Community Health Study Guide

BASIC CARE AND COMFORT (4)

Cancer Disorders: Promoting Nutrition for Esophageal Cancer
-obtain daily weight
-support nutrition with a high-calorie diet, semi-soft foods, thickened liquids,
& supplements
avoid alcohol consumption
-promote smoking cessation
-avoid foods containing nitrates
-treat GERD with diet, positioning, and medications

Postpartum Physiological Adaptations: Interventions for Perineal Lacerations

stool softeners
-peri care to prevent infection
ice packs
anaglesia
dermoplast

Nutrition Assessment: Client who has Chronic Obstructive Pulmonary Disease

high-calorie, high-protein meals, low carb

encourage 3L of fluid a day
small, frequent meals.
Limit liquid intake at meal times
Consume foods w/ protein (like eggs)
Maintain an upright position (High Fowler's position) to promote ventilation
Use milk instead of water when making soup

Osteoarthritis: Teaching About Disease Management

Take a hot shower or bath daily = improves joint mobility + pain
Get 8-10 hours of sleep + additional 1-2 hrs during the day
Consume well-balanced diet + weight loss can reduce severity of disease
Exercise Daily
HEALTH PROMOTION AND MAINTENANCE (7)
Communicable Diseases, Disasters, and Bioterrorism: Vector-Borne Illnesses

Via a carrier such as a mosquito or tick

Lyme Disease
Malaria
Rocky Mountain spotted fever

 Overview of Community Health Nursing: Tertiary Prevention Strategy

Maximize recovery AFTER injury/illness (REHAB)
Nutrition Counseling
Exercise REHAB
Case Management of chronic illnesses
Physical Therapy
Support Groups
Exercise of hypertensive clients
Teaching a client with rheumatoid arthritis measure to prevent joint
deformities
Teaching foot care to adults who have Diabetes

Overview of Community Health Nursing: Principles of Epidemiology

Health-related trends in populations
Based on statistical evidence to determine rate of spread of disease +
proportion of people affected
Spread, transmission, incidence of disease + injury
Relationships among agent, host, + environment

Community Health Program Planning: Planning Primary Prevention Activities

Prevention of the initial occurrence of disease/injury (DOES NOT have it)

Nutrition Education
Family planning/Sex education
Smoking education
Communicable disease education
Education about health + hygiene
Safety education
Prenatal education
Advocating for access to health care, healthy environments
Immunizations (prevents disease)

Community Health Program Planning: Initial Phase of Planning a Smoking

Cessation Program
Overview of Community Health Nursing: Epidemiological Triangle
The Agent is the animate or inanimate object that causes the disease.
Chemical Agents: Drugs, Toxins, Physical Agents: Noise, Temperature,
Infectious Agents: Viruses, Bacteria

 The host is the living being that is affected by the agent.

Susceptible Host: Age, Gender, Genetics, Ethnicity, Immunological status,
Physiological state, Occupation
The environment is the setting or surrounding that sustains the host.
Physical Environment: Geography, Water/food supply, Presence of
reservoirs/vectors
Social Environment: Access to health care, High-risk working conditions,
Poverty

Overview of Community Health Nursing: Goal of Screening

MANAGEMENT OF CARE (13)
Managing Client Care: Use of Web-based Information
Telehealth useful in rural areas.
Telehealth audio: data Voice conversation, heart sounds, lung sounds, bowel
sounds
Telehealth physical data: BP, weight, Blood O2, Blood glucose, HR, temp, ECG
results
Telehealth visual data: images of wounds, images of surgical incisions
Overview of Community Health Nursing: Ethical Principle
Beneficence, non-maleficence, autonomy, distributive justice, veracity
Care of Special Populations: Migrant Population
Practice Settings and Aggregates: Primary Prevention Activity

Prevention of the initial occurrence of disease/injury (DOES NOT have it)

Nutrition Education
Family planning/Sex education
Smoking education
Communicable disease education
Education about health + hygiene
Safety education
Prenatal education
Advocating for access to health care, healthy environments
Immunizations (prevents disease)

Practice Settings and Aggregates: Reporting to Governmental Agency

State departments of Health
Manages women, infants and children (WIC) program
oversees children's health insurance program, which offers expanded health
coverage to uninsured children whose families do not qualify for Medicaid.

Establishes public health policies.

Provides assistance to public health departments. Responsible for the
administration of the medicaid program.
Reports notifiable communicable disease within the state to the CDC.

