nurs 102 lecture week 7
Terms
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- when one person in an intimate relationship is able to get and maintain the power and control over the other person
- power and control
- domestic violence affects how many women?
- 1 in 4
- what is the percentage of victims of intimate partner violence that are against women?
- 85%
- each year, how many pregnant women are victims of intimate partner violence in us?
- 324,000
- intimate partner violence is responsible for what percentage of female homicides?
- 33%
- gay and bisexual men experience abuse in intimate partner relationship at what rate?
- 2 to 5
- how much money was spent on direct medical andmental health services in the US as a result of intimate partner violence?
- 4.1 billion
- what means an incident that results in bodily harm, bodily injury, assault, or threat of physical violence?
- family violence
- what does not consitute family violence unless there is a present danger and likelihood that physical violence will occur?
- verbal abuse / argument
- ANA has shifted from illness and cure to:
- wellness and care
- what abilities do advance practice registered nurses have?
- perscriptive
- clinical/critical pathways replace:
- old care plans
- ensures quality client care, reduces costs, manages high volume, high risk cases
- case manager
- case managers may also be
- social workers
- work with multidisciplinary team to measure effectiveness of plan, monitor outcomes
- case managager
- regulated by state, provincial board of nursing, national accrediting bodies
- nursing education
- focuses on critical thinking, applicaiton from evidence based theory
- nursing education
- professional values, attitudes reflect in ethical, culturally sensitive practice
- nursing education
- three types of nurses licensed:
- rn,lpn,aprn
- the nurse's role in research:
- identify areas of study
- federally funded national health insurance:
- medicare
- federally funded, state operated:
- medicaid
- What part of medicare provides basic medical, surgical, psychiatric care based on drg's
- A
- what part of medicare covers physicians and certain outpatient services?
- B
- categorically needy (blind, disabled) people are eligable for:
- medicaid
- limits amt paid to hospitals that are reimbursed by medicare
- pps Prospective payment system
- payment based on drgs
- pps Prospective payment system
- set by admission record, not txment received
- pps Prospective payment system
- DRG: diagnostic related group has been created by
- medicare
- system that sets predetermined fees based on a specific diagnosis, regardless of cost for services, length of stay, acuity, complexity
- DRG
- hmo stands for
- health maintenence organization
- group of health care agencies that provide basic, supplemental services to voluntary enrollees
- hmo
- What do HMO's stress? **
- wellness, health maintence and promotion
- group of physician and/or hospital that provides an insurance comapnay or employer with services at discounted rate.
- PPO
- Under this, the customer chooses among participating providers
- ppo
- payment system capped revenue, establishes plan of care for each dx, usually monthly payment to primary care provider
- capitation
- the fee for dianosis framework is used by
- medicare
- employers contract with providers for a package price **
- direct contracting
- school health services, occupational health services, physician office/private practice, ambulatory clinics, nursing centers, block and parish nursing and volunteer agencies:
- preventative and primary care services
- preventative and primary care services provide services for:
-
health education/promotion
disease management - hospitals, intensive care, sub acute care, psychiatric facilities, and rural hospitals are examples of:
- secondary and tertiary care
- tertiary care provides:
- special care, highly technical services
- home health care, rehab, ecf's are examples of:
- restorative care
- nursing facilities, assisted living, respite care, adc's, hospice are examples of:
- continuing care
- case manager, collaborator, educator, counselor, client advocate, change agent, clinician, researcher are roles of the:
- community nurse
- healthy ppl 2010: environmental health is aimed at
- increasing life span in americans
- what percentage of children in the soviet union have resp. disease?
- 75%
- each person, per year wastes about how many lbs of waste?
- 1,000-1,500lbs
- what type of effect do toxic chemicals have?
- cumulative
- who has the highest infant mortality rate of the 25 industrialized nations?
- U.S.
- what are some meternal, prenatal and newborn risk factors:
- drugs, alcohol, tobacco, sti's, hiv, malnutrition, teenage pregnancy
- what is the leading cause of death for toddler, preschool and school age clients:
- accidents
- what are some major safety risks for the adolscent?
- drugs, alcohol, tobacco, risky sexuality, suicide, motor vehicle accidents, poor nutrition,communicable diseases
- what are some safety risks for adults, and the working population?
- drugs/alcohol, poor nutrition, communicable disease, lack of ins, inadequate housing, unintentional injury
- a person lawfully invested with power, and charged with the duty of taking care of a person and managing property of another person who for fect of age, understanding or self control is considered incapable of administering his own affairs
- guardian
- appointed by probate court to manage affairs, estate of one who is unable to manage property and business affairs effectively
- conservator
- is a conservator able to make medical decisions?
- yes
- governs withholding or withdrawal of life sustaining treatment from an individual in event of incurable or irreversible condition that will cause death within relatively short time and person no longer able to make decisions regarding medical treatment.
