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UTAH VALLEY UNIVERSITY NURSING STUDY GUIDE ,DEFINATION &NOTES, Study notes of Nursing

Utah Valley University (UVU)Nursing
Prof. Weslie E. Sheldon

To help you prepare for the exam, use power points, audios, Intro to Epidemiology online assignment, module self-assessments, and readings to utilize the following study guide. This is not intended to be inclusive. Know all key terms (vocabulary words) and objectives for each chapter. I encourage you to form study groups and use this as a guide for discussion. There will be 32 questions (worth 50 points) - matching, multiple-choice, select-all-that-apply, & true/false. Chapter 15 Globalization Nongovernmental Organizations (NGO) Primary Care World Health Organization (WHO) Centers for Disease Control and Prevention (CDC) World Population & Urbanization Global Infectious Diseases Developed & Developing Countries

Typology: Study notes

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UTAH VALLEY UNIVERSITY
NURSING STUDY GUIDE ,DEFINATION &NOTES
To help you prepare for the exam, use power points, audios, Intro to Epidemiology online
assignment, module self-assessments, and readings to utilize the following study guide. This
is not intended to be inclusive. Know all key terms (vocabulary words) and objectives for each
chapter. I encourage you to form study groups and use this as a guide for discussion. There
will be 32 questions (worth 50 points) - matching, multiple-choice, select-all-that-apply, &
true/false.
• Chapter 15
• Globalization
• Nongovernmental Organizations (NGO)
• Primary Care
• World Health Organization (WHO)
• Centers for Disease Control and Prevention (CDC)
• World Population & Urbanization
• Global Infectious Diseases
• Developed & Developing Countries
• Chapter 31
• Primary, Secondary, & Tertiary Prevention
• Health Promotion
• Safety
Chapter 5 Epidemiology
Epidemiology is the study of the distribution and determinants of health and disease in human
populations and is the principal science of public health.
Descriptive epidemiology is the study of the amount and distribution of disease.
Analytic epidemiology investigates the causes of disease, or etiology.
The web of causation model illustrates the complexity of relationships among causal variables for
heart disease.
Rates are arithmetic expressions that help practitioners consider a count of an event relative to the size
of the population from which it is extracted. They are population proportions or fractions in which the
numerator is the number of events occurring in a specified period. The denominator consists of those
in the population at the specified time period. This proportion is multiplied by a constant (k) that is a
multiple of 10. The constant usually converts the resultant number to a whole number.
Incidence rates describe the occurrence of new cases of a disease or condition in a community over a
given period relative to the size of the population at risk for that disease or condition during that same
period. The denominator consists of only those at risk for the disease or condition; therefore, known
cases or those not susceptible are subtracted from the total population. Incidence rates are useful for
detecting short-term changes in acute disease in which the duration of the disease is typically short.
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UTAH VALLEY UNIVERSITY

NURSING STUDY GUIDE ,DEFINATION &NOTES

To help you prepare for the exam, use power points, audios, Intro to Epidemiology online

assignment, module self-assessments, and readings to utilize the following study guide. This

is not intended to be inclusive. Know all key terms (vocabulary words) and objectives for each

chapter. I encourage you to form study groups and use this as a guide for discussion. There

will be 32 questions (worth 50 points) - matching, multiple-choice, select-all-that-apply, &

true/false.