Continuity of Care: Role of Negotiator

Care of Special Populations: Teaching Pregnant Adolescent Clients
Community Health Program Planning: Priority Teaching for Inmates
Practice Settings and Aggregates: Primary and Secondary Needs of Congregation
Overview of Community Health Nursing: Scope of Practice for CommunityOriented Nurse
Communicable Diseases, Disasters, and Bioterrorism: Triage and Priority Care
Following a Tornado
Practice Settings and Aggregates: Nursing Role in Planning Client Care
Practice Settings and Aggregates: Evaluating Family Understanding of Hospice
Care

PHARMACOLOGICAL AND PARENTERAL THERAPIES (4)

Medications Affecting Urinary Output: Preventing Adverse Effects of High-Ceiling
Diuretics

obtain baseline data

weigh clients
monitor BP, I&O
avoid administering at night to prevent nocturne
consume foods high in K
monitor blood glucose levels

Medications Affecting Coagulation: Risks for Adverse Effects

Heparin
Hemorrhage secondary to Hep overdose: monitor VS, observe for bleeding
Hep induced thrombocytopenia (abnormally low amt. of platelets): monitor
platelet count
Hypersinsitivity rxn: chills, fever, uticaria
admin small test dose prior to admin.
Toxicity/overdose: administer protamine
Warfarin
Hemorrhage:

 -monitor for bleeding

-check PT, PTT, INR
-administer vit K
Hepatitis:
-monitor liver enzymes AST/ALT, check for jaundice
Toxicity:
-admin vit K to promote synthesis of coag factors
-if vit K doesnt work, admin frozen plasma or whole blood.
DO NOT GIVE TO:
-Pregnant women. category X
-Pt with low platelet counts
-Pt who have uncontrollable bleeding
-Pt going for surg of eye, brain, spinal cord, LP, regional anesth.
-Pt who have K deficiencies

Cardiovascular Diagnostic and Therapeutic Procedures: Teaching Central Line

Care in the Home Setting
Capping, cleaning ends with alcohol, hand hygiene, change dressing if wet/dirty,
sterile technique

Oxygen and Inhalation Therapy: Teaching About Metered-Dose Inhaler Use

fungal infections of the oral cavity may occur with corticosteroid use; assist
the child with rinsing his mouth after administration
shake the inhaler 5-6x,
attach the spacer for proper inhalation,
hold the inhaler with the mouthpiece at the bottom,
hold the inhaler with the thumb near the mouthpiece, and the index and
middle fingers at the top,
take a deep breath and then exhale, tilt the head back slightly, and press the
inhaler. While pressing the inhaler, begin a slow, deep breath that lasts for 35 sec., hold the breath for about 10 sec., take the inhaler out of the mouth
and slowly exhale through the nose, resume normal breathing
PHYSIOLOGICAL ADAPTATION (4)
Hypothyroidism: Assessment Findings
Weakness, muscle fatigue, arthralgias, cramps, cold intolerance, constipation,
weight gain

Dry skin, thinning hair, brittle nails, pufffy eyes, thick tongue, edema of hands and
face, bradycardia, alopecia, ascites, hypoactive bowel sounds
Communicable Diseases: Clinical Findings Associated with Fifth Disease
spreads by blood and droplet
incubation 4-14 days can be up to 20 days
*onset of symptoms before rash appears
low fever, fatigue, a "slapped cheeks" rash, joint aches, and a whole body
rash.
Cancer Treatment Options: Adverse Effects of Radiation Therapy
Nausea, dysguesia, fatigue, skin damage, mucositosis
Tuberculosis: Evaluating Client Teaching
return for a reading of theinjection site by a health care provider within 48 to
72 hr
Instruct clients to take medication on an empty stomach.
family members need to be tested for TB.
continue medication therapy for its full duration of 6 to 12 months.
Emphasize that failure to take the medications may lead to a resistant strain
of TB
Clients are no longer considered infectious after three
negative sputum cultures
Teach clients to cough and expectorate sputum into tissues that are disposed
of
by clients into provided sacks

PSYCHOSOCIAL INTEGRITY (7)

Care of Special Populations: Providing Culturally Sensitive Care
Care of Special Populations: Interventions for Suspected Victims of Abuse

Build trust and confidence with a client.

Focus on the client rather than the situation.
Assess for immediate danger.
Provide emergency care as needed.
Develop a plan for safety.
Make needed referrals for community services and legal options.
If abuse has occurred, complete mandatory reporting, following agency
guidelines.

