Exam 1 Study Guide
Savage, C., (2020) Public/Community Health and Nursing Practice – Chapters 1, 2, 7, 19
ATI Content Mastery Series. RN Community Health Nursing, Ed. 8.0. – Chapters 1, 2, 5, 6
Chapter 1 Public Health Nursing Practice
Levels of prevention (primary, secondary, tertiary)
Primary prevention
Primary prevention aims to prevent disease or injury before it ever occurs. This is done by preventing
exposures to hazards that cause disease or injury, altering unhealthy or unsafe behaviours that can lead
to disease or injury, and increasing resistance to disease or injury should exposure occur. Examples
include:
legislation and enforcement to ban or control the use of hazardous products (e.g. asbestos) or to
mandate safe and healthy practices (e.g. use of seatbelts and bike helmets)
education about healthy and safe habits (e.g. eating well, exercising regularly, not smoking)
immunization against infectious diseases.
Secondary prevention
Secondary prevention aims to reduce the impact of a disease or injury that has already occurred. This is
done by detecting and treating disease or injury as soon as possible to halt or slow its progress,
encouraging personal strategies to prevent reinjury or recurrence, and implementing programs to return
people to their original health and function to prevent long-term problems. Examples include:
regular exams and screening tests to detect disease in its earliest stages (e.g. mammograms to detect
breast cancer)
daily, low-dose aspirins and/or diet and exercise programs to prevent further heart attacks or strokes
suitably modified work so injured or ill workers can return safely to their jobs.
Tertiary prevention
Tertiary prevention aims to soften the impact of an ongoing illness or injury that has lasting effects. This
is done by helping people manage long-term, often-complex health problems and injuries (e.g. chronic
diseases, permanent impairments) in order to improve as much as possible their ability to function, their
quality of life and their life expectancy. Examples include:
cardiac or stroke rehabilitation programs, chronic disease management programs (e.g. for diabetes,
arthritis, depression, etc.)
support groups that allow members to share strategies for living well
vocational rehabilitation programs to retrain workers for new jobs when they have recovered as much
as possible.
Culturally competent care (cultural competence)
For CHWs, cultural competence is being able to help the people in your community have better access
to appropriate healthcare and to have their best possible health. It also means doing so while working
within the context of your clients' cultural beliefs, behaviors, and needs.
Improving health literacy (plain Language)
Speak more slowly when providing instructions. Be respectful and clear without being patronizing. Use
graphics and pictures instead of long written instructions. Provide information at an appropriate grade
level.
WHO
Founded in 1948, WHO is the United Nations agency that connects nations, partners and people to
promote health, keep the world safe and serve the vulnerable – so everyone, everywhere can attain the
highest level of health.
6 standards of practice for PHNs
Standards of Practice The Standards of Practice describe a competent level of nursing care as
demonstrated by the critical thinking model known as the nursing process. The nursing process includes
the components of assessment, diagnosis, out- comes identification, planning, implementation, and
evaluation.
Scope of practice for local public health departments
Local health departments work with healthcare and community partners to prevent and target the
cause of disease outbreaks, and then determine the appropriate response.
Challenges faced by public health services
Health is influenced by many factors, which may generally be organized into five broad categories
known as determinants of health: genetics, behavior, environmental and physical influences, medical
care and social factors. These five categories are interconnected.
Chapter 2 Optimizing Population Health
Advocating for population health
For example, community health advocates can help eligible patients enroll in Medicare and Medicaid.
Once enrolled, patients can also look to community health advocates for help with health care
navigation and coordination between multiple healthcare teams. Community health nurses work in
schools, churches, and government agencies. They focus on vulnerable populations, including lowincome families, people living in rural areas, immigrants, and individuals with disabilities.