- Chapter 15

  • Globalization
  • Nongovernmental Organizations (NGO)
  • Primary Care
  • World Health Organization (WHO)
  • Centers for Disease Control and Prevention (CDC)
  • World Population & Urbanization
  • Global Infectious Diseases
  • Developed & Developing Countries - Chapter 31
  • Primary, Secondary, & Tertiary Prevention
  • Health Promotion
  • Safety Chapter 5 Epidemiology Epidemiology is the study of the distribution and determinants of health and disease in human populations and is the principal science of public health. Descriptive epidemiology is the study of the amount and distribution of disease. Analytic epidemiology investigates the causes of disease, or etiology. The web of causation model illustrates the complexity of relationships among causal variables for heart disease. Rates are arithmetic expressions that help practitioners consider a count of an event relative to the size of the population from which it is extracted. They are population proportions or fractions in which the numerator is the number of events occurring in a specified period. The denominator consists of those in the population at the specified time period. This proportion is multiplied by a constant (k) that is a multiple of 10. The constant usually converts the resultant number to a whole number. Incidence rates describe the occurrence of new cases of a disease or condition in a community over a given period relative to the size of the population at risk for that disease or condition during that same period. The denominator consists of only those at risk for the disease or condition; therefore, known cases or those not susceptible are subtracted from the total population. Incidence rates are useful for detecting short-term changes in acute disease in which the duration of the disease is typically short.

Incidence rate = number of new cases or events occurring in the population in a specified period divided by the population at risk during same specified period multiplied by “k.” A prevalence rate is the number of all cases of a specific disease or condition in a population at a given point in time relative to the population at the same point in time. Prevalence rate = number of existing cases in population at a specified point in time divided by the population at same specified point in time multiplied by “k.” Screening programs are conducted by community health nurses. They may perform physical examinations, promote client self-examination, conduct screening programs in schools, clinicals, or community settings. Guidelines for screening programs include screening for conditions in which early detection and treatment can improve disease outcome and quality of life; screening populations that have risk factors or are more susceptible to the disease; select a screening method that is simple, safe, inexpensive to administer, acceptable to clients, and has acceptable sensitivity and specificity; plan for the timely referral and follow-up of clients with positive results; identify referral resources that are appropriate, cost effective, and convenient for clients. Surveillance is a mechanism for the ongoing collection of community health information. Monitoring for changes in disease frequency is essential to effective and responsive public health programs. Identifying trends in disease incidence or identifying risk factor status by location and population subgroup over time allows the community health nurse to evaluate the effectiveness of existing programs and to implement interventions targeted to high-risk groups. The agent, host, and environment are what are analyzed by the epidemiologist and is referred to as the epidemiological triangle. The development of disease depends on the extent of the host’s exposure to an agent, the strength or virulence of the agent, and the host’s genetic or immunological susceptibility. Disease also depends on the environmental conditions existing at the time of exposure, which include the biological, social, political, and physical environments. The model implies that the rate of disease will change when the balance among these three factors is altered. By examining each of these three elements, a community health nurse can methodically assess a health problem, determine protective factors, and evaluate the factors that make the host vulnerable to disease. The role of the epidemiologist includes examining the interrelationships between host and environmental characteristics and uses an organized method of inquiry to derive an explanation of disease. They describe disease patterns in aggregates and quantify the effects of exposure to particular factors on the disease rates. To identify specific risk factors, epidemiologists compare rates of disease for those exposed with those not exposed. Objectives

  • Identify epidemiological models used to explain disease and health patterns in populations.
    • Person-Place-Time Model: this was used by researchers to examine whether common time factors existed (i.e., when people acquired disease). Use of this model organized epidemiologists’ investigations of disease pattern in the community. The person is the “who” factor, such as demographic characteristics, health, and disease status. The place is the “where” factor, such as geographic location, climate and environmental conditions, and political and social environment. The time is the “when” factor, such as time of day, week, or month and secular trends over months and years.
    • Epidemiological triangle: the epidemiologist analyzes the agent, host, and environment. The agent of disease refers to etiologic factors such as nutritive elements and chemical, physical and infectious agents. The host factors are those that

to manipulate the specific exposure or experience or to control or limit the effects of other extraneous factors that may influence disease development.

