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CommHealth/Psych
Exam I self study mods and mods 1-3
Question | Answer |
---|---|
What are the indications for progression from one step to the next with stepwise dose escalation of morphine sulfate? | 1. Requirement of greaterthan 2 rescue doese in any four-hour interval. 2. Requirement of greater than six rescue doese in 24 hours. |
Name three opiod agonist drugs that are usually prescribed to treat moderate pain (weak opiods) | codeine, oxycodone, propoxyphene |
name a few opiiod agonist drugs usually prescribed to treat severe pain (strong opioids) | morphine, oxycodone, hydromorphone, methadone, meperidine, oxymorphone, levorphanol, fentanyl |
describe Pre-interaction phase. | explore self-perceptions, obtain info about pt from chart |
Describe orientation phase (introductory) | Establish trust, formulate contract for intervention |
Describe working phase | promote Pt change. |
Describe termination phase | evaluate goal attainment, ensure therapeutic closure |
Define community | a colletion of people who interact w/one another and whose common interests or characteristics form a basis for a sense of unity or belonging |
What does a social system include? | economy, ed, religion, welfare, politics, legal system, rec, safety, transportation, comm systems and healthcare |
Community based nursing is? | nursing care w/in the context of teh Pts family and community w/ a prevention focus that enchances the Pts ability for self care |
What is specific about a CBN compared to a CHN or PHN? | ADN or BSN employed in a noninstitutional setting but doesn't have to specialized courses in PHN. Requires training and special skills to work w/ population |
What is specific about CHN compared to CBN and PHN? | Has a setting for practice fo nursing ie HD, and some of the areas for PHN |
What is specific about PHN compared to CBN and CHN? | Requires specific educational preparation r/t public health issues, policies and research. |
What does a boundary do? | separate the system from its environment and regulates the flow fo energy, matter and info between system and environmnet |
What is an environment? | Everything outside the boundaries of the system |
What is an outcome? | created products, energy, and info that emerge from the system into the environment |
What are external influences? | the matter, energy and info that come from the environment into the system |
What is feedback? | info channeled back into the system from its environment that describes the condition of system. |
What is a subsytem? | 1. structural subsystem: relates to the organization. 2. Functional subsystem: relates to specific purposes. |
Suprasystem is? | next larger system in a hierarcy. The suprasystem of a couunty is the state. |
Orems self care theory: | production of actions directed to self or to the environment in order to regulate ones functioning in the interests of ones life, integrated funct and well being. |
Primary prevention is ? | aimed at altering the susceptibility or reducing the exposure of persons who are at risk for developing a specific disease |
Secondary prevention is? | aimed at early detection and prompt treatment either to cure a disease as early as possible or to slow its progression, thereby preventing disability or complications |
Tertiary prevention is? | Aimed at limiting existing disability in persons in the early stages of disease and at providing rehabiliataion for persons who have experienced a loss of function resulting from a disease process or injury |
Distributive justice is? | ethical concept concerned w/the fair provision of opportunities, goods, and services to populations of people. |
Utilitarian system is? | Utilitarian system: resources are distributed to provide the greatest good for the greatest number w/the least amount of harm |
Egalitiarian system IS? | Egalitiarian system: each person has equal access to equal health services. |
Name some responsibilities of PHN. | providing care to ill and disable in their homes, maintaing healthful environ, teaching about health promotion, IDing those w/ inadequate standards of living, preventing and reporting neglect and abuse, collaborating to develop appropriate |
What is quality assurance? | CHN are expected to fulfill requirements for relicensure and participate in self-evaluation, continuing ed, and peer review |
What does axis I-V stand for on the multiaxil system? | I= mental d/o except peronality and MR II=personality d/o and MR (think childhood) III=General medical conditions IV=Psychosocial and environ problems V=Global Assesment of Functioning (number 100-0) |
What does Milieu mean? | environment |
General Adaptation Syndrome (GAS) (Hans Selye). What are the three parts to physiologic reaction to stress? | 1. Alarm reaction stage-prepares for fight or flight. 2. Resistance stage- body stabilizes 3. Exhaustion stage-body can no longer resist the effects of the stressor. |
What is the difference between coping and defense mechanisms? | Coping-you are aware you are doing it. Its how you manage stess. Defense-Unaware you are doing it. Protecting your self from stress. |