- living will
- agent appointed with authority to perform certain specified acts on behalf of principal. areas covered include real estate goods, transactions, commodities, banking etc. DOES NOT COVER DECISIONS R/T WITHDRAWAL OF LIFE SUPPORT/FOOD, FLUIDS, PALLIATIVE CAR
- durable power of attorney
- requires employer to carry ins that provides compensation for lost wages and med cost associated with workload
- workers comp act of 1911
- provides financial resources for the aged, blind, disabled, high risk, mothers/children
- social security act of 1935
- ensures worker education regarding hazards in workplace
- hazard comm act of 1986
- who assures safe, healthful work conditions, offer free hep b vaccine and provide ppe?
- osha
- nuclear, chemical and biological weapons. proliferatonof nuclear bio and chem weapons and related to technology
- weapons of mass destruction
- four examples of biological agents
- bacteria, viruses, toxins, rickettsia
- most common biological agents
- anthrax, plague, small pox, botulinum
- 4 types of chemical agents
-
blood agents, vesicant/blister agents
pulmonary agents and nerve agents - heics stands for;
- hospital emergency incident command system
- when this is in place, your talking to fed gov and local authority
- heics
- heavy, soft malleable bluish metal
- lead
- naturally occurs as by product of ag
- lead
- used by man since 650 bc
- lead
- not found naturally in body
- lead
- lead has what type of effect on the body
- cumulative
- lead affects what four things?
- cns, liver, kidneys and brain
- lead tricks the body into thinking it is what 3 things?
- fe, ca, zn
- having the recommended daily allowances of fe, ca and zn decrease:
- lead absorption
- lead can cause concurrent:
- iron deficiency anemia
- a low fat diet may decrease absorption of what?
- lead
- binds to rbc membranes and prevents rbc production
- lead
- may cause decreased sperm count and motility
- lead
- interferes with vit d synthesis, cell maturation and skeletal growth
- lead
- with low levels of lead poisoning, what four things can happen?
-
decrease in intelligence
behavior problems
decreased growth
impaired hearing - 40 or more mcg/dl of lead is considered a:
- moderate amount
- 10-19mcg/dl of lead is considered a:
- low amount
- 89 or higher mcg/dl of lead is considered
- high amount
- with a moderate level of lead toxicity, what is affected?
- brain, cns, kidney liver
- high level of lead toxicity causes:
- coma, convulsions and death
- the most common pedi public health problem
- lead poisoning
- lead poisoning causes:
- irreversible damage
- can lead be passed in utero to fetus?
- yes
- the young are at higher risk for lead poisoning because
- developing cns, smaller body size, absorbs pb easier, hand-mouth activities, sweet taste
- what are some effects of lead on children?
-
reading difficulties
poor vocab
poor fine motor skills
attention problems
absenteeism
lower class ranking - early s/s of lead poisoning:
- tiredness, restlessness, irritability, stomachache, cramping, constipation, poor appetite
- later s/s of lead accumulation:
- clumsiness, weakness, losing skills, regression
- s/s of severe lead poisoning cases:
- vomiting, loss of sight/hearing, lapses of consciousness, death
- chelation therapy must be started when blood levels of lead are at:
- 20 mcg
- what does chelation therapy do?
- removes lead from blood and body
- if blood level is at 70mcg/dl, or greater, it is considered a
- medical emergency
- what will happen to hbg and hct with lead poisoning?
- decrease
- before chelation therapy can start, what has to be done?
- bowels need to be emptied (enema/cathartics)
- malaise, n/v, diarrhea, transient liver enzyme elevations, metallic tasts, reversible neutropenia
- side effects of chelation therapy
- edetate calcium disodium promotes:
- urinary excretion of lead
- edetate calcium disodium can be given im or iv for levels of lead above
- 45
- BAL (british antilewisite in peanut oil) eliminates lead through
- urine and bile
- BAL is used in levels of lead above
- 70
- how should you cook your food to decrease absorption of lead
- bake or broil
- you should not cook foods this way, it may increase absorption of lead
- fry
- eggs, dried fruit, peanut butter, green leafy veggies, beans, pas, lentils, lean red meat, chicken, turkey fish, clams, oysters, and mussels are examples of food that are:
- iron rich
- milk, yogurt, cheese dairy prods, sardines, canned salmon with bones, grean leafy veggies are ex. of food that are:
- CALCIUM RICH
- milk, cheese eggs, chicken, turkey, lean meats, fish, clams, oysters, mussels, crap, dried beans, lentils are ex.s of
- zinch rich foods
- oranges, grapefruit, strawberries, cantaloupe, green peppers, cauliflower, broccoli, potatoes are foods rich in
- vitamin c
- on an empty stomach:
- lead can be easily absorbed
- all medicaid children are tested for:
- lead