  • Cross-sectional studies examine relationships between potential causal factors and disease at a specific time. Surveys that simultaneously collect information about risk factors and disease exemplify this design. These studies have limitations in discovering etiological factors of disease. These studies help identify preliminary relationships that other analytic designs may explore further; therefore, they are hypothesis-generating studies.
  • Retrospective studies compare individuals with a particular condition or disease and those who do not have the disease. These studies determine whether cases, or a diseased group, differ in their exposure to a specific factor or characteristic relative to controls, or to a non-diseased group. Data collection extends back in time to determine previous exposure or risk factors. These studies address the question of causality better than cross-sectional studies and also require fewer resources and less data collection time than prospective studies.
  • Prospective studies monitor a group of disease-free individuals to determine whether and when disease occurs. These individuals, or the cohort, have a common experience within a defined period. The study assesses the cohort with respect to an exposure factor associated with the disease and thus classified it at the beginning of the study. The study then monitors the cohort for disease development. These summarize data collected over time by the incidence rates of new cases. These are advantageous because they obtain more reliable information about the cause of disease than do other study methodologies. These studies establish a stronger temporal relationship between the presumed causal factor and the effect than do retrospective and cross-sectional studies.
  • Experimental studies are used to test treatment and prevention strategies. It is useful for investigating chronic disease prevention. They may help evaluate community health nursing interventions. Chapter 14 Environmental Health In 1994, President Clinton signed Executive Order 12898, which required all federal agencies to develop comprehensive strategies for achieving environmental justice. This directive has served to increase public participation and access to information as well as provision of education about multiple risks and cumulative exposures but failed to address poor economic growth in low-income minority communities. Participatory action research calls for nurses, community members, and other resource people to work together in identifying health problems, designing the studies, collecting and analyzing the data, disseminating the results, and posing solution to the problems. Sick building syndrome describes a phenomenon in which public structures and homes cause occupants to experience a variety of symptoms, such as headache, fatigue, and exacerbation of allergies. It typically results from poor ventilation and building operations, hazardous building materials, furniture and carpeting substances, and cleaning agents. Radiation risks

Health History – I PREPARE is an environmental exposure history mnemonic. I – investigate potential exposures, P – present work, R – residence, E – environmental concerns, P – past work, A – activities, R

  • referrals and resources, and E – educate Objectives
    • Describe areas of environmental health, environmental health problems, and related human health risks. Areas of Environmental Health - Built environment: buildings, spaces, and products that are created or modified by people, including homes, schools, workplaces, parks/recreation areas, greenways, business areas, and transportation systems - Work-related exposure: occupational exposure to environmental hazards that can cause illness or injury - Outdoor air quality: the protectiveness of the atmospheric layers, the risks of severe weather, and the purity of the air for breathing purposes - Healthy home: the availability, safety, structural strength, cleanliness, and location of shelter, including public facilities and family dwellings including indoor air quality - Water quality: the availability of and accessibility to a clean water supply, the mineral content levels, pollution by toxic chemicals, and the presence of pathogenic microorganisms - Food safety: the availability, relative costs, variety, safety, and health of animal and plant food sources - Waste management: the management of waste materials resulting from industrial and municipal processes, human consumption, and efforts to minimize waste production Examples of Environmental Health Problems - Built environment: drunk driving, secondhand smoke, noise exposure, urban crowding, technological hazards - Work-related exposure: asbestos exposure, agricultural accidents, excessive exposure to x-rays - Outdoor air quality: gaseous pollutants, greenhouse effect, destruction of the ozone layer, aerial spraying of herbicides and pesticides, acid rain, and nuclear facility emissions - Healthy home: homelessness, rodent and insect infestation, presence of lead-based paint, sick building syndrome, unsafe neighborhoods, radon gas seepage in homes and schools - Water quality: contamination of drinking supply by human waste, oil spills in the world’s waterways, pesticide or herbicide infiltration of groundwater, aquifer contamination by industrial pollutants, heavy metal poisoning of fish - Food safety: malnutrition, bacterial food poisoning, food adulteration, disruption of food chains by ecosystem destruction, carcinogenic chemical food additives - Waste management: use of nonbiodegradable plastics, poorly designed solid- waste dumps, inadequate sewage systems, transport and storage of hazardous waste, illegal industrial dumping, radioactive hazardous wastes
    • Apply the basic concepts of critical theory to environmental health nursing problems. Critical theory suggests that nurses must be aware of environmental threats or factors that might detrimentally affect the safety and well-being of particular populations or deprive them of access to resources necessary in the pursuit of health. This awareness may include recognizing, supporting, and maintaining positive environmental influences.
  • Chronic diseases – CVD, metabolic syndrome, HTN, diabetes, arthritis, osteoporosis, and cancer (breast, lung, and gynecological)
  • Mental disorders and stress Unintentional Injury
  • Acciden ts Domestic Violence
  • Domestic violence is the single largest cause of injury to women between the ages of 15 and 44 in the US Family Planning
  • Includes fertility control and infertility
  • Need multiple safe options designed to meet the individual needs of all women Sexually Transmitted Diseases
  • STIs, HIV, and AIDS
  • Women need age appropriate STI prevention, education, and counseling
  • Worldwide, AIDS is the leading cause of death among young women Public Health Service Act (1982)
  • Provides biomedical and health services research, information dissemination, resource development, technical assistance, and service delivery
  • Includes the Family Planning Public Services Act Healthy People 2020 for Women

