Exam 2 Objectives (chap 13, 15, 19, 21, 23, 24, 25, 28, 29, 30, 31, 32, 33, 34)
Chapter 13: Cultural Diversity and Community Health Nursing
-Describe ethical definitions of Autonomy, Non-maleficence, Beneficence, Distributive Justice and how
lack of can affect health care and access to all.
Autonomy- patient independence, making own decisions, a self-governing state
Non-maleficence- to do no harm
Beneficence- doing good
Distributive justice- perceived fairness of how rewards and costs are shared by
(distributed across) group members. Distributive justice concerns the equitable distribution
of scarce resources among all socioeconomic groups and population sectors.
Chapter 19: Senior Health
-Identify age-related risk factors and education for Senior Health
Nutrition status and exercise
Falls
Dental, hearing, & vision problems
Abuse/maltreatment
Medication safety
o When applicable, anti-inflammatory medications may be administered before physical
activity to address accompanying pain
Cold and heat stress:
o Hypothermia (very serious)- keep the patient warm; watch for the signs: confusion or
sleepiness, slowed slurred speech, weak pulse, shivering, poor control of body
movements
o Heatstroke (life-threatening) - wrap a wet sheet, move to a cooler area; watch for hot
dry skin that’s usually red, mottled, or cyanotic, loss of consciousness, or convulsions
-What are functional assessments and why are they used when assessing the elderly?
Examinations and Tests; a continuous collaborative process that combines observing, asking
meaningful questions, listening to family stories, and analyzing individual child skills and
behaviors within naturally occurring everyday routines and activities across multiple situations
and settings.
For All Older Adults
o Complete physical: Annually
o Blood pressure: Annually; more frequently if hypertensive or at risk
o Blood glucose: Annually; more frequently if diabetic or at risk
o Serum cholesterol: Every 5 years; more frequently if at high risk
o Fecal occult blood test: Annually
o Sigmoidoscopy: Every 5 years
o Colonoscopy: Every 10 years; more frequently if at high risk
o Visual acuity and glaucoma screening: Annually
, o Dental examination: Annually for those with teeth with cleaning every 6 months;
cleaning every 2 years for denture wearers
o Hearing test: Every 2 to 5 years
For Women
o Breast self-examination: Monthly
o Clinical breast examination: Annually
o Mammogram: Every 1 to 2 years if aged 40 years or older; check with health care
provider if 74 years or older
o Pelvic examination and Papanicolaou smear: Annually; may check with health
care provider about discontinuation at 66+ years or after three consecutive
negative Pap test results or >2 consecutive negative HPV and Pap tests, no
abnormal results in previous 10 years and not otherwise at risk, or have had a
total hysterectomy
o Digital rectal examination: Annually with pelvic examination
o Bone density: Once after menopause and more frequently if at risk
For Men
o Digital rectal examination and prostate examination: Annually
o Prostate-specific antigen (PSA) blood test: Annually
Immunizations for All Older Adults
o Tetanus, diphtheria, pertussis (Tdap): Every 10 years
o Influenza/flu vaccine: Annually
o Pneumonia vaccine: Once after age 65 years; ask physician about booster every 5
years
o Hepatitis A (liver infection found in stool and blood very contagious )and B(is
spread when blood, semen, or other body fluids from a person infected)those at
risk
o Herpes zoster (shingles): One-time dose
o Varicella (chickenpox): If evidence of lack of immunity and significant risk for
exposure
Chapter 21: Populations Affected by Disabilities
-Medicare and Medicaid access and funding
medicare
o Medicare is the federal health insurance program for:
people 65 or older
certain younger people with disabilities
people with ESRD (end stage renal disease)
funded by the social security administration (tax payers)
medicaid
o For low-income families w/ disability and pregnant women
o Funded by federal and state government
, o Provides insurance to people of low socioeconomic status and children,
eligibility is based off of household size and income and priority given to
children, pregnant women, and those with a disability (federally funded)
-What protection is provided to those who identify having a disability
Contemporary disability policy minimizes the disadvantaged view and maximizes
opportunities for people with disabilities to live productively in their communities.
Public policy on disability (these are your programs) includes civil rights protections,
skill enhancement programs, and income and in-kind assistance programs (e.g., Social
Security Disability Insurance [SSDI] and Medicare)
-What does ADA accommodations mean and do they refer to
The Americans with Disabilities Act (ADA) (PL 101-336) became a law in July 1990. This
landmark civil rights–styled legislation prohibits discrimination against people with
disabilities by guaranteeing equal opportunities for people with disabilities in relation to
employment, transportation, public accommodations, public services, and
telecommunications
A qualified individual with a disability must meet legitimate skill, experience, education,
or other requirements of an employment position. The person must be able to perform
the essential job functions, such as those contained within a job description, with or
without reasonable accommodation(s). Reasonable accommodations should make it
easier to be successful in job duties and may either involve altering the duties or the
tasks of the job performed. Qualifying organizations must provide reasonable
accommodations unless they can demonstrate that the accommodation will cause
significant difficulty or expense, producing an undue hardship.
-Discuss the Ticket to Work Act and how it affects Medicaid or Medicare
Addresses employment and benefit issues for persons with disabilities.
Increase access to vocational services and provided methods for retaining health insurance.
Provided higher cap to accommodate earnings when beneficiaries make progress in their
employment plans but before they reach the level of earnings that would terminate their
benefits
Chapter 23: Homeless Populations (ati pg 64)
-Identify health care workers engagement and care with homeless populations
Refer those who have underlying mental health disorders to therapy and counseling
Enhance parenting skills that can prevent teens from running away
Assist in temporary shelter, long-term shelter
Advocate and provide efforts towards political change
Make referrals for employee assistance and emotional programs
Chapter 13: Cultural Diversity and Community Health Nursing
-Describe ethical definitions of Autonomy, Non-maleficence, Beneficence, Distributive Justice and how
lack of can affect health care and access to all.