Factors Influencing Community Health: Conducting a Cultural Assessment

Religious Preference
Food Patterns

Health Practices (immunizations)

Gather data about the client's cultural beliefs
Nutritional practices,
family structure,
health care interactions, views about illness

Care of Special Populations: Recognizing Signs of Abuse

Child Abuse/Neglect: Unexplained injury Unusual fear of the nurse and
others Injuries/wounds not mentioned in history Fractures, including
older healed fractures Presence of injuries/wounds/fractures in various
stages of healing Subdural hematomas Trauma to genitalia
Malnourishment or dehydration General poor hygiene or inappropriate
dress for weather conditions Considered to be a bad child
Recognizing Potential or Actual Older Adult Abuse: Unexplained or
repeated physical injuries Physical neglect and unmet basic needs
Rejection of assistance by caregiver Financial mismanagement
Withdrawal and passivity Depression

Factors Influencing Community Health: Planning Meals for a Client who has
Diabetes Mellitus
instruct client to limit calories and decreased total fat intake to 30% of total
daily calories
-Encourage diet low in saturated fats to decrease low-density lipoprotein
(LDL)
assist with weight loss for secondary prevention of diabetes/reduce risk of
heart disease
Modify diet to include Iomega-3 fatty acids/fiber to lower cholesterol levels
improve blood glucose for client to have diabetes, secondary prevention of
diabetes/to reduce risk of heart disease
Care of Special Populations: Exploring Suicidal Intent
Care of Special Populations: Neglect of a Client who has Alzheimers disease
REDUCTION OF RISK POTENTIAL (2)
Coagulation Disorders: Thrombocytopenia Clinical Findings
Diabetes Mellitus Management: Providing Education

Test bath water w/ thermometer (prevent burns)

Wear shoes that extend 2.54 cm (1 inch) past longest toe
Don't use heating pads or ice packs
Inspect feet for areas of redness + skin breakdown daily
Monitor temperature of feet + lower extremities for changes
Consult with dietician to determine appropriate school lunch for child
Eat a snack within 2 hrs of physical activity
DON'T provide info to insurance company

 Test ketone levels when client is sick or blood glucose levels are elevated (not
daily)
SAFETY AND INFECTION CONTROL (9)
Practice Settings and Aggregates: Safety Evaluation
Communicable Diseases, Disasters, and Bioterrorism: Developing Disaster Plan
Priority Action
Home Safety: Home Oxygen Use

family members must smoke outside

no nail polish near oxygen
a no smoking sign on the front door
a fire extinguisher required inside

Factors Influencing Community Health: Federal Agencies and Asbestos

Overview of Community Health Nursing: Secondary Level of Prevention
Secondary Prevention Early detection + treatment of disease (goal = limit severity
+ adverse effects)

Community Assessments
Home safety checks
Disease Surveillance (communicable diseases)
SCREENINGS
Control outbreaks of communicable diseases

(Implementing program to notify individuals exposed to a communicable disease)

Communicable Diseases, Disasters, and Bioterrorism: Providing Education for a
Client who has Pertussis
Instruct parent to keep child home until coughing stage has passed (when
disease is most communicable)
Encourage family members to obtain prophylactic treatment (erythromycin,
clarithromycin, azithromycin)
Check immunizations status of child's classmates
pneumococcal vaccine is not effective against pertussis
Communicable Diseases, Disasters, and Bioterrorism: Disaster Preparedness
s Communicable Diseases, Disasters, and Bioterrorism: Priority Principles of Triage
Triaging involves identifying those who have serious versus minor injuries,
prioritizing care of victims, and transferring those requiring immediate
attention to medical facilities.
Triage Emergent category (class I) - Highest priority is given to clients who
have life-threatening
injuries but also have a high possibility of survival once they are stabilized

 Triage Urgent category (class II) - Second-highest priority is given to clients

who have major injuries that are not yet life-threatening and usually can wait
45 to 60 min for treatment
Triage Nonurgent category (class III) - The next highest priority is given to
clients who have minor injuries that are not life-threatening and do not need
immediate attention
Triage Expectant category (class IV) - The lowest priority is given to clients
who are not expected to live and will be allowed to die naturally. Comfort
measures may be provided, but restorative
care will not
Communicable Diseases, Disasters, and Bioterrorism: Assessment Following
Tuberculosis Outbreak