Chapter 19 Senior Health Objectives

  • Discuss the aging process
  • Aging is a natural process that affects all living organisms.
  • Chronological age
  • The young-old (ages 65-74)
  • The middle-old (ages 75-84)
  • The old-old (ages 85 and older)
  • The elite-old (more than 100 years old)
  • Functional ages: functional ability and the ability to perform activities of daily living (ADLs); a better measure of age than chronological age
  • Discuss the demographic characteristics of the elderly population
  • Americans are living longer than ever before, and the older population will continue to grow
  • Older population is becoming more diverse
  • Number of seniors differs by geographic location
  • Older women outnumber older men
  • Older men are more likely than older women to be married
  • Educational attainment has increased among older adults
  • Older women are more than twice as likely as older men to live alone
  • Older adults want to live in their own home for as long as possible – “age in place.”
  • Alternative housing options are available with services to help seniors
  • With aging, a good percentage of income is spent on health care
  • The proportion of the older population living in poverty has decreased but is affected by gender, marital status, race, and ethnicity
  • Recognize Healthy People 2020 wellness goals and objectives for older

adults Improve the health, function, and quality of life of older adults.

  • Describe health/illness concerns common to the elderly population.
    • Poor nutrition in older adults is common
    • Monitor for chronic disease – leading cause of death among persons 65 years and older
    • Monitor medication use – older adults consume more than 1/3 of all prescription drugs, as well as many OTC drugs and “folk” remedies
  • Identify nursing actions that address the needs of older adults
  • Identify resources available to older adults AARP Diseases Common to the Older Adult
  • Arthritis
  • HTN
  • Diabetes
  • Visual impairments – cataracts, macular degeneration, diabetic retinopathy, and glaucoma
  • Hearing loss – presbycusis and tinnitus
  • Dental issues
  • Incontinence Interventions for the Older Adult
  • Recommended screenings and Exams
  • Complete physical annually
  • BP annually
  • Blood glucose annually
  • Serum cholesterol every 5 years
  • Fecal occult blood test annually
  • Sigmoidoscopy: every 3-5 years OR colonoscopy every 10 years
  • Visual acuity and glaucoma screening annually
  • Dental exam annually; cleaning every 6 months
  • Hearing test every 2-5 years
  • For all older women
  • Break self-exam monthly
  • Clinical breast exam annually
  • Mammogram every 1-2 years if age 40 or older
  • Pelvic exam and pap smear annually
  • Digital rectal exam annually with pelvic exam
  • Bone density once after menopause
  • For all older men
  • Digital rectal exam and prostate exam annually
  • Prostate-specific antigen blood test annually
  • Immunizations for older adults
  • Tetanus, diphtheria, pertussis every 10 years
  • Influenza vaccine annually
  • Pneumonia vaccine once after age 65
  • Hepatitis A and B for those at 4risk
  • Herpes zoster one-time dose
  • Varicella
  • Encourage physician activity and fitness Elder Abuse
  • Safety and security elder need Falls