Autonomy- patient independence, making own decisions, a self-governing state
Non-maleficence- to do no harm
Beneficence- doing good
Distributive justice- perceived fairness of how rewards and costs are shared by
(distributed across) group members. Distributive justice concerns the equitable distribution
of scarce resources among all socioeconomic groups and population sectors.
Chapter 19: Senior Health
-Identify age-related risk factors and education for Senior Health
Nutrition status and exercise
Falls
Dental, hearing, & vision problems
Abuse/maltreatment
Medication safety
o When applicable, anti-inflammatory medications may be administered before physical
activity to address accompanying pain
Cold and heat stress:
o Hypothermia (very serious)- keep the patient warm; watch for the signs: confusion or
sleepiness, slowed slurred speech, weak pulse, shivering, poor control of body
movements
o Heatstroke (life-threatening) - wrap a wet sheet, move to a cooler area; watch for hot
dry skin that’s usually red, mottled, or cyanotic, loss of consciousness, or convulsions
-What are functional assessments and why are they used when assessing the elderly?
Examinations and Tests; a continuous collaborative process that combines observing, asking
meaningful questions, listening to family stories, and analyzing individual child skills and
behaviors within naturally occurring everyday routines and activities across multiple situations
and settings.
For All Older Adults
o Complete physical: Annually
o Blood pressure: Annually; more frequently if hypertensive or at risk
o Blood glucose: Annually; more frequently if diabetic or at risk
o Serum cholesterol: Every 5 years; more frequently if at high risk
o Fecal occult blood test: Annually
o Sigmoidoscopy: Every 5 years
o Colonoscopy: Every 10 years; more frequently if at high risk
o Visual acuity and glaucoma screening: Annually
, o Dental examination: Annually for those with teeth with cleaning every 6 months;
cleaning every 2 years for denture wearers
o Hearing test: Every 2 to 5 years
For Women
o Breast self-examination: Monthly
o Clinical breast examination: Annually
o Mammogram: Every 1 to 2 years if aged 40 years or older; check with health care
provider if 74 years or older
o Pelvic examination and Papanicolaou smear: Annually; may check with health
care provider about discontinuation at 66+ years or after three consecutive
negative Pap test results or >2 consecutive negative HPV and Pap tests, no
abnormal results in previous 10 years and not otherwise at risk, or have had a
total hysterectomy
o Digital rectal examination: Annually with pelvic examination
o Bone density: Once after menopause and more frequently if at risk
For Men
o Digital rectal examination and prostate examination: Annually
o Prostate-specific antigen (PSA) blood test: Annually
Immunizations for All Older Adults
o Tetanus, diphtheria, pertussis (Tdap): Every 10 years
o Influenza/flu vaccine: Annually
o Pneumonia vaccine: Once after age 65 years; ask physician about booster every 5
years
o Hepatitis A (liver infection found in stool and blood very contagious )and B(is
spread when blood, semen, or other body fluids from a person infected)those at
risk
o Herpes zoster (shingles): One-time dose
o Varicella (chickenpox): If evidence of lack of immunity and significant risk for
exposure
Chapter 21: Populations Affected by Disabilities
-Medicare and Medicaid access and funding
medicare
o Medicare is the federal health insurance program for:
people 65 or older
certain younger people with disabilities
people with ESRD (end stage renal disease)
funded by the social security administration (tax payers)
medicaid
o For low-income families w/ disability and pregnant women
o Funded by federal and state government
, o Provides insurance to people of low socioeconomic status and children,
eligibility is based off of household size and income and priority given to
children, pregnant women, and those with a disability (federally funded)
-What protection is provided to those who identify having a disability
Contemporary disability policy minimizes the disadvantaged view and maximizes
opportunities for people with disabilities to live productively in their communities.
Public policy on disability (these are your programs) includes civil rights protections,
skill enhancement programs, and income and in-kind assistance programs (e.g., Social
Security Disability Insurance [SSDI] and Medicare)
-What does ADA accommodations mean and do they refer to
The Americans with Disabilities Act (ADA) (PL 101-336) became a law in July 1990. This
landmark civil rights–styled legislation prohibits discrimination against people with
disabilities by guaranteeing equal opportunities for people with disabilities in relation to
employment, transportation, public accommodations, public services, and
telecommunications
A qualified individual with a disability must meet legitimate skill, experience, education,
or other requirements of an employment position. The person must be able to perform
the essential job functions, such as those contained within a job description, with or
without reasonable accommodation(s). Reasonable accommodations should make it
easier to be successful in job duties and may either involve altering the duties or the
tasks of the job performed. Qualifying organizations must provide reasonable
accommodations unless they can demonstrate that the accommodation will cause
significant difficulty or expense, producing an undue hardship.
-Discuss the Ticket to Work Act and how it affects Medicaid or Medicare
Addresses employment and benefit issues for persons with disabilities.
Increase access to vocational services and provided methods for retaining health insurance.
Provided higher cap to accommodate earnings when beneficiaries make progress in their
employment plans but before they reach the level of earnings that would terminate their
benefits
Chapter 23: Homeless Populations (ati pg 64)
-Identify health care workers engagement and care with homeless populations
Refer those who have underlying mental health disorders to therapy and counseling
Enhance parenting skills that can prevent teens from running away
Assist in temporary shelter, long-term shelter
Advocate and provide efforts towards political change
Make referrals for employee assistance and emotional programs