Upstream thinking
Upstream thinking considers the social, economic, and environmental origins of health problems that
manifest at the population levels. These upstream factors affect patient behaviors such as smoking, poor
nutrition, low physical activity, violence, alcohol and substance use, and sexual behavior. Further
downstream are disease and injury such as communicable disease, chronic disease and intentional and
unintentional injury
Upstream determinants of health
Some examples include: access to healthy foods, access to quality health care, reliable transportation,
stable housing, and economic stability.
Screening (purpose)
A community health assessment gives organizations comprehensive information about the community's
current health status, needs, and issues. In turn, this information can help with developing a community
health improvement plan by justifying how and where resources should be allocated to best meet
community needs.
Adult learning (pedagogy, andragogy, constructivism, humanism)
Constructivism is a learning theory which believes that people learn best by actively constructing their
own knowledge. This happens when they make sense of the information they receive and connect it to
what they already know. Humanistic theory uses the idea that people are inherently good to focus on
the individual's experiences and inner thoughts. This type of learning depends on the belief that
everyone has the potential to grow and develop if they have the right environment and opportunity.
This classic image is called “pedagogy,” or the practice of teaching children, and is derived from the
Greek word for “child” (paidi) and “guide” (ago). But where do adult learners fall in this scenario?
“Andragogy,” or the practice of teaching adults, is derived from the Greek word for “man” (andras) and
differs greatly from pedagogy in its practice.
Health literacy
Personal health literacy is the degree to which individuals have the ability to find, understand, and use
information and services to inform health-related decisions and actions for themselves and others.
Community collaboration
The Community Health Collaborative at Lincoln Memorial Hospital connects healthcare providers,
organizations, businesses, private individuals and churches to improve the health of the people and
communities it serves.
Prevalence pot
Prevalence, sometimes referred to as prevalence rate, is the proportion of persons in a population who
have a particular disease or attribute at a specified point in time or over a specified period of time.
Nursing intervention wheel
The Intervention Wheel describes the scope of practice by what is similar across settings and describes
the practice of public health nursing at the individual/family, community, or systems level.
Chapter 7 Health Disparities and Vulnerable Populations
Challenges faced accessing health care (transportation, resources, etc.)
These include things like housing, financial security, community safety, employment, education and the
environment.
Ways to identify patients from the LGBTQ community
LGBTQ health disparities and stigmas
Sti, violence, cancers, heart disease, eating disorders, mental health, substance abuse, mistrust
Health equity
As defined by the U.S. Department of Health and Human Services, health equity is the attainment of the
highest level of health for all people. Population-level factors, such as the physical, built, social, and
policy environments, can have a greater impact on health outcomes than individual-level factors.
Optimum health
Optimal health is a state of complete physical, mental, and social well-being. Promote healthy behaviors
by focusing on a holistic approach to achieving your best health outcome.
Migrant workers (health disparities)
All of the health care problems found in the general population are found in migrant groups. Some,
however, occur more frequently. These include diabetes, cardiovascular disease, and asthma.
Asylee
Asylees are entitled to certain public benefits. For the first seven years after being granted asylum,
asylees are eligible for Social Security Income, Medicaid, and Food Stamps, and a variety of other
benefits and services.
Homelessness(types)
The definition of those who are experiencing homelessness includes: An individual or family who lacks a
fixed, regular, and adequate nighttime residence, such as those living in emergency shelters, transitional
housing, or places not meant for habitation,
Diversity
Diversity: At Public Health, diversity means we are a workforce made up of unique individuals. Our
differences include, but are not limited to: values, background, experiences, ethnicity, race, ability,
national origin, religion, sexual orientation, gender identity or expression, age, and socioeconomic
status.
Incarcerated persons health disparities
It directly and indirectly affects the health of individuals and communities, increasing rates of illness
while simultaneously undermining the supports that contribute to community health and well-being. As
such, incarceration is a critical social determinant of health.
Chapter 19 Health Planning for Older Adults
Challenges faced when accessing care (rural population)
Physical health and psychosocial challenges of dependent elderly in rural areas include vision and
mobility problems; loneliness, grief, and sadness; feelings of inferiority in the family; abuse and neglect;
lack of meaningful activities; and the feeling of being a burden on the family.
Hospice services (role of nurse)
Hospice care focuses on the care, comfort, and quality of life of a person with a serious illness who is
approaching the end of life. At some point, it may not be possible to cure a serious illness, or a patient
may choose not to undergo certain treatments. Hospice is designed for this situation.
Mental health in older adults
Mental health problems are common among seniors and may include isolation, affective and anxiety
disorders, dementia, and psychosis, among others. Many seniors also suffer from sleep and behavioral
disorders, cognitive deterioration or confusion states as a result of physical disorders or surgical
interventions.
Substance use (standards for alcohol consumption)
The nurse provides the knowledge of addiction and abuse and assists the community in its health
enhancement by using addiction and nursing theory, interpersonal process, research competencies, and
teaching skills.
Recommended vaccinations
The most important vaccinations seniors should discuss with their physicians include the flu vaccine,
pneumococcal vaccine to prevent pneumonia, shingles vaccine, and a tetanus-diptheria-pertussis
vaccine (Tdap).
Palliative services
Palliative care in hospitals. Residential palliative nursing in a care home or hospice. Day care at a
hospice. Palliative home care.
Adult Protective services
The goal of Adult Protective Services is to assist vulnerable persons age 18 and older who are unable to
take the steps necessary to protect themselves from abuse, neglect or exploitation.
Caring for patients with dementia(caregivers)
Community mental health nurses are also known as community psychiatric nurses (CPNs). They provide
treatment, care and support for people with mental health problems and dementia. They might assess
you at home, and they advise you and your carers on ways of improving your health and quality of life.
Risk factors for elder abuse
an increase in physical health problems/conditions e.g. heart disease, stroke, Alzheimer's disease
chronic pain
side-effects from medications
losses: relationships, independence, work and income, self-worth, mobility and flexibility
social isolation
significant change in living arrangements e.g. moving from living independently to a care setting
admission to hospital. particular anniversaries and the memories they evoke.
Jeopardy
Notify adult protective services- neglect, failure to protect them from harm, should be reported
Social determinants of health- conditions they grow in, location, education, money
Standard for alcohol consumption – no more than 3 per day or 7 per week
Nurse assess for admitted falls- alcohol consumption
Standard of public health- assessment, population diagnosis and priority, outcomes identification,
planning, implementation, evaluation,
Vaccines older adults- zosters, pcv,
Scope of practice LHD- surveillance, investigations, and quarantine that is reported to CDC
Immigrant- legal moves to
Migrant- follow
Refugees- unable to return to country
Asylees- unwanting to leave to go back to country
Elder abuse risk factors- cognitive decline, mental/physical health strain and financial issues
Health equity- avoidable gaps in health outcomes
Goal of WHO- build a better healthier future for all over the world
Primary homelessness-vehicles,parks,abandoned
Secondary homeless- shelters
Tertiary homelessness- rent hotel room
Prevalence pot- identify concerns that are increasing cases and check data
Incarcerated disparities- limit access, low education, risk of drug
Population based approach- how to stop spread of total population. Vaccinations, advocate policies that
provide care
Primary prevention- vaccines
Secondary prevention- screening
Tertiary prevention- treatment
Dementia support safety- childproof the home prevents harm and escape
Hospice care recommended and nurse role- 6 or less month left to live. Provide care to persons at end
of life. Assist client/family with dying process
Migrant health disparities- move to get work
Constructivism- reflects on own feelings
Humanism- uses feelings and relationships
Pedagogy- teaching strategies to provide best learning
Andragogy- art and science of helping adults
Equity- concept behind optimum health as a health right
Palliative care- car
Upstream approach- eliminating factors that increase risk to a populations health
Cultural competnency- attidude, knowledge, skill uses to provide quality care Intervention wheel- individual, community, system