What are the 4 phases of a crisis? | I-exposed to a precipitating stressor. II-Previous problem solving techniques don't relieve the stressor and anxiety continuse to increase. III-All resources are used to resolve the problem and relieve discomfort. IV-if resolution han't occuured |
Balancing factors in a stressful event | 1. individuals perception of the event 2. Availiability of situational supports 3. Availiability of adequate coping mechanisms |
What are two types of crisis? | 1.Maturational or developmental crisis 2.Situational crisis |
Epidemiology is? | investigates the DISTRIBUTION or the patterns of health events in pops and the determinants or the factors that influeence those patterns. |
Causation: Strenght of association is? | a strong association betweena potential risk factor and an outcome supports a causal hypothesis. ex. potential risk of lung cancer is stronger if a person has been smoking for 20ys opposed to 2ys |
causation: Dose - response relationship is? | the risk of developing an outcome should increase w/increaseing exposure (either in duration or quaintly) to the risk factor of interest. ex. studies have shown that the more a woman smokes during pregnancy the greater risk of delivering a low weigh baby |
Causation: Temporally correct relationships is ? | for a risk factor to cause an outcome, it must precede the onset of the outcome. |
Causation: Biological plausibility is? | demonstration of a physiologic mechanism by which the risk factor acts to cause disease enhances the causal hypothesis. Conversely, an association that doesn't initally seem biologically defensible may later be discovered to be so. |
Causation: Consistency with other studies is? | repeated findings of an association w/differnt study designs and in different pops strengthen causal inference. |
Causation: Specificity is? | the presence of a 1:1 relationship between an agent and a disease (the idea that a disease is caused by only one agent and that agent results in only one disease lends support to a causal hypothesis, but its absence doesn't rule out causality |
Iceberg Model: Think of icebergs in the ocean. how much of the iceberg is actually visible only about 10%....so it is with disease.... | We may only see 10% of the disease present in the population, but 90% is not visible or even diagnosed; or only 10% is clinically active disease, while the other 90% is subclinical. |
Rate and Ratio is... | Rates: # of events (OVER)Population at risk (X) 100,000 or another standard base #. Ratio: city A to city B is 103 to 253, which is expressed as 103:253. dividing equals 2.4563 or a ratio of 1:2.45 |
Morbidity is ? | the DISEASE RATE of a given product in a given population. |
Moratlity is? | the DEATH rate of a given product in a given population. |
Incidence is? | the number of NEW CASES of a given disease ina given time |
Prevalence is | the # of NEW and EXISTING cases of a given disease in a given time |
Attack rate is? | the RATE or PROPORTION of persons who are exposed to an agent and develop the disease. |
Healthy People 2010 is : Quality and Years of Life Objectives... | 1. decrease the total death rate to no more than 454 per 100,000. Reduce the death rate for: 2.adolescents and young adults to no more than 81 and Adults to no more than 358 per 100,000. 4. Increase life expectancy to 77.3 years one more can't fit :( |
Epidemiologic triangle | Susceptible person or host : environment : causative agent |
Descriptive epidemiologic | describes the distribution of disease, death and other health outcomes in the pop according to a person, place, and time. Gives a picture of how things are or have been-the who, where land when of disease patterns. |
Analytical Epi is? | Deals with the factors that influence the observed patterns of health and disease and increase or decrease the risk of adverse outcomes. |
Multiple causation of disease: remember BEINGS | B-biologic factos and behavioral factors E-Environmental factos I- Imunologic factors N- Nutritional factos G-Genetic factos S- Services, social factors and spiritual factors |
Top five causes of death from 92-04 are? FYI smoking, alchol, HTN, high cholesterol and obesity contribute to #1 | #1. Disease of hear #2. Malignant neoplasms #3 Cerebrovascular diseases #4 Chronic lower respiratory tract disease #5 Accidents |
Communicable disease: contemporary issues...what are some? | drug resistant disease, TB (dificult to control, STDS, Hepatitis, HIV. New ones..norwalk-like virus, lyme disease, west nile virus, avian influenza, and Hantavirus Pulmonary Syndrome (a new infection) |
What is pluralism? | a mutual appreciation and understanding of the various cultures and subcultures ina society |
Subsets of culture: Influences | age, religion, dialects and languages, gender ID roles, socioeconomic, geographic location in the country of origin and teh current county, HX. of subculture in which pt IDs self in current country and country of origin |
Subsets of culture: Subcultures: | grouops of individuals who, although emembers of a larger cultural group have shared characteristics not related to larger group. ie nurses |
Subsets of culture: difference between health care provider and client | Nurse must be sensitive to needs of Pt and not infict her/his values or standard to the Pt |