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Details

NU 406: Community
Community
65
Health Care
Graduate
01/21/2007

Additional Health Care Flashcards

 


 

Cards

Term
Biomedical
Definition
Curing/diagnosing a disease or pathologic process
Term
Web of causality
Definition
how do individuals deal with health and illness in the context of day to day life?
Term
Upstream thinking
Definition
looking at ways to prevent disorders in health
Term
Advocacy in community health
Definition
for populations; ex: public policy or transportation issues
Term
Examples of Community health nurses
Definition
Public health nursing

Community health nursing

TB Surveillance nurse

Term
Example of nurses in the community
Definition
School nursing

Adult day health centers

Home care

Community health centers

Homeless shelters

Term
Geopolitical community
Definition
A community with geographic boundaries and structures that support a community. Example: The City of Boston, Boston College, Assistive Living facility
Term
Phenomenological Community
Definition
Community that has no geographic place. It does have struture, though. Ex. Gay and Lesbian Alliance; Haitian Americans
Term
Function of Communities
Definition
Meet the needs of members

Shared values, beliefs and institutions

Persue common goals

Provide structure for living and working with others; for sharing resources

preserve history, culture and identity

to educate and socialize the young

to care for the vulnerable

Term
Winshield assessment
Definition
Looking at a community. What can you see? Things like parks; grocery stores; gyms, sidewalk quality. Are they there? What's missing?
Term
EPA Reports
Definition
Can tell you air quality.
Term
Department of Labor
Definition
Unemployment rates (if increased, increase crime, decrease incidence of health insurance, and there's less money for healty food, childcare and transporatation)
Term
CDC reports
Definition
Rates of disease (flu, stroke, falls)
Term
Water Authority Reports
Definition
quality of water, which has significant health implications
Term
Primary prevention
Definition
interventions to prevent disease and injury. Ex: vaccine, seat belt laws, bicycle helmet laws, sex ed (esp STD teaching), condom distribution
Term
Secondary Prevention
Definition
aimed at early detection and treatment of disease. Ex: breast cancer screening, pap smear, bp screenings, diabetes screenings, child hearing/vision screenings, colonoscopy
Term
Tertiary Prevention
Definition
aimed at treatment of a disease; occurs when people actually have an illness.
Term
Incidence
Definition
rate of new cases. Tells you how much the disease is growing, or whether it's been affected by interventions
Term
Prevalance
Definition
rate or pre-exisiting conditions or health events. Example the rate of diabetes in Dorchester from 2000-2005
Term
Morbidity
Definition
Frequency of an illness in a given population in a given time
Term
Mortality
Definition
death rates of a population in a period of time
Term
Infant mortality
Definition
The rate of death among infants born alive but that die within the first year of life.
Term
Name the things that resulted from Lillian Wald's work
Definition
Henry Street Settlement

School Nursing

Play grounds in the lower east side and theater programs for adults at the Henry Street Settlement

"Milk Stations" in LES so that mothers would have access to pasturized milk

Rural Nursing (Town and Country by the American Red Cross)

Factory Reform and Child Labor Laws (with the help of Jacob Reece who took compelling pictures of factory life)

Brownsille Clincal: Margaret Sanger gae birth control info to poor women.

Term
Premature Death
Definition
Death before age 75
Term
What do hospitalization rates tell us?
Definition
Info about the burden of chronic illness (diabetes, COPD)

Lack of access to preventative/primary care (maybe lack of insurance?)

Term
What do infant mortality rates tell us?
Definition
How a community is able to care for their most vulnerable. It is a bell weather for the heath of a community

Def: Death of a live birth within the first year of life

*When infant mortality was controlled for SES and education there was still a higher rate in black populations. This is tied to the stress of enduring discrimination/racism

Term
HIV Rates in Boston
Definition
Black women are more than 10X as likely to have HIV/AIDS than white women. Black men are 2X as likely to have HIV/AIDS as white men.
Term
Why are diabetes rates so high for minorities?
Definition
They often are not being diagnosed early enough. They are often not diagnosed until they come in with complications

They don't have the resources to control their BS

lack of concistency with PCP (the poor end up going to clinics where residents rotate)

Term
Why is obesity a bigger problem for minorities?
Definition
Less access to healthy foods (placement of grocery stores)

healthy food costs more

It's difficult to transport groceries

Term
What are factors that lead to increased rates of asthma in minorities?
Definition
air quality (Dorchester has the poorest air quality)

housing conditions: mold/cochroach droppings

money for medicines

health illiteracy: how to use medicines

Term
Feaderal Poverty Rates
Definition
1 Person $9570/year

3 people $19350/year

If somone worked full time, 52 weeks per year at minimum wage they would not reach the federal poverty rate

Term
How does education relate to health?
Definition
Education relates to income and access to employment (health insurance)

Relates to health literacy. The ability to understand verbal and written instructions

Term
Why are there desparities in exercise among minorities?
Definition
No time--working too much

No $$ for the gym

Less access to open spaces

devaluing exercise

Saftey in neighborhoods

Term
Stair dangers, and how to improve them
Definition
Dangers: falls especially with impared gate
Improvement: slipper socks, stair tread, 100W light bulbs (40W is too low!); night lights
Term
Cords, dangers and how to improve them
Definition
Danger: tripping, use duct tape, or bright green glow in the dark tape
Term
Toilets, danger and how to improve
Definition
Danger: hips and back problems. Getting up multiple times in the night, in the dark

Improve: nightlights to get to the bathroom (especially light sensing ones that don't need to be turned off/on). Bedside commode for continuous falls during the night; Raised seat or backless commode for the toilet

