mandatory for health care workers to report suspected child abuse to appropriate professionals. The Child abuse orevention and treatment act served to aim at solving the growing problem of child abuse in the country. Publics laws supports funding to states in their efforts to prevent violence in families and to identify and treat victims. INformation on adoption, out-of-home care for children, preventing and responding to child abuse and neglect, supporting and preserving families, and resources are available via the child welfare information gateway, a program under the united states department of health and human services. The goal of healthy people 2010 regarding violence and abuse is to reduce injuries, disabilities, and death due to violence amoung all people of the united states. |
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Term
| Identify characteristics of abuse against infants, children, and adolescents |
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Definition
- The child is frightened of parent/caretakers.
- The child is excessively passive, overly compliant, apathetic, withdrawn or fearful or, at the other extreme, excessivly aggressive
- The child/ or caretaker attempts to hide injuries with makeup, clothes, layers, child is frequently absent from school.
- child is frightened of going home
- the child is clingy and forms indiscriminant attachments
- the child is apprehensive when other children cry
- the child is wary of physical contact with adults
- The child exhbits drastic behavorioral changes in and out parental/caretaker presence.
- the child is hypervigilant
- The child suffers from seizures or vomiting
- the adolescent exhibits depression, self-mutilation, suicide attempts, substanc abuse, or sleeping and eating disorders
- parent fails to take child to the doctor. |
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Term
| Describe the “cycle of violence” seen in intimate partner/spousal abuse. |
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Definition
| The cycle of violence is a repetitive. cyclic pattern of abuse seen in domestic violence. The cycle includes the tension building phase, the acute battering incident, and the loving reconciliation. This explains why women feel so guilty and ashamed of their partners violence, and why they find it hard to leave, and even when their lives are in danger. |
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Term
| Explain common types of elder abuse |
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Definition
| The mistreatment of elders may involve neglect; physical; sexual, emotional, or fiduciary abuse, or any combination of these treatments. The can be abused by abandoment or neglect ( physically or emotionaly); by physical, sexual, or emotional abuse by exploitation. Physical abuse includes : rough handling during caregiving, pinching, hitting, and slapping. Emotional abuse includes: being shouted at threatened, or having needed care withheld. Unwashed, unfed, neglected. Taking social security retirment money, savings, and investment to use on themselves. |
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Term
| Describe the community health nurse role with families in crises at each level of prevention |
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Definition
Primary prevention: Nurses often make home visits to families based on referrals from hospital perinatal departments. On the first visit the nurse assesses the family and determines needs for teaching, they could also involve them with other people wanting to learn the same stuff.
SECONDARY PREVENTION: Early diagnosis and prompt treatment of the effects of the family crisis or violence; seeks to reduce the intensity and duration of a crisis and promote adaptive behavior
Tertiary Prevention: focuses on rehibilitation of the family from violence and crisis they have substained |
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Term
| Discuss the effects of vulnerability and relative risk. |
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Definition
The effects are higher mortality rates, less access to health care, and uninsured or underinsured, have lower life expectancy, and overall diminshed quality of life.
RELATIVE RISKS: refers to exposure to risk factors identified by a substantial body of research such as lifestyle, behaviors and choices ( e.g diet, exercise, use ob tabbacco or alcohol, and other drugs, sexual behaviors) ; use of screenign services ( immunizations, use of seatbelts, health promotion). |
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Term
| Differentiate between the concepts of social capital and human capital |
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Definition
social capital - consists of martial status, family structure, social ties, and networks, memberships in voluntary organizations, such as church or clubs.
HUMAN CAPITaL: to invest in individual capabilites and skills ( education, job training), and notes that it comprimises jobs, income, housing, and education. |
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Term
| Identify the key premise of the differential vulnerability hypothesis. |
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Definition
| says " negative or stressful events ( such as unemployment, divorce, death of a loved one) burt some peopl more than others". Even though we are subjected to streddful events ( nursing school) , research showing that low socioeconomic status groups experience more stress. In other words, early chronic stressors can induce physiological changes that leas to later negative health outcomes.Low socioeconomic status (SES) groups are more adversely affected than higher SES groups. Negative or stressful events hurt some people more than others. |
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Term
| Explain the socioeconomic gradient in health. |
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Definition
| The inverse relationship between social class or income and health has been termed the socioeconomic gradient. inverse relationship between social class or income and health |
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Term
| Describe three types of health disparities. |
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Definition
* is a chain of events signified by a difference in:( 1) enviroment,(2) access to, utilization of, and quality of care, (3) health status, or (4) a particular health outcome that deserves scrutiny.
1. Poor access to care; quality of care
2. Overt discrimination ( delivering health care provider is biased against a specific group or hold stereotypical beliefs about that group.
3. Levels and types of care and care settings- there is a lack of medical in low income communities, and everyone has either no health insurance or health insurance. |
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Term
6.Apply the following theories and models of vulnerability to the videos for this class:
•Framework for studying Vulnerable Populations (Aday, 2001)
•Model of Vulnerability (Flaskerud & Winslow, 1998)
•Behavioral Model for Vulnerable Populations (Andersen & Leake, 2000) |
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Definition
* Framework for studying vulnerable populations: Effects of policies on community and individuals; differentail vulnerability hypothesis; social and human capitol.
The model of vulnerability says that a lack of resources( socioeconomic, and enviromental), increases a populations exposure to risk factors and reduces their ability to avoid illness ( morbidity, and mortality.
BEHAVORIAL MODEL FOR VULNERABLE POPULATIONS: looked at population characteristics(predisposing, and enabling factors and needs) as an explanantion of health behaviors and eventual health outcomes.
Predisposing factors
Demographic and social variables
Health beliefs
Enabling factors
Personal, family, community resources
Perceived health needs
Use of health services
Personal health practices |
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