Possible Community Health Hesi Topics

September 10, 2018 Health

These are some additional areas you may want to considering being familiar with: Ancathosis nigricans A skin condition characterized by dark, thick, velvety skin in body folds and creases. Most often, acanthosis nigricans affects your armpits, groin and neck. There’s no specific treatment for acanthosis nigricans — but treating any underlying conditions, such as diabetes and obesity, may cause the changes in your skin changes to fade Characteristics of acanthosis nigricans include: Skin changes. Skin changes are the only signs of acanthosis nigricans.

You’ll notice dark, thick, velvety skin in body folds and creases — typically in your armpits, groin and neck. Sometimes the lips, palms or soles of the feet are affected as well. Slow progression. The skin changes appear slowly, sometimes over months or years. Possible itching. Rarely, the affected areas may itch. Acanthosis nigricans is often associated with conditions that increase your insulin level, such as type 2 diabetes or being overweight. If your insulin level is too high, the extra insulin may trigger activity in your skin cells. This may cause the characteristic skin changes.

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Question pertained to nurse checking for lice and noticing dark patch of skin on neck. Advisor role Antepartum – risk factors Anthrax incubation and exposure Assess trends and patterns Assessing income Assessment – validation Assignments – home care; Make sure students know how to prioritize home health clients (i. e. which ones to see/call back first. ) When given the choice between a patient with COPD who is short of breath, a terminally ill pt who refuses to eat or drink, or a pt with congestive heart failure who has gained 3 lbs, choose the last one. Asthma triage

Battering-communication If the question pertains to a nurse suspecting a female patient has been abused and the woman has her child in the room with her, the nurse should ask the child to leave the room and question the woman about the abuse. The question does not pertain to the child being abused. Breast cancer-risk (who is at greatest risk) Calculate rate – population COBRA-cost (client still has to pay for expenses) When the question asks what would be a concern for a person who has lost their job but has COBRA, the answer is paying for health care/expenses.

Communicable disease (pertussis) Community – assessment Community Assessment – TB Community data source Community education – evaluate Community resource – elderly Community resources-population age Community resources – rural Community strategies – mental deficiencies Cultural competence Cultural –lactose intolerant Cultural – Native American (Native Americans are at high risk for diabetes – have the highest rates, so the nurse needs to screen for and educate about this). Culturally sensitive teaching CV disease – African American Diabetes A1C

If a nurse is working in a community with high rates of diabetes and implements a program, at the end of 1 year (or whatever evaluation period is stated) the nurse will want to evaluate hemoglobin A1C levels to determine effectiveness of program. Disaster – Cholera (Priority for treating those with cholera: fluid and electrolytes) Disaster- Professional Disaster – red tag triage Disaster planning Disaster Preparedness – START Disaster triage – color system Elder abuse-Home setting Elder health – assessment Employee health Epidemiological triad host Epidemiological triad agent Fall in home

Family assistance – ophthalmic meds Family ecomap Flu vaccine-priority Gatekeeper Genetic risk – assessment Geriatrics – home nutrition Geriatric syndrome – home health GTD-hCG values Health Promotion Program – Planning Heart healthy diet – limit Heat stroke If an adolescent is playing sports at school and goes to the school nurse with red, dry skin and other symptoms of heat stroke, the first thing the nurse should do is call for emergency personnel (not assess). Hepatitis A – risk Hep B vaccine – pregnancy Hepatovax B allergy Home care referral Home Health – Management Home health – PT Home safety – post arthroplasty

Hypertension-BP measure Immunize – 3rd world country Immunization rates Increase vaccination rates Infant mortality rate Influenza –prophylactic Relenza Lillian Wald – Henry Street (she established the Henry Street Settlement) Lipid screening Long-term care-infection Long-term car – fall prevention Meals-on-Wheels Medicare Menomune vaccine Migrant worker risks Morbidity data – gather Morbidity data-glaucoma If a nurse is working with an elderly population and most of them are choosing to get a surgery that will CURE glaucoma, then the nurse will be concerned with assessing prevalence of glaucoma (not morbidity).

Needs assessment Neighborhood safe houses Neuman model – line of defense Obese children-Parent involvement Occupational health – smoking Occupational nurse practitioner role Oral contraceptives – smokers Osteoporosis – prevention Outcome evaluation Polypharmacy – GERI Post vaccination teaching Primary prevention – adolescents Primary prevention – WIC Priority – HF lab results Program goal setting Quality Care – nursing home Quality Care – public clinic management Quality health – bicycle safety Rash with fever – PEDI (chicken pox) Ritalin evaluation – adolescent

Assessing intervention with ADHD in an adolescent: get their feedback on improvement, as their self-esteem is priority School age screen (obesity) School nurse role If an adolescent comes to a school nurse and tells her she is pregnant, the nurse will want to implement measures to ensure the teen and her baby are healthy. These things include referral to prenatal care, encouraging prenatal vitamins, etc. The nurse will NOT tell the parents and things like arranging childcare or teaching breastfeeding are not something the school nurse will be involved in.

Screening – DM – PEDI Screening priority Question regarding hypothyroidism and the nurse recognizes that mental dysfunction is a long-term consequence. What is screening priority? Answers included screening for T3 in preschoolers or children (? ), iodine screening in people over 60, TSH in women over 45, and T4 in newborns. The answer is T4 in newborns. Seat belt safety-adolescents Secondary prevention – tobacco Secondary prevention – children Sensitivity of tests Social organization Stakeholder If a community health nurse is going into a community to try to develop or

implement an intervention, remember one of the key things he/she must do is form a relationship with someone who would be identified as the stakeholder. Stakeholders will be someone who is invested in the health of the community and will be invested in the program to be implemented. They will be vital in the nurse gaining access into the community, the success of the program, and ensuring the sustainability of the program. STD-Reporting If an adolescent goes to the health dept and is diagnosed with chlamydia, the nurse must report this.

It is a reportable disease that is monitored by the state and the CDC, and the disease intervention specialist must be informed to do contact tracing. The nurse is NOT reporting this to the parents, so even if the teen asks for the nurse to not report her infection because she does not want her parents to find, the nurse must respond that it is her duty to report this case of infection. TB – directly observed treatment (DOT) TB screen TB skin test – follow up Teaching elders-diet Teaching – setting This question may refer to teaching an adolescent. You would want to teach them in the classroom. Teaching strategy

Teen pregnancy Telephone triage Tertiary prevention Toddler care – breastfeeding TQM/CQI Triage tags – colors Vector-borne diseases To prevent Lyme disease (or other tick-borne disease), you need to teach client to wear proper, protective clothing. Teaching a client how to remove a tick is not prevention because they have already been bitten. Vision screening – preschool Voluntary agency Given the choices of: local health dept, NIH, city water works, or American Diabetes Association the ADA is a voluntary agency. -Gaps in demographical data may include past statistics (Not sure what topic this pertained to)


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