Term
Tubs, danger and how to improve
Definition
Danger: Slips and falls; burns, esp for peripheral neuropathy

Improve: non-slip stickies for the tub; tub chair, especially with transfer bench to ease in; turn down hot water tank

Term
Ovens, dangers and how to improve
Definition
Danger: burns; leaving gas on; fire, especially with hoarders

Improve: get them to use the microwave; take knobs off the stove

Term
Rats/Roaches, dangers, how to improve
Definition
Danger: rat bites, dandriff from mice/rats and cochroach droppings are major asthma triggers

Improve: proper garbage disposal

Term
In the community, what are the major causes of medication errors?
Definition
*The further from the hospital we are, the less control we have of heath care

forgetfullness: taking multiple times or not taking at all

noncompliance: dislike SE

health literacy: they don't know how to take them, have vision problems, dexterity problems

can't afford meds

Feel fine on maintence meds, so they stop taking them

Transportation to pharmacy, and whether pharmacy carries the medications

Term
Beer's Criteria
Definition
List of meds that you should use caution with when perscribing to the elderly
Term
Checking for orthostatic hypotension
Definition
Assess BP/P when supine

Then again after going from supine to sitting or standing

Then at 1-3 minute intervals over the next 10 minutes

Patient is orthostatic if there is a SUSTAINED drop in SBP of 20mmHG and for DBP of 10mmHg or acccompanied by an increase in the HR of 20bpm or more.

Term
Three things you need for fall prevention to work
Definition
Lower extremety strength and balance exercises

Environmental changes

Comprehensive medication review

Term
What is a chronic illness?
Definition
Irreversable illness one must live with for the remander of his or her life

Illness where there MAY be no treatment to manage symptoms but for which there is NO cure

Illness characterized by ambiguity and uncertainty-by periods of control and episodes of exacerbation

Term
ADL
Definition
Activities of daily living

Very basic activities

ex: thinking, toileting, communicating, bathing, grooming, dressing, eating

Deficits in ADLs make people eligable for subsidized programs

Term
IADLs
Definition
Instrumental Activities of Daily Living

less basic than ADLs. You need access ability ot engage in these and manage them independantly (or make adaptive changes) or have support system to help with these

ex. food/meal preparation, shopping, driving/taking public transportation, doing laundry, using the telephone

Term
How low does glucose need to be for healing?
Definition
Less than 200mg/dL
Term
What are HTN guidelines for people with diabetes?
Definition
BP higher than 130/80 is HTN

130-140/80-90 can try to be managed with lifestyle changes for 3mo before trying a med

140/90 and above should be put on anti hypertensive

Term
Recommended norms for glycemic control
Definition
FBS: 90-130

PP <180mg/dl

HgbA1C: <7

Term
Signs of hypoglycemia
Definition
sweating, shaking, dizziness, hard time concentrating
Term
Hypoglycemic unawareness
Definition
Person doesn't know that they're exhibiting hypoglycemic symptoms

This occurs often in the elderly, and with Beta blockers

Term
Characteristics of diabetic foot ulcers
Definition
Usually have a callus ring; a ring of white callus which makes it difficult to heal.
Term
Microfiliment test
Definition
If they can't feel 3/5 places they have "loss of protective sensation" and should be referred to a podiatrist (which is covered by medicare if they have this)[image]
Term
TB Infection
Definition
Positive PPD (and need for chest x-ray)

bacteria is in the body, but the immune system is strong enough to wall off the bacteria.

not contageous; not sick.....

but if the immune system becomes comprimised, it can lead to TB disease

Term
TB disease
Definition
Exhibits the signs and symptoms of TB including: cough, chest pain, coughing up blood tinged sputum, weakness/fatigue, anorexia/wasting, fever, night sweats

high risk for TB: HIV+, homeless, Asia community (TB is more common in Asian countries)

Term
PPD screening
Definition
Screen for TB antibodies

Positive: a whiel the size of a pencil eraser or larger

Negaitive: clear skin at site of injection

False positive: reaction to the serum

Who should be screened? healt care workers; if you think you've been exposed, immunocomprimised patients

w/exposure you should have a PPD shortly after, and then serial testing for 6 months

Term
TB treatment
Definition
INH (Izoniazid).

Rifampin and streptomycin are also new antibodies to deal with resistant strains

You need to stay on meds for 6-9 months and compliance/adherance is difficult....stoping the drugs leads to resistant strains

Term
DRG
Definition
Diagnostic related groups: Hospitals are paid a lump sum based on diagnosis, reguardless of how much care the patient requires. Lead to shorter hospital stays and a spike in homecare for post-acute care.
Term
Homehealth aid
Definition
provides personal care: bathing, dressing, toileting
Term
Homemaker
Definition
does meal prep, shopping, errands...but NOT personal care
Term
Skilled services
Definition
Requires the skills, educatoin and knowldege of a nurse to perform.

NOT skilled: DSD; prefilling med boxes

Skilled WTD; injections, catheters, colostomy care

Term
Intermittant Services
Definition
Can not be 24h, 7day care. Most frequent is twice daily, least frequent is 2X/month.
Term
Homebound
Definition
leaving home is a considerably taxing activity. The patient can leave for MD appointments and church.
Term
Medicare
Definition
Federal program from the department of health and human services.

Insurance for people 65 and over and for some people with disabilities

Pays for ACUTE illness, not for care after stabilization or prevention and maintence

Does not payed for "non-skilled" work

Term
Medicaid
Definition
Federal and State monies for insurace, administered by the state

For low income populations

Much more generous tha medicare. Covers acute illness AND chronic care. Covers things like filling med boxes and syringes, to see someone with a chronic illness, and some adaptive equiptment (wheelchairs, scooters ect)

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