ATI Community Health Nursing Proctored Focus Complete Solutions

ATI Community Health Nursing Proctored Focus Complete Solutions Care of specific populations: Migrants Migrant workers health problems include: Ans- 1. Dental disease 2. TB 3. Chronic conditions 4. Stress, anxiety, & other mental health conditions 5. Leukemia 6. Iron deficiency anemia 7. Stomach, uterine, & cervical cancers 8. Lack of prenatal care 9. Higher infant mortality rates Primary Prevention for Rural or Migrant Health care: Ans- -educate on measures to reduce exposure to pesticides -teach on accident prevention -prenatal care -mobilize preventative services (dental, immunizations) Secondary Prevention measures for Rural/Migrant Health care: Ans- SCREENING! screen for: -pesticide exposure -skin cancer -chronic preventable diseases -communicable diseases Tertiary Prevention measures for Rural/Migrant Health care: Ans- -treat for symptoms of pesticide exposure -mobilize primary care and emergency services Client's rights include... Ans- -right to info disclosure -privacy -informed consent -info confidentiality -participation in treatment decisions Autonomy Ans- respecting a client's right to choose (i.e. refusing chemo) Nonmaleficence Ans- doing no harm Beneficence Ans- maximize benefits and minimize possible harms Justice situation: Ans- determining eligibility for health care services based on income and fiscal resources HIPAA rules about information security: Ans- -only staff assigned to the patient may view/read client's health record (no other nurses or doctors) -client's have the right to read or obtain a copy of their health record -nurses may not photocopy any part of med record except for authorized exchange of docs between facilities & providers -staff must keep records/names of client in secured place -electronic records are password protected -no sharing info to family members w/out code in person, email, or phone call -talking about a client must be in a private setting so no one can overhear HIPAA info security protocols include: Ans- -log off computer before leaving workstation -never share ID or password -never leave med records where ppl can see it -shred any printed info about client after use -don't use or view social media in clinical settings -no posting about clinical stuff Caring for a client with gonorrhea: Ans- -nationally notifiable disease -women are frequently asymptomatic -CDC recommends yearly screening for all sexually active women 25 yrs or older or w/risk factors -at risk pregnant women must be screened at first prenatal visit -identify & treat all partners -admin erythromycin to all infants following delivery -ceftriaxone IM or azithromycin PO -it is the responsibility of the provider to report gonorrhea to local health dept -state notification to CDC is voluntary -if left untreated in women it can lead to PID which can cause infertility Referrals: Client barriers include: Ans- -lack of motivation -inadequate info about community resources -inadequate understanding of the need for referral -accessibility needs -priorites -finances -cultural factors Referrals: Resource barriers include: Ans- -attitudes of health care personnel -costs of services -physical accessibility of resources -time limitations -limited expertise working w/culturally diverse populations Just because someone is exposed to asbestos once doesn't mean they will develop health problems... Ans- long term exposure can lead to mesothelioma and lung conditions. Risk factors include workers (office buildings with it when they work there everyday). Priority action(s) in developing a disaster plan: Ans- -set up communication alternatives -highlight possible evac routes -identify local & distant meeting places -create disaster kit AS A NURSE: -identify at risk populations in community -identify community disaster warning system & how to access -identify 1st responders -make list of agencies for all levels of disaster -triage -gather equipment, check often Hyperthyroidism: Radioactive iodine therapy home safety: Ans- Client is radioactive! -no pregnant people -no breastfeeding -keep distance from others, limit visits to 30 min at a 6 ft distance -drink lots of fluid -maintain good hygiene to prevent infection Teaching safe disposal of insulin syringes: Ans- -put in strong plastic container i.e. old detergent container (no soda bottles) -DO NOT recycle old needles, throw container in trash -seal the container when 3/4 full with duct tape -facilities throw it in sharps red container Teaching about use of crutches: Ans- -don't alter crutches after fitting -follow prescribed crutch gait -support body weight at the hand grips w/elbows flexed at 30 degrees -position crutches on unaffected side when sitting or rising from a chair Demographics of homeless population: Ans- -families w/children are the fastest growing segment -people with mental illness (large segment) -veterans -substance abuse disorders -youth and runaways -intimate partner abuse victims -people with HIV or AIDS -older adults Planning Primary Prevention Activities Ans- -determine solutions -establish goals -give responsibilities to individuals -determine resources -screening and education -determine funding, develop budget -plan for evaluation Parish nursing: Ans- promotes health and wellness within populations of faith communities -work with: pastoral care staff, professional health care members, and volunteers to provide holistic approach to healing Functions: -personal health counseling -health education -liaison between faith & community & local resources -facilitate support groups -spiritual support Windshield survey: Ans- -nurse and other driver drive through community assessing components -time consuming -provides descriptive overview of community -results limited because it is only based on visualization & doesn't include community member input nurse looks for: -pets and animals -evidence of drug abuse/substance abuse -origin/race/ethnicity of population -general appearance -natural/man made boundaries -housing details -social systems: clinics, hospitals, dentists, parks & rec, worship places, stores, public protection & transport Positive Mantoux skin test for TB includes: Ans- an induration-palpable, raised, hardened area of 10 mm or greater in diameter Positive Mantoux test indicates that... Ans- the client has developed an immune response to TB it does not confirm active TB Mantoux test: an induration of 5 mm may be considered Ans- positive mantoux test in immunocompromised clients Recognizing signs of abuse: Ans- Child: -unexplained injury -unusual fear of nurses or others -injuries/wounds not mentioned in hx -fractures, including other healed fractures -presence of wounds/fractures/injuries 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" Adult: -unexplained or repeated physical injuries -physical neglect & unmet basic needs -rejection of assistance by caregiver -financial mismanagement -withdrawal & passivity -depression Manifestations of alcohol withdrawal: Ans- -abd cramping -vomiting -tremors -restlessness -irritability -increased HR -transient hallucinations or illusions -anxiety -increased BP and RR -increased temp -tonic-clonic seizures -alcohol withdrawal delirium (2-3 days after stopping) Provide culturally appropriate care by: Ans- -addressing clients by last name until told otherwise -introduce thyself and explain position -be authentic and honest about what you don't know about a culture -use culturally sensitive language -don't make assumptions about the client -encourage the client to ask questions -find out what the client knows about condition and treatments -respect beliefs, practices, and values -show respect